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Psychological Disorders CHAPTER EIGHTEEN What Are Psychological Disorders? SECTION 1 Quick Definitions Psychological Disorders: patterns of thoughts or behaviors that interfere with lives or cause suffering Culture-Bound Syndromes: what we consider a disorder may actually be considered normal in other areas Did You Know? How many Americans suffer from psychological disorders? Studies vary, but the results range from one-fourth up to half! For the test, we’ll say: One-third of adults in the United States have experienced some type of psychological disorder. Symptoms Typicality—is the behavior average of the rest of society? 2. Maladaptive Behavior—determines whether the behavior is harmful to self or others 3. Emotional Discomfort—if a person suffers from extreme or long-lasting feelings of hopelessness or helplessness 4. Socially Unacceptable Behaviors—actions that violate society’s norms 1. Classifying Psychological Disorders It’s important to have a system for classifying disorders for diagnosis and treatment. Disorders were first classified based on their presumed causes. Today, psychologists use the DSM-IV to classify disorders. DSM-V: Diagnostic and Statistical Manual of Mental Disorders; 5th edition (first published in 1960) Anxiety Disorders SECTION 2 Introduction Description: a general state of uneasiness or dread that occurs in response to a vague or imagined danger Characteristics: nervousness, inability to relax, concern about losing control Physical Signs: trembling, sweating, rapid heart rate, shortness of breath, increased blood pressure, flushed face, feelings of faintness A problem when this happens all the time and is out of proportion to the situation Types of Anxiety Disorders • Phobic disorder • Panic Disorder • Generalized Anxiety Disorder • Obsessive Compulsive Disorder • Compulsive Hoarding Syndrome • Post Traumatic Stress Disorder Phobic Disorder A lot of us say we have phobias, but we really don’t Description: an excessive/irrational fear of a certain subject or situation Diagnosed when the fear leads to avoidant behavior and changes in a person’s life Panic Disorder 1/75 people have this disorder Have recurrent and unexpected panic attacks A short period of intense fear/discomfort with shortness of breath, dizziness, rapid heart beat, trembling/shaking, sweating, nausea, choking, and more Generalized Anxiety Disorder Description: an excessive and unrealistic worry about life in general that lasts for six months or more Worry about: finances, work, relationships, accidents, illnesses, etc. Obsessive-Compulsive Disorder Obsessions: unwanted thoughts, ideas, or mental images that occur over and over again; often senseless Compulsions: repetitive, ritual behaviors; often involve checking and cleaning Sufferers usually know their obsessions and compulsions are unwarranted Compulsive Hoarding Syndrome Characterized by the excessive collection of items, along with the inability to discard them Often creates cramped living conditions, with only narrow pathways winding through stacks of clutter Leads to limited interaction with others Post Traumatic Stress Disorder Description: intense, persistent feelings of anxiety caused by a traumatic experience (rape, war, abuse, assault, accident, etc.) Symptoms: flashbacks, nightmares, numbness of feelings, avoidance, increased tension and jumpiness Explanation Psychological Views Biological View Learned in childhood It’s genetic—we inherit A cover for forbidden these obsessions and compulsions from our parents urges Due to feelings of worthlessness A negative response to a situation Dissociative Disorders SECTION 3 Background Information Dissociation refers to the separation of personality components or mental processes from conscious thought The most common form of “normal” dissociation is daydreaming Dissociation removes stress or lessens anxiety There are four disorders we’re going to discuss. Dissociative Amnesia Characteristic: a sudden loss of memory May last a few hours or several years Often appears after a traumatic experience and returns with little notice Usually doesn’t occur again Dissociative Fugue Characteristics forget information and events Relocate Develop a new identity Most common during wars and natural disasters Just like in the soap operas! Dissociative Identity Disorder Also known as Multiple Personality Disorder Characteristic: two or more personalities exist in one person Each personality is different from each other A history of severe child abuse is common with most DID patients (physical, sexual, or psychological) Depersonalization Disorder Characteristic: detachment from one’s mental processes and/or body Explaining this Disorder Psychoanalytic Psychologists A response to inappropriate urges Learning Psychologists People have been taught not to think about disturbing events Most believe there is no link between dissociation and genetics Gender Identity Disorder Symptoms Children Are disgusted by their own body parts Are rejected by their peers, feel alone Have depression or anxiety Say that they want to or will be the opposite sex Adults Dress like or live the life of the opposite sex Feel alone Have depression or anxiety Causes/Diagnosis The cause is unknown In order to diagnose this disorder, the feeling of being in the body of the "wrong" gender must last for at least two years Treatment Counseling: have the patient talk about the issues Hormonal Therapy: give him/her the hormones that correspond with the gender he/she was born with Sex Reassignment Surgery: your basic sex change Somatoform Disorders SECTION 4 Introduction Definition: the expression of psychological distress through physical symptoms This disorder is NOT intentional Some diagnosed cases are reversed because a medical illness is found! Some cases go unreported because the focus is on medical tests. Conversion Disorder Description: experience a change in or loss of physical functioning in a major part of the body with no medical reason Example: when a person cannot move his/her legs or see at night Some people are unconcerned about these symptoms! Hypocondriasis Also known as hypochondria Description: a person’s unrealistic preoccupation with the fear he/she has a serious disease Example: when a person is sure a belly ache is actually stomach cancer Some people will see several doctors until one gives them any form of treatment! Explanation A person converts psychological stress into actual medical problems Example: a pilot afraid to fly since September 11th may develop problems with his/her vision Impulse Control Disorders Description defined primarily by loss of control characterized by an inability to resist the impulse to perform an action that is harmful to one's self or others Intermittent Explosive Disorder the inability to control violent impulses result in serious damage to either persons or property the degree of the aggressiveness is not in proportion to cause Trichotillomania Hair loss caused by compulsive pulling or twisting of the hair until it breaks off An uneven appearance to the hair Bare patches or all around loss of hair Constant tugging, pulling, or twisting of hair Denying the hair pulling Patients say they have a sense of relief, pleasure, or gratification after the hair pulling These symptoms are usually seen in children Kleptomania Involves the compulsive stealing of items that aren’t needed There is usually a feeling of tension before stealing, and a sense of pleasure at the time of the theft A rare problem; more common in women Pathological Gambling The uncontrollable impulse to gamble It often results in disrupted relationships, financial problems, and/or criminal behavior and yet the individual can’t stop Often are obsessed with gambling and need to increase the amount of money gambled in order to experience the same rush Pyromania Involves setting fires for pleasure The individual usually has a significant fascination with fire Experience a sense of relief or gratification from the experience Treatment Some of the disorders are helped by behavior therapy Reduce stress and help the patient develop other habits There may also be a neurological explanation (there’s something wrong in the brain) Treat with anti-depressants Mood Disorders SECTION 5 Introduction Mood changes refers to being “up” or “down” depending on life experiences Becomes a disorder when changes are inappropriate or inconsistent SAD HAPPY Major Depression Another one of the most common disorders Effects over 100 million people worldwide A person must have five of the nine symptoms which must occur every day for two weeks Depressed mood Loss of interest in activities Weight loss or gain Sleeping more or less Faster/slower reactions— physically and emotionally Loss of energy Feeling worthless or guilty Unable to concentrate or make decisions Thoughts of death or suicide Bipolar Disorder Also known as manic depression Characterized by dramatic ups and downs; changes quickly for no reason at all The depressive characteristics are the same as major depression There are five characteristics of the manic stage Inflated self-esteem Inability to sit still or sleep Racing thoughts Pressure to talk to switch topics Difficulty concentrating Explanation Psychological Views Learned helplessness It is simply a person’s habit Biological Views Heredity A chemical imbalance; due to low levels of serotonin Schizophrenia SECTION 6 Introduction Most serious disorder Very rare; .5% - 1% suffer from this disorder Characterized by a loss of contact with reality Can develop gradually or very quickly Worsens over time Very difficult to treat 20% with schizophrenia will attempt suicide; 10% of the attempts are successful Often starts between 18-25 Symptoms Hear Voices Hallucinations: see things that aren’t there Can be visual or auditory Delusions: believe things to be true that aren’t; often believe they can do things they can’t and that they’re better than they are Thought Disorders Organization: skip around Content: repetition Social Withdrawal Catatonic Stupor: an immobile, expressionless, coma-like state Explanation Genetics Injury or trauma at birth Birth during a winter month A viral infection during infancy A brain defect Personality Disorders SECTION 7 Description Patterns of inflexible traits that disrupt social life or work and/or distress the affected individual; are major components of a person’s personality Effects up to 10% of the population Prevalence in American Adults Affected Unaffected Types of Disorders Paranoid: distrustful and suspicious of others, see others as harmful and evil, threatening and insulting Schizoid: no interest in relationships with others, lack normal emotional responses Antisocial: show disregard for others and violate the rights of others with no guilt or remorse More Types of Disorders Avoidant: want relationships, but are afraid; act shy and withdrawn Borderline: have unstable relationships and an unstable self-image Dependent: clingy and submissive Histrionic: excessively emotional; always need attention Explanation Not clearly explained until the 1980s Were rejected by adults as children, severely punished Reinforced negative behaviors genetics