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Chapter 12 Overview Defining psychological disorders Anxiety disorders Mood disorders Schizophrenia Other psychological disorders Defining Psychological Disorders Mental processes and/or behavior patterns that cause emotional distress and/or substantial impairment in functioning What criteria can be used to determine whether behavior is abnormal? Behavior may be considered abnormal if – It is considered strange within a person’s own culture – It causes personal distress – It is maladaptive – It is a danger to the self or others – A person is not legally responsible for his or her acts How do clinicians use the DSM-IVTR? The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) provides a system for diagnosing and classifying psychological disorders It describes about 300 specific disorders and organizes them into categories How prevalent are psychological disorders? Lifetime prevalence of psychological disorders What are the theoretical approaches that attempt to explain the causes of psychological disorders? Biological perspective – Abnormal behavior arises from a physical cause – Biological treatments, such as drug therapy, are favored Biopsychosocial perspective – Psychological disorders result from a combination of biological, psychological, and social causes – Treatments that include drugs and psychotherapy are employed Psychodynamic perspective – Psychological disorders stem from childhood experiences and unresolved, unconscious conflicts – Treatment involves psychoanalysis What are the theoretical approaches that attempt to explain the causes of psychological disorders? Learning perspective – Abnormal thoughts and behaviors are learned and sustained like any other behaviors – Treatment uses classical and operant conditioning and modeling to extinguish maladaptive behavior and increase adaptive behavior Cognitive perspective – Faulty thinking and distorted perceptions can cause psychological disorders – Treatment tries to change faulty, irrational, and/or negative thinking Schizophrenia A severe psychological disorder characterized by loss of contact with reality, hallucinations, delusions, inappropriate or flat affect, some disturbance in thinking, social withdrawal, and/or other bizarre behavior What are the positive and negative symptoms of schizophrenia? Positive symptoms are abnormal behaviors that are present in people with schizophrenia – Hallucinations – Delusions – Delusion of grandeur – Delusions of persecution – Disorganized behavior – Inappropriate affect What are the positive and negative symptoms of schizophrenia? A Negative symptom is a loss or deficiency in thought or behavior that is characteristic of normal functioning – – – – – – Social withdrawal Apathy Loss of motivation Flat affect Limited speech and slow movements Poor hygiene and grooming What are the four types of schizophrenia? Paranoid schizophrenia – Characterized by delusions of grandeur and delusions of persecution Disorganized schizophrenia – Characterized by extreme social withdrawal, hallucinations, delusions, and bizarre behavior Catatonic schizophrenia – Characterized by complete stillness or great excitement and agitation Undifferentiated schizophrenia – Term used when schizophrenic symptoms are present, but do not conform to the criteria of any one type What factors increase the risk of developing schizophrenia? There is probably no single cause of schizophrenia Instead, several factors interact to produce schizophrenia, including: – Constitutional vulnerability – Stress – Neuromaturational processes Anxiety Disorders Psychological disorders characterized by frequent fearful thoughts about what might happen in the future The most common category of psychological disorders – Accounting for more than 4 million visits to doctor’s offices in the US each year What are the characteristics of panic attacks and agoraphobia? Panic attack – An episode of overwhelming anxiety, fear, or terror – The brains of panic-attack sufferers respond to normal changes in the body as if they were life threatening Agoraphobia – Intense fear of being in a situation from which escape is not possible if one experiences overwhelming anxiety or a panic attack – Often begins with repeated panic attacks – People with agoraphobia sometimes plan their entire lives around avoiding feared situations How do the symptoms of four common anxiety disorders differ? Generalized anxiety disorder – Disorder involving chronic, excessive worry for six months or more Panic disorder – Disorder in which a person experiences recurring, unpredictable episodes of overwhelming anxiety, fear, or terror How do the symptoms of four common anxiety disorders differ? A phobia is a persistent, irrational fear of some object, situation, or activity that poses little or no real danger – Social phobia Fear and avoidance of any social or performance situation in which one might embarrass or humiliate oneself in front of others – Specific phobia is a fear of a specific object or situation, a general label for any phobia other than agoraphobia or social phobia Categories of specific phobias – – – – Situational phobias Fear of the natural environment Animal phobias Blood, injection, injury phobias What thought and behavior patterns are associated with obsessive-compulsive disorder? Disorder in which a person suffers from recurrent obsessions and/or compulsions Obsession – A persistent, involuntary thought, image, or impulse that causes great distress Compulsion – A persistent, irresistible, and irrational urge to perform an act or ritual repeatedly – Compulsions often involve cleaning and washing, counting, checking, touching objects, hoarding, or excessive organizing Mood Disorders Disorders characterized by extreme and unwarranted disturbances in emotion or mood What are the symptoms of major depressive disorder? A mood disorder marked by feelings of great sadness, despair, and hopelessness as well as loss of the ability to feel pleasure – Symptoms also include changes in appetite, weight, and sleep patterns, and difficulty thinking or concentrating What are the extremes of mood suffered by those with bipolar disorder? A mood disorder in which manic episodes alternate with periods of depression, usually with relatively normal periods in between – Manic episodes are periods of excessive euphoria, inflated self-esteem, wild optimism, and hyperactivity, often accompanied by delusions of grandeur and by hostility if activity is blocked What are some risk factors for mood disorders? A small area in the prefrontal cortex, that plays a role in controlling emotions, is smaller than normal in people with major depression Abnormal levels of serotonin are strongly linked to depression People suffering from mood disorders have abnormal production, transport, and reuptake patterns for dopamine, GABA, and norepinephrine What are some risk factors for mood disorders? Heredity plays a role in mood disorders – Twin studies indicate a genetic bases for bipolar disorder and major depression Life stresses are also associated with depression – The majority of first episodes of depression strike after major life stress What are some risk factors for mood disorders? Prevalence of depression varies greatly across cultures Prevalence rates also differ between men and women – In most countries, rate of depression in females is about twice that for males Lifetime Risk for developing depression in 10 countries What are some of the risk factors for suicide? Depression, schizophrenia, substance abuse, and a family history of suicide Risk of suicide also increases when people are exposed to major life stressors Older white males commit suicide more often than members of other race or age groups Women are more likely to attempt suicide, but men are more likely to succeed Differences in suicide rates according to race, gender, and age Other Psychological Disorders Somatoform disorders Dissociative disorders Sexual disorders Personality disorders What are two somatoform disorders, and what symptoms do they share? Disorders in which physical symptoms are present that are due to psychological causes rather than any known medical condition Hypochondriasis – Characterized by excessive concern about one’s health and fear that normal physical symptoms are signs of serious disease Conversion disorder – Disorder in which one suffers a loss of sensory or motor functioning which has no physical cause How do the various dissociative disorders affect behavior? Disorders in which consciousness becomes dissociated from a person’s identity and/or his or her memories Dissociative amnesia – A complete or partial loss of the ability to recall personal information and/or past experiences Dissociative fugue – Complete loss of memory of one’s entire identity and traveling away from home Often involves assuming a new identity How do the various dissociative disorders affect behavior? Dissociative identity disorder (DID) is a disorder in which two or more distinct personalities occur in the same person – A host personality – Alter personalities DID, like other dissociative disorders, seems to be a response to unbearable stress – Among DID patients, at least 95% have history of severe physical and/or sexual abuse What are the main characteristics of the various sexual disorders? Sexual disorders are disorders with a sexual basis that are destructive, guilt- or anxiety-producing, compulsive, or a cause of discomfort or harm to one or both parties involved Sexual dysfunctions – Persistent and distressing problems involving sexual desire, sexual arousal, or the pleasure associated with sex or orgasm What are the main characteristics of the various sexual disorders? Paraphilias – Recurrent sexual urges, fantasies, or behavior involving nonhuman objects, children, other nonconsenting persons, or the suffering or humiliation of the person or his or her partner Gender identity disorder – A problem accepting one’s identity as male or female What behaviors are associated with personality disorders in Clusters A, B and C? A personality disorder is a long-standing, inflexible, maladaptive pattern of behavior and relating to others, which usually begins in early childhood or adolescence The DSM-IV-TR groups personality disorders into clusters – Cluster A Characterized by odd behavior, such as extreme suspiciousness – Cluster B Characterized by erratic, overly dramatic behavior – Cluster C Characterized by intense feelings of anxiety