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Psychological Disorders Chapter 13 Perspectives on Psychological Disorders Section 1 Historical Views of Psych Disorders • Attributed to supernatural powers • Madness was a sign that spirits had possessed a person • Middles Ages • Believed in exorcisms • People were put in asylums-chained down and deprived food, light or “air” to cure them • 1793 turning point in treating the ill • Phillipe Pinel made the asylums more humane, sanitary and comfortable • Dorthea Dix (1802-1887) • American reformer • Boston teacher that lead the way for humane treatment of the mentally ill • New hopsitals were built but very little changes were made Theories of Nature, Causes, and Treatment of Psych Disorders • The Biological Model • Behavior is caused by physiological malfunctions linked to heredity • Genetic factors involved with schizophrenia, depression, anxiety, and autism • Psychoanalytical Model • Behavior disorders are symbolic expressions of unconscious internal conflicts, that are traced to earlier like • Freudian ideology • The Cognitive-Behavioral Model • Like all behavior, abnormal behavior is the result of learning • Learned behaviors like fears, anxiety, and sexual deviations can be learned and unlearned • The Diathesis-Stress Model • Some people are biologically prone to developing a particular disorder under stress, whereas others are not • Systems Theory • Emotional problems are “lifestyle diseases” that like heart disease are caused by a combination o biological risks, psychological stresses and societal pressures and expectations • Causes of Mental Disorders • Biological and psychological factors are connected • Both are factor and can affect a person Classifying Psych Disorders • For nearly 40 years, the American Psychiatric Association (APA) has issued a manual describing and classifying various psych disorders • Diagnostic and Statistical Manual of Mental Disorders (DSM) • In 4th edition Prevalence of Psych Disorders • How common are psych disorders in the United States? • 32% of all Americans suffer from one or more serious mental disorders during their lifetime • At any given time, more than 15% are experiencing a mental disorder • Drug abuse is the most common disorder • Anxiety disorders are the second most common • Mood disorders like depression are a problem for almost 8% of the population • Schizophrenia afflicts 1.5 % of the population (about 3 million people!) Mood Disorders Section 2 • Mood Disorders: disturbances in mood or prolonged emotional state • Usually you have an rang of moods and emotions • With mood disorders people seem stuck at one end of the spectrum or the other—really happy or really sad Depression • Depression: overwhelming feelings of sadness, lack of interest in activities, and perhaps excessive guilt or feeling of worthlessness • Most common mood disorder • Seriously depressed people suffer from insomnia, lose interest in food, trouble thinking and concentrating • In extremely serious cases may experience suicidal thoughts ot even attempt suicide • Important to distinguish between clinical and the “normal” depression • Entirely normal to become sad when a loved on has died, break up with your significant other—considered “normal” depression • 2 forms of depression—Major Depressive Disorder and Dysthymia • Major Depressive Disorder • Episode of intense sadness that may last for several months • Caused from difficult life events • Dysthymia • Less intense sadness but persists with little relief for a period of 2 years • Biological problem Mania and Bipolar Disorder • Mania: euphoric states, extreme psychical activity, excessive talkativeness, distractedness, and sometimes grandiosity • unlimited hopes but little motivation to act on them • Can sometimes become aggressive and hostile toward others as their self confidence grows • Manic periods usually alternate with depression • Bipolar Disorder: periods of mania and depression alternate, sometimes with periods of normal moods intervening • Much less common, equally prevalent in men and women • Stronger biological component than depression • Strongly linked to heredity and is often treated with drugs Causes of Mood Disorders • Biological Factors • Consistent evidence that genetic factors play a role in depression and Bipolar Disorder • Strongest evidence come from Twin Studies • Chemical imbalances of neurotransmitters • Medications can help create balanced neurotransmitters • Psychological Factors • Cognitive Distortions: illogical and maladaptive response to early negative life events that leads to feelings of incompetence and unworthiness that are reactive whenever a new situation arises that resembles the original events • Social Factors • Difficulties in interpersonal relationships • Depression stems from excessive grief and irrational grief over a real or “symbolic” loss Anxiety Disorders Section 3 • Anxiety Disorders: disorders in which anxiety is a characteristic feature or the avoidance of anxiety seems to motivate abnormal behavior • Does not know why they are afraid or the anxiety is inappropriate to the circumstance • Fear and anxiety doesn’t make sense Specific Phobias • Specific Phobias: anxiety disorder characterized by intense, paralyzing fear of something • Interferes with life functioning • EX: fear of flying, spiders, animals, heights, blood etc • Social Phobia: fear connected with social situations or performances in front of other people • EX: public speaking • Agoraphobia: anxiety disorder that involves multiple, intense fears of crowds, public places, and other situations that require separation fron a source of security such as home Panic Disorders • Panic Disorders: recurrent panic attacks in which the person suddenly experiences intense fear or terror without reasonable cause • During a panic attack a person may feel impending doom, chest pains, dizziness or fainting, sweating, difficulty breathing, and fear of losing control and dying • Usually only lasts a few minutes, but can occur for no reason Other Anxiety Disorders • Generalized Anxiety Disorder: prolonged vague but intense fears that are not attached to any particular object or circumstance • Inability to relax, constantly feeling restless, muscles tension, rapid heart beat apprehensiveness about the future • Obsessive-Compulsive Disorder (OCD): a person feels driven to think disturbing thoughts and/ or perform senseless rituals Causes of Anxiety Disorders • Often learned from others or experiences • If you feel like you do not have control over your life and the events in it you may suffer from anxiety disorders Psychosomatic Disorders Section 4 Psychosomatic Disorders • Psychosomatic Disorders: there is a real psychical illness that is largely caused by physiological factors such as stress and anxiety • EX: tension headaches • Caused by muscle contractions brought on by stress • Headache is real but considered psychosomatic because stress and anxiety (psychological factors) play an important role in causing symptoms • Somatoform Disorders: there is an apparent psychical illness for which there is no organic basis • Do not mean to mislead others about their physical condition • The symptoms are very real to them, not faked are under voluntary control • Somatization Disorder: person experiences vague, recurring psychical symptoms for which medical attention is sought after repeatedly but no cause is found • Common Complaints: back pains dizziness, partial paralysis, abdominal pains, and sometimes anxiety and depression • Conversion Disorder: dramatic specific disability has no psychical cause but instead seems related to psychological problems • Also, blindness, deafness, seizures, and lose of feeling, or false pregnancy • Have healthy muscles and nerves, yet symptoms are very real • Usually caused to resolve a difficult conflict or relieves the patient of the need to confront a difficult situation • EX: worry your self sick • Hypochondriasis: person interprets insignificant symptoms as signs of serious illness in the absence of any organic evidence of such illness • You have a headache and you assume you actually have a brain tumor • Body Dimorphic Disorder: person becomes so preoccupied with his or her imaged ugliness that normal life is impossible • EX: think you have big ears and eventually cant function in regular life Dissociative Disorders Section 5 Dissociative Disorders • Disorders in which some aspect of the personality seems separated from the rest • Involves memory loss– though temporary– change in identity • Dissociative Amnesia: loss of memory fro past events without organic cause • Usually block out stressful events or periods of life that may seem extremely stressful • EX: extreme/ extensive abuse • Dissociative Identity Disorder: person has several distinct personalities that emerge at different times • Commonly know as multiple personalities • In true multiple personalities, the various personalities are distinct people, whit their own names, identities, memories, mannerisms, and speaking voices, and even IQ’s • Personalities sharply contrast each other • Depersonalization Disorder: essential feature is that people suddenly feels changed or different in a strange way • Feel like that have left their bodies, or their actions have become mechanical or dream like • Common during adolescence and young adulthood when our sense of ourselves and interactions changes rapidly Personality Disorders Section 6 • Personality Disorders: inflexible and maladaptive ways of thinking and behaving learned early in life cause distress to the person and/or conflicts with others • EX: harmless eccentrics to cold blooded killers Types of Personality Diosrders • Schizoid Personality Disorder: person is withdrawn and lacks feelings for others • Lacks desire to form social relationships • No feelings towards others • Seldom marry, have trouble holding jobs that require them to work with others • Paranoid Personality Disorder: person is inappropriately suspicious and mistrustful of others • There is no reason for suspicion or mistrust • Refuse to accept blame or criticism when necessary • Guarded, secretive, devious, scheming, and argumentative but see themselves and rational and objective • Dependent Personality Disorder: person is unable to make choices and decisions independently and cannot tolerate being alone • Underlying fear they will be rejected or abandoned by the important people in their lives • Avoidant Personality Disorder: person’s fear of rejection by other leads to social isolation • Person is timid, anxious, fearful of rejection • Social anxiety leads to isolation but unlike schizoid people, they WANT to have close relationship with people • Narcissistic Personality Disorder: person has an exaggerated sense of self-importance and needs constant admiration • Believe they are extraordinary, need constant attention and admiration, display sense of entitlement, and tend to exploit others • Borderline Personality Disorder: marked by instability in selfimage, mood, and interpersonal relationships • Tend to act impulsively, and often in self destructive ways, • Feel uncomfortable being alone, ad often manipulate self destructive impulses in an effort to control or solidify their personal relationships—promiscuity, drugs, alcohol, and threats of suicide • Common and serious • Although genetics do play a role, not an important role in development • Usually generates out of exposure to dysfunctional relationships with parents, frequent exposure to domestic violence, and physical or sexual abuse • Antisocial Personality Disorder: involves a pattern of violent, criminal, or unethical and exploitative behavior and an inability to feel affection for others • Lie, steal, cheat, and show little to no responsibility, often intelligent, and charming • The “con man” • Show little to no remorse, guilt or anxiety about behavior Schizophrenic Disorders Section 7 • Schizophrenic Disorder: severe disorders in which there are disturbances of thoughts, communications, and emotions, including delusions and hallucinations. • Lasts for months, even years • Out of touch with reality– insanity is a legal term for mentally disturbed people who are not considered responsible for their criminal actions • Suffer from hallucinations—sensory experiences in the absence of external stimulation • Usually takes the form of hearing voices that are not really there • Frequently suffer from delusions– false beliefs about reality that have no basis in fact • These delusions are usually paranoid– believe people are our to harm them • Believe their doctors want to kill them, receiving radio messages fro aliens • Distorted thoughts sometimes lead to self-destructive behaviors, increasing their risk fro suicide • Difficult to live a normal life unless treated with medication Types of Schizophrenic Disorders • Disorganized Schizophrenia: bizarre childlike behaviors are common • Giggling, frantic gesturing, show childish regard for social conventions and ma urinate and defecate at inappropriate times • Catatonic Schizophrenia: disturbed behavior is prominent • Alternate between catatonic state (mute and immobile) and extremely active state (constant shouting and talking) • Paranoid Schizophrenia: marked by extreme suspiciousness and complex, bizarre delusions • May believe themselves to someone they are not (Napoleon or the Virgin Mary) • Undifferentiated Schizophrenia: there are clear schizophrenic symptoms that don’t meet the criteria for another subtype of the disorder • May have delusions, hallucinations, or incoherence but doesn’t fit into any of the subtypes for the disorder Causes of Schizophrenia • Genetic component • People with schizophrenia are more likely to have children with the disorder, as well • May also be related to those who have excessive amounts of the neurotransmitter dopamine