Download Psychological Disorders

Psychological Disorders
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U – njustifiable
M – aladaptive
A – typical
D – istorted thinking,
D-isturbed
•Qualitatively
•Quantitatively
Etiology
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Psychoanalytic theory
Humanistic theory
Behavioral theory
Cognitive theory
Psychophysiological
Cultural
Classifying Psychological Disorders
• DSM V
– Classification orders and describes symptoms
– Predicts its future course
– Treatment
– Stimulate research
• “Anything you put in that book, any little change you make,
has huge implications not only for psychiatry but for
pharmaceutical marketing, research, for the legal system,
for who’s considered to be normal or not, for who’s
considered disabled,” said Dr. Michael First, a professor of
psychiatry at Columbia University who edited the fourth
edition of the manual but is not involved in the fifth.
• “And it has huge implications for stigma,” Dr. First
continued, “because the more disorders you put in, the
more people get labels, and the higher the risk that some
get inappropriate treatment.”
• NY Times Revising Book on Disorders of the Mind
• Benedict Carey Feb 10, 2010
Anxiety Disorders
- Most common disorder after substance abuse
What differentiates phobias and normal fear?
- Intensity
- Length of anxiety
- Able to adequately respond
Anxiety Disorders
• Generalized anxiety disorder – continuously
tense
• Phobic disorder – irrational and intense fear of
object
• Obsessive compulsive disorder – repetitive
thoughts or actions
• Panic disorder – anxiety tornado
– “fear of fear”, sudden episodes
• Post traumatic stress disorder – after trauma
• Panic Disorder:
• Minute-long episodes of intense dread which
may include feelings of terror, chest pains,
choking, or other frightening sensations.
• Anxiety is a component of both disorders
(generalized anxiety disorder and panic
disorder). It occurs more in the panic
disorder, making people avoid situations that
cause it.
• Post-traumatic stress disorder (PTSD)
– Affects soldiers from Vietnam, Operation Desert
Storm, and Iraqi wars; also Nazi death camp and
prison camp survivors)
– Suffering severe reactions years after traumatic
event (some recover, some get worse over time)
– Experiences include:
• Dreams with horror
• Intense emotional bodily reactions
• Difficulty concentrating or sleeping
Stressors Causing PTSD
• Combat-related events
• Sudden death of loved one
• Involved in or witnessing accidents
• Physical assault, rape, sexual molestation
experienced by women
• Terrorism experiences
Who Develops PTSD
• Four factors involved
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– Severity of stress
• Risk increased when physical injury occurs
– Person’s characteristics before event
• Affects those with higher anxiety levels, lower
intelligence, previous mental health problems
– Social support
• More support lessens risk
– Sex of the victim
• Women more at risk
Etiology of Anxiety Disorders
• Psychoanalytic –
– GAD – id overcomes ego => anxiety
– Phobias – Little Hans
– OCD – fixated an anal stage
• Behavioral – classical conditioning, modeling, reinforcement
– Little Albert
• Humanistic – gap between one’s real self and ideal self
• Cognitive – misinterpret bodily sensations, lack ability to cope with stress
• Biomedical
– genetic predisposition,
- Lower levels of GABA neurotransmitter – inhibitory “brakes of a car”
- Malfunctions in amygdala – part of brain that deals with agression and fear
Kinds of Phobias
- Intense, unrealistic or irrational fear
Agoraphobia
Acrophobia
Claustrophobia
Hemophobia
Phobia of open places.
Phobia of heights.
Phobia of closed spaces.
Phobia of blood.
Phobias
• Agoraphobia – fear of panic attacks in public
places
• Social phobias – social anxiety disorders
– More women than men
– Irrational fear of being embarrassed, judged or
critically evaluated by others
– Realize that their fear is excessive but they still
approach social situations with tremendous
anxiety
Phobias
• More unusual phobias:
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Amathophobia- fear of dust
Amenophobia – fear of wind
Aphephobia – fear of being touched by another person
Bibliophobia- fear of books
Catotrophobia – fear of breaking a mirror
Ergophobia – fear of work or responsibility
Gamophobia – fear of marriage
Hypertrichophobia – fear of growing excessive amounts of body hair
Levophobia – fear of things being on the left side of your body
Phobophobia – fear of acquiring a phobia
Phonophobia – fear of sound of your own fource
Triskaidekaphobia – fear of the number 13
Phobias
– Humans are predisposed – biologically prepared to
acquire certain fears
• Fear of particular situations – flying, driving,
tunnels, bridges, elevators, crowds, enclosed
places
• Fear of features of the natural environment –
thunder, heights, water
• Fear of injury or blood – injections, needles,
medical or dental procedures
• Fear of animals and insects – snakes, spiders,
dogs, slugs, bats
• Agoraphobia – fear of panic attacks in public
places
• Social phobias – social anxiety disorders
– More women than men
– Irrational fear of being embarrassed, judged or
critically evaluated by others
– Realize that their fear is excessive but they still
approach social situations with tremendous
anxiety
Somatoform Disorders
– Experiencing symptoms of physical health problems with
psychological causes, Symptoms take a somatic (bodily) form
without apparent physical cause
• Four types
– Hypochondriasis – preoccupation with health
– Conversion disorders – symptoms not medically possible
• person experiences very specific genuine physical symptoms for which
no physiological basis can be found
– Somatoform pain disorders – primary symptom is pain with no
physical cause
– Body dysmorphic disorder - exaggerated concern and
preoccupation about minor or imagined defects in appearance
Somatoform Disorders
– Symptoms take a somatic (bodily) form without
apparent physical cause
Conversion disorder: person experiences very
specific genuine physical symptoms for which no
physiological basis can be found
Hypocondriasis: person interprets normal physical
sensations as symptoms of a disease
Body dysmorphic disorder: exaggerated concern and
preoccupation about minor or imagined defects in
appearance
Disassociative Disorders
• Broad category of loosely related conditions
– Conscious awareness becomes separated
(dissociated) from previous memories, thoughts,
and feelings. People lose contact with portions of
their consciousness or memory, resulting in
disruptions in their sense of identity
– Dissociative amnesia – psychological cause
– Dissociative fugue – complete loss of memory
– Dissociative identity disorder – once known as
multiple personality disorder; very controversial issue
Criticism of DID
• Critics argue that the diagnosis of DID
increased in the late 20th century. DID has
not been found in other countries.
– Role-playing by people open to a therapist’s
suggestion.
– Learned response that reinforces reductions in
anxiety
Mood Disorders
• Extreme and persistent feelings
of despondency, worthlessness
and hopelessness, causing…
impaired emotional, cognitive,
behavioral and physical
functioning
Blue mood
Major Depressive Disorder
Gasping for air after a hard run
Chronic shortness of breath
Mood Disorders
• Extreme and persistent feelings
of despondency, worthlessness
and hopelessness, causing…
impaired emotional, cognitive,
behavioral and physical
functioning
Types of mood disorders
• Major depression – “common cold” of
psychological disorders
• Dysthymic disorder
• Seasonal affect disorder – depression
associated with seasons
• Bipolar – emotional roller coaster
• Cyclothymic Disorder - moderate mood
swings
Etiology of Mood Disorders
• Genetic predisposition
• Disruptions in brain chemistry
– Antidepressants – increase 2 neurotransmitters
• Norepinephrine
• Seratonin
– Lithium – regulates avaliability of NT called
glutamate
• Stress
Bipolar disorder
• Formerly called manic-depressive
disorder. An alternation between
depression and mania signals bipolar
disorder.
Gloomy
Elation
Withdrawn
Euphoria
Inability to make decisions
Desire for action
Tired
Hyperactive
Slowness of thought
Multiple ideas
Explaining Depression…
Cognitive
Beck
Attributions
Internal personal factors/external situational factors
Stable or unstable over time
Global /specific implications
People who make global, stable, internal
personal attribution => more prone to depression
Seligman: learned helplessness
Depression is caused by person learning that his effort does not pay off
“giving up behavior”
Originally conditioning => more cognitive slant
Etiology of Depression (con’t)
• Cognitive
– Beck
– Attributions
• Internal personal factors/external situational factors
• Stable or unstable over time
• Global /specific implications
People who make global, stable, internal
personal attribution => more prone to
depression
– Seligman: learned helplessness
• Depression is caused by person learning that his effort does not pay
off “giving up behavior”
– Originally conditioning => more cognitive slant
Etiology of Depression (con’t)
• Behavioral:
– Inadequate social skills
– Not enough reinforcement of social relationships
– Depressed people can be depressing to be around
Social-Cognitive Perspective
• The social-cognitive perspective suggests
that depression arises partly from selfdefeating beliefs and negative explanatory
styles.
Disassociative Disorders
• People lose contact with portions of their
consciousness or memory, resulting in
disruptions in their sense of identity
– Disassociatve amnesia
– Disassociative fugue
– Disassociatve Identity Disorder or Multiple
personality disorder
Schizophrenia
• “split mind” – split from reality
– Disorganized thinking
• Delusions -false beliefs, grandeur
– Disorganized perceptions
• Hallucinations – sensory experiences without sensory
stimulation
– Inappropriate emotions or action
• Laughing when inappropriate/flat affect
Subtypes of schizophrenia
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Paranoid
Disorganized
Catatonic
Undifferentiated
Schizophrenia
• “split mind” – split from reality
– Disorganized thinking
• Delusions -false beliefs, grandeur
– Disorganized perceptions
• Hallucinations – sensory experiences without sensory
stimulation
– Inappropriate emotions or action
• Laughing when inappropriate/flat affect
Schizophrenia
• Subtypes
– Paranoid schizophrenia
• False beliefs, delusions (grandeur, paranoia, persecution),
hallucinations
– Disorganized schizophrenia
• Delusions, hallucinations, cognitive processes highly
disorganized or fragmented
• Extreme social withdrawal
– Catatonic schizophrenia
• May have delusions and hallucinations; most abnormalities
in social interaction, body posture and movement (waxy
flexibility in stupors)
Schizophrenics have inappropriate
symptoms (hallucinations, disorganized
thinking, deluded ways) that are not present
in normal individuals (positive symptoms).
Schizophrenics also have an absence of
appropriate symptoms (apathy,
expressionless faces, rigid bodies) that are
present in normal individuals (negative
symptoms).
Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited
by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found that
schizophrenic patients express higher levels of
dopamine D4 receptors in the brain.
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Abnormal Brain Activity
Brain scans show abnormal activity in the
frontal cortex, thalamus, and amygdala of
schizophrenic patients. Adolescent
schizophrenic patients also have brain lesions.
Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro
Imaging and Judith L. Rapport, National Institute of Mental Health
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Abnormal Brain Morphology
Schizophrenia patients may exhibit
morphological changes in the brain like
enlargement of fluid-filled ventricles.
Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC
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Viral Infection
Schizophrenia has also been observed in
individuals who contracted a viral infection
(flu) during the middle of their fetal
development.
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Genetic Factors
The likelihood of an individual suffering from
schizophrenia is 50% if their identical twin has
the disease (Gottesman, 1991).
0 10 20 30 40 50
Identical
Both parents
Fraternal
One parent
Sibling
Nephew or niece
Unrelated
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Genetic Factors
The following shows the prevalence of
schizophrenia in identical twins as seen in
different countries.
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Psychological Factors
Psychological and environmental factors can
trigger schizophrenia if the individual is
genetically predisposed (Nicols & Gottesman,
1983).
The genetically identical Genain
sisters suffer from schizophrenia. Two
more than others, thus there are
contributing environmental factors.
Courtesy of Genain Family
Genain Sisters
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Personality Disorders
Personality
disorders are
characterized by
inflexible and
enduring behavior
patterns that impair
social functioning.
They are usually
without anxiety,
depression, or
delusions.
• Schizoid personality disorder
– Blunted emotions, social
withdrawal, but no serious
cognitive disturbances
• Antisocial personality disorder
– Feel little guilt, exploit
others, frequent violation
of social rules and laws
– Difficulty with personal
relationships
– Low tolerance for
frustration, lie
easily/skillfully
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Personality Disorders
• Inflexible, maladaptive patterns of thoughts,
emotions, behavior and interpersonal
functioning that are stable over time and
across situations, and deviate from the
expectations of the individual’s culture
• Person doesn’t consider his personality
characteristics as problematic => don’
Types of Personality Disorders
Odd, eccentric
• Paranoid Personality Disorder
• Schizoid Personality Disorder
• Schizotypal Personality Disorder
Dramatic,
emotional, erratic
• Antisocial Personality Disorder
• Borderline Personality Disorder
• Histrionic Personality Disorder
• Narcissistic Personality Disorder
Anxious, fearful
• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive-Compulsive Personality Disorder
Antisocial Personality Disorder
A disorder in which the person (usually men)
exhibits a lack of conscience for wrongdoing, even
toward friends and family members. Formerly,
this person was called a sociopath or psychopath.
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Understanding Antisocial Personality
Disorder
Like mood disorders
and schizophrenia,
antisocial personality
disorder has biological
and psychological
reasons. Youngsters,
before committing a
crime, respond with
lower levels of stress
hormones than others
do at their age.
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Understanding Antisocial Personality
Disorder
PET scans of 41 murderers revealed reduced
activity in the frontal lobes. In a follow-up study
repeat offenders had 11% less frontal lobe activity
compared to normals (Raine et al., 1999; 2000).
Courtesy of Adrian Raine,
University of Southern California
Normal
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Murderer
Understanding Antisocial Personality
Disorder
The likelihood that one will commit a crime doubles
when childhood poverty is compounded with
obstetrical complications (Raine et al., 1999; 2000).
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Risk and Protective Factors
Risk and protective factors for mental disorders
(WHO, 2004).
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Risk and Protective Factors
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