Download XII. Psychological Disorders

XII. Psychological Disorders
A. Who is mentally ill?
What is “disordered” behavior?
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Psychological disorder: typically includes constellation of
cognitive, emotional, and behavioral symptoms that create
significant stress (impair work, relationships, etc.)
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1. Characteristics of disordered behavior.
– Atypical, but...
– Disturbing, but particularly worrisome when ...
– Maladaptive
– Unjustifiable
– Involuntary
A. Who is mentally ill?
What is “disordered” behavior?
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2. Diagnosing disordered behavior.
230 possible diagnoses.
a. Development of the DSM
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(Diagnostic and Statistical Manual for Mental Disorders)
First edition 1952: too subjective.
Third edition 1980: created objective criteria.
Today - Fourth Edition
- How it is used
Important today for insurance.
A. Who is mentally ill?
What is “disordered” behavior?
ii. The DSM and labeling.
- Can giving people a label be problematic?
- Rosenhan et al., (1973)
- Stigma associated with mental illness.
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B. Why are people mentally ill?
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1. Historically (1600-1700’s):
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Supernatural, witch craft.
Treatment?
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Bleeding, magic, drill holes in skull
Institutions like zoos
B. Why are people mentally ill?
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2. Medical Model
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In reaction to maltreatment.
First scientific approach to disorders.
Psychological disorders are caused by physical
conditions that can be cured.
(disease not depravity).
B. Why are people mentally ill?
3. Bio-Psycho-Social Perspective
- More contemporary.
- Considers more influences.
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Biological (genes, brain chemistry)
Environment (stress, roles, expectations)
Culture
- Reflects the nature/nurture perspective.
C. Anxiety Disorders
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1. General Description
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experience extreme/intense fear, panic, anxiety
most treatable, best prognosis
2. Generalized Anxiety Disorder
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Unfocused, free-floating anxiety
5% of N. Americans experience disorder at some point in life.
Symptoms:
physiological
psychological
visual
**Must occur for more days than not for 6 month period.
C. Anxiety Disorders
2. Generalized Anxiety Disorder
Causes:
Genetic predisposition
Hyper-vigilance/Over-arousal in brain
Environment
Can lead to panic attacks, panic disorder.
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C. Anxiety Disorders
3. Phobias
- Focus anxiety on specific source.
- Examples…
- Causes: Learning approach:
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Classical conditioning
Observational learning
Genetic (amygdala)
Freud
C. Anxiety Disorders
4. Obsessive Compulsive Disorder
- Trapped in endless cycle of repetitive thoughts
(obsessions) and actions (compulsions).
- Possibly 4 million people have OCD at one time
in life.
- Examples...
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C. Anxiety Disorders
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Symptoms:
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Severe, prolonged, disrupts normal living
Consumes more than one hour a day.
Causes similar to generalized anxiety.
Post-Traumatic Stress Disorder – see text.
D. Dissociative Disorders
1. General Description
- Most controversial of disorders.
- Experience sudden loss of memory or change
identity.
- “Dissociate” in response to stressful event.
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D. Dissociative Disorders
2. Dissociative Amnesia
- Selective memory loss in response to
intolerable psychological stress.
- Cannot remember distant/recent past
name, identity
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D. Dissociative Disorders
3. Dissociative Fugue
- Flight from one’s home and identity
accompanies memory loss.
(take on complete new identity in different
place).
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D. Dissociative Disorders
4. Dissociative Identity Disorder
- Previously called multiple personality.
- People have two or more distinct personalities
that alternately control behavior.
- Why is this disorder so controversial?
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D. Dissociative Disorders
Causes:
- natural, protective response
- often women who were abused as kids
- may be encouraged by inborn, biological capacity
Or - contrived fantasy?
Or - created by therapist?
E. Schizophrenia
1. General Description and Symptoms.
- Accounts for higher % of patient population in mental
hospitals than any other disorder.
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E. Schizophrenia
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1. Symptoms:
Disorganized Thinking: no organization, fragmented,
includes delusions.
Disturbed Perceptions: perceive things that aren’t
there, hallucinations.
(typically auditory “hear voices”)
Inappropriate Emotions & Actions: Strike out, cry
when should laugh, flat affect, movement - rocking,
rubbing, motionless
E. Schizophrenia
2. Types of Schizophrenia
Positive - disorganized, deluded, acting out
Negative - mute, catatonic, expressionless
Chronic or Process - develops gradually, long
history, recovery doubtful.
Acute or Reactive - develops in reaction to life
stress, recovery more likely.
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E. Schizophrenia
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Causes:
Genetic:
Many genes involved
Brain:
Excess number of dopamine receptors.
Abnormal brain tissue.
Low brain activity in frontal lobes.
Environment?: need to have predisposition.
F. Mood Disorders
Mood:
 Prolonged emotional state that colors many (or
all) aspects of thoughts & behavior.
 Spans from severe sad/bad (depression) to
unbridled elation, happiness (mania).
Depression:
- Number one reason people seek mental health
services.
F. Mood Disorders
1. Depression
Symptoms:
focused on negative
absence of pleasure, hopelessness
self-blame, worthlessness
affects sleep, speech, movement, eating
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F. Mood Disorders
1. Major Depressive Disorder
- 2 levels:
Dysthymic Disorder - sad mood, low energy,
difficulty concentrating.
Major Depressive Disorder - more disabling,
possibly with suicidal thoughts.
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F. Mood Disorders
1. Major Depressive Disorder
 Causes
- Brain: neurotransmitters
- Genetic: twin studies
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F. Mood Disorders
1. Major Depressive Disorder
 Causes:
- Socio-Cognitive Perspective
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Influence of interpreting events & coping.
Attribution process for negative events:
internal, stable, global
Ruminate, develop hopelessness and learned
helplessness.
F. Mood Disorders
2. Bipolar Disorder
- Was manic depressive disorder.
- Alternate between hopelessness (dep) and
overexcitedness (mania).
Symptoms:
overtalkative, easily irritated, little need for
sleep, loud speech, high opinion of self,
reckless, fewer sexual inhibitions
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F. Mood Disorders
2. Bipolar Disorder
Causes:
- genetic: 7 in 10 chance for twins.
- brain: neurotransmitters abundant during
mania
- environmental influence unclear.
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Disorders – rates are increasing
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1 in 6 Americans
Symptoms by age 24
G. Personality Disorders – see text
Inflexible and enduring patterns of behavior
that impair one’s social functioning.
1. Histrionic: shallow, attention-getting
2. Narcissistic: unwarranted sense of selfimportance, cannot accept criticism, demand
for constant attention.
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G. Personality Disorders
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3. Antisocial: socio or psychopath.
Typically male, lack of conscience.
Lie, steal, fight, unrestrained sexual behavior,
fear and feel for few, no guilt.
4. Borderline: unstable identity, relationships,
and emotions.
C. Anxiety Disorders
5. Posttraumatic Stress Disorder – see text
- Only anxiety disorder directly tied to
experiencing or witnessing traumatic event(s).
- Symptoms:
nightmares, reliving events
sleeplessness, irritability, guilt
emotional numbing, depression
- Importance of social support/genetics.
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