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Stress, Coping and Health Stress and Health • Leading causes of death in the US in 1900 and 1991 Percentage U.S.deaths Percentage U.S.deaths 30 30 20 20 10 10 0 0 Tuberculosis Pneu- Diarrhea/ Heart monia enteritis disease 1900 Unlike many leading killers a century ago, today’s major killers are more lifestyle-related Heart Cancer disease Strokes Chronic lung disease 1991 What is Stress? • Stress Stressors Catastrophes Life changes Hassles Intervening factors Appraisal Perceived control Personality Social support Coping behaviors Stress reactions Physiological Emotional Behavioral – the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging Stressful Life Events • Catastrophic Events – earthquakes, combat stress, floods • Life Changes – death of a loved one, divorce, loss of job, promotion • Daily Hassles – rush hour traffic, long lines, job stress, burnout • Perceived Control – loss of control can increase stress hormones Measuring Life Changes Social Readjustment Rating Scale (SRRS) – – – – Outline of 43 life events from most to least stressful Point value assigned to each event Negative and positive events both cause stress Point totals describe impact of stress and chance of illness over a two-year period – Score of 150-300: 50% chance of stress-related illness within 2 years – Score of 300+: 80% chance of stress-related illness within 2 years – Change in one’s life requires an effort to adapt and then an effort to regain stability Shortcomings of SRRS include: – Individual’s coping styles not taken into account – Good coping strategies reduce impact of each stressful event Copyright © 2011 Pearson Education, Inc. All rights reserved. Responding to Stress The General Adaptation Syndrome – The predictable sequence of reactions (stages) that organisms show in response to stressors 1. Alarm Stage Burst of energy that aids in dealing with the stressful situation Adrenal cortex releases hormones called glucocorticoids Increased heart rate, blood pressure, and blood sugar levels 2. Resistance stage Intense physiological efforts to either resist or adapt Glucocorticoids continue to be released Length of stage based on stressor intensity and ability to adapt 3. Exhaustion stage Occurs if an organism fails in its efforts to resist the stressor Stores of energy are depleted Copyright © 2011 Pearson Education, Inc. All rights reserved. The General Adaptation Syndrome The Immune System and Stress Lymphocytes – Key components of the immune system in the white blood cells, including B and T cells – B cells: produced in the bone marrow Produce antibody proteins –Destroy antigens in the bloodstream and surrounding body tissues – T cells: produced in the thymus gland Defeat harmful foreign invaders that reside inside the body’s cells Copyright © 2011 Pearson Education, Inc. All rights reserved. The Immune System and Stress Copyright © 2011 Pearson Education, Inc. All rights reserved. The Immune System and Stress Periods of high stress are correlated with: – Oral and genital herpes – Susceptibility to colds and flu – Potential reduction in the effectiveness of vaccines – Decreased levels of B and T cells – Worsened autoimmune diseases – Increased illness behaviors (reporting and seeking medical care) – Suppressed immune system long after a stressful event is over Increased academic pressures, poor marital relationships, severe depression, and sleep deprivation due to suppressed immune system Severe bereavement affects physical and mental ailments up to 2 years following a partner’s death Copyright © 2011 Pearson Education, Inc. All rights reserved. Stress and Disease • Negative emotions and health-related consequences Heart disease Negative emotions Stress hormones Immune suppression Autonomic nervous system effects Unhealthy behaviors (smoking, drinking, poor nutrition and sleep) (headaches, hypertension) Copyright © 2011 Pearson Education, Inc. All rights reserved. Coping Strategies Coping – Efforts through action and thought to deal with demands that are perceived as taxing or overwhelming Problem-focused coping – Direct response aimed at reducing, modifying, or eliminating a source of stress After getting a poor grade, student decides to study harder or get a tutor Emotion-focused coping – A response involving reappraising of a stressor to reduce its emotional impact View loss of a job as a challenge or opportunity not a tragedy Copyright © 2011 Pearson Education, Inc. All rights reserved. Coping Strategies Defensive coping • Use of defense mechanisms as protection against the unpleasant emotions brought on by stress. • Small illusions may be beneficial, large distortions are maladaptive. • • • • Constructive coping Confront problems directly Realistic appraisal of stress and coping resources Learn to recognize and stop disruptive emotional reactions Make efforts to protect the body from the damaging effects of stress Personal Factors Reducing The Impact of Stress and Illness Optimism – Cope more effectively with stress – Reduced risk of illness – Generally expect good outcomes – Find positives even in the darkest circumstances – Generally more stress resistant Copyright © 2011 Pearson Education, Inc. All rights reserved. Personal Factors Reducing The Impact of Stress and Illness Hardiness – A combination of three psychological qualities shared by people who can handle high levels of stress and remain healthy 1. Commitment To both work and personal life 2. Control Do not see themselves as victims of what life brings Believe they have control over consequences and outcomes 3. Challenge Act to solve their own problems Welcome challenges in life View challenges as opportunities for growth and improvement Personal Factors Reducing The Impact of Stress and Illness Social Support – Tangible and/or emotional support provided in time of need by family members, friends, and others – The feeling of being loved, valued, and cared for by those toward whom we feel a similar obligation – Has a positive effect on the immune, cardiovascular, and endocrine systems – Encourages health-promoting behaviors and reduces impact of stress Less likely to use unhealthy methods of coping Relaxation Techniques Health psychology – Devoted to understanding the psychological influences on: How people stay healthy Why they become ill How they respond when they do get ill Copyright © 2011 Pearson Education, Inc. All rights reserved. The Biopsychosocial Model of Health and Stress Focuses on health as well as on illness Holds that both are determined by a combination of biological, psychological, and social factors Most health psychologists endorse this model Copyright © 2011 Pearson Education, Inc. All rights reserved. Psychological Disorders Copyright © 2011 Pearson Education, Inc. All rights reserved. Defining Psychological Disorders Psychological Disorders – Mental processes and/or behavior patterns that cause: Emotional distress Substantial impairment in functioning What is abnormal? – Is the behavior considered strange within the person’s own culture? What is normal in some cultures is abnormal in others – Does the behavior cause personal distress? Experiencing considerable emotional distress without any life experience that seems to be causing it. Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Four Criteria for Abnormal Behavior Copyright © 2011 Pearson Education, Inc. All rights reserved. Defining Psychological Disorders • Abnormal Behavior: patterns of emotion, thought, & action considered pathological for one or more of four reasons: • statistical infrequency • disability or dysfunction • personal distress • violation of norms Defining Psychological Disorders • Dysfunction is key to defining a disorder: An intense fear of spiders may be deviant, but if it doesn’t impair your life (ability to function) it is not a disorder. Copyright © 2011 Pearson Education, Inc. All rights reserved. Psychological Disorders Insanity – legal term applied when people cannot be held responsible for their actions or allowed to manage their own affairs because of mental illness. -- Mental health professionals do not use this term. Copyright © 2011 Pearson Education, Inc. All rights reserved. Classifying Psychological Disorders Diagnostic and Statistical Manual of Mental Disorders 4th Edition, Text Revision (DSM-IV-TR) – First published in 1952 – 300 specific disorders listed along with criteria to make a diagnosis – Authoritative scheme for classifying psychological disorders. – Insurance companies usually require a DSM-IV-TR diagnosis before they pay for therapy. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. DSM-IV-TR The Diagnostic and Statistical Manual IV-Text Revision was revised in 2000 with updated research. Since then, the lengthy process of assembling DSM-V has begun. It is a collaborative effort involving several mental health organizations, including the American Psychiatric Association and the World Health Organization. One key goal of DSM-V is to incorporate the multidisciplinary Research advances in mental health that have occurred worldwide in recent years. DSM-V is scheduled to be published in 2012 (Fink & Taylor, 2008). Copyright © 2011 Pearson Education, Inc. All rights reserved. Information provided by the DSM-IV-TR • • • • • Diagnostic features Specific cultural, age and gender features Prevalence Course of the disorder Familial pattern Copyright © 2011 Pearson Education, Inc. All rights reserved. Figure 14.1Sample DSM-IV-TR Diagnostic Criteria Each of the more than 250 psychological disorders described in DSM-IV-TR has specific criteria that must be met in order for a person to be diagnosed with that disorder. Shown above are the DSM-IV-TR criteria for antisocial personality disorder, which is also referred to as psychopathy, sociopathy, or dyssocial personality disorder. The number 301.7 identifies the specific disorder according to an international code developed by the World Health Organization. The code helps researchers make statistical comparisons of the prevalence of mental disorders in different countries and cultures. Source: DSM-IV-TR (2000), p. 706. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Anxiety Disorders Anxiety Disorder: unrealistic, irrational fear Major Anxiety Disorders: 1. Generalized Anxiety Disorder (GAD) 2. Panic Disorder 3. Obsessive-Compulsive Disorder (OCD) 4. Posttraumatic Stress Disorder (PTSD) 5. Phobias Generalized Anxiety Disorder • An anxiety disorder characterized by chronic, excessive worry for at least six months or more. – Worrying either has no cause or is greatly exaggerated. – People feel tense, irritable and have trouble concentrating and sleeping. – Twice as common in women than men. Copyright © 2011 Pearson Education, Inc. All rights reserved. Panic Disorder • An anxiety disorder marked by unpredictable minutes-long episodes of intense fear and other frightening sensations (heart pounding, shortness of breath, choking sensations, dizziness) • Visit doctors and emergency rooms quite frequently • Person is often left with fear of having another panic attack • Can lead to agoraphobia-intense fear of being in a situation from which no escape is possible if the person experienced a panic attack. Copyright © 2011 Pearson Education, Inc. All rights reserved. Obsessive-Compulsive Disorder (OCD) Anxiety disorder in which a person suffers from recurrent obsession, compulsions, or both Obsession – Persistent, involuntary thoughts, images, or impulse that invades consciousness and causes great distress Contamination by germs Whether they performed a specific action – Turning off the stove or locking the door Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Obsessive-Compulsive Disorder (OCD) Compulsion – A persistent, irresistible, and irrational urge to perform an act or ritual repeatedly – Individuals know the act is senseless but cannot resist performing it without experiencing intolerable anxiety Anxiety is relieved only by doing the action – Becomes a psychological problem only if: The person cannot resist performing it It is very time-consuming It interferes with normal activities and relationships with others Copyright © 2011 Pearson Education, Inc. All rights reserved. • Examples of obsessions: – Concern for order and constancy – Cleanliness (body or living space) – Forbidden sexual thoughts • Examples of compulsions: – Hand washing – Checking – Collecting – Repeating behaviors (in and out of a door) – Arranging things – Cleaning Copyright © 2011 Pearson Education, Inc. All rights reserved. Explaining Obsessive-Compulsive Disorder (OCD) 75% of OCD involves cleaning and checking 2-3% of U.S. population Twin and family studies indicate genetic factors Genes affecting serotonin are suspected of causing OCD Antidepressant drugs that increase serotonin levels often helpful Copyright © 2011 Pearson Education, Inc. All rights reserved. Posttraumatic Stress Disorder (PTSD) • Typically occurs after a traumatic event (especially crimes, war) – Symptoms include re-experiencing trauma (dreams, flashbacks), avoidance of anything associated with trauma, and constant state of jumpy anxiety – Sense of having no control over the traumatic event – “the world is a dangerous place” • Drug abuse is high w/ PTSD – Negative reinforcement (avoidance of symptoms with use) Copyright © 2011 Pearson Education, Inc. All rights reserved. ) Copyright © 2011 Pearson Education, Inc. All rights reserved. Phobias • An anxiety disorder characterized by intense fear of specific situations or objects. • The individual knows the fear is irrational. • Common phobias include animals, heights, closed places, needles • Social phobias – An irrational fear and avoidance of any social or performance situation in which one might embarrass or humiliate oneself in front of others Shaking, blushing, sweating, or appearing clumsy, foolish, or incompetent – Most common type of anxiety disorder Copyright © 2011 Pearson Education, Inc. All rights reserved. Phobias • Specific phobias- A marked fear of a specific object or situation. – Phobic items include (ordered by frequency of occurrence): Situational phobias (elevators, airplanes, enclosed places, tunnels) Fear of natural environment (storms or water) Animal phobias (dogs, snakes, insects, or mice) Blood injection-injury phobia (fear of seeing blood or receiving an injection Copyright © 2011 Pearson Education, Inc. All rights reserved. EXAMPLES OF PHOBIC DISORDERS Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15-46 Copyright © 2011 Pearson Education, Inc. All rights reserved. Phobias • http://www.youtube.com/watch?v=tPFQM Rx2l3Y • http://www.youtube.com/watch?v=44DCW slbsNM&feature=fvwrel Copyright © 2011 Pearson Education, Inc. All rights reserved. Anxiety Disorders Copyright © 2011 Pearson Education, Inc. All rights reserved. Dissociative Disorders Disorders in which, under unbearable stress, consciousness becomes dissociated from a person’s identity, her/his memories of important personal events, or both • Types of Dissociative Disorders: – Dissociative Amnesia – Dissociative Fugue – Depersonalization Disorder – Dissociative Identity Disorder Copyright © 2011 Pearson Copyright © 2011 Pearson Education, Inc. All rights reserved. Dissociative Disorders Dissociative Identity Disorder (DID) – Two or more distinct, unique personalities occur in the same person – Severe memory disruption concerning personal information about the other personalities – Change usually occurs suddenly and during stress – In 80% of cases, host personality doesn’t know alter personalities – Alter personalities have varying levels of awareness of each other – Lost time – periods with no memory while in alter personality – 95% have history of severe physical and/or sexual abuse – Previously known as multiple personality disorder Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Schizophrenia Psychosis • A condition characterized by loss of contact with reality • Schizophrenia is the chief example of a psychotic disorder. 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 • Includes a class of disorders • Prevalence rate—1% of the population Copyright © 2011 Pearson Education, Inc. All rights reserved. Symptoms of Schizophrenia • Delusions and irrational thought – Delusions are false beliefs that are maintained even though they are clearly out of touch with reality. • Distorted perceptions (Hallucinations) – Sensory perceptions that occur in the absence of real stimulus. Usually auditory. • Disturbed emotions – Some show a flattening of emotion. – Some show inappropriate emotional responses. Copyright © 2011 Pearson Education, Inc. All rights reserved. Symptoms of Schizophrenia – Positive symptoms: (known by their presence) • delusions, hallucinations, abnormal movements, or thought disorders. – Negative symptoms: (characterized by absence) • social withdrawal, lack of affect, and reduced motivation. Copyright © 2011 Pearson Education, Inc. All rights reserved. Types of Schizophrenia Paranoid Schizophrenia – Characterized by delusions of grandeur or persecution and hallucinations. – Convinced they have an identity other than their own or that they possess great ability or talent – Often show exaggerated anger and suspiciousness – Feel they are being harassed or threatened – Behavior is not as disturbed as other types – The chance for recovery is better Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Types of Schizophrenia Catatonic schizophrenia – Complete stillness or stupor – Great excitement or agitation – Frequently alternate rapidly between the two – May assume an unusual posture Remain in the pose for long periods of time Undifferentiated schizophrenia – Catchall term used when schizophrenic symptoms either: Do not conform to the criteria of any one type of schizophrenia or Conform to more than one type Copyright © 2011 Pearson Education, Inc. All rights reserved. Types of Schizophrenia Disorganized Schizophrenia – Most serious type – Extreme social withdrawal – Hallucinations and delusions – Silliness – Inappropriate laughter – Grotesque mannerisms – Flat or inappropriate affect – Frequently incoherent – May exhibit obscene behavior – Results in the most severe disintegration of personality – Poorest chance of recovery Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2004 Allyn and Bacon Causes of Schizophrenia • Genetic vulnerability – Evidence suggests heredity plays a role – Identical twins concordance rates-48% – Offspring of two schizophrenic parents has about a 46% probability of developing the condition. Copyright © 2011 Pearson Education, Inc. All rights reserved. Genetic Similarity and Probability of Developing Schizophrenia Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Causes of Schizophrenia • Effects of Prenatal environment – Malnutrition – Prenatal viral infections and birth complications • Effects of the family environment – Results of research shows that a degree of disorganized communication at home that does not harm most children may have damaging effects on those genetically predisposed to schizophrenia Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Mood Disorders Mood-A prolonged emotional state that colors a person’s thoughts and behavior. Mood Disorder-Characterized by extreme disturbances in emotion or mood. DSM-IV identifies two main categories: Depressive Disorders-prolonged depression Bipolar Disorders-alternate between extreme depression and extreme elation (mania) Copyright © 2011 Pearson Education, Inc. All rights reserved. Mood Disorders Major Depressive Disorder – Marked by feelings of great sadness, despair, and hopelessness as well as the loss of the ability to experience pleasure – Symptoms Changes in appetite, weight, or sleep patterns Loss of energy Difficulty in thinking or concentrating Present for at least 2 weeks Psychomotor disturbances – Slowed body movements, reaction time, and speech – Constant movement, fidgeting, wringing of hands, and pacing Copyright © 2011 Pearson Education, Inc. All rights reserved. Culture, Gender, and Depression Rate of depression for females twice that for males Largely due to conflicting roles of wife, mother, lover, friend, etc. Boys twice as likely before puberty; after, females twice as likely Women more likely to face negative consequences from depression Lifetime Risk for Developing Depression in 10 Countries Bipolar Disorder Bipolar disorder A mood disorder in which manic episodes alternate with periods of depression Usually with relatively normal periods in between Manic episodes are characterized by – Excessive euphoria – Inflated self-esteem – Wild optimism – Hyperactivity – Frequently have delusions of grandeur along with euphoric highs – May waste large sums of money on get-rich schemes – Likely become irritable, hostile, enraged, or dangerous if stopped Copyright © 2011 Pearson Education, Inc. All rights http://www.youtube.com/watch?v=AKV5slC DYs8&NR=1 Copyright © 2011 Pearson Education, Inc. All rights reserved. Causes of Mood Disorders Neurological Correlates – Heredity and abnormal brain structure and chemistry Abnormal levels of serotonin linked to depression and suicide Neurotransmitter abnormalities may reflect genetic variations Heritability of depressive disorder is 70%, environment 30% – Twins of those diagnosed with bipolar disorder: 50% of identical twins also diagnosed 7% of fraternal twins also diagnosed Causes of Mood Disorders • Psychological factors – Cognitive distortions • Maladaptive response to early negative life events that leads to feelings of incompetence and unworthiness – These responses are reactivated whenever a new situation arises that resembles the original events Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Suicide • 19,000 people commit suicide in the U.S. every year, the 11th leading cause of death • More women than men attempt suicide, but more men succeed Copyright © 2011 Pearson Education, Inc. All rights reserved. Suicide and Race, Gender, and Age Mood disorders, schizophrenia, and substance abuse are major risk factors for suicide in all age groups Suicide rates far lower for white and African American women than for men Older Americans are at far greater risk than young people 90% of individuals who commit suicide leave clues – Verbally: “You won’t be seeing me again” – Behavioral: giving away most valued possessions – Taking unnecessary risks – Showing personality changes – Losing interest in favorite activities Warning signs should be taken seriously Encourage them to get professional help or call 24-hour hotline Personality Disorders • A long-standing, inflexible, maladaptive pattern of behaving and relating to others, which usually begins in early childhood or adolescence • Approximately 3% of men and 1% of women have a personality disorder • Rate among prisoners is close to 50% Copyright © 2011 Pearson Education, Inc. All rights reserved. Personality Disorders Characteristics of personality disorders Extremely difficult to get along with Unstable work and social histories Know their behavior causes problems, yet seem unable to change Blame other people or situations for their problems Treatment options are few – Most seek treatment by legal authorities or family members – Seldom engage in self-reflection essential for success Psychological and behavioral factors that lead to a personality disorder diagnosis may be resolved to some degree or become less severe over time Copyright © 2011 Pearson Education, Inc. All rights reserved. Personality Disorders • Three clusters – Dramatic, Emotional: Histrionic Narcissistic Antisocial Borderline – Anxious, Fearful: Avoidant Dependent Obsessive-Compulsive Odd, Eccentric: Paranoid Schizoid Schizotypal Copyright © 2011 Pearson Education, Inc. All rights reserved. Personality Disorder • Antisocial Personality Disorder – Most troubling and heavily researched personality disorder – Disregards rights, feelings; manipulates, etc. without remorse – Aggressive, irresponsible, reckless, willing to break the law – Breaks the law, lies, cheats, exploits, and fails to hold jobs – Typically a male, whose lack of conscience becomes plain before age 15 Copyright © 2011 Pearson Education, Inc. All rights reserved. Paranoid Personality Disorder • • • • • • • • • Symptoms of Paranoid Personality Disorder Paranoid personality disorder is characterized by a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. This usually begins in early adulthood and presents in a variety of contexts, as indicated by four (or more) of the following: Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her Reads hidden demeaning or threatening meanings into benign remarks or events Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights) Perceives attacks on his or her character or reputation that are not apparent to others, and is quick to react angrily or to counterattack Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner Copyright © 2011 Pearson Education, Inc. All rights reserved. Narcissistic Personality Disorder • • • • • • • • • • • Symptoms of Narcissistic Personality Disorder In order for a person to be diagnosed with narcissistic personality disorder (NPD) they must meet five or more of the following symptoms: Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) Requires excessive admiration Has a very strong sense of entitlement, e.g., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations Is exploitative of others, e.g., takes advantage of others to achieve his or her own ends Lacks empathy, e.g., is unwilling to recognize or identify with the feelings and needs of others Is often envious of others or believes that others are envious of him or her Regularly shows arrogant, haughty behaviors or attitudes Copyright © 2011 Pearson Education, Inc. All rights reserved. Somatoform Disorders Disorders in which physical symptoms are present due to psychological causes rather than any known medical condition People with somatoform disorders are not faking illness to avoid work or other activities Hypochondriasis – Persons preoccupied with their health; fear their physical symptoms are the sign of some serious disease – Not convinced when medical examination reveals no problem – Symptoms are not consistent with known physical disorders – May “doctor shop,” seeking confirmation of their worst fears – Not easily treated . Copyright © 2011 Pearson Education, Inc. All rights reserved. Somatoform Disorders Conversion Disorder – A person suffers a loss of motor or sensory functioning in some part of the body – Loss has no physical cause but solves some psychological problem – May become blind, deaf, unable to speak, or paralysis in some part of the body – Freud believed it is an unconscious process to help solve an unconscious sexual or aggressive conflict . Copyright © 2011 Pearson Education, Inc. All rights reserved. Therapies Psychodynamic therapies – Attempt to uncover childhood experiences that are thought to explain a patient’s current difficulties Psychoanalysis –Freud’s first psychodynamic therapy –Uses free association and dream analysis Copyright © 2011 Pearson Education, Inc. All rights reserved. Psychodynamic Therapies Free association – Technique used to explore the unconscious by having patients reveal whatever thoughts, feelings, or images come to mind Analyst pieces together the free-flowing associations, explaining their meanings Helps the patient gain insight into troubling thoughts and behaviors Dream analysis – Areas of repressed emotional concerns expressed symbolically in dreams Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Humanistic Therapies Assume people have the ability and freedom to lead rational lives and make rational choices Person-Centered Therapy – A nondirective, humanistic therapy Developed by Carl Rogers – Therapist creates an accepting climate and shows empathy Unconditional positive regard – Frees clients to be themselves, releasing their natural tendency toward self-actualization – Psychological disorders result when a person’s natural tendency towards self-actualization is blocked by oneself or others – Therapist empathizes with client’s concerns and emotions Reflecting listening used in responses, allowing the client to control the direction of the sessions . Copyright © 2011 Pearson Education, Inc. All rights reserved. Behavior Therapies Based on the idea that abnormal idea is learned Applies the principles of operant and classical conditioning, or observational learning Eliminate inappropriate or maladaptive behaviors and replace them with more adaptive responses – Doesn’t change the individual’s personality structure or search for the origin of the problem Behavior modification – Uses learning principles to eliminate inappropriate or maladaptive behaviors and replace them with more adaptive responses Copyright © 2011 Pearson Education, Inc. All rights reserved. Behavior Therapies Systematic desensitization Used to treat fears by training clients in deep muscle relaxation Then they confront a hierarchy of anxiety producing situations (Real or Imagined) Repeated until they remain relaxed even in the most feared situation Highly successfully treatment for eliminating fears and phobias in a short period of time Exposure and response prevention A behavior therapy that exposes clients with obsessivecompulsive disorder to stimuli that trigger obsessions and compulsive rituals While clients resist performing the compulsive rituals for progressively longer periods of time . Copyright © 2011 Pearson Education, Inc. All rights reserved. Cognitive Therapies Assume maladaptive behavior can result from irrational thoughts, beliefs, and ideas – Often called cognitive-behavioral approach – Combine cognitive insight with methodological behavioral approach – Therapists seek to change the way clients think Determine effectiveness by assessing changes in the client’s behavior – Effective in treatment of: Anxiety disorders Hypochondriasis Psychological drug dependence Copyright © 2011 Pearson Education, Inc. All rights reserved. Cognitive Therapies Beck’s cognitive therapy – Therapist identifies and challenges irrational thoughts – Sets up a plan and guides the client so life experiences become evidence to refute false beliefs – Homework assignments given to track automatic thoughts and feelings evoked by them; clients write substitute rational thoughts – Brief, lasting 10-20 sessions – Extensive research demonstrates high success rate with: Mild to moderate depression Panic disorder Generalized anxiety disorder Cocaine addiction, insomnia, and bulimia Negative and positive symptoms of schizophrenia Less likely to relapse than those treated with antidepressant drugs Copyright © 2011 Pearson Education, Inc. All rights Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Copyright © 2011 Pearson Education, Inc. All rights reserved. Biomedical Therapies Therapy based on the assumption that psychological disorders are symptoms of underlying physical problems Includes drug therapy, electroconvulsive therapy, and psychosurgery Millions of people take medications for psychological problems Drug therapy – Antipsychotic drugs Drugs used to control severe psychotic symptoms – Delusions, hallucinations, disorganized speech and behavior Inhibiting dopamine activity – 50% of patients have a good response Copyright © 2011 Pearson Education, Inc. All rights reserved. Biological Therapies Antipsychotic drugs – Atypical neuroleptics (newer drugs) – Clozapine, Risperidone, Olanzipine Target both dopamine and serotonin Treat both positive and negative effects of schizophrenia Copyright © 2011 Pearson Education, Inc. All rights reserved. Antidepressant Drugs Act as mood elevators for severely depressed people and are also prescribed to treat some anxiety disorders 65-75% of patients report significant improvement 40-50% report complete recovery – Placebo studies demonstrate almost equal effectiveness – Responses to antidepressants a combination of physiological effects on the brain and the patient’s confidence in effectiveness of treatment . Copyright © 2011 Pearson Education, Inc. All rights reserved. Antidepressant Drugs Second generation antidepressants – Selective serotonin reuptake inhibitors Block the reuptake of serotonin increasing availability at the brain synapses – Fewer side effects and safer in case of overdose – Effective in treating: Obsessive-compulsive disorder Social phobia Panic disorder Generalized anxiety disorder . Copyright © 2011 Pearson Education, Inc. All rights reserved. Electroconvulsive Therapy An electric current is passed through the right hemisphere of the brain Usually reserved for severely depressed patients who are suicidal and don’t respond to other treatments Highly effective for major depression Unilateral ECT used today instead of bilateral ECT – Equally effective with milder cognitive side-effects Patients are given anesthesia, controlled oxygenation, and a muscle relaxant When effective, ECT: – Changes the biochemical balance in the brain – Reduces cerebral blood flow in the prefrontal cortex No structural brain damage demonstrated in MRI or CT scans . Copyright © 2011 Pearson Education, Inc. All rights reserved.