Download Psychological Dysfunction and Treatment

Psychological Dysfunction and
Treatment
Disorders are given psychological
labels and listed in the DSM
Source of Psychological Disorders
• Nurture or Nature
• Biological or Learned
• Though our culture believes in the biological
model, there is extensive research showing
that our experiences play a significant role
Early Trauma results in an overly
developed Stress Axis: HPA Axis
Need HAP Axis to survive and protect r
• If overly concerned about threats, our brain
can’t be curious and open to experiences
• This reduced learning results in underdeveloped cerebral cortex and hippocampus
• Children who experienced early traumas show
serious cognitive deficits
How can children learn to become anxious:
Raised in Stressful Environment
• Overly protective, intrusive &/or demanding
parents
• Very unstable and unpredictable early
environment
• Parents model excessive number of anxieties
and fears, as Mrs. Hughes did for Howard
toward germs
Classical Conditioning Paradigm
• How Howard Hughes develop phobia toward
germs
UCS
UCR
CS
CR
In the film Shine, David Helfgot and volitile,
demanding & abusive father
UCS
CS
UCR
CR
Anxiety Disorders
General Anxiety Disorder
Panic Disorder: Anxiety Levels can
result in Panic Attacks
Symptoms:
Racing heart
Feel faint and/or dizzy
Tingling or numbness in hands or arms
Sense of impending doom
Chest pains
Difficulty with breathing
Feel a loss of control
Social Anxiety Disorder
Behavioral Clinic that teaches socially
phobic people to learn how to reach out
• Model and rehearse simple and appropriate
ways to initiate a social interaction
• Give weekly assignments that start very
simple and move forward step-by-step
• Report back to group every week on successes
the previous week
Obsessive Compulsive Disorder
Common Thoughts or Obsessions
• Fear of dirt or contamination by germs
• Fear of doing harm to another
• Obsess if proper order and neatness has not been maintained
• Excessive doubt and need for constant reassurances
• Fear of thinking evil or sinful thoughts
Common Compulsions
• Repeatedly showering or washing hands
• Refuse to shake hands or touch door knobs
• Repeatedly checking things, as locks
• Constantly arranging things in certain order
• Collecting or hoarding items of no value
Aviator: Life Howard Hughes
Childhood of Howard Hughes
•
1) He grew up with a mother who forced him to endure odd cleaning rituals,
as dousing himself with mineral oil daily.
•
2) She disapproved of him making friends as believed they were carriers of
disease, resulting in him spending much of his childhood alone or with his mother.
•
3) Mother insisted on giving Howard hand baths until he reached his teens.
•
4) She watched for slightest changed in physical condition, sniffles, a cough as well
as any abnormality in his feet, teeth or digestion and then would whisk to a doctor,
in the process lavishing much attention and sympathy.
•
5) Observers were amazed at the extreme closeness between Howard and his
mother and how often they would kiss and hug.
Hughes also developed life-long
obsession with germs
• Not like anyone touching him
• Over-react to people around him to be messy or
dirty, especially when under stress
• Wash his hands many times every day
• Become more and more reclusive through the years
Last 20 years live alone in hotel room
Cognitive therapy for anxiety: challenge a
person’s inaccurate perceptions
• Will touching doorknobs cause contamination & then serious illness?
• What will be the dire consequences of not washing your hands more than
5 times a day?
• Are people really watching and judging you when you walk into a
restaurant or library?
• Are you really having a heart attack during a panic episode?
• So what if not do a job perfectly?! So what if not get an A on every tests?!
• Can control habitual anxious thinking & so reduce anxious feelings
Behavioral Therapy: Can learn behaviors that
effectively reduce anxiety
• Meditation
Yoga
Depression
Causes of Depression: operant
conditioning
• Child receive much extinction &/or lots of
discouraging feedback
• Receive very little positive, encouraging feedback
• Not encouraged to become independent—or
develop a sense of autonomy
• Given sense that they are not valued, lovable or
competent
How do depressed people think?
• Believe cannot control environment so feeling helpless and
hopeless
• Learn selective perception: focus on what did wrong, not
what did right as what parents did
• Develop pessimistic attitude and low self-esteem
• When experience loss or set-backs, over-react and become
depressed and blame self
Cognitive Behavioral Therapy
• Structured therapy where analyze ways think
and behave that are causing anxiety and/or
depression
• Use role playing and homework assignments
to practice new ways of thinking and behaving
Cure for Depression—Become
active and productive
Books Cognitive Behavioral Therapy
Cognitive Behavioral Books focused on
specific problems
Sociopath: Anti-social Personality
•
•
•
•
No conscience
Inability to feel remorse
Lacking structure or restraints in childhood
Lacking loving and affectionate care in
childhood
• Serial killers, cheaters, liars
• Hurt others with no concern: very selfabsorbed
Treatments for Anti-Social
Personalities
• How determine that a person has this
disorder?
• Why do they not go for treatment?
• What could the treatment be if they did?
Behavioral Changes for Anxiety
• Practice the “relaxation response:" Starts with
the mind which, in turn, relaxes the body
• Learn deep muscle relaxation exercises: Starts
with the body which, in turn, relaxes the mind
(Yoga)
Cognitive-behavioral therapy for
depression
• Identify thinking patterns that are common
among people who are depressed
• Practice keeping a journal of every positive
event that occurred during the day
• Practice positive self-statements about an
event or interaction you handled well
Feeling Good Handbook
• All or nothing thinking
• Discounting the positive
• Believe need to be perfect or have failed
• Buy into view ‘am a loser,’ no matter what
Behaviors to reduce depression
• Step-by-step increase in level of exercise do on
daily basis: start at 250 steps per day & week
by week increase up to 10,000
• Increase social network: create one social
interaction during a week
• Join new social groups via meetup.com
Increase One’s Productivity
• Establish goals for each day that are realistic
• Give oneself credit for accomplishing each
goal!!
• Slowly increase level of productivity plan for
each day
Schizophrenia is most serious
psychological dysfunction
• Diathesis-Stress Model: Born with genetic
defect that predisposes them to overreact to
stressors
OR
• Early severe stressful events cause abnormal
neurodevelopment that has caused nervous
system to be hyper sensitive to stressors
Abnormalities found in
schizophrenics
• Over-reactivity of hypothalamic-pituitaryadrenal axis
• Structural brain changes, including
hippocampus damage and cerebral atrophy
• Elevation of release of cortisol and dopamine
when exposed to stress
What could these neurological
abnormalities explain?
• Oversensitivity to stress
• Cognitive impairments
• Relationship between psychotic and
hallucinations, delusions and paranoia
Problem with biological model
• Impede adequate consideration of relevance
of stress, trauma, neglect and loss in early
childhood
• Diathesis-stress model only measure stressors
a few weeks or months prior to outbreak so
not consider early life events
• Gross imbalance in examining biological
psychological and social factors
“Genotype-environment interaction in
schizophrenic-spectrum disorder”
• British Journal of Psychiatry (2004)
• 36% of high-genetic risk adoptees raised in
dysfunctional families develop symptoms
• 5.8% of high-genetic risk adoptees raised in
healthy families
• Demonstrates protective effect of family
Factors in Environment: High Degree
of Stress Early in Life
• Genetic risk
combined with
volatile, hostile
unpredictable,
judgmental
and/or overly
protective
environment
Healthy Families
• Have good sense of humor and can laugh at
themselves
• Respect each other’s need for privacy and not
engage in mind reading
• Negotiate and compromise
Findings of Adoptee studies
• Genes do not operate alone
• Environmental factors play a significant role
• Much of environmental influences are result
of family environment
• Developing brain vulnerable early in life
Traits of Healthy Families
• Speak clearly and are not rigid nor confusing
• Friendly environment & able to disagree
without upsetting other members
• Can express happiness or sadness to each
other
Treatment for Schizophrenia:
Limited to Biological Treatments
Biological Treatments
• Medications
Thorazine one popular anti-psychotic
medication: very strong sedative
Action of Antidepressants
ECT: Electro-convulsive therapy
Deep Stimulation of the
Reward Centers in the Brain
Trans-cranial Magnetic Stimulation