* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Memory
Impulsivity wikipedia , lookup
Obsessive–compulsive personality disorder wikipedia , lookup
Obsessive–compulsive disorder wikipedia , lookup
Biology of depression wikipedia , lookup
Major depressive disorder wikipedia , lookup
Personality disorder wikipedia , lookup
Bipolar disorder wikipedia , lookup
Autism spectrum wikipedia , lookup
Death anxiety (psychology) wikipedia , lookup
Psychological trauma wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Eating disorders and memory wikipedia , lookup
Schizophrenia wikipedia , lookup
Memory disorder wikipedia , lookup
Panic disorder wikipedia , lookup
Social anxiety disorder wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Anxiety disorder wikipedia , lookup
Conduct disorder wikipedia , lookup
Eating disorder wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Asperger syndrome wikipedia , lookup
Conversion disorder wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Munchausen by Internet wikipedia , lookup
Glossary of psychiatry wikipedia , lookup
Mental disorder wikipedia , lookup
Treatment of bipolar disorder wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Social construction of schizophrenia wikipedia , lookup
Separation anxiety disorder wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Spectrum disorder wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Child psychopathology wikipedia , lookup
Psychological Disorders Chapter 13 1 Chapter 13: Psychological Disorders I. II. III. IV. V. VI. Perspectives on Psych Disorders Anxiety Disorders Dissociative and Personalityh Mood Disorders Schizophrenia Rates of Psychological Disorders 2 Chapter 13Objectives 1. Identify the criteria for judging whether behavior is psychologically disordered. 2. Contrast the medical model w/ the biopsychological approach to disordered behavior. 3. Describe the goals and content of the DSM-IV; discuss dangers and benefits of labels. 4. Describe the symptoms of generalized anxiety disorder, panic disorder, phobias, OCD, and PTSD. 5. Discuss the contributions of learning and biological perspectives to understanding the development of anxiety disorders. 3 Objectives 6. Describe the symptoms of dissociative disorders and the controversy regarding the diagnosis of dissociative identity disorder. 7. Contrast the three clusters of personality disorders. 8. Define mood disorders; contrast major depressive and bipolar disorders. 9. Explain the development of mood disorders, using biological and social-cognitive perspectives. 10. Describe the symptoms of schizophrenia, and contrast chronic and acute schizophrenia. 4 I. Perspectives on Psychological Disorders Where should we draw the line b/w normality & disorder? • Behavior is disordered when it is deviant, distressful, and dysfunctional. (psych disorder) • Definition of defiant varies w/ context and culture. • Varies w/ time… children who might have been judged rambunctious now are being diagnosed w/ attention deficit hyperactivity disorder. 5 I. Perspectives People are fascinated by the exceptional, the unusual, and the abnormal. This fascination may be caused by two reasons: 1. During various moments we feel, think, and act like an abnormal individual. 2. Psychological disorders may bring unexplained physical symptoms, irrational fears, and suicidal thoughts. 6 I. Perspectives To study the abnormal is the best way of understanding the normal. William James (1842-1910) 1. There are 450 million people suffering from psychological disorders (WHO, 2004). 2. Depression and schizophrenia exist in all cultures of the world. 7 I. Perspectives… Defining Psychological Disorders •Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions. •When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered. I. Perspectives… Deviant, Distressful & Dysfunctional Carol Beckwith 1. Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest. 2. Deviant behavior must accompany distress. 3. If a behavior is dysfunctional it is clearly a disorder. In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal. 9 I. Perspectives… Understanding Psychological Disorders •Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood. John W. Verano Trephination (boring holes in the skull to remove evil forces) 10 I. Perspectives… The Medical Model Philippe Pinel (1745-1826) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago Dance in the madhouse. 11 I. Perspectives… Medical Model •When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. •The concept that diseases, like psych disorders, have physical causes that can be diagnosed, treated, and cured in a hospital. 1. Etiology: Cause and development of the disorder. 2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3. Treatment: Treating a disorder in a psychiatric hospital. 4. Prognosis: Forecast about the disorder. 12 I. Perspectives… The Biopsychosocial Approach Assumes that biological, socio-cultural, and psychological factors combine and interact to produce psychological disorders. 13 I. Perspectives… Biopsychological Approach • Assumes that disordered behavior, like other behavior, arises from genetic predispositions and physiological states, inner psychological dynamics, and socialcultural circumstances. I. Perspectives… Classifying Psychological Disorders •Many psychiatrists and psychologists use the American Psychiatric Association’s Diagnostic & Statistical Manual of Mental Disorders (DSM-IV). •This names and describes psych disorders in treatment and research. •Diagnostic labels aid mental health professionals by providing a common language and shard concepts for communications & research. •US health insurances require DSM-IV diagnoses before they pay for therapy. •Describes 400 psychological disorders compared to 60 in the 1950s. 15 I. Perspectives… Labeling • Disorders outlined by DSM-IV are reliable; therefore, diagnoses by different professionals are similar. • Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. 16 I. Perspectives…. Labeling Psychological Disorders Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, 1995. Cornell University Press. Critics of the DSM-IV argue that labels may stigmatize individual. Can create preconceptions that unfairly stigmatize people and can bias our perceptions of their past and present behavior. Asylum baseball team (labeling) 17 Labeling Psychological Disorders Elaine Thompson/ AP Photo “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes. Current Examples? Theodore Kaczynski (Unabomber) 18 II. Anxiety Disorders What are anxiety disorders; how differ from ordinary worries and fears we all experience? •Our uneasiness is not intense and persistent •Anxiety Disorder: characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. •Five Anxiety Disorders: 1. 2. 3. 4. 5. Generalized anxiety disorder Panic disorder Phobias Obsessive-compulsive disorder Post-traumatic stress disorder 19 II. Generalized Anxiety Disorder 1. Persistent and uncontrollable tenseness and apprehension; jittery, agitated, sleep-deprived; concentration is difficult. 2. Inability to identify or avoid the cause of certain feelings so difficult to deal w/ or avoid. 2/3s of whom are women. May lead to physical problems: ulcers or high blood pressure. Def: An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. 3. 4. 5. 20 II. Panic Disorder •Def: Disorder marked by unpredictable minutes-long episodes of intense dread; person experiences terror, chest pains, choking, or other frightening sensations. •Strikes suddenly, wreaks havoc, and disappears. •Other symptoms: heart palpitations; shortness of breath, trembling, dizziness •Anxiety is a component of both disorders. It occurs more in the panic disorder, making people avoid situations that cause it. 21 II. Anxieties… Phobias •Marked by a persistent and irrational fear of an object or situation that disrupts behavior. •Usually leads to avoidance of a specific object or situation. 22 II. Kinds of Phobias Agoraphobia Acrophobia Claustrophobia Hemophobia Phobia of open places. Phobia of heights. Phobia of closed spaces. Phobia of blood. 23 II. Anxieties: ObsessiveCompulsive Disorder •Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress. •Characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) •Effective functioning can become impossible 24 II. Anxieties: Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD): 1. Haunting memories 2. Nightmares 3. Social withdrawal Bettmann/ Corbis 4. Jumpy anxiety 5. Sleep problems 25 II. Anxieties… Resilience to PTSD •Only about 10% of women and 20% of men react to traumatic situations and develop PTSD. •Holocaust survivors show remarkable resilience against traumatic situations. •All major religions of the world suggest that surviving a trauma leads to the growth of an individual. •Current Issues or Concerns? 26 II. Anxieties… Explaining Anxiety Disorders What are the sources of the anxious feelings and thoughts that characterize anxiety disorders? •Psychoanalytic perspective (Freud) viewed anxiety disorders as the discharging of repressed impulses. •Freud’s theory proposed that, beginning in childhood, people repress intolerable impulses, ideas, and feelings and that this submerged mental energy sometimes produces mystifying symptoms such as anxiety. •Today’s psychologists turned toward two contemporary perspectives: learning and biological. 27 II. Anxieties: The Learning Perspective • Psychologists working from the learning perspective view anxiety disorders as a product of fear conditioning, stimulus generalization, reinforcement of fearful behaviors, and observational learning. • Fear conditioning: ex: rats subjected to unpredictable shocks become anxious • Stimulus Generalization: person fears heights after a fall and is afraid to go on airplane. • Reinforcement: helps maintain anxieties. • Observational Learning: observing other’s fears. 28 II. Anxieties: The Biological Perspective • This perspective considers the evolutionary survival value of fears of life-threatening animals, objects, or situations; inherited predispositions; and abnormal responses in the brain. • Natural Selection: many of our modern fears come have an evolutionary explanation. • Genes: Some may be predisposed to anxiety • Brain: generalized anxiety, panic attacks, and even obsessions are biologically measureable in the brain. 29 The Biological Perspective S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action monitoring in obsessive-compulsive disorder. Psychological Science, 14, 347-353. Generalized anxiety, panic attacks, and even OCD are linked with brain circuits like the anterior cingulate cortex. Anterior Cingulate Cortex of an OCD patient. 30 IV. Dissociative Disorders •Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Symptoms 1. Having a sense of being unreal. 2. Being separated from the body. 3. Watching yourself as if in a movie. 31 III. Dissociative Identity Disorder (DID) A disorder in which a person exhibits two or more distinct and alternating personalities, formerly called multiple personality disorder. Lois Bernstein/ Gamma Liason Chris Sizemore (DID) 32 III. DID Critics Critics argue that the diagnosis of DID increased in the late 20th century. DID has not been found in other countries. Critics’ Arguments 1. Role-playing by people open to a therapist’s suggestion. 2. Learned response that reinforces reductions in anxiety. 33 III. Personality Disorders •Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. •“BTK Killer” 34 III. 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. •Genetic Predispositions may interact with environment to produce this disorder. 35 III. 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. 36 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 (Raine et al., 1999; 2000). Courtesy of Adrian Raine, University of Southern California Normal Murderer 37 IV. Mood Disorders •Characterized by emotional extremes •Emotional extremes of mood disorders come in two principal forms. 1. Major depressive disorder 2. Bipolar disorder 38 IV. MD… Major Depressive Disorder •Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002). Blue mood Major Depressive Disorder Gasping for air after a hard run Chronic shortness of breath 39 IV. MD…. Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. 1. 2. 3. 4. Signs include: Lethargy and fatigue Feelings of worthlessness Loss of interest in family & friends Loss of interest in activities 40 IV. MD…. Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania(hyperactivity) signals bipolar disorder. Depressive Symptoms Manic Symptoms Gloomy Elation Withdrawn Euphoria Inability to make decisions Tired Slowness of thought Desire for action Hyperactive Multiple ideas 41 IV. Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Earl Theissen/ Hulton Getty Pictures Library The Granger Collection Wolfe George C. Beresford/ Hulton Getty Pictures Library Bettmann/ Corbis Whitman Clemens Hemingway 42 IV. Mood Disorders: What causes mood disorders and what explains its increase? • Depression researchers are exploring two sets of influences. • One: genetic predispositions and on abnormalities in brain structures and functions. • Second: social-cognitive perspective, examining the influence of cyclic self-defeating beliefs, learned helplessness, negative attributions, and stressful experiences. • Biopsychosocial: considers influences on many levels. • Increased rates of depression among young Westerners may be due to rise of individualism and decline of 43 commitment to religion and family. IV. Explaining Mood Disorders 1. Many behavorial and cognitive changes accompany depression… trapped in depressed mood; also exhibit anxiety or substance abuse. 2. Women are nearly twice as vulnerable to depression. Men tend to be more external. 3. Most major depressive episodes self-terminate. 4. Stressful events related to work, marriage, and close relationships often precede depression. 5. With each new generation, depression is striking earlier. 44 IV. Theory of Depression Gender differences 45 IV. Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide. 1. 2. 3. 4. 5. Suicide Statistics National differences Racial differences Gender differences Age differences Other differences 46 IV. MD… Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Jerry Irwin Photography Linkage analysis and association studies link possible genes and dispositions for depression. 47 IV. The Depressed Brain PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine 48 IV. MD & Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles. 49 IV. MD… Negative Thoughts and Moods Explanatory style plays a major role in becoming depressed. 50 IV. MD… Depression Cycle 1. Negative stressful events. 2. Pessimistic explanatory style. 3. Hopeless depressed state. 4. These hamper the way the individual thinks and acts, fueling personal rejection. 5. Therapists try to break this cycle by changing the way depressed people process events. 51 V. Schizophrenia The literal translation is “split mind” which refers to a split from reality. A group of severe disorders characterized by the following: 1. Disorganized and delusional thinking. 2. Disturbed perceptions. 3. Inappropriate emotions and actions. 52 V. Schizophrenia What patterns of thinking, perceiving, feeling, and behaving characterize schizophrenia? • A group of disorders that typically strike during late adolescence, affect men very slightly more than women, and seem to occur in all cultures. • Symptoms: disorganized and delusional thinking (which may stem from selective attention), disturbed perceptions, and inappropriate emotions and actions. • Delusions are false beliefs; hallucinations are sensory experiences w/o sensory stimulations. 53 V. Schizophrenia What forms does schizophrenia take? • May emerge gradually from a chronic history of social inadequacies (recovery is dim) or suddenly in reaction to stress (recovery is brighter). • Positive symptoms are defined as the presence of inappropriate behaviors. • Negative symptoms: as the absence of appropriate behaviors. 54 IV. What causes Schizophrenia? • May have increased receptors for the neurotransmitter dopamine, which may intensify the positive symptoms of schizophrenia. • Brain abnormalities include enlarged, fluid-filled cerebral cavities and corresponding decreases in the cortex. • Brain scans reveal abnormal activity in the frontal lobes, thalamus, and amygdala. • Malfunctions in the brain regions and their connections apparently interact to produce symptoms of schizophrenia. • Twin/Adoptive studies also point to genetic disposition that interact w/ environmental factors . 55 Disturbed Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory. L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg 56 Inappropriate Emotions & Actions A schizophrenic person may laugh at the news of someone dying or show no emotion at all (flat affect). Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia). 57 Onset and Development of Schizophrenia Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease (WHO, 2002). Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women. 58 Chronic and Acute Schizophrenia When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms. When schizophrenia rapidly develops (acute/reactive) recovery is better. Such schizophrenics usually show positive symptoms. 59 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. 60 Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health 61 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 62 Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development. 63 Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 2001). 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated 64 Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries. 65 VI. Rates of Psychological Disorders • Research: 1 in 7 US adults has, or has have, a psychological disorder, usually by early adulthood. • Poverty is a predictor of mental illness. • Conditions and experiences associated w/ poverty contribute to the development of mental disorders, but some, like schizophrenia, can drive people into poverty. • Among Americans who have ever experienced a psychological disorder, the three most common were phobias, alcohol abuse, and mood disorder. 66 Rates of Psychological Disorders 67 Rates of Psychological Disorders The prevalence of psychological disorders during the previous year is shown below (WHO, 2004). 68