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Perspectives on the Causes of Mental Disorders • Psychodynamic – Results from intrapsychic conflict and ineffective defense mechanisms • Medical – Caused by abnormalities of brain & nervous system • Cognitive-Behavioral – Due to learning and/or faulty beliefs • Humanistic – Being overly sensitive to the expectations & criticisms of others • Sociocultural – Mismatch between behavior & expectations of culture • Diathesis-Stress Model – Genetic predispositions triggered by stress that exceeds coping ability Classification of Mental Disorders • The DSM-IV • How are diagnoses done? – The clinical approach: Based upon experience of therapist – The actuarial approach: Applying statistical rules based on research – Research shows actuarial approach to be superior Types of Psychological Disorders • Psychoses – Severely Disordered Thinking – Delusional – Person may be unaware that anything is wrong • Neuroses – People are anxious, fearful, unhappy, depressed – Behavioral/Perceptual Strategies no longer work well – Person knows that something is wrong • Mood Disorders • Miscellaneous Disorders Psychoses (Schizophrenia) • Positive Symptoms of Schizophrenia – Thought Disorders • Loose associations; word salads; clang associations • Excessively concrete thinking – Hallucinations (Usually auditory) – Delusions • • • • • Persecution Grandeur Somatic Control Reference • Negative Symptoms of Schizophrenia – – – – – Flattened, blunted emotions; apathetic Poverty of speech Social Withdrawal Lack of Initiative Inability to experience pleasure Classification of Schizophrenia • Catatonic – Catatonic postures; Waxy Flexibility – Alternates with repetitive activity • Paranoid – Delusions of persecution & grandeur • Disorganized – Progressive, irreversible disturbances of thought • Undifferentiated – Pattern of symptoms change; a little bit of everything Causes of Schizophrenia • There have been a variety of different theoretical explanations over time, but it has a clear biological basis • A Biological predisposition activated by stress – Positive symptoms seem to be the result of the overproduction of Dopamine (Can be treated by Chlorpromazine [brand name = Thorazine]) – Negative symptoms appear to be due to an actual loss of brain tissue • Evidence indicates a genetic link • Neurodevelopmental hypothesis: – Nervous system impairments that develop around the time of birth (not necessarily genetic) • (e.g., People in North born in winter are at greater risk) Neuroses • Anxiety Disorders – Generalized Anxiety Disorder – Panic Disorder • • • • Attacks of terror (may last seconds or hours) Often afraid that they are dying or going crazy Hyperventilation More common in women – Phobic Disorders • Agoraphobia • Social Phobias • Specific Phobias • Obsessive-Compulsive Disorders • Somatoform Disorders • Dissociative Disorders Neuroses • Obsessive-Compulsive Disorders – Obsession (thought) leads to compulsion (behavior) – Obsessions center on doubts/uncertainty or fear of doing something prohibited – Common categories: counting, checking, cleaning, avoidance • Somatoform Disorders – Physical symptoms without apparent cause – Somatization Disorder: Pain, heart symptoms, gastrointestinal symptoms – Conversion Disorder: Blindness, deafness, loss of felling, paralysis. – Often occurs in response to an event • Dissociative Disorders – Dissociative Amnesia – Dissociative Fugue State (Fugue State) – Dissociative Identity Disorder (DID) (Multiple personality Disorder) Mood Disorders • Seasonal Affective Disorder (SAD) – Overeating, oversleeping, lethargy • Bipolar Disorder – Alternating Mania & Depression • Severe Depression – – – – – – – Sad, apathetic mood Feelings of worthlessness/hopelessness Social Withdrawal Sleeplessness, loss of appetite & sexual desire Change in activity level In extreme cases there may be delusions CAUSES: Faulty cognitions; internal attributions for negative things; genetic predisposition – TREATMENT: ECS; Lithium Carbonate (Bipolar); Anti-depressants; Cognitive Therapy Miscellaneous Disorders • Substance Abuse Disorders (More common in men) • Impulse Control Disorders – Intense drive; behaviors reduce tension – Gambling, Pyromania, Kleptomania • Psychosexual Disorders – Gender Identity Issues (Transexualism, Transvestism) – Paraphilias – Sexual Dysfunction • Personality Disorders – Narcissism – Anti-Social Personality (Psychopath, Sociopath) Types of Psychotherapy • Insight Therapies – Psychoanalysis – Person-Centered Therapy (Humanistic) – Existential Therapy • Gestalt Therapy • Behavior Therapies – – – – Systematic Desensitization Aversion Therapy Implosive Therapy/Flooding Behavior Modification • Cognitive-Behavior Therapies – Rational-Emotive Therapy (RET) – Beck’s Cognitive Therapy for Depression – Cognitive-Behavior Therapy Types of Psychotherapy • Somatic/Biological Therapy – Psychosurgery – Electroconvulsive Therapy – Psychopharmacology • Group Therapy Does Psychotherapy Work? Professionals Involved in Therapy A History of Treating Mental Disorders