Download Dissociative Disorders

Dissociative Disorders
Conscious awareness becomes separated
(dissociated) from painful 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.
Dissociative Identity Disorder (DID)
A disorder in which a person exhibits two or
more distinct and alternating personalities,
formerly called multiple personality disorder.
Chris Sizemore (DID)
DID Critics
• Between 1930 to 1960 the diagnosis was only 2
percent
• Since it made it to DSM in 1980’s the reported
cases has jumped to 20,000
• Number of personalities mushroomed from 3 to
12 per patient
• This disorder is unknown in Japan and India
DID Critics
Critics’ Arguments
1. Role-playing by people open to a
therapist’s suggestion.
2. Learned response that reinforces
reductions in anxiety.
Personality Disorders
Personality disorders
are characterized by
inflexible and
enduring behavior
patterns that impair
social functioning.
They are usually
without anxiety,
depression, or
delusions.
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
The pattern normally begins in late childhood
½ children who show the pattern become
sociopaths, unable to keep a job, irresponsible,
and assaultive, or criminal.
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.
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
Mood Disorders
Emotional extremes of mood disorders come in
two principal forms.
1. Major depressive disorder
2. Bipolar disorder
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
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
Bipolar Disorder
Formerly called manic-depressive disorder. An
alternation between depression and mania
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
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
Theory of Depression
Depression is prevalent worldwide
Gender differences
Depression is increasing, especially in the teens.
Biological Perspective
Genetic Influences: Mood disorders run in
families. The rate of depression is higher in
identical (50%) than fraternal twins (20%).
PET scans show that brain energy consumption
rises and falls with manic and depressive
episodes.
The Depressed Brain
•Neurotransmitters:
•
Norepineprine: Smoke releases norepinehrine
•
Serotonine
•Drugs block the reuptake, or the chemical breakdown of these two
neurotransmitters
•Jogging has the same effect
•Deep brain stimulation
Social-Cognitive Perspective
The social-cognitive perspective suggests that
depression arises partly from self-defeating
beliefs and negative explanatory styles.
Negative Thoughts and Moods
Explanatory style plays a major role in becoming depressed.
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. Break the cycle by moving
to a different
environment, reversing
our self blame, turning
our attention outward, or
engage in more pleasant
and rewarding activities
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.
Symptoms of Schizophrenia
Positive symptoms: the presence of inappropriate
behaviors (hallucinations, disorganized or
delusional talking)
Negative symptoms: the absence of appropriate
behaviors (expressionless faces, rigid bodies)
Disorganized & Delusional Thinking
This morning when I was at Hillside [Hospital], I was
making a movie. I was surrounded by movie stars …
I’m Mary Poppins. Is this room painted blue to get me
upset? My grandmother died four weeks after my
eighteenth birthday.”
(Sheehan, 1982)
Other
forms of delusions
delusions
of
This
monologue
illustratesinclude,
fragmented,
bizarre
persecution
is following
me”) or
thinking
with (“someone
distorted beliefs
called delusions
grandeur
(“I am
a king”).
(“I’m Mary
Poppins”).
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
August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg
Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign
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).
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.
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.
Understanding Schizophrenia
Dopamine Overactivity: Researchers found that
schizophrenic patients express higher levels of
dopamine D4 receptors in the brain.
Drugs that blocks dopamine receptors help
with symptoms
Drugs that increase dopamine level
(amphetamines, cocaine) increase the symptoms
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
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
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