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Psychological Disorders What is a Psychological Disorder? • Psychological Disorders are “harmful dysfunctions” in which behavior is judged to be atypical, disturbing, maladaptive, and unjustifiable •Atypical is abnormal – being different from most other people in one’s culture • Disturbing means that a behavior goes against the standards of acceptable behavior, is unnerving, grotesque, or otherwise disruptive to a generally acceptable level of comfort. • Maladaptiveness is the key to defining a disorder – the behaviors must be distressing or disabling or put one at a greatly increased risk of suffering or death •Unjustifiable means irrational, or that a behavior lacks any mental clarity or reason What is the nature of Psychological Disorders and their causes? • Biological Model (Medical Model) – Abnormal behaviors are caused by physiological malfunctions – IE. a failure of the central nervous system, an improperly working endocrine system, an abnormal flow of a specific hormone, genetic factors, brain damage • Psychoanalytical Model – Abnormal behaviors are symbolic expressions of unconscious, internal conflicts, often associated with early childhood – IE. A fear of open water due to almost drowning as a child, obsessions with women who remind you of the mother who abandoned you, serial violence against homosexuals based on your own internal orientation conflicts • Behavioral Model – Abnormal behavior is the result of learned behavior – IE. you are a psychopathic killer because you watched violent programming on tv….you obsessively clean the house because Mom obsessively cleaned the house • Diathesis-Stress Model (BioPsycho-Social Perspective) – Abnormal behavior is caused when prone individuals who otherwise may not exhibit symptoms are put into stressful situations and then exhibit symptoms • IE. Your repressed fear of spiders doesn’t affect you until you are lost in a cave and stumble into a huge nest of spiders…you are naturally a calm person, but then your house burns down, your ID is stolen online, and your bank accounts are emptied, thus you “snap” Classifying Psychological Disorders • There are 17 categories of Psychological Disorders, as specified in the DSM-IV – the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders” Insanity • This is a LEGAL definition only, whereas a person is unable to determine between right & wrong or understand consequences due to metal illness Anxiety Disorders • Anxiety Disorders are any disorders characterized by an intensely distressing, persistent stress, or maladaptive behaviors that reduce stress Anxiety Overview Anxiety Disorders are… • Irrational (exaggerated or non existent threats, response is out of proportion) • Uncontrollable (can not be “turned off, even if the person wants to) • Disruptive (interferes with life) • Generalized Anxiety Disorder – a person is continually tense, apprehensive, and in a state of autonomic system arousal • • • • • • Dizziness Sweaty Palms Heart Palpitations Ringing in the Ears Edgy and Shaky Unfocused and Out-of-Control Negative Feelings • Worried constantly about bad things that may happen • Twitchiness and/or trembling •Panic Disorder sufferers have acute episodes of intense anxiety without any apparent provocation • Obsessive-Control Disorder is characterized by unwanted repetitive thoughts (obsessions) or actions (compulsions) – Checking to see if a door is locked is normal. Doing it 30 times or “I will die” is not. Washing your hands is normal. Washing them until your hands are raw so that “all of the germs are gone” is not. • Living with an Anxiety Disorder • Phobias are marked by persistent, irrational fears and avoidance of a specific object or situation –Some phobias are so intense that they are incapacitating Common and Uncommon Fears 100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 0 Snakes Being Mice Flying Being Spiders Thunder Being Dogs in high, on an closed in, and and alone exposed airplane in a insects lightning In a places small house place at night Afraid of it Bothers slightly Not at all afraid of it Driving Being Cats a car In a crowd of people • Post-Traumatic Stress Disorder usually involves flashbacks or nightmares following a person’s involvement in or observation of an extremely troubling event, such as a war or a natural disaster Dissociative Disorders • Dissociative disorders involve disturbances in a person’s consciousness, memories, identity, and perception of the environment • Dissociative Identity Disorder, in which a person has two or more distinct personalities that alternate in their control of the person’s behavior • Amnesia, loss or impairment of memory. Amnesia is usually associated with some form of brain damage, but it may also be caused by severe psychological trauma. Amnesia with a physical cause is called organic amnesia, whereas amnesia of psychological origin is called functional amnesia • Three Faces of Eve - Dissociative Identity Disorder • Dissociative Identity Disorder Eating Disorders • Eating disorders are conditions in which an individual experiences severe disturbances in eating behaviors • Anorexia nervosa is essentially a form of selfstarvation in order to lose weight, while bulimics don’t necessarily lose as much of their body weight due to their binge-and-purge behaviors. • Anorexia • Bulimia Impulse-Control Disorders • Impulse control disorders involve the loss or lack of control in certain specific situations. The hallmark of these disorders is the individual's inability to stop impulses that may cause harm to themselves or others. Affected individuals often feel anxiety or tension in considering these behaviors. This anxiety or tension is relieved or diminished once the action is performed. • Kleptomania – compulsive stealing • Pyromania – setting fires • Trichotillomania – compulsive hair pulling • Dermatillomania – compulsive skin picking • Intermittent Explosive Disorder – aggressive outbursts • Trichotillomania Mood Disorders Mood Disorders •Mood disorders, also called affective disorders, create disturbances in a person’s emotional life • Symptoms of major depression may include feelings of sadness, hopelessness, and worthlessness, as well as complaints of physical pain and changes in appetite, sleep patterns, and energy level. The length of time of the depression is a key also. What is Depression? • In mania, an individual has an abnormally elevated mood, often marked by exaggerated self-importance, irritability, agitation, and decreased sleep Bipolar Overview • In bipolar disorder, also called manic-depressive illness, a person’s mood alternates between extremes of mania and depression Personality Disorders • Personality disorders are wellestablished, maladaptive ways of behaving that negatively affect a person’s ability to function in society. • An “enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it". These patterns are inflexible and pervasive across many situations • People with narcissistic personality disorder have a grandiose sense of selfimportance. They seek excessive admiration from others and fantasize about unlimited success or power. They believe they are special, unique, or superior to others. • Paranoid personality disorder is characterized by irrational suspicions and mistrust of others. • Avoidant personality disorder is characterized by social inhibitions, feelings of inadequacy, extreme sensitivity to negative evaluation, and exaggerated emotions. • People with antisocial personality disorder act in a way that disregards the feelings and rights of other people. Antisocial personalities often break the law, and they may use or exploit other people for their own gain. They may lie repeatedly, act impulsively, and get into physical fights. They may even kill other people. People with this disorder are also sometimes called sociopaths or psychopaths. Manson Interview Schizophrenia and Other Psychotic Disorders • Schizophrenia Overview • Schizophrenia is a chronic, severe, and disabling brain disease • People with schizophrenia often suffer terrifying symptoms such as – hearing internal voices not heard by others – believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. – speech and behavior can be so disorganized that they may be incomprehensible or frightening to others. Causes of Schizophrenia? • It has long been known that schizophrenia runs in families. A child whose parent has schizophrenia has about a 10 percent chance. By comparison, the risk of schizophrenia in the general population is about 1 percent. The strongest evidence to date leads to chromosomes 13 and 6 but remains unconfirmed. Causes of Schizophrenia? • It is likely, although not yet certain, that the disorder is associated with some imbalance of the complex, interrelated chemical systems of the brain, involving the presence of excessive amounts of the neurotransmitters dopamine and glutamate Causes of Schizophrenia? • Many studies of people with schizophrenia have found abnormalities in brain structure. Schizophrenia may be a developmental disorder resulting when neurons form inappropriate connections during fetal development. These errors may lie dormant until puberty, when changes in the brain that occur normally during this critical stage of maturation interact adversely with the faulty connections. • Hallucinations –perceptions that occur without connection to an appropriate source; hearing voices that other people do not hear is the most common type of hallucination in schizophrenia –Voices may describe the patients activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. • Delusions —false personal beliefs that are not subject to reason or contradictory evidence – patients suffering from paranoid-type symptoms often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. – In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia • Disorganized Thinking – Schizophrenia often affects a persons ability to think straight. Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. – People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. • Inappropriate Effect –expressing improper emotions, related to the environmental context they are presented in, or –a person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic • Schizophrenia Part 1 - ABC 20/20 coverage • Schizophrenia Part 2 - ABC 20/20 coverage Sleep Disorders Sleep Disorders Overview •Sleep Disorders affect sleep. They may include Insomnia (lack of sleep), apnea (stop breathing), and narcolepsy (always tired, sleep) • Sleep Disorders Overview • Living with Sleep Apnea • Waking Up from Narcolepsy Sexual Disorders Sexual Disorders • Sexual dysfunctions are problems with sexual response that cause distress. Erectile dysfunction (impotence) refers to the inability of a man to have or maintain an erection. Premature ejaculation occurs when a man is not able to postpone or control his ejaculation. Inhibited male orgasm, or retarded ejaculation, occurs when a man cannot have an orgasm despite being highly aroused. • Female orgasmic dysfunction (anorgasmia, or inhibited female orgasm) refers to the inability of a woman to have an orgasm. Vaginismus refers to a spastic contraction of the outer third of the vagina, a condition that can close the entrance of the vagina, preventing intercourse. PARAPHILIAS INCLUDE FANTASIES, BEHAVIORS, OR SEXUAL URGES FOCUSING ON UNUSUAL OBJECTS, ACTIVITIES, OR SITUATIONS TYPES OF PARAPHILIAS EXHIBITIONISM • SEXUALLY EXPOSING ONESELF (GENITALS) TO OTHERS FETISHISM • SEXUAL URGES AND BEHAVIORS ASSOCIATED WITH NON-LIVING OBJECTS Specific Fetishes • • • • • • • • Agriozoophilia – wild animals Alektorophilia – chickens Anthophilia – flowers Autodysomophilia – bad smells Bibliophilia – books Chaetophilia – hair Coimetrophilia – cemeteries Coprophilia – feces Specific Fetishes • • • • • • • • • Daimonophilia – ghosts Didaskaleinophilia – school Dontophilia – teeth Ecclesiophilia – church Emetophilia – vomit Epistaxiophilia – nosebleeds Geniophilia – chins Gerontophilia – old people Heliophilia – sun Specific Fetishes • • • • • • • • Hoplophilia – guns Ichthyophilia – fish Lachanophilia – vegetables Leprophilia – leprosy Lutraphilia – otters Melophilia – music Necrophilia – dead Nephophilia – clouds Specific Fetishes • • • • • • • Nosophilia – terminal illness Ombrophilia – rain Ophidiophilia – snakes Peladophilia – baldness Pogophilia – beards Thassophilia – sitting Urophilia – urine FROTTEURISM • SEXUAL URGES ARE FOCUSED ON OR RELATED TO TOUCHING OR RUBBING AGAINST UN-SUSPECTING, NONCONSENTING, AND UNFAMILIAR PEOPLE OF THE OPPOSITE SEX MASOCHISM • SEXUAL PLEASURE DERIVED FROM BEING HURT OR HUMILIATED VERBALLY AND/OR PHYSICALLY SADISM • SEXUAL PLEASURE DERIVED FROM MISTREATING OTHERS TRANSVESTITISM • CROSS-DRESSING VOYEURISM • SEXUAL PLEASURE IS DERIVED FROM SECRETLY OBSERVING OTHERS Somatoform Disorders • Somatoform Disorders are characterized by the presence of physical symptoms that cannot be explained by a medical condition or another mental illness • Somatoform disorder is characterized by physical symptoms that mimic disease or injury for which there is no identifiable physical cause for physical symptoms such as pain, nausea, depression, and dizziness. • Somatoform disorder is a condition in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can not be traced to a specific physical cause. • Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have somatoform disorder are not faking their symptoms. The pain that they feel is real. • Hypochondriasis refers to an excessive preoccupation or worry about having a serious illness. Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, the concerns are far in excess of what is appropriate for the level of disease. • Hypochondria is often characterized by fears that minor bodily symptoms may indicate a serious illness, constant selfexamination and self-diagnosis, and a preoccupation with one's body. • With Conversion Disorder, patients present with neurological symptoms or deficits that affect voluntary motor or sensory function such as numbness, paralysis, blindness, etc.. It is thought that these problems arise in response to difficulties in the patient's life. • The diagnosis of conversion disorder involves three elements - the exclusion of neurological disease, the exclusion of feigning, and the determination of a psychological mechanism • Body Dysmorphic Disorder is a preoccupation with an imagined or minor defect in appearance which causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. • The disorder generally is diagnosed in those who are extremely critical of their physique or self-image even though there may be no noticeable disfigurement or defect, or a minor defect which is not recognized by most people. Too Ugly To Live - Part 1 Substance-Related Disorders Substance Abuse Disorders •Substance-related disorders result from the abuse of drugs, side effects of medications, or exposure to toxic substances Adjustment Disorders • Adjustment disorders are defined as a inability or maladaptive reaction to an identifiable stressful life event/ stressor. ( e.g., divorce, family crises). Symptoms must occur within three months of the event/stressor and persisted for no longer than six months. Usually includes depression, withdrawal, or a rebellion against society, family, or the law. Cognitive Disorders •Cognitive disorders, such as delirium and dementia, involve a significant loss of mental functioning • Dementia, for example, is characterized by impaired memory and difficulties in such functions as speaking, abstract thinking, and the ability to identify familiar objects. The conditions in this category usually result from a medical condition, substance abuse, or adverse reactions to medication or poisonous substances Disorders usually first diagnosed in Infancy, Childhood, or Adolescence • Childhood Disorders are those disorders that are generally diagnosed in children through the age of 18 • Autism is most commonly characterized by non-normal social attachments, withdrawal, echolalia (repeat word patterns), strange motor behaviors, and those affected are often mentally retarded Factitious Disorders • People with factitious disorders intentionally produce or fake physical or psychological symptoms in order to receive medical attention and care. For example, an individual might falsely report shortness of breath to gain admittance to a hospital, report thoughts of suicide to solicit attention, or fabricate blood in the urine or the symptoms of rash so as to appear ill Mental Disorders Due to a General Medical Condition • The general mental disorders are diagnosed when there is evidence they are caused by the specified medical conditions –IE. A coma caused by a bad food reaction, a change in personality or mood due to a hormonal change in the body Other Conditions • “Other’s” are not mental disorders, but one of the individuals involved may have a mental disorder that is not itself the focus of, and may or may not be related to the clinical attention