Download Chapter 14, Psych Disorders

Psychological Disorders
• Psychological disorders are
behavior patterns or mental
processes that cause serious
personal suffering or interfere with
a person’s ability to cope with
everyday life.
• Estimates suggest that almost
one third of adults in the U.S.
have experienced some type of
psychological disorder.
• People with psychological
disorders do not differ very much
from people who are “normal”.
The primary difference is the
simple exaggeration of certain
behaviors or mental process.
• Psychologists generally use
several criteria to determine
whether a person’s behavior
indicates the presence of a
psychological disorder:
• 1. Typicality – how normal is this
behavior in society?
• 2. Maladaptivity – does the
behavior impair an individual’s
ability to function adequately in
everyday life or is it hazardous to
one’s health?
• 3. Emotional Discomfort – are
there feelings such as
hopelessness, helplessness, guilt,
extreme sadness?
• 4. Socially Unacceptable
Behavior – does the behavior
violate society’s accepted norms?
• The importance of culture is
demonstrated by culture-bound
syndromes, clusters of symptoms
that describe an illness.
• It is important to classify
psychological disorders so that
individuals can be correctly
diagnosed and treated.
• The most widely used
classification system for
psychological disorders is the
DSM, or Diagnostic and Statistical
Manual of Mental Disorders,
published by the American
Psychiatric Association. The
DSM-IV, published in 1994,
recognized 18 different categories
of psychological disorders.
• Until 1980, psychological
disorders were classified on the
basis of their presumed causes.
(Most suggested by Freud’s
psychoanalytic theory.) Many
were grouped together under the
labels “neuroses” and
“psychoses”.
• Since 1980, they are categorized
on the basis of observable signs
and symptoms rather than
presumed causes.
• Anxiety refers to a general state
of dread or uneasiness that
occurs in response to a vague or
imagined danger.
• It is typically characterized by
nervousness, inability to relax,
and concern about losing control.
• Physical signs may include
trembling, sweating, rapid heart
rate, shortness of breath,
increased blood pressure, flushed
face, and feelings of faintness
and light-headedness.
• Some people feel anxious all the
time, or anxiety is out of
proportion with what is causing it.
• When it interferes with effective
living, the achievement of desired
goals, life satisfaction, and
emotional comfort, it is
considered a sign of a
psychological disorder.
• Types of Anxiety Disorders:
• 1. Phobic Disorder
• a. simple phobia – refers to a
persistent, excessive or irrational
fear of a particular object or
situation.
• b. social phobia – characterized by
persistent fear of social situations in
which one might be exposed to the
close scrutiny of others and thus be
observed doing something
embarrassing or humiliating.
• 2. Panic Disorder and Agoraphobia –
People with panic disorders have
recurring and unexpected panic
attacks that may last from a few
minutes to a few hours.
• Many who suffer from panic
attacks also have agoraphobia
and may be especially afraid of
crowded public places such as
movie theaters, shopping malls,
buses, or trains.
• One or both of these disorders
make up about 50 to 80 percent
of the phobic individuals seen in
clinical practice.
• 3. Generalized Anxiety Disorder –
This is an excessive or unrealistic
worry about life circumstances
that lasts for at least six months.
Typically, the worries focus on
finances, work, interpersonal
problems, accidents, or illness.
• GAD is one of most common
disorders, but few people seek
treatment because it does not
differ, except in intensity and
duration, from the “normal”
anxiety of everyday life. Many
people with GAD have other
disorders as well, often phobias.
• 4. Obsessive-Compulsive
Disorder – Obsessions are often
senseless or repulsive, and most
people with obsessions try to
ignore or suppress them.
• People who experience
obsessions are usually aware that
the obsessions are unjustified.
(Thus, they are not delusions.)
• Obsessions can make people feel
extremely anxious, and they can
seriously interfere with daily life.
• Compulsions may alleviate
anxiety, but the compulsions
themselves are time-consuming
and usually create additional
interference with daily life.
• 5. Stress Disorders – include
post-traumatic stress disorder
(PTSD) and acute stress disorder
• They have similar symptoms, but
differ in how quickly they occur
after the traumatic event that
triggers the disorder and in how
long they last.
• PTSD refers to intense, persistent
feelings of anxiety that are caused by
an experience so traumatic that it
would produce stress in almost
anyone.
• Symptoms include flashbacks,
nightmares, avoidance of stimuli
associated w/trauma, sleep
disturbances, & irritability. They can
occur six months or more after the
traumatic event, and they last for
years or even decades.
• Acute stress disorder is a shortterm disorder with symptoms
similar to those of PTSD. It also
follows a traumatic event, but the
symptoms occur immediately or
at most, within a month of the
event. The anxiety lasts a shorter
time.
• Not everyone who experiences a
trauma will develop one of these
disorders.
• Dissociative Disorders
• Dissociative Amnesia –
characterized by sudden loss of
memory, usually following a
particularly stressful or traumatic
event. The person usually forgets
any events that occurred for a
certain period of time surrounding
the traumatic event.
• Less commonly, the person may
forget all prior experiences, even
their name and family & friends.
May persist for hours or years.
Memory is likely to return just as
suddenly as it was lost and it
rarely recurs.
• Dissociative Fugue – characterized
by not only forgetting personal
information and past events, but
also by suddenly relocating from
home or work and taking on a new
identity.
• It usually follows a traumatic event
and when the fugue comes to an
end, the person no longer
remembers what happened during
the fugue state.
• Dissociative Identity Disorder –
involves the existence of two or more
personalities within a single
individual, usually due to severe
childhood abuse or other types of
trauma.
• The various personalities may or may
not be aware of the others, and at
least two of the personalities take
turns controlling the individual’s
behavior.
• Each personality is likely to be
different from the others,
including voice, facial
expressions, and handedness,
as well as self-perceived age,
gender, and physical
characteristics. The
personalities may even have
different allergies and eyeglass
prescriptions.
• Depersonalization Disorder –
refers to feelings of detachment
from one’s mental processes or
body. People feel “outside” of
their bodies. It is a common
symptom of other psychological
disorders as well as being a
disorder in its own right.
• SOMATOFORM DISORDERS
• Somatoform comes from the
Greek word, soma, meaning
body. Somatization is the
expression of psychological
distress through physical
symptoms.
• People with somatoform disorders
have psychological problems but
experience inexplicable physical
symptoms.
• They do not intentionally fake an
illness (malingering), but honestly
feel pain or believe they cannot
move their limbs.
• 1. Conversion Disorder – People
experience a change in or loss
of physical functioning in a major
part of the body for which there
is no medical explanation.
• It is further complicated in many
cases by the person’s little
concern about the symptoms.
• 2. Hypochondriasis – Also called
hypochondria, this is defined as
a person’s unrealistic
preoccupation with the fear that
he or she has a serious disease.
• They become absorbed by minor
physical symptoms and
sensations, convinced that there
is a serious medical illness.
• MOOD DISORDERS
• Major Depression – Major
depression is diagnosed when
an individual experiences at
least five of the following nine
symptoms (at least one has to
be from the first two on the list):
• Persistent depressed mood for
most of the day
• Loss of interest or pleasure in all,
or almost all activities
• Significant weight loss or gain due
to changes in appetite
• Sleeping more or less than usual
• Speeding up or slowing down of
physical and emotional reactions
• Fatigue or loss of energy
• Feelings of worthlessness or
unfounded guilt
• Reduced ability to concentrate or
make meaningful decisions
• Recurrent thoughts of death or
suicide
• Bipolar Disorder – characterized
by ups and downs in mood.
(manic depression) Periods of
mania can change into
depression very quickly and for
no apparent reason.
• Manic moods can be characterized
by elation or irritation. They can
also have at least some of the
following traits:
– Inflated self-esteem
– Inability to sit still or sleep restfully
– Pressure to keep talking and
switching from topic to topic
– Racing thoughts
– Difficulty concentrating
• People in the manic phase can
experience delusions or
hallucinations and can also
engage in impulsive behaviors.
• SCHIZOPHRENIA
• This is usually considered the
most serious psychological
disorder and is characterized by a
loss of contact with reality.
• It usually appears in early
adulthood, but can be brought on
at any age and becomes worse
over time.
• The most obvious symptoms are
hallucinations, delusions, and
thought disorders. Most
hallucinations are auditory.
• There may be delusions of grandeur
or of persecution. Thought disorders
involve problems in the organization
or the content of mental processes.
• Thoughts can skip from topic to topic.
People may repeat the same word
over and over again, or invent new
words. Some people may even go
into a catatonic stupor.
• PERSONALITY DISORDER
• These are patterns of inflexible
traits that disrupt social life or
work and/or distress the affected
individual. They usually show up
late in adolescence and affect all
aspects of the individual’s
personality, including thought
processes, emotions, and
behavior.
• 1. Paranoid Personality Disorder –
People with this tend to be
distrustful and suspicious of others
and to interpret others’ motives as
harmful or evil. They are difficult to
get along with and are usually
considered argumentative, cold, and
aloof. Their view of reality is
distorted and they are unlikely to
see their mistrust and suspicions as
abnormal.
• 2. Schizoid Personality Disorder
– People who suffer from this
have no interest in relationships
with other people and lack
normal emotional responses.
They stay in touch with reality
(unlike schizophrenics), but do
not develop attachments for
other people.
• 3. Antisocial Personality
Disorder – People with this show
a persistent behavior pattern of
disregarding and violating the
rights of others. They do not feel
guilt or remorse for their
behaviors and continue despite
the threat of punishment.
• 4. Avoidant Personality Disorder
– These people desire
relationships with others, but are
hindered by tremendous fear of
the disapproval of others. They
are shy and withdrawn.