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Psychological Disorders An Introduction Stolen from www.appsychology.com What is a Psychological Disorder? • A “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable. All this depends on: •Culture Is playing video games 5 hours per day a disorder? •Time Period •Environmental Conditions •Individual Person Early Theories • Afflicted people were possessed by evil spirits. Early Theories • Music or singing was often used to chase away spirits. •In some cases trephening was used: Cutting a hole in the head to let out evil spirit. Trephening Early Theories • Another theory was to make the body extremely uncomfortable. History of Mental Disorders • In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill. They were first put in hospitals. Did this mean better treatment? Early Mental Hospitals • They were nothing more than barbaric prisons. •The patients were chained and locked away. •Some hospitals even charged admission for the public to see the “crazies”, just like a zoo. Philippe Pinel • French doctor - first to say these people aren’t mad – they are sick. Pinel ordering chains taken off At women’s asylum in France Explaining Mental Disorders? • Medical Perspective: psychological disorders are sicknesses and can be diagnosed, treated and cured. Current Perspectives • Bio-Psycho-Social Perspective: assumes biological, psychological and sociocultural factors combine to interact causing psychological disorders. Used to be called Diathesis-Stress Model: diathesis meaning predisposition and stress meaning environment. Classifying Psychological Disorders • What is the DSMIV? Diagnostic Statistical Manual of Mental Disorders: the book to classify mental disorders Two Major Classifications: Two Major Classifications in the DSM Neurotic Disorders • Distressing but one can still function in society and act rationally. Psychotic Disorders • Person loses contact with reality, experiences distorted perceptions. John Wayne Gacy What is a delusion? A delusion is a false belief. Ex: Obama is trying to kill my dog. Ex: I’m going to UM even though my GPA is .75 Ex: She’ll be back; she loves me (When she doesn’t) What is a hallucination? • Hearing things; seeing things (that aren’t there) • People with schizophrenia, psychotic depression, and drug induced states have these. Personality Disorders Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning. Personality Disorders • • • • • • • • Paranoid Antisocial Borderline Histrionic Narscisstic Schizoid Avoidant dependent Paranoid Personality Disorder • Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives. Everyone is out to get you. Paranoid Personality Disorder • They search for hidden meanings in everything and read hostile intentions into the actions of others. •They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges. Antisocial Personality Disorder • antisocial personality disorder is characterized by a lack of conscience •People with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of. They tend to lie and steal Antisocial Personality Disorder • they are careless with money and take action without thinking about consequences They are often aggressive and are much more concerned with their own needs than the needs of others. • Antisocial does NOT mean introverted!!! Antisocial behavior Borderline Personality Disorder • characterized by mood instability and poor self-image “I hate you. Get away! . . . Why did you leave me asshole?!” Borderline Personality Disorder • they will take their anger out on themselves, causing themselves injury Suicidal threats and actions are not uncommon They are quick to anger when their expectations are not met. Histrionic Personality Disorder • constant attention seekers They need to be the center of attention all the time, often interrupting others in order to dominate the conversation. Histrionic Personality Disorder • They may dress provocatively or exaggerate illnesses in order to gain attention. They also tend to exaggerate friendships and relationships, believing that everyone loves them Narcissistic Personality Disorder • characterized by selfcenteredness They exaggerate their achievements, expecting others to recognize them as being superior Narcissistic Personality Disorder They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend. They are generally uninterested in the feelings of others and may take advantage of them. Schizoid Personality Disorder • People with schizoid personality disorder avoid relationships and do not show much emotion They genuinely prefer to be alone and do not secretly wish for popularity. Schizoid Personality Disorder They tend to seek jobs that require little social contact Their social skills are often weak and they do not show a need for attention or acceptance Often are termed "loners." Avoidant personality disorder characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation. consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed or humiliated. Remember! • Schizoid – prefers to be alone • Avoidant – would rather have friends but has a social phobia Dependent personality disorder • characterized by a pervasive psychological dependence on other people. • has difficulty making everyday decisions without an excessive amount of advice and reassurance from others Obsessive –Compulsive Personality Disorder • Overly concerned with certain thoughts and performing certain behaviors. • OCPD makes you annoying. • OCD makes you dysfunctional OCPD behavior • 4. Psychotic disorders frequently involve perceptions of nonexistent sensory stimulation, such as voices. Symptoms such as these are called • a. delusions • b. paraphilias • c. hallucinations • d. paranormal images • e. psychic phenomena DSM stands for a. diagnostic schedule of medicine b. diagnostic and statistical manual c. depressive scale modalities d. doctor of surgical medicine • Bob has never met Madonna but he is convinced that she is deeply in love with him. Bob is suffering from • a. grandiose delusions • b. jealous delusions • c. obsessive-compulsive disorder • d. erotomatic delusions Retreat from reality by hallucinations and delusions and by social withdrawal typically characterizes ______ disorders a. somatoform b. anxiety c. psychotic d. personality Discomfort in social situations, fear of evaluation and timidity are characteristic of what personality disorder? • a. histrionic b. obsessive-compulsive • c. schizoid d. avoidant • Sensory experiences that occur in the absence of a stimulus are called • a. illusions b. hallucinations • c. delusions d. affect episodes What are Mood Disorders? • Dysthymic Disorder • Major Depressive Disorder •Seasonal Affective Disorder •Bipolar Disorder Depression Depression Major Depressive Disorder • A person, for no apparent reason, experiences two or more weeks of depressive moods. Includes feelings of worthlessness and diminished interest or pleasure in most activities. Dysthymic Disorder • Suffering from mild depression every day for at least two years. Seasonal Affective Disorder Bipolar Disorder • Person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. Famous People with Bipolar Bipolar Brain Serotonin Norepinephrine Increases arousal and boosts moods. Suicide Suicide Eating disorders • Anorexia – starving yourself • Bulimia – binging and purging • Both deal with poor self image and • possibly body dysmorphic disorder Anxiety Disorders a group of conditions where the primary symptoms are anxiety or defenses against anxiety. the patient fears something awful will happen to them. Are anxiety disorders a neurosis or psychosis.? Anxiety disorders? • • • • GAD – generalized anxiety disorder Panic disorder – Phobias OCD – obsessive compulsive disorder What is anxiety? • is a state of intense apprehension, uneasiness, uncertainty, or fear. Generalized Anxiety Disorder • An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal. The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia. Panic Disorder • An anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations. • Chest pains, hyperventilating Can cause secondary disorders, such as agoraphobia. Phobias • A person experiences sudden episodes of intense dread. Common phobias • Agoraphobia – fear of leaving house and open spaces • Arachnophobia – fear of spiders • Claustrophobia – fear of closed in spaces • Acrophobia – fear of heights • Social phobias • Pteromerhanophobia – fear of flying Obsessive Compulsive Disorder • An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions). Common Examples of OCD Common Obsessions: Common Compulsions: Contamination fears of germs, dirt, etc. Washing Imagining having harmed self or others Repeating Imagining losing control of aggressive urges Checking Intrusive sexual thoughts or urges Touching Excessive religious or moral doubt Counting Forbidden thoughts Ordering/arranging A need to have things "just so" Hoarding or saving A need to tell, ask, confess Praying Explanations for Anxiety Disorders • You Learn them through conditioning. •Evolution •Genes •Physiology (the brain) • 5. Intense artificial light is most successfully used as therapy for • a. disorganized (hebephrenic) schizophrenia • b. seasonal affective disorder • c. bipolar disorder • d. panic disorder • 4. Persistent repetitive thoughts that cannot be controlled are known as • a. compulsions • b. obsessions • c. phobias • d. delusions • e. sublimations • Along with _________, abnormalities in neural circuits that use __________ have recently been implicated in panic and obsessive-compulsive disorders. • a. dopamine; androgen • b. acetylcholine; cortisol • c. GABA; serotonin • d. endorphins; epinephrine • e. glutamate; thyroxine Dissociative Disorders What are dissociative disorders? DID – dissociative identity disorder Dissociative amnesia (like Freud’s repression) Dissociative fugue Think of the word “associate.” Dissociative is like not associating yourself with yourself. What are dissociative disorders? • Dissociative fuge • Dissociative amnesia • Dissociative identity disorder Dissociative Disorders • Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings. Dissociative Amnesia • This disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature. Dissociative Amnesia • Dissociative amnesia, unlike other types of amnesia, does NOT result from other medical trauma (e.g. a blow to the head). Dissociative Amnesia • Localized amnesia is present in an individual who has no memory of specific events that took place, usually traumatic. The loss of memory is localized with a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia. • Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time. For example, an abuse victim may recall only some parts of the series of events around the abuse. • Generalized amnesia is diagnosed when a person's amnesia encompasses his or her entire life. • Systematized amnesia is characterized by a loss of memory for a specific category of information. A person with this disorder might, for example, be missing all memories about one specific family member. Dissociative Fugue • An individual with dissociative fugue suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind. •These journeys can last hours, or even several days or months. Dissociative Fugue • Individuals experiencing a dissociative fugue have traveled over thousands of miles. An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception). Dissociative Identity Disorder • A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. •was known as multiple personality disorder. Somatoform disorders • Soma = body • Physical illnesses caused by the mind • ex: conversion disorder – significant loss of bodily function with no physical cause • Ex: hysterical blindness – blindness after traumatic event (no physical cause) • Hysterical pregnancy – • Hypochondriasis – • 2. A conversion disorder is most closely associated with which more general type of disorder? • a. dissociative • b. adjustment • c. somatoform • d. factitious • e. mood • 7. A man who experiences sudden blindness on witnessing the death of his wife is probably suffering from • a. type of paraphilia • b. psychosis • c. multiple personality disorder • d. panic disorder • e. conversion disorder • 6. Phobic and panic disturbances are examples of which of the following kinds of disorder? • a. Personality • b. Somatoform • c. Schizophrenic • d. Dissociative • e. Anxiety Schizophrenia How Prevalent? • About 1 in every 100 people are diagnosed with schizophrenia. Symptoms of Schizophrenia • Disorganized thinking. •Disturbed Perceptions •Inappropriate Emotions and Actions Disorganized Thinking • The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs. •Disorganized thinking comes from a breakdown in selective attention.they cannot filter out information. Often causes……… Delusions (false beliefs) • Delusions of Persecution • Delusions of Grandeur Disturbed Perceptions • hallucinations- sensory experiences without sensory stimulation. Inappropriate Emotions and Actions • Laugh at inappropriate times. • Flat Effect (no emotion) • Senseless, compulsive acts. • Catatonia- motionless Waxy Flexibility Positive v. Negative Symptoms Positive Symptoms • Presence of inappropriate symptoms Negative Symptoms • Absence of appropriate ones. Types of Schizophrenia Paranoid Schizophrenia • preoccupation with delusions or hallucinations. • Somebody is out to get me!!!! Disorganized Schizophrenia disorganized speech or behavior, or flat or inappropriate emotion. Flat effect – no emotion Catatonic Schizophrenia • parrot like repeating of another’s speech and movements Undifferentiated Schizophrenia • Many and varied Symptoms. • 1 A person who seeks therapy form a clinical psychologist because she is tense, has difficulty sitting still, and is continually worried about the future is suffering from a/an ____________________ disorder. • • • • • A) anxiety B) panic C) obsessive-compulsive D) somatoform • 2 A college student seeks help from the counseling center because he is experiencing frequent episodes during which he becomes very fearful, or even terrified, often for no apparent reason. A likely diagnosis for this student's problem is ___________. • A) phobic • B) dysthymic • C) panic • D) conversion • 3 A person who has developed such an intense fear of insects that she rarely leaves her apartment has developed a _______________ disorder. • A) panic • B) post-traumatic stress • C) bipolar • D) phobic • 4. A student visits the student health service several times each week complaining of severe stomach pain, but no physical cause of his symptoms can be found. The student is experiencing a __________ disorder. • A) panic • B) bipolar • C) somatoform • D) dissociative • 5. A young man found wandering the streets of his hometown claimed that he did not know his name or where he lived. He was taken to a hospital for examination, but no physical injuries were found. After several days in the hospital, he awoke and remembered that he had had an argument with his parents that included threats of physical violence on both sides. In order to escape this stressful situation, the young man developed ____________________. • • • • A) dissociative amnesia B) learned helplessness C) agoraphobia D) catatonic schiziophrenia • 6 A middle-aged woman did not return from a shopping trip one day and was not found until the police located her in another city three months later. Formerly a restaurant owner, she was working as a server in a restaurant and had just been promoted to a supervisory role. She had rented an apartment and was engaged to be married. This behavior is an example of ____________________. • A) paranoid schizophrenia • B) post-traumatic stress disorder • C) dissociative fugue • D) bipolar disorder • 7. A psychologist who spends most of his time treating people suffering from depression and bipolar disorders focuses on ____________________. • A) phobic disorders • B) somatoform disorders • C) dissociative disorders • D) mood disorders • 8 A college student seen by a counseling psychologist stated that he had cut almost all his classes during the past two weeks, had experienced difficulty sleeping, and felt like his academic situation was hopeless. The psychologist's diagnosis would be _____________________. • A) dissociative disorder • B) major depressive disorder • C) undifferentiated schizophrenia • D) bipolar disorder • 9. After being depressed for two years following her divorce, a middle-aged woman makes an appointment with a clinical psychologist. She tells the psychologist that in addition to her mood, she lost weight and has never felt happy for more than a week during this time. The psychologist's diagnosis would be ____________________, • A) bipolar disorder • B) major depressive disorder • C) paranoid schizophrenia • D) dysthymic disorder • 10. For the past two weeks, a realtor has been so depressed that she can barely make the effort to show houses to prospective buyers. However, this period of depression was preceded by a similar period when her energy and enthusiasm enabled her to sell several houses. She is consulting a clinical psychologist because this is a recurring behavior pattern. The psychologist's diagnosis will be ______________________. • A) major depressive disorder • B) hypochondriasis • C) bipolar disorder • D) panic disorder • 11. Because of his age, a man in late middle age has been unable to find a permanent job since being laid off by his employer three years ago. During this time, he has had to sell many of his possessions and has been unable to provide the medical care his wife requires. He is referred to a clinical psychologist because he is apathetic and tells people that he can do nothing about his situation. This behavior is an example of ____________________. • A) learned helplessness • B) post-traumatic stress disorder • C) catatonic schizophrenia • D) antisocial personality disorder • 12. A psychologist who bases his diagnosis of a man's mental disorder primarily on the presence of hallucinations and delusions is making a diagnosis of ____________________. • A) phobic disorder • B) mood disorder • C) dysthymia • D) schizophrenia • 13. A man believes that his escape from a house destroyed by a tornado was a message that he has a special mission in life to advise the president about religious matters. He has been referred to a clinical psychologist because he believes that people opposed to his views are attempting to kill him in order to keep him from expressing them. The psychologist diagnosis would be ________________ schizophrenia. • A) catatonic • B) disorganized • C) paranoid • D) undifferentiated • 14. A clinical psychologist is treating a man whose behavior includes hallucinations, delusions, and incoherent speech and mannerisms. However, the man's behavior does not clearly fit a particular type of schizophrenia. The man's behavior is an example of _______________ schizophrenia. • A) catatonic • B) disorganized • C) paranoid • D) undifferentiated • 15. A clinical psychologist explains his diagnosis of paranoid schizophrenia to a client's family by stating that the client had a genetic predisposition to develop the disorder and that the stress of losing her job was probably the precipitating event. The psychologist's explanation is based on _______________. • A) the diathesis-stress view • B) learned helplessness • C) an insanity defense • D) DSM-IV • 8. Bernice says “I am the ruler of Xylomek and have come to your planet to marry my long time lover, who has been communicating to me through television waves,” Bernice is most likely • a. engaging in word salad • b. delusional • c. hallucinating • d. exhibiting multiple personalities