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Chapter 9 Client Issues Model of Psychological Dysfunction • The part of the brain that identifies a lack of something we require is unconscious. • The neurons in that part of the brain register the lack as a need. • Neurotransmitters are sent to the conscious part of the brain and a feeling is then created. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 2 Model of Psychological Dysfunction • The feeling is processed with beliefs and perceptions that create an appraisal which is expressed as self talk. • That appraisal transforms the feeling into emotion which powers the action to meet the original need. • Neurotransmitters are then produced that stop the action. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 3 Model of Psychological Dysfunction • Three basic categories of client issues impact this process at different points. – Irrational beliefs are learned beliefs that are used to process feelings. – Adjustment issues arise due to changes in the world around us or in our ability to act on the world around us. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 4 Model of Psychological Dysfunction – Mental illness is the result of a disturbance in the production or concentration of the neurotransmitters which create feelings, thoughts, and perceptions. One in ten Americans has a mental disorder and one in five will develop a mental illness sometime during their lifetime. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 5 Psychiatric Disorders • Mental illness has a combination of genetic and environmental causes. • Physical illness and mental illness often occur together. Physical illness is easier to see and thus more often what is treated. • Diagnosis of an illness is a determination of what is wrong and relies on the identification of signs and symptoms. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 6 Psychiatric Disorders – Signs: differences that are objective such as temperature or blood pressure that can be identified without the patient’s participation – Symptoms: differences that are subjective such as dizziness or pain; they are felt by the patient but cannot be seen by the doctor • Once a diagnosis is made, providing treatment can sometimes be a challenge © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 7 Psychiatric Disorders • There are over four hundred types of mental disorders. • Five major categories are identified: – Disorders diagnosed during childhood – Organic mental disorders – Substance-related disorders – Mood disorders and personality disorders – Schizophrenia and other psychotic disorders © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 8 Psychiatric Disorders • Disorders usually Diagnosed in Childhood: presents for a very strong genetic connection which is expressed as the child begins to develop, such as: – Attention deficit disorder – Autism – Mental retardation © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 9 Psychiatric Disorders • Attention Deficit/Hyperactive Disorder: there are three forms of ADHD: – ADD, attention deficit disorder, is the inability to pay attention. – HD, hyperactivity disorder, is being hyperactive and impulsive. – ADHD, attention deficit hyperactive disorder, is a combination of the two. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 10 Psychiatric Disorders • Autism These children are unable to mentally process information from the body language, gestures, facial expression or tone of voice of other people. • Mental Retardation is based on a combination of IQ scores in areas such as self-care, safety, home living, social skills, and communication © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 11 Psychiatric Disorders • Organic Mental Disorders: are temporary or permanent dysfunctions of brain tissue caused by chemicals or disease, such as: – Alzheimer’s Disease: disease of the aging, cause is unknown and as of today there is no cure; symptoms become worse over the course of five to ten years © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 12 Psychiatric Disorders – Dementia: a normal decline in brain function that affects many mental abilities – Delirium: a syndrome produced by recent brain or mental dysfunction – Amnesia: a disturbance of memory; may be temporary, permanent, or unpredictable and may begin suddenly or very gradually © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 13 Psychiatric Disorders • Types of Amnesia: – Anterograde amnesia – Retrograde amnesia – Traumatic amnesia – Korsakoff’s syndrome – Alzheimer’s disease – Dissociative amnesia – Dissociative fugue – Blackout (anterograde amnesia) © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 14 Psychiatric Disorders • Substance-Related Disorders Drugs have such a powerful affect on our society because they have such a powerful affect on individuals. • Categories of drugs: – Alcohol: depresses the CNS – Marijuana: produces relaxation and euphoria © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 15 Psychiatric Disorders – Opiates produce pain reduction, constipation and powerful euphoria. – Hallucinogens produce hallucinations: sensory, perceptual, and cognitive. – Sedatives depress the CNS and induce sleep. – Stimulants increase activity of the CNS, decrease fatigue, increase alertness and arousal, and can include euphoria © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 16 Psychiatric Disorders • Mood Disorders: long lasting disturbances in emotions that strongly affect feelings, thoughts, and behaviors • Types of Mood Disorders include; – Major Depressive Disorder-MDD: clinical depression that lasts about two weeks – Bipolar Spectrum Disorder: alternating major depressive and manic episodes with periods of normal functioning in between © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 17 Psychiatric Disorders – Anxiety Disorders produce worry with irrational fears and apprehensions that at times escalate to terror. • Types of Anxiety Disorders: – Generalized AD: excessive or unrealistic worry about almost everything – Phobia: fearful response to danger – Panic D: recurrent and unexpected panic © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 18 Psychiatric Disorders – Posttraumatic stress disorder: anxiety caused by a life threatening event that shatters the sense of being able to control a situation and stay safe and secure – Obsessive-compulsive disorder: obsessive, unwanted, and uncontrollable thoughts, impulses, or images that intrude repeatedly and suppress normal thoughts and actions © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 19 Psychiatric Disorders • Personality Disorders: sets of enduring traits that shape behaviors that seriously impair functioning or cause severe distress in a person’s personal and social life • Personality disorders come from a combination of genetic, environmental, psychological, and social factors. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 20 Psychiatric Disorders • Types of Personality Disorders include; – Paranoid PD: a consistent pattern of mistrust and suspicion with the perception that others around them have sinister intentions – Schizotypical PD: deep mistrust of others and extreme anxiety in close relationships – Histrionic PD: pervasive and excessively emotional pattern of attention seeking © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 21 Psychiatric Disorders – Dependent PD: excessive need to be taken care of by others – Antisocial PD: about 3% of people, most often men, who disregard or violate the rights or property of others – Schizophrenia: a serious mental disorder that produces symptoms that interfere with personal/social functioning © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 22 Psychiatric Disorders • Types of Schizophrenia include; – Paranoid: a person may hear voices telling them to do things or have delusions – Disorganized: marked by bizarre ideas and behavior with powerful mood swings – Catatonic: a person may sit rigid and unresponsive for hours or have periods of wild excitement and activity © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 23 Summary • Irrational beliefs begin as learned beliefs that are used to process feelings. • Adjustment issues arise due to changes in the world around us or in our ability to act on the world around us. • Individuals can hold onto beliefs with an array of defense mechanisms. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 24 Summary • Mental illness is the result of a faulty disturbance in the brain combined with genetic and environmental causes. • Physical illness and mental illness often occur together and can confuse diagnosis, decrease compliance, and complicate care. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 25 Summary • There are five major categories identified for mental disorders: – Disorders identified in childhood – Organic mental disorders – Substance-related disorders – Mood disorders and Personality disorders – Schizophrenia and other Psychotic disorders © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 26 Summary • The health care provider needs to have an understanding of mental illness. • Be tolerant of the range, intensity, and unpredictable nature of the illness. • Give support to the client and any family members involved. • Remain professional at all times. © Copyright 2009 Delmar, Cengage Learning. All Rights Reserved. 27