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Psychological Disorders Definition, diagnosis and treatment Understanding psychological disorders through the ages • Ancient Greece: imbalance of the “four humours” – Treated with bloodletting & vomiting Understanding psychological disorders through the ages • Dark ages-Middle ages: devil or witchcraft – Treated with various tortures – Patients locked in asylums • Away from public • On display Understanding psychological disorders through the ages • 18th century: medical model of disease – Medical and social reforms • 20th century: biopsychosocial model of psychological disorders – Considers biological, psychological and sociocultural influences Classification of disorders • DSM-IV-TR - diagnostic manuals used by clinicians – Symptoms – Labels – Prognoses – Sample cases – Statistics What constitutes a disorder? • Behavior is ___________ • Behavior is ___________ • Behavior is ___________ Anxiety disorders • Characterized by feelings of excessive apprehension and anxiety – Generalized anxiety disorder – Phobic disorders – Panic disorder – Obsessive-compulsive disorder – Post-traumatic stress disorder Generalized Anxiety disorder • Symptoms - • Prevalence Phobic disorders • Persistent and irrational fears – Agoraphobia – Social phobias – Specific phobias • Acrophobia, claustrophobia, hemophobia, pyrophobia, triskadekaphobia, ophidiophobia, astraphobia, nyctophobia, aichmophobia, coulrophobia, trichophobia… Panic disorder • Panic attacks – Symptoms – Not: – May result in agoraphobia Obsessive-Compulsive disorder • Persistent obsessions and compulsions – Obsession = – Compulsion = Post-Traumatic Stress disorder • Result of severe trauma and emotional distress. – Symptoms – Lasting 4+ weeks • Relies on (lack of) emotional resilience Treatment for anxiety disorders • Biological – Antianxiety drugs – Antidepressant drugs • Cognitive – Cognitive-behavior therapy • Behavioral – Exposure therapy – Systematic desensitization Mood disorders • Disorders characterized by emotional extremes – Major depressive disorder – Bipolar disorder Major Depressive disorder • Overwhelming sadness, hopelessness and loss of interest – Symptoms • • • • Emotional Cognitive Motivational Somatic – Symptoms last 2+ weeks – Prevalence Bipolar disorder • Characterized by wide swings between two emotional extremes – Mania – Depression • Cyclic switching between moods Treatment for mood disorders • Biological – Antidepressants (depression) – Mood stabilizers (bipolar) – Electroconvulsive therapy (depression) – Deep-brain stimulation (depression) – Transcranial magnetic stimulation (depression) • Psychotherapy – Cognitive-behavioral therapy – Psychodynamic/Interpersonal therapy Dissociative disorders • Separation of conscious awareness from previous memories, thoughts and feelings – Dissociative identity disorder – Dissociative fugue Dissociative Identity disorder • Alternation between two or more distinct personalities – Symptoms Dissociative Fugue • Spontaneous break from personal identity – Symptoms – Results from recent psychological trauma Treatment for dissociative disorders • Psychotherapy • Antidepressants Personality disorders • Maladaptive behaviors which impair social functioning – Antisocial personality disorder – Borderline personality disorder Antisocial personality disorder • Marked by a lack of conscience and malicious behavior patterns – Symptoms – Prevalence Borderline personality disorder • Unstable personality, mood, identity and behavior – Symptoms – Prevalence Schizophrenia • Split from reality – Disorganization of thought, perceptions, emotions and behaviors Schizophrenia • Symptoms – Positive • Thought disorder • Hallucinations • Delusions – Negative • Flat affect • Lack of motivation • Decline in communication and interaction Schizophrenia • Dopamine hypothesis - excess of DA causes positive symptoms • Prenatal factors – Virus – Stress • Environmental or developmental factor influences onset Treatment for Schizophrenia • Biological – Antipsychotic drugs • Reduce dopamine • Long-term consequences • Behavioral – Operant conditioning • Token economy Resources • NSCC Counseling Center (TB 1650), (206) 527-3676 – individual, group, couples counseling, crisis counseling, walk-in, psychiatric consultation • Crisis Line: (206) 461-3222 – or 1(866)-4CRISIS – www.crisisclinic.org
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