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Psychological Disorders: Part 2 Music: “Mad World” Gary Jules “Mad World” Tears for Fears (original) Today’s Agenda 1. Schizophrenic Disorders 2. Personality Disorders A) Symptoms B) Theories Paranoid Histrionic Narcissistic Antisocial / Borderline Obsessive-compulsive Dependent 3. Review Quiz 4. Movie: “The New State Asylums” (chapters 1, 3, and 5) available on the web http://www.pbs.org/wgbh/pages/frontline/shows/asylums/ 1. Schizophrenic Disorders Schizophrenia: “split mind” A) Symptoms: 1. Disorganized thinking Content is disturbed (e.g. delusions) Expression is bizarre (e.g. word salad) 2. Disturbed perceptions E.g. auditory hallucinations 3. Inappropriate emotions and actions E.g. Catatonic stupor, laughing inappropriately, speaking to imaginary people 4. Deterioration in adaptive functioning E.g. Neglect of personal hygiene, social withdrawal Prisons: The New State Asylums Frontline Show: http://www.pbs.org/wgbh/pages/frontline/shows/asylums/ Chapters 1, 3, and 5 were shown in class 2 multiple choice questions extracted from these segments will be on the final 1. b) Theories of Schizophrenia • Genetic Contribution: (p. 601) 1. b) Theories of Schizophrenia • Genetic Contribution: (p. 601) • • • But what is inherited? Excess dopamine: Evidence: • • Drugs that increase dopamine produce symptoms similar to schizophrenia Anti-psychotic drugs that decrease dopamine activity lessen schizophrenic symptoms • 14.18, p. 602 Prenatal Trauma p. 603 Integrated Model of Schizophrenia (p. 613) 2. Personality Disorders Definition: Inflexible, enduring patterns of behavior that create impairment in functioning or subjective distress DSM-IV has 3 categories: Cluster A: Odd-Eccentric Cluster B: Dramatic/Impulsive schizoid, schizotypal, paranoid histrionic, narcissistic, anti-social, borderline Cluster C: Anxious/Fearful dependent, obsessive-compulsive, avoidant 2. Personality Disorders: Paranoid: Pervasive suspiciousness, mistrust of people Guarded, cold, defensive Impairment in interpersonal relationships Histrionic: Theatrical, dramatic and expressive Needs to be center of attention; Uses physical appearance to draw attention Rapidly shifting, shallow emotions Somatization disorder 2. Personality disorders (cont’d) Narcissistic: Need for admiration/grandiose sense of selfimportance Entitlement to special treatment Fantasies of unlimited success Borderline: Instability in mood (e.g. intense anger) Identity disturbance (e.g. feelings of emptiness) Physically self-damaging acts (slashing wrists) Inability to be alone Intense and volatile relationships 2. Personality Disorders (cont’d) Antisocial: Antisocial behaviors; violate the rights of others without shame or regret Superficial charm but deceitful, using lies to con others Lack of anxiety and no sense of personal responsibility Onset before age 15 Most promising cause: Biological predisposition (limbic and frontal lobe abnormalities) Combined with neglect and abuse 2. Personality Disorders (cont’d) Obsessive-compulsive: Preoccupied with rules, details, organization Perfectionism that interferes with task completion Inflexible about matters of morality, ethics Excessive mental and interpersonal control Dependent: Unable to function independently Allow others to take responsibility for major areas of their lives Lack in self-confidence/ subordinates needs to those of others 3. Review Quiz For each case presented below, select a possible diagnosis according to the following choices: A) Social anxiety D) Hypochondriasis B) Obsessive Compulsive Disorder E) Somatoform Disorder C) Generalized anxiety disorder F) Agoraphobia Wesley has gone in for a psychiatric assessment. He tells the clinician the he has been feeling apprehensive an edgy for the last month, but so far his anxiety hasn’t interfered with his job or home life. Doris feels terrified every time she leaves her house, and avoids doing so whenever possible. Kate constantly thinks about jumping in front of an oncoming car when she is walking. The only way she seems to be able to stop these self-destructive thoughts is to say Mother Goose nursery rhymes over and over to herself. Laura takes over 40 different vitamins and herbal remedies each day to keep herself in top physical health. Recently she had some severe dizziness, but her family doctor assured her that is was just a minor ear infection that would clear up in a few days. Laura is concerned because she is sure the ear infection is the sign of something much more serious, such as a brain tumor, and she has made appointments with three different specialists to have more testing done. 3. Review Quiz (cont’d) For each case, select the most appropriate personality style: A) Narcissistic B) Dependent C) Obsessive Compulsive D) Borderline E) Histrionic F) Antisocial Sophia has always been preoccupied with schedules, lists, and trivial details. She plans everything sown to the last detail and becomes very upset if things don’t work out the way she has planned. In the past 9 months Andrew has been fired by three different employers. He was unreliable and often missed work, and each employer finally let him go when they found he had been stealing money and materials. Andrew feels no remorse over his actions, but he has managed to convince each of his former employers that he is sorry for his actions, and none plan to press any charges. Ellen is self-centered, immature, and excitable. She craves attention, especially from men, with whom she is flirtatious and seductive. Roy alternates between periods in which he remains motionless and seems oblivious to his environment, and periods of hyperactivity and frenzied excitement. He seems to be responding to voices in his head. 4. Movie See slide #4