Download Ch 12

Histrionics
Obsessive- Schizophrenia
Dissociative
Compulsive
Disorder
Bipolar or Manic-Depressive Borderline Personality
Disorder
disorder
Here are your chapter project
options about psychological
disorders.
Go to http://psimonciniohs.net/
and write a report on any of the topics
listed for this chapter.
Observe the following film clip from
the commercial film, Patch Adams.
Watch the characters. List what ever
behaviors exhibited by them that you
consider to be abnormal. Be prepared
to discuss them.
15.4% of the population suffers
from diagnosable mental health
problems
Any year: 56 million Americans meet the
criteria for a diagnosable psychological
disorder;
Over the lifespan, 32% of Americans will
suffer from some psychological disorder
Definitions of Abnormal Behavior
Any deviation from the average
or the majority
Failure to adjust to the rules of
society: physically, emotionally,
and socially
Thomas Szasz (1984): people who
have problems “living”—serious
conflicts with the world around
them
Three Classic Symptoms of Severe
Psychopathology
Hallucinations
Delusions
Affect
The Spectrum of Mental Disorder
No
Disorder
Mild
Disorder
Moderate
Disorder
Severe
Disorder
Clear
Few
Indicators
signs
signs
ofsigns
ofdisorder
distress
psychological
or
areother
more
disorder,
Absence
ofof
of psychological
pronounced
which
dominate
the
occur
person’s
more
life
indicators
of and
psychological
disorder
disorder
frequently
Severe
and
frequent
behavior
Few
behavior
problems;
responses
Absence
of behavior
problems
More
distinct
behavior
problems;
behavior
is problems;
usually
usually
appropriate
to
the situation
No
problems
with
interpersonal
behavior
inappropriate
is often
towith
the
inappropriate
situation to
Few
difficulties
relationships
relationships
the situation
Many
poor relationships or lack of
More
frequentwith
difficulties
relationships
others with
relationships
Hippocrates and the 4 humors
Blood (heart—sanguine or
cheerful)
Phlegm (mucus from brain—sluggish)
Black bile (spleen—melancholy)
Yellow bile (liver—angry or choleric)
Asylum Movement
Political pressures eventually turned
the initially therapeutic asylums into
overcrowded warehouses of neglect
Weaknesses in medical model
Assumption of disease leads to a doctorknows-best approach; therapist takes all
responsibility for diagnosing the illness and
prescribing treatment. The patient may
become passive and dependent on the
doctor
Social-cognitive-behavioral approach
Cognitive: looks inward, emphasizing mental
processes;
Behaviorism: looks outward, emphasizing
the influence of the environment
The two now seen as complementary
Behaviorism and abnormal behaviors
Acquired through behavioral learning
Behavior and environmental conditions
(rewards and punishments)
Cognitive and abnormal behaviors
Also consider how people perceive themselves and their relations with others
Cognitive variables: whether people believe
they have control over their lives; how they
cope with stress and threat; do they attribute
behavior to situational or personal factors?
Albert Bandura: Reciprocal Determinism
Proposes that behavior,
cognition, and social/ environmental all influence each other
A fear of public speaking can be
understood as a
product of behavioral
learning, cognitive
learning, and social
learning
Modern research and the brain
It is a complex organ whose mental
functions depend on a delicate balance of
chemicals and ever-changing circuits
Subtle alterations can profoundly alter
thoughts and behaviors
Subtle signs that may also indicate
psychological disturbances
Distress: prolonged levels of unease or anxiety
Maladaptiveness:
acts in a way that
makes others fearful
or interfere with his
or her well-being
Irrationality: act or talk in ways
that are irrational or incomprehensible to others; inappropriate
behavior or emotional responses
Subtle signs that may also indicate
psychological disturbances
Unpredictability: behave
erratically and inconsistently at
different times or from one
situation to another
Unconventionality and
undesirable behavior: behave
in ways that are statistically
rare and violate social norms
of what is legally or morally
acceptable or desirable
Classifying Emotional Disorders
Challenges in doing so
1952: American Psychiatric Assn.
agreed on a standard system for
classifying abnormal symptoms,
published in the:
Diagnostic And Statistical Manual
For Mental Disorders (DSM)
4+ versions; latest update: DSM-IV-TR
2000 (1994)
In this chapter we shall be
discussing psychological
disorders. But please be
careful to avoid. . .
Medical
Students’
Disease
Helps psychologists
look at the entire
person as they make
evaluations.
Process called:
multiaxial diagnosis—
professionals consider
not only abnormal
behavior, but also
general medical
conditions
Classifying Emotional Disorders
Five axes, or dimensions
Axis I: classifies current symptoms into
explicitly defined categories
Axis II: describes developmental disorders and long-standing personality
disorders or maladaptive traits (compulssiveness, over-dependency, etc.)
Axis III: physical disorders or general
medical conditions that are potentially
relevant to understanding or caring
for a person (brain damage)
Classifying Emotional Disorders
Five axes, or dimensions
Axis IV: a measurement of the current
stress level at which the person is
functioning (a rating of stressors based
on what the individual has experienced
in the past year)
Axis V: describes the highest level of
adaptive functioning present within
the past year (social relations,
occupational functioning, use of
leisure time)
Oh noooooooo:
Here’s a homework
assignment.
Try one of the
following behaviors.
Observe/record
peoples’ reactions.
Shake hands; hold longer/normal
Eye contact > 10 seconds from afar
“Why do you want to know?”
Before 1980: neurosis and psychosis
were the most commonly used
diagnostic distinctions
Now those terms have been replaced
by more specific terms
Neurosis: now called a disorder
Psychosis: loss of contact with reality
We shall now study those specific terms
Somatoform
Dissociative
Anxiety
Mood
Schizophrenia
Disorders
disorders
Disorders
Disorders
I’m obviously in a BAD
mood. Would someone
please give us the
definition of mood
disorders?
As someone who suffers from
shifts in moods, here goes:
abnormal disturbances in
emotion or mood.
Major Depressive Disorder
Individuals suffering from
this disorder spend at
least two weeks feeling
depressed, sad, anxious,
fatigued, and agitated,
experiencing a reduced ability to
function and interact with others.
Cannot be attributed to bereavement
Major Depressive Disorder
Marked by at least 4 of
following: problems eating,
sleeping, thinking,
concentrating, decision
making; lacking energy;
thinking about suicide; and feeling
worthless or guilty.
Associated with low levels of serotonin
Martin Seligman: depression
is the common cold of
psychological disorders
Almost everyone has
suffered from some sort of
depression
In the U. S. depression accounts for the
majority of all mental hospital admissions—
Still believed to be under-diagnosed and
under-treated
$43 Billion a year in the U.S.
Depression-Suicide Linkage
Suicide claims 1 in 50 depression
sufferers
Suicide is a greater risk when a
depressed person is on the way down
in a depressive episode
In the depths of a
depressive episode,
usually no energy or
will to do anything,
much less suicide
Seasonal Affective Disorder (SAD)
Some people suffer from depression in
winter and spirits only lift with coming
of spring (depression caused by
sunlight deprivation)
Seasonal Affective Disorder (SAD)
Winter: SAD sufferers
sleep and eat
excessively
The hormone
melatonin may play a
role: less light—more
melatonin secreted by the brain’s
pineal gland. High levels of melatonin
can cause some to suffer from SAD.
Elements of Depression
Dependency
Need for others’ help and
support
Self-Criticism
Negative assessment of
one’s own worth.
Inefficacy
“Nothing I do matters”
Elements of Depression
•Draw illogical conclusions about
themselves.
•Blame selves for normal problems
•Consider every minor failure a
catastrophe
Depression: a Vicious Cycle
Negative Event
Other people
avoid
Negative
behaviors
(crying)
Negative Selfevaluation
Low selfesteem
Attribution of negative
events to personal
flaws: learned
helplessness
Depression Greater in Women
Susan Nolen-Hoeksema
Differing response styles of women and
men experiencing negative moods
Women: tend to think about possible
causes and implications
of their feelings
Men attempt to distract
themselves from depressed feelings—
shifting attention to something else or
engaging in a physical activity
Depression Now Often a Teen Issue
Still more prevalent in females
Three factors
1. Out of
control
individualism and self-centeredness that
focuses on individual success & failure
2. The self-esteem movement (should feel good
about yourself irrespective of efforts &
achievements
3. Culture of victimology—points the finger of
blame at someone or something else
Bipolar disorder—individuals are
excessively and inappropriately
happy or unhappy
High elation; hopeless depression
or an alteration between the two
Manic phase—a person experiences
elation, extreme confusion,
distractibility, and racing thoughts
Often exaggerated self-esteem &
irresponsible behavior (sprees,
insulting remarks)
Depressive phase—the individual is
overcome by feelings of failure,
sinfulness, worthlessness, and despair
Depressive-type reaction: lethargy,
despair, unresponsiveness.
To illustrate bipolar disorder, we
are going to watch a short film
clip about a person who suffers
from bipolar disorder: NBC
News personality, Jane Pauley.
Most common mental illness in U. S.;
19 million Americans endure symptoms
typical of anxiety-based disorders
annually (15% of population)
Common characteristics:
Feelings of anxiety
Feelings of personal inadequacy
Avoid dealing with problems
Unrealistic self-images
Can’t get rid of recurring fears &
worries
Anxious people often have
difficulty forming stable and
satisfying relationships.
That’ right Elizabeth. Also even though the
behavior of anxious people may be selfdefeating and ineffective in solving problems,
those driven by anxiety often refuse to give up
their behaviors in favor of more effective ways
of dealing with anxiety.
Generalized Anxiety Disorder
Anxiety is a generalized
apprehension that is a
reaction to vague or
imagined dangers.
Generalized Anxiety
Disorder is a continuous,
generalized anxiety. Fearing unknown
and unforeseen circumstances, people
suffering from the disorder are unable
to make decisions or enjoy life.
Generalized Anxiety Disorder
So preoccupied with internal
problems, people have:
Trouble dealing with family/
friends
Trouble fulfilling responsibilities
Feel trapped in a vicious cycle:
Worry
Difficulty
Worry
Physical symptoms: muscle tension;
can’t relax; strained face; poor appetite;
indigestion, diarrhea; frequent urination
Panic Disorder
Sudden, unexplainable
attack of intense fear—
sense of inevitable doom
or even death.
Sx: smothering
choking
difficulty breathing
nausea
chest pains
Panic disorder probably can be traced back
to the Amygdala in the limbic system of the
brain (unconscious, emotional pathways)
Now, we’ll watch a brief film clip
from the Today Show on NBC
about panic disorder and its
treatment.
Would somebody please define
the term “agoraphobia?”
2% of the
Population;
more women
than men
Fear of the marketplace—fear may experience
some kind of attack in large places; become
prisoners in their own homes (Emily Dickenson)
Phobic Disorder
Severe anxiety focused
on a particular object,
activity or situation when
compared to real danger
Specific phobias
Social phobias
Agoraphobia
Often elaborate plans to avoid
feared situations. For example
the situation in this film clip:
My therapist said I have many phobias.
What kinds of phobias do people
experience?
Mohini, there are many
different phobias. Some
examples are clowns,
spiders, cats or chickens.
12% of all Americans
Acrophobia
Aerophobia
Agliophobia
Alektorophobia
Alliumphobia
Amaxophobia
Anuptaphobia
Apiphobia
Arachnophobia
Atychiphobia
Heights
Drafts
Pain
Chickens
Garlic
Riding in a car
Staying single
Bees
Spiders
Failure
Aulophobia
Autophobia
Aviophobia
Blennophobia
Cacophobia
Claustrophobia
Coulrophobia
Cynophobia
Dementophobia
Dromophobia
Flutes
Being alone
Flying
Slime
Ugliness
Confined spaces
Clowns
Dogs or rabies
Insanity
Crossing streets
Elurophobia
Ephebiphobia
Herpetophobia
Hominophobia
Katagelophobia
Lachanophobia
Metrophobia
Necrophobia
Photophobia
Scotophobia
Thalassophobia
Vestiphobia
Cats
Teenagers
Reptiles
Men
Ridicule
Vegetables
Poetry
Dead things
Light
Darkness
The sea
Clothing
Now, we’ll watch two brief film
clips from the Today Show on
NBC; one about phobias and
their treatment, and the other
about social phobias and their
treatment.
Obsessive-Compulsive Disorder
Obsession: Uncontrollably
thinking same thoughts
over and over again.
Compulsion: Repeatedly
performing irrational actions
We all have obsessions and
compulsions. What are some of
yours or of someone you know?
Obsessive-Compulsive
Only a psychological problem when
thoughts and activities interfere with
what a person wants and needs to do.
Some people experience both
obsession and compulsion together—
Obsessive-Compulsive Disorder.
+
Obsessive-Compulsive Disorder
Observe Melvin
in the following film
clip from James L.
Brooks’ As Good As It Gets and list
as many instances of his compulsive
behavior as you can.
Have you ever known anyone who can
be characterized as obsessivecompulsive?
Now, we’ll watch another brief
film clip from the Today Show
on NBC about ObsessiveCompulsive Disorder and its
treatment.
Post-Traumatic
Stress Disorder
Person who has
experienced a
traumatic event feels severe and
long-lasting after-effects.
War
Victims of natural
veterans
disasters
Victims of human aggression
Experiencing physical symptoms for
which there is no apparent physical
cause .
Conversion
Disorder
Hypochondriasis
Conversion Disorder
Convert emotional difficulties into the
loss of a specific physiological function.
Real, prolonged handicap:
Sudden paralysis, not caused by
anything physical. . .
. . . the victim accepts the malady
with relative calm
Victims unconsciously invent physical
symptoms to gain freedom from
unbearable conflict.
Glove anesthesia: a pattern of
insensitivity to touch or pain that
fits the patient “like a glove;” but the
symptoms do not match any possible
pattern of nerve impairment
Hypochondriasis
Person who is in good health becomes
preoccupied with imaginary ailments.
Spends much time looking for signs
of serious illness—misinterprets
minor aches, pains, etc. as
something very serious.
Hypochondriacs, such as
the character Felix Unger
in the Odd Couple.
A person experiences alterations in
memory, identity, or consciousness:
3 types
Dissociative amnesia: cannot recall
important personal events or information
Escape problems by blotting them out,
often resulting from a traumatic event
Dissociative fugue: amnesia plus flight
Depersonalization Disorder
The sensation that mind and body have
separated (also known as “out-of-body”
experiences)
External observers in own bodies or feel
like in a dream
OCD and personality disorders often
accompany this condition
Dissociative identity disorder: a person
exhibits two or more personality states,
each with its own patterns of thinking
and behaving.
Primarily a problem of cognition,
rather than a problem of emotion
Considerable loss of contact with
reality
Emotions blunted
Thoughts: bizarre; language: strange
twists
Memory may become fragmented
Breaks the unity of the mind—sends
the victim on meaningless mental
detours
Confused verbalizations (word salads)
Lives life as an unreal dream
No single cause or single cure
A collection of symptoms that
indicates an individual has serious
difficulty in meeting the demands of
life
Half of the patients in U.S. mental
hospitals
Confused & disordered thoughts
and perceptions
Many experience delusions—
false beliefs maintained in
the face of contrary evidence
Many experience hallucinations—
sensations in the absence of
appropriate stimulation
Some experience incoherence—a
marked decline in thought process
Some experience disturbances of
affect—emotions that are
inappropriate for circumstances
Some experience a marked
decline in previous levels of
functioning—serious productivity
decline at work
Some experience diverted attention:
often caused by “cognitive flooding”
inability to focus attention
Disorganized schizophrenia–
incoherent language,
inappropriate emotions, giggling
for no apparent reason, generally
disorganized motor behavior,
delusions and hallucinations
Catatonic schizophrenia
Motionless for long periods,
exhibiting “waxy flexibility”– limbs
in unusual positions may take a
long time to the resting, or relaxed,
position.
Undifferentiated schizophrenia—
hallucinations and delusions,
scrambled speech and thought
processes
Paranoid Schizophrenia
Delusions, including grandeur, or
persecution
Residual: individuals who have suffered
from a schizophrenic episode in the past
but currently have no major symptoms;
rather, their thinking is mildly disturbed or
emotional lives impoverished
Typical symptoms: chronic history of poor
judgment, disordered thinking, emotional
disturbances, disrupted social relationships, or
lack of impulse control
Narcissistic Personality Disorder
Narcissistic Personality Disorder
Pervasive pattern of
grandiosity, need for
admiration and lack of
empathy
Five or more of following:
Grandiose sense of self-importance
Preoccupied with fantasies of unlimited
success, power, etc.
Believes is special and unique—only
associate with other high-status people
Requires excessive admiration
Sense of entitlement
Narcissistic Personality Disorder
Interpersonally exploitive
Lacks empathy
Often envious of others or
believes others are
envious of him/her
Shows arrogant or haughty behaviors or
attitudes
Antisocial Personality Disorder
•Long-standing pattern of disregard
for other people’s rights
•Occurred since age 15
•Majority of following symptoms
Failure to conform to social norms
Deceitfulness
Impulsivity
Irritability & aggressiveness
Reckless disregard for safety
Consistent irresponsibility
Lack of remorse
Avoidant Personality Disorder
Long-standing & complex pattern
of feelings of inadequacy;
Extreme sensitivity to what others
think about them
Social inhibition
Majority of following:
Unibomber,
Avoids occupational activities Ted Kaczynski
involving interpersonal contact
Unwilling to get involved with
people
Restraint within intimate relationships
Preoccupied with being criticized
Views self as socially inept
Usually reluctant to take personal risks
Borderline Personality Disorder
Labile interpersonal
relationships characterized by instability
Paris Hilton
labile \LAY-byl\, adjective:
Constantly or readily undergoing chemical,
physical, or biological change or breakdown;
unstable.
May exhibit impulsive or unstable behaviors;
unpredictable moods; stormy interpersonal
relationships; little tolerance for frustration
(substance abuse, promiscuity, gambling,
binge eating, reckless driving, etc.)
Borderline Personality Disorder
Majority of following:
Frantic efforts to avoid
real or imagined
abandonment
Pattern of unstable & intense interpersonal
relationships, characterized by alternating
between extremes of idealization &
devaluation
Identity disturbance
Impulsivity in at least two of the following:
spending, sex, substance abuse,
reckless driving, binge eating
Recurrent suicidal behavior, threats, etc.
Borderline Personality Disorder
Affective instability
Chronic feelings of
emptiness
Inappropriate, intense
anger or difficulty controlling anger
Transient, stress-related paranoid ideation
or severe dissociative symptoms
Dependent Personality Disorder
Long-standing need to
be taken care of plus a
fear of being abandoned
or separated from
important individuals;
Clinging behavior;
Majority of following:
Difficulty making everyday decisions without
an excessive amount of advice
Need others to assume responsibility
Difficulty expressing disagreement
Difficulty initiating projects
Excessive lengths to gain nurturance
Histrionic Personality Disorder
Pattern of excessive emotionality &
attention seeking
Five or more of following:
Uncomfortable if not center of
attention
Interaction often characterized by
inappropriate sexually seductive
or provocative behavior
Rapidly shifting & shallow
expression of emotions
Consistently uses physical
appearance to draw attention to self
Impressionistic style of speech; lacking detail
Histrionic Personality Disorder
Self-dramatization and exaggerated
expression of emotion
Easily influenced by others
Considers relationships to be more
intimate than they actually are
She’s
madly in
love with
me!.
What a
weirdo!