Download Understanding Psychological Disorders

Myers’ Psychology for
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David G. Myers
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Unit 12:
Abnormal Behavior
Unit 12 - Overview
• Introduction to Psychological
Disorders
• Anxiety Disorders, ObsessiveCompulsive Disorder, and
Posttraumatic Stress Disorders
• Mood Disorders
• Schizophrenia
• Other Disorders
Click on the any of the above hyperlinks to go to that section in the presentation.
Module 65:
Introduction to
Psychological Disorders
Psychological Disorders
I felt the need to clean my room … would
spend four to five hours at it… At the time I
loved doing it. Then I didn't want to do it any
more, but I couldn’t stop… The clothes hung…
two fingers apart… I touched my bedroom
wall before leaving the house… I had constant
anxiety… I thought I might be nuts.
Marc, diagnosed with
obsessive-compulsive disorder (OCD)
(from Summers, 1996)
6
Introduction
• How should we define psychological
disorders?
• How should we
understand disorders?
• How should we classify
psychological
disorders?
Defining Psychological
Disorders
Psychological Disorders
People are fascinated by the exceptional,
the unusual, & the abnormal.
This fascination may be caused by two reasons:
1. During various moments we feel,
think, & act like an abnormal
individual.
2. Psychological disorders may bring
on unexplained physical symptoms,
irrational fears, & suicidal thoughts.
9
Psychological Disorders
To study the abnormal is the best
way of understanding the normal.
William James (1842-1910)
1. There are 450 million people
suffering from psychological
disorders (WHO, 2004).
2. Depression & schizophrenia exist
in ALL cultures of the world.
10
Defining
Psychological Disorders
Definition of Disorders -
• Psychological disorders a syndrome
Video 3min
marked by a clinically significant disturbance in an
individual’s cognition, emotion regulation, or behavior.
Behavior that is deviant, distressful, & dysfunctional
Varies between cultures, over time, & must be more than
just deviant, must be harmful (distressful)
Controversial & unclear at times:
Attention deficit hyperactivity Disorder
a psychological disorder marked by the appearance
by age 7 of 1 or more of 3 key symptoms; extreme
inattention, hyperactivity, & impulsivity.
Understanding
Psychological Disorders
Understanding Psychological Disorders
The Medical Model
• Until early 1800s mental illness- largely
viewed as possession, evil, godly intervention
• Philippe Pinel French, late 17th–early
1800s REFORMER. Insisted these behaviors were a
“sickness of the mind” often caused by severe stress
& inhumane conditions
• Medical model
– Mental illness (psychopathology)
Medical Model
When physicians discovered that syphilis
led to mental disorders, they started using
medical models to review the physical
causes of these disorders.
1.
2.
3.
4.
Etiology: Cause & development of the disorder.
Diagnosis: Identifying (symptoms) &
distinguishing one disease from another.
Treatment: Treating a disorder in a psychiatric
hospital.
Prognosis: Forecast about the disorder.
14
Understanding Psychological Disorders
The Biopsychosocial Approach
Today, psychologist contend that ALL behavior
(normal/abnormal) arises from Interaction of
nature & nurture
But “mental illness” implies an internal problem or
sickness.
Current psychology considers the problem may be a
growth-blocking difficulty in the person’s
environment, current interpretation of events, or bad
habits & poor social skills
• Influence of culture on disorders- may share
underlying dynamic while differing in symptoms
– Bulimia, Susto ,Taijain-kyofusho
Classifying
Psychological Disorders
Classifying Psychological
Disorders
Classification and Diagnosis - Free Intro to Psychology Video 5:44
• Diagnostic & Statistical Manual of Mental
Disorders (DSM)
video\_Advanced Assessment & Diagnosis Using the DSM-IV-TR®..._ Seminar with Brooks Baer, MA, LCPC,
CMHP.mp4 4min
– DSM-V
– Reliable across practitioners
• International Classification of Diseases
(ICD-10) coordinated to develop DSM classifications
used as diagnosis codes for insurance companies
• Criticisms of the DSM- creates labels that bias people /
may lead to stigmatizing people
How are Psychological Disorders Diagnosed?
Multiaxial Classification
Axis I
Axis II
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders [16 syndromes]) present?
Is a Personality Disorder or Mental Retardation
present?
Axis III
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis IV
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis V
What is the Global Assessment of the person’s
functioning?
18
Labeling Psychological
Disorders
Labeling Psychological
Disorders
Critics of the DSM-IV argue that labels may
stigmatize individuals.
Rosenhan’s study “hearing voices,” saying
“empty,” “hollow,” or “thud.” Otherwise gave
good info…. All 8 diagnosed mentally ill
• Power of labels
• Labels may be helpful for healthcare professionals when
communicating with one another & establishing therapy.
– Preconception can stigmatize
• Stereotypes of the mentally ill
• “Insanity” labels raise moral & ethical questions about
how society should treat people who have disorders & have
committed crimes.
Rates of Psychological
Disorders
Rates of Psychological Disorders
Module 66:
Anxiety Disorders,
Obsessive-Compulsive
Disorder, & Posttraumatic
Stress Disorder
Anxiety Disorders
video\217_Experiencing_Anxiety.mp4 1:30 min
• Anxiety disorder psychological
disorders characterized by distressing, persistent
anxiety or maladaptive behaviors that reduce
anxiety
Anxiety Disorders - Free Intro to Psychology Video 8min
–Generalized anxiety
disorder
–Panic disorders
–Phobias
Generalized Anxiety
Disorder
Generalized Anxiety Disorder
• Generalized anxiety disorder - an
anxiety disorder in which a person is continually
tense, apprehensive, & in a state of autonomic
nervous system arousal. (persistent)
– Unexplainably & continually tense, jittery &
uneasy, muscle tension, sleeplessness &
agitation, Feeling unfocused, out of
control & negative
– Physical symptoms (dizziness,
sweating palms, heart palpitations,
High BP, ulcers, etc) w/o any physical problem
video\216_Anxiety_Disorders.mp4 7min
– 2/3 women
– Cause not Identifiable thus can not be dealt with
»Free floating anxiety
Panic Disorder
Panic Disorder
• Panic disorder- an anxiety disorder
marked by unpredictable minutes-long
episodes of intense dread in which a
person experiences terror &
accompanying chest pain, choking, or
other frightening sensations.
–Panic attacks- minutes long
episode of intense fear that something horrible is about to happen.
Usually involves physical symptoms.
Smokers have a 2-4 X higher risk
Phobias
Phobias
• Phobias an anxiety disorder marked by a
persistent, irrational fear & avoidance of a
specific object, activity, or situation.
– Specific phobia – can lead to incapacitating
efforts to avoid the feared situation
– Social anxiety disorder - intense fear of social
situations, leading to avoidance of such.
(Formerly called social phobia)
– Social phobia – intense fear of being
scrutinized by others
– Agoraphobia- fear/avoidance of a situation in
which escape might be difficult or help
unavailable when panic strikes
Specific Phobia
Phobias
Obsessive-Compulsive
& Related Disorders
Obsessive-Compulsive Disorder
• Obsessive-compulsive disorder - an
anxiety disorder characterized by unwanted
repetitive thoughts (obsessions) and/or
actions (compulsions). video\219_OCD_Young Mother.mp4
–An obsession vs a compulsion
–Checkers
–Hand washers
Obsessive-Compulsive
Disorder
Obsessive-Compulsive
Disorder
Obsessive-Compulsive
Disorder
Obsessive-Compulsive
Disorder
Obsessive-Compulsive
Disorder
Trauma Stressor &
Related Disorders
Post-Traumatic Stress Disorder
• Post-traumatic stress disorder - an
anxiety disorder characterized by haunting
memories, nightmares, social withdrawal,
jumpy anxiety, and/or insomnia that lingers
for four weeks or more after a traumatic
experience.
– AKA: PTSD, “shellshock”
or “battle fatigue”
– Not just due to a war situation
video\THIS EMOTIONAL LIFE _ PTSD _ Treatment _ PBS.flv
• Post-traumatic growth
Understanding Anxiety
Disorders, OCD & PTSD
Understanding Anxiety Disorders
The Learning Perspective
• Fear conditioning- general anxiety has
been linked with classical conditioning of fear
–Stimulus generalization
–Reinforcement- avoidance,
compulsions
• Observational learning
–We can learn fear thru
observing other’s fears
Understanding Anxiety Disorders
The Biological Perspective
• Natural selection
• Genes
– Anxiety gene
– Twin studies support
• The Brain
– scans reveal specific brain activity in OCD &
depressed people
–Anterior cingulate cortex- monitors our
actions & checks for errors. Extremely active in
OCD patients
Module 67:
Depressive & Bipolar Disorders
Depressive Disorders
Mood Disorders
• Mood disorders psychological disorders
characterized by emotional extremes.
Mood Disorders - Free Intro to Psychology Video
– Major depressive disorder mood disorder in
which a person experiences, in the absence of
drugs or a medical condition, 2 or more weeks of
significantly depressed moods, feelings of
worthlessness, & diminished interest or pleasure
in most activities.
– Bipolar disorder a mood disorder in which the
person alternates btwn the hopelessness &
lethargy of depression & the overexcited state of
mania. (formerly called manic-depressive
disorder.)
Major Depressive Disorder
• Major depressive disorder
– Lethargy
– Discouraged, dissatisfied, isolated
– Unable to concentrate, eat or
sleep
– Feelings of worthlessness
– Loss of interest in family &
friends
– Loss of interest in activities
Dysthymic disorder- btwn normal sadness &
major depression. Everyday > than 2 yrs
Bipolar & Related Disorders
Bipolar Disorder
• Bipolar Disorder a mood disorder in which the
person alternates between the hopelessness & lethargy
of depression & the overexcited state of mania. (formerly
named manic-depressive disorder)
– Mania (manic)
• Overtalkative, overactive, elated, little need for
sleep, etc.
– Disruptive Mood Dysregulation Disorder
– Bipolar disorder and creativity
Understanding Depressive &
Bipolar Disorders
Understanding Depressive &
Bipolar Disorders
• Many behavioral & cognitive changes accompany
depression
• Depression is widespread, nearly ½ of depressed
people have other disorders (anxiety, substance
abuse)
• Compared with men, women are nearly twice as
vulnerable to major depression
• Most major depressive episodes self-terminate
• Stressful events related to work, marriage & close
relationships often precede depression
• With each new generation, depression is striking
earlier & affecting more people
Understanding Depressive &
Bipolar Disorders
Understanding Mood Disorders
The Biological Perspective
• Genetic Influences
video\225_Mood_Disorders.mp4
11 m
• Heritability- mood disorders run in families
• Linkage analysis- process of elimination
• Association studies- correlation btwn more specific
DNA variation & population traits
The depressed brain- Left Frontal Lobe. Genes act by
directing biochemicals that down the line, influence
behavior
– Biochemical influences (key)
• Norepinephrine -increases arousal, boosts mood. scarce
during depression, in overabundance during Mania
• Serotonin-scarce during Depression
Understanding Depressive and Bipolar Disorders
The Biological Perspective
Understanding Depressive &
Bipolar Disorders
The Biological Perspective
Understanding Depressive & Bipolar
Disorders
The Biological Perspective
Understanding Depressive & Bipolar
Disorders
The Biological Perspective
Understanding Depressive & Bipolar Disorders
The Social-Cognitive Perspective
• Negative Thoughts & Moods Interact
• Mind’s negative thoughts can influence biological events
that can be a vicious cycle amplifying depression
–Self-defeating beliefs
• Learned helplessness
• Rumination
–Explanatory style
• Stable, global, internal explanations
–Cause versus indictor of depression?
– Bad moods feed on themselves
1:27 - Lucille
I Will Survive
Understanding Depressive & Bipolar Disorders
The Social-Cognitive Perspective:
Depression’s Vicious Cycle
Understanding Depressive and Bipolar Disorders
The Social-Cognitive Perspective:
Depression’s Vicious Cycle
Understanding Depressive and Bipolar Disorders
The Social-Cognitive Perspective:
Depression’s Vicious Cycle
Understanding Depressive and Bipolar Disorders
The Social-Cognitive Perspective:
Depression’s Vicious Cycle
Module 68:
Schizophrenia Spectrum
Symptoms of
Schizophrenia
Symptoms of Schizophrenia
• Schizophrenia (split mind) a group of severe
disorders characterized by disorganized &
delusional thinking, disturbed perceptions, &
inappropriate emotions & actions.
schizophrenia 229 -4:20
–Not multiple personalities
Positive symptoms
Negative symptoms
–Psychosis
(psychotic disorder)
Symptoms of Schizophrenia
Disorganized Thinking
• Disorganized thinking
– Delusions false beliefs, often of persecution or
grandeur, that may accompany psychotic
disorders
• Delusions of persecution (paranoid)
• Word Salad
• Breakdown in selective attention ability
• Disturbed perceptions
– Hallucinations- no stimulus
• hearing voices
• Visual, smells, touch hallucinations are rare
Symptoms of Schizophrenia
Inappropriate Emotions & Actions
• Inappropriate Emotions
– Flat affect – zombielike state of apparent
apathy
• Inappropriate Actions
– Catatonia- to remain motionless for hrs
on end & then become agitated
– Disruptive social behaviordisorganized thinking, disturbed
perceptions & inappropriate emotions &
actions
Onset & Development of
Schizophrenia
Onset and Development
of Schizophrenia
•
•
•
•
Statistics on schizophrenia: 1 in 100
Onset of the disease: Early adulthood
Positive vs negative symptoms
Chronic (process) schizophrenia
develops gradually, emerging from a long history
of social inadequacy. Recovery in doubtful
• Acute (reactive) schizophrenia develops
rapidly in response to particular life stresses.
Recovery is much more likely
Understanding
Schizophrenia
Understanding Schizophrenia
Brain Abnormalities:
Dopamine Overactivity
• Dopamine Overactivity
– Dopamine – D4 dopamine receptor increased receptors for dopamine.
– Dopamine blocking drugs
• Glutamate : impaired glutamate acitivity =
another symptom
• Scans : indicate abnormal activity in multiple
brain areas. Out of sync neurons may
disrupt the integrated functioning of the
neural ntwks
Understanding Schizophrenia
Brain Abnormalities:
Abnormal Brain Activity & Anatomy
• Abnormal Brain Activity & Anatomy
–Frontal lobe and core brain activity
–Fluid filled areas of the brain
Understanding Schizophrenia
Brain Abnormalities:
Maternal Virus During Mid pregnancy
• Maternal Virus During Pregnancy
• Studies on maternal activity & schizophrenia
• Influence of the flu during mid pregnancy may
impair fetal brain development
Understanding Schizophrenia
Genetic Factors
• Genetic predisposition
• Twin studies
Understanding Schizophrenia
Genetic Factors
• Genetic predisposition- risks increases to
in if a family member had/s schizophrenia &
in 1 in 2 if an identical twin has/d it
• Twin studies & adoption studies confirm
genetic connection
• Genetics & environmental influenceswork together
Understanding Schizophrenia
Psychological Factors
• Possible warning signs
– Mother severely schizophrenic
– Birth complications (low weight/oxygen
deprivation)
– Separation from parents
– Short attention span
– Disruptive or withdrawn behavior
– Emotional unpredictability
– Poor peer relations and solo play
video\227_Schizophrenia_Case_Study.mp4 9:24
Module 69:
Other Disorders
Somatic Symptom &
Related Disorders
Somatic Symptom &
Related Disorders
Somatoform Disorders - Free Intro to Psychology Video
• Somatic symptom disorder
psychological disorder in which the symptoms
take a somatic (bodily) form without apparent
physical cause.
–Somatic (body)
–Conversion disorder
• Functional neurological symptom disorder
–Illness anxiety disorder
• Hypochondriasis
Dissociative Disorders
Dissociative Disorders
Dissociative Disorders - Free Intro to Psychology Video
• Dissociative disorders disorders in
which conscious awareness becomes separated
(dissociated) from previous memories, thoughts,
and feelings
– Fugue state -a patient
completely forgets their
personal identity (only
temporarily)
– Dissociate
(become separated)
Dissociative Disorders
Dissociative Identity Disorder
• Dissociative identity disorder
(DID) a rare dissociative disorder in which a
person exhibits two or more distinct & alternating
personalities.
–Multiple personality
disorder
video\232_Multiple_Personality_Disorder.mp4 9 min
Dissociative Disorders
Understanding Dissociative
Identity Disorder
• Genuine disorder or not?
• DID rates
• 1930 2 cases a year to > 20,000 in the 1980s
• Therapist’s creation shows up most with
therapist who utilize hypnosis
• Differences are too great
Feeding and Eating
Disorders
Feeding & Eating
Disorders
=-causes-eating-disorders-risk-factors 8 m
• Eating disorders
..\Motivation and Work\Gimme The Short Version - Eating Disorders - Igloo Animations.flv
..\Motivation and Work\the thinnest woman in the world.flv
–Anorexia nervosa
–Bulimia nervosa
–Binge
-eating
disorder
Personality Disorders
Personality Disorders
• Personality disorders
psychological
disorders characterized by inflexible & enduring
behavior patterns that impair social functioning
– Cluster A
• Schizoid personality disorder
– Cluster B
• Histrionic personality disorder
• Narcissistic personality disorder
• Antisocial personality disorder
– Cluster C
• Avoidant personality disorder
Most troubling of Personality Disorders:
Antisocial Personality Disorder
Personality Disorders
• Personality disorders psychological
disorders characterized by inflexible & enduring
behavior patterns that impair social functioning
–Anxiety cluster- avoidant
–Eccentric cluster- schizoid
–Dramatic/impulsive cluster- histrionic &
narcissistic
–
Personality Disorders - Free Intro to Psychology Video 5min
Most troubling of Personality Disorders:
Antisocial Personality Disorder
Personality Disorders
Antisocial Personality Disorder
• Antisocial personality disorder
–Sociopath or psychopath
• Understanding anti social
personality disorder
brain scans reveal reduced activity
in the frontal lobes (controls
impulses) A genetic pre- disposition may
interact with
environ-mental
influences to
produce this
disorder
Rates of Disorder
• Mental health
statistics
– 1 in 6-7 consistently
in studies.
– Lowest rates –
Shanghai
– Highest rates- US
Rates of Disorder
•Poverty is a predictor
•Serious psychological disorders are doubly
high among those below the poverty line
• Chicken or egg?
Both
•Schizophrenia leads to poverty
•Kids in poverty exhibit more deviant & aggressive
behavior
•When people move out of poverty these rates drop
40%
•Women in poverty= higher rates of substance abuse &
depression
•Other factors:
Age
•Antisocial & phobias appear the earliest ages 8-10
•OCD/alcohol abuse/bipolar/schizophrenia=median 20
•Major Depression = median age 25
Genetic Connections to
Psychological Disorders
genetic-influence-on-psychological-disorders 6:48
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Definition
Slides
Psychological Disorder
= a syndrome marked by a clinically
significant disturbance in an
individual’s cognition, emotion
regulation, or behavior.
Attention-Deficit Hyperactivity
Disorder (ADHD)
= a psychological disorder marked by
the appearance by age 7 of one or
more of three key symptoms;
extreme inattention, hyperactivity,
and impulsivity.
Medical Model
= the concept that diseases, in this
case psychological disorders, have
physical causes that can be
diagnosed, treated, and, in most
cases, cured often through
treatment in a hospital.
DSM-5
= the American Psychiatric
Association’s Diagnostic and
Statistical Manual of Mental
Disorders, Fifth Edition; a widely
used system for classifying
psychological disorders.
Anxiety Disorders
= psychological disorders
characterized by distressing,
persistent anxiety or maladaptive
behaviors that reduce anxiety.
Generalized Anxiety
Disorder
= an anxiety disorder in which a
person is continually tense,
apprehensive, and in a state of
autonomic nervous system arousal.
Panic Disorder
= an anxiety disorder marked by
unpredictable minutes-long
episodes of intense dread in which
a person experiences terror and
accompanying chest pain, choking,
or other frightening sensations.
Often followed by worry over a
possible next attack.
Phobia
= an anxiety disorder marked by a
persistent, irrational fear and
avoidance of a specific object,
activity, or situation.
Social Anxiety Disorder
= intense fear of social situations, leading to
avoidance of such. (Formerly called social
phobia)
Agoraphobia
= fear or avoidance of situations, such as
crowds or wide open spaces, where one
has felt loss of control and panic.
Obsessive-Compulsive Disorder
(OCD)
= a disorder characterized by unwanted
repetitive thoughts (obsessions) and/or
actions (compulsions).
Post-Traumatic Stress Disorder
(PTSD)
= a disorder characterized by haunting
memories, nightmares, social withdrawal,
jumpy anxiety, numbness of feeling, and/or
insomnia that lingers for four weeks or
more after a traumatic experience.
Post-Traumatic Growth
= positive psychological changes as
a result of struggling with
extremely challenging
circumstances and life crises.
Mood Disorders
= psychological disorders characterized by
emotional extremes.
Major Depressive Disorder
= a mood disorder in which a person
experiences, in the absence of
drugs or a another medical
condition, two or more weeks with
five or more symptoms, at least
one of which must be either (1)
depressed mood, or (2) lost of
interest or pleasure.
Mania
= a mood disorder marked by a
hyperactive, wildly optimistic state.
Bipolar Disorder
= a mood disorder in which a person
alternates between the
hopelessness and lethargy of
depression and the overexcited
state of mania. (formerly called
manic-depressive disorder.)
Rumination
= compulsive fretting; overthinking
about our problems and their
causes.
Schizophrenia
= a group of severe disorders characterized
by delusions, hallucinations, disorganized
speech, and/or diminished or inappropriate
emotional expression.
Psychosis
= a psychological disorder in which a
person loses contact with reality,
experiencing irrational ideas and
distorted perceptions.
Delusions
= false beliefs, often of persecution
or grandeur, that may accompany
psychotic disorders.
Hallucinations
= false sensory experience, such as
seeing something in the absence
of an external visual stimulus.
Somatic Symptom Disorder
= psychological disorder in which
the symptoms take a somatic
(bodily) form without apparent
physical cause.
Conversion Disorder
= a disorder in which a person experiences
very specific genuine physical symptoms
for which no psychological basis can be
found. (Also called functional neurological
symptom disorder)
Illness Anxiety Disorder
= a disorder in which a person interprets
normal physical sensations as symptoms
of the disease. (Formerly called
hypochondriasis)
Dissociative Disorders
= disorders in which conscious
awareness becomes separated
(dissociated) from previous
memories, thoughts, and feelings.
Dissociative Identity
Disorder (DID)
= a rare dissociative disorder in
which a person exhibits two or
more distinct and alternating
personalities. Formerly called
multiple personality disorder.
Anorexia Nervosa
= an eating disorder in which a
person (usually an adolescent
female) maintains a starvation diet
despite being significantly (15
percent or more) underweight.
Bulimia Nervosa
= an eating disorder in which a
person alternates binge eating
(usually of high-calorie foods) with
purging (by vomiting or laxative
use), excessive exercise, or fasting.
Binge-Eating Disorder
= significant binge-eating episodes,
followed by distress, disgust, or
guilt, but without the compensatory
purging, fasting, or excessive
exercise that marks bulimia
nervosa.
Personality Disorders
= psychological disorders
characterized by inflexible and
enduring behavior patterns that
impair social functioning.
Antisocial Personality Disorder
= a personality disorder in which a
person (usually a man) exhibits a
lack of conscience for wrongdoing,
even toward friends and family
members. May be aggressive and
ruthless or a clever con artist.