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Psychological Disorders
An Introduction
Psychological Disorder
• A “harmful dysfunction” in which behavior
is judged to be atypical, disturbing,
maladaptive and unjustifiable.
What is abnormal, disturbing maladaptive
and unjustifiable depends on:
•Culture
•Time Period
•Environmental Conditions
•Individual Person
Defining Psychological Disorders
Mental health workers view psychological
disorders as persistently harmful thoughts,
feelings, and actions.
When behavior is deviant, distressful, and
dysfunctional psychiatrists and psychologists
label it as disordered (Comer, 2004).
The 3 D’s
Deviant, Distressful & Dysfunctional
Carol Beckwith
1. Deviant behavior
(going naked) in one
culture may be
considered normal,
while in others it may
lead to arrest.
2. Deviant behavior must
accompany distress.
3. If a behavior is
dysfunctional it is
clearly a disorder.
In the Wodaabe tribe men
wear costumes to attract
women. In Western society
this would be considered
abnormal.
Early Theories
• Afflicted people
were
possessed by
evil spirits.
Understanding Psychological
Disorders
Ancient Treatments of psychological disorders
include trephination, exorcism, being caged like
animals, being beaten, burned, castrated,
mutilated, or transfused with animal’s blood.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)
Early Theories
• Music or singing was
often used to chase
away spirits.
•In some cases
trephening was
used:
Cutting a hole in
the head of the
afflicted to let out
the evil spirit.
Trephening
Early Theories
• Another theory was to make the body
extremely uncomfortable.
History of Mental Disorders
• In the 1800’s,
disturbed people
were no longer
thought of as
madmen, but as
mentally ill.
They were first put in hospitals.
Did this mean better treatment?
Early Mental Hospitals
• They were nothing more than barbaric
prisons.
•The patients were chained
and locked away.
•Some hospitals even charged admission
for the public to see the “crazies”, just like
a zoo.
Philippe Pinel
• French doctor who
was the first to take
the chains off and
declare that these
people are sick and
“a cure must be
found!!!”
Somatogenic
• At this time- it was believed that mental
illness had a bodily cause- Somatogenic.
But Somatogenic could not explain
disorders such as hysteria (now
called conversion disorder).
Many disorders are psychogenic: the
origin is psychological, not physical.
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 and development of the
disorder.
Diagnosis: Identifying (symptoms) and
distinguishing one disease from another.
Treatment: Treating a disorder in a psychiatric
hospital.
Prognosis: Forecast about the disorder.
Current Perspectives
• Medical Perspective: psychological
disorders are sicknesses and can be
diagnosed, treated and cured.
Current Perspectives
• Bio-Psycho-Social Perspective:
assumes biological, psychological and
sociocultural factors combine to interact
causing psychological disorders.
Used to be called Diathesis-Stress Model:
diathesis meaning predisposition and stress
meaning environment.
Classifying Psychological Disorders
The American Psychiatric Association rendered
a Diagnostic and Statistical Manual of Mental
Disorders (DSM) to describe psychological
disorders.
The most recent edition, DSM-IV-TR (Text
Revision, 2000), describes 400 psychological
disorders compared to 60 in the 1950s.
Classifying Psychological Disorders
• DSM-IV: Diagnostic
Statistical Manual of
Mental Disorders:
the big book of
disorders.
Two Major Classifications:
Neurotic
Disorders
• Distressing but
one can still
function in
society and act
rationally
Psychotic Disorders
• Person loses contact with
reality, experiences
distorted perceptions
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?
Is a General Medical Condition (diabetes,
Axis III
hypertension or arthritis etc) also present?
Are Psychosocial or Environmental Problems
Axis IV
(school or housing issues) also present?
What is the Global Assessment of the person’s
Axis V functioning?
Multiaxial Classification
Note 16 syndromes in Axis I
Multiaxial Classification
Note Global Assessment for Axis V
Goals of DSM
1.
2.
Describe (400) disorders.
Determine how prevalent the
disorder is.
Disorders outlined by DSM-IV are reliable.
Therefore, diagnoses by different professionals
are similar.
Others criticize DSM-IV for “putting any kind
of behavior within the compass of psychiatry.”
Labeling Psychological Disorders
1. Critics of the DSM-IV argue that labels may
stigmatize individuals.
2. Rosenthal-Being sane in insane places
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, 1995. Cornell University Press.
Asylum baseball team (labeling)
Labeling Psychological Disorders
2. Labels may be helpful for healthcare
professionals when communicating with
one another and establishing therapy.
Labeling Psychological Disorders
Elaine Thompson/ AP Photo
3. “Insanity” labels
raise moral and
ethical questions
about how society
should treat people
who have
disorders and have
committed crimes.
Theodore Kaczynski
(Unabomber)
Anxiety Disorders
a group of conditions where the
primary symptoms are anxiety or
defenses against anxiety.
the patient fears something
awful will happen to them.
What is anxiety?
• is a state of
intense
apprehension,
uneasiness,
uncertainty, or
fear.
Generalized Anxiety Disorder
• An anxiety disorder in which a person
is continuously tense, apprehensive and
in a state of autonomic nervous system
arousal.
The patient is constantly tense and worried,
feels inadequate, is oversensitive, can’t
concentrate and suffers from insomnia.
Panic Disorder
• An anxiety disorder marked by a
minutes-long episode of intense dread in
which a person experiences terror and
accompanying chest pain, choking and
other frightening sensations.
Can cause secondary disorders, such as
agoraphobia.
Phobias
• A person experiences sudden
episodes of intense dread.
The Phobia
List Link
Obsessive Compulsive Disorder
• An anxiety disorder characterized
by unwanted repetitive thoughts
(obsessions) and/or actions
(compulsions).
Common Examples of OCD
Common Obsessions:
Common
Compulsions:
Contamination fears of germs, dirt,
Washing
etc.
Imagining having harmed self or
Repeating
others
Imagining losing control of
aggressive urges
Checking
Intrusive sexual thoughts or urges
Touching
Excessive religious or moral doubt
Counting
Forbidden thoughts
Ordering/arranging
A need to have things "just so"
Hoarding or saving
A need to tell, ask, confess
Praying
Explanations for Anxiety
Disorders
• You Learn them through
conditioning.
•Evolution
•Genes
•Physiology (the brain)
Dissociative Disorders
Dissociative Disorders
• Disorders in which
conscious
awareness becomes
separated
(dissociated) from
previous memories,
thoughts and
feelings.
Dissociative Amnesia
• This disorder is
characterized by a
blocking out of
critical personal
information, usually
of a traumatic or
stressful nature.
Dissociative Amnesia
• Dissociative amnesia, unlike other types
of amnesia, does NOT result from other
medical trauma (e.g. a blow to the head).
Dissociative Amnesia
• Localized amnesia is present in an individual who has no
memory of specific events that took place, usually
traumatic. The loss of memory is localized with a specific
window of time. For example, a survivor of a car wreck
who has no memory of the experience until two days later
is experiencing localized amnesia.
• Selective amnesia happens when a person can recall
only small parts of events that took place in a defined
period of time. For example, an abuse victim may recall
only some parts of the series of events around the abuse.
• Generalized amnesia is diagnosed when a person's
amnesia encompasses his or her entire life.
• Systematized amnesia is characterized by a loss of
memory for a specific category of information. A person
with this disorder might, for example, be missing all
memories about one specific family member.
Dissociative Fugue
• An individual with dissociative fugue
suddenly and unexpectedly takes
physical leave of his or her surroundings
and sets off on a journey of some kind.
•These journeys can last hours, or even
several days or months.
Dissociative Fugue
• Individuals experiencing a dissociative fugue
have traveled over thousands of miles.
An individual in a fugue state is unaware of or
confused about his identity, and in some
cases will assume a new identity (although
this is the exception).
Depersonalization Disorder
• is marked by a feeling of detachment or
distance from one's own experience,
body, or self.
One can easily relate to feeling as they
in a dream, or being "spaced out."
A person's experience with depersonalization
can be so severe that he or she believes the
external world is unreal or distorted.
Dissociative Identity Disorder
• A rare dissociative disorder in which
a person exhibits two or more
distinct and alternating personalities.
•Also known as multiple personality
disorder.
Mood
Disorders
Mood Disorders
• Psychological Disorders
characterized by
emotional extremes.
• Dysthymic Disorder
• Major Depressive
Disorder
•Seasonal Affective
Disorder
•Bipolar Disorder
Depression
• The common cold of psychological
disorders.
It is like a warning that
something is wrong.
Depression
Depression
Major Depressive Disorder
• A person, for no
apparent reason,
experiences two or
more weeks of
depressive moods.
Includes feelings of
worthlessness and diminished
interest or pleasure in most
activities.
Dysthymic Disorder
• Suffering from
mild depression
every day for at
least two years.
Seasonal Affective Disorder
Bipolar Disorder
• Person alternates between the
hopelessness and lethargy of
depression and the overexcited state
of mania.
Famous People with Bipolar
Bipolar Brain
Norepinephrine
Increases arousal and boosts moods.
Suicide
Suicide
Schizophrenia
How Prevalent?
• About 1 in every 100 people are
diagnosed with schizophrenia.
Symptoms of Schizophrenia
• Disorganized thinking.
•Disturbed Perceptions
•Inappropriate Emotions and
Actions
Disorganized Thinking
• The thinking of a person with
Schizophrenia is fragmented and
bizarre and distorted with false beliefs.
•Disorganized thinking comes from a
breakdown in selective attention.they cannot filter out information.
Often causes………
Delusions (false beliefs)
• Delusions of
Persecution
• Delusions of
Grandeur
Disturbed Perceptions
• hallucinations- sensory experiences
without sensory stimulation.
Inappropriate Emotions and
Actions
• Laugh at
inappropriate times.
• Flat Effect
• Senseless,
compulsive acts.
• Catatoniamotionless Waxy
Flexibility
Positive v. Negative Symptoms
Positive Symptoms
• Presence of
inappropriate
symptoms
Negative Symptoms
• Absence of
appropriate ones.
Types of Schizophrenia
Paranoid Schizophrenia
• preoccupation
with delusions
or
hallucinations.
• Somebody is out
to get me!!!!
Disorganized Schizophrenia
• disorganized speech or behavior, or flat or
inappropriate emotion.
Catatonic Schizophrenia
• parrot like repeating of another’s speech
and movements
Undifferentiated Schizophrenia
• Many and varied Symptoms.
Personality Disorders
Psychological disorders characterized by
inflexible and enduring behavior patterns
that impair social functioning.
Paranoid Personality Disorder
• Paranoid personality
disorder is
characterized by a
distrust of others
and a constant
suspicion that people
around you have
sinister motives.
Paranoid Personality Disorder
• They search for hidden meanings in
everything and read hostile intentions into
the actions of others.
•They are quick to challenge the loyalties of friends and loved ones and often
appear cold and distant to others. They usually shift blame to others and tend to
carry long grudges.
Antisocial Personality Disorder
• antisocial personality disorder is
characterized by a lack of conscience
•People with this disorder are prone to criminal behavior, believing that their victims are
weak and deserving of being taken advantage of. They tend to lie and steal
Antisocial Personality Disorder
• they are careless with money and take
action without thinking about
consequences
They are often aggressive and are much more concerned with their own
needs than the needs of others.
Borderline Personality Disorder
• characterized by mood instability and
poor self-image
People with this disorder are prone to constant mood swings and bouts of
anger.
Borderline Personality
Disorder
• they will take their
anger out on
themselves, causing
themselves injury
Suicidal threats and actions are not uncommon
They are quick to anger when their expectations are not met.
Histrionic Personality Disorder
• constant attention seekers
They need to be the center of attention all the time, often
interrupting others in order to dominate the conversation.
Histrionic Personality
Disorder
• They may dress
provocatively or
exaggerate
illnesses in order
to gain attention.
They also tend to exaggerate friendships and relationships, believing that
everyone loves them
Narcissistic Personality Disorder
• characterized
by selfcenteredness
They exaggerate their achievements, expecting others to recognize them as
being superior
Narcissistic Personality Disorder
They tend to be
choosy about
picking friends,
since they believe
that not just
anyone is worthy of
being their friend.
They are generally uninterested in the feelings of others and may take advantage
of them.
Schizoid Personality Disorder
• People with schizoid
personality disorder
avoid relationships
and do not show
much emotion
They genuinely prefer to be alone and do not secretly wish for popularity.
Schizoid Personality Disorder
• They tend to seek jobs that require
little social contact
Their social skills are often weak and they do not show a need for attention or
acceptance
They are perceived as humorless and distant and often are termed "loners."
Schizotypal Personality Disorder
• characterized by a need for social
isolation, odd behavior and thinking, and
often unconventional beliefs such as
being convinced of having extra sensory
abilities.
• Some people believe that schizotypal
personality disorder is a mild form of
schizophrenia.
Avoidant personality disorder
• characterized by a pervasive pattern of
social inhibition, feelings of inadequacy,
and extreme sensitivity to negative
evaluation.
• consider themselves to be socially inept
or personally unappealing, and avoid
social interaction for fear of being
ridiculed or humiliated.
Dependent personality disorder
• characterized by a pervasive
psychological dependence on other
people.
• has difficulty making everyday decisions
without an excessive amount of advice
and reassurance from others
Obsessive Compulsive Personality
Disorder
• characterized by a general psychological
inflexibility, rigid conformity to rules
and procedures, perfectionism, and
excessive orderliness.
• people with OCPD tend to stress
perfectionism above all else, and feel
anxious when they perceive that things
aren't "right".