Download Mood Disorders

Unit 5
Abnormal
Psychology
4th Edition
Anxiety & Mood
Disorders
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12-1
Criteria of Abnormal Behavior
• statistical rarity-- behavior is
infrequent in population.
• Dysfunctional-- behavior
interferes with daily
functioning.
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Abnormal Behavior
• personal distress – behavior is
upsetting/confusing to patient
• Deviates from social norms =
abnormal (deviant) behavior
• social norms can change over
time and vary across cultures.
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Abnormal Behavior
• Insanity - a legal ruling that an
accused individual is not
responsible for a crime.
• Criteria: unable to tell right from
wrong when crime was committed
• Insanity pleas are infrequently
used and rarely successful.
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Abnormal Behavior Models
• medical model: abnormal
behaviors are illnesses prescribe medical treatments.
• psychodynamic model:
unconscious conflicts from
childhood.
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Abnormal Behavior Models
• behavioral model: abnormal
behaviors are learned (cond.,
modeling)
• cognitive model: our
interpretation of events/ our
beliefs influence our behavior.
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Abnormal Behavior Models
• sociocultural model social
/cultural factors considered
• Biopsychosocial—
combination approach
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Classifying and Counting
Psychological Disorders
• The American Psychiatric
Association's (APA) Diagnostic
and Statistical Manual of Mental
Disorders (DSM) provides rules
for diagnosing psychological
disorders that have increased
reliability.
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Rorschach Test (Projective Tests)
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Thematic Apperception Test
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Classifying and Counting
Psychological Disorders
• Rosenhan's pseudopatient
study questions our ability to
distinguish normal and
abnormal behaviors and how
labels affect perception of
behavior.
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Classifying and Counting
Psychological Disorders
• Epidemiologists study prevalence & incidence of
accidents, diseases, and psychological disorders.
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Classifying and Counting
Psychological Disorders
• Phobias, substance
abuse/dependence, and MDD
are among most common d/o.
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Classifying and Counting
Psychological Disorders
• Many suffer from more than one psychological
disorder (co-morbidity).
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Anxiety, Somatoform, and
Dissociative Disorders
• Anxiety involves behavioral,
cognitive, and physiological
elements.
• Biopsychosocial model most
effective.
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Anxiety, Somatoform, and
Dissociative Disorders
• a chronically high level of
anxiety = generalized anxiety
disorder (GAD)
• Worry about 2 or more areas
of life.
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Anxiety, Somatoform, and
Dissociative Disorders
• Phobias are excessive,
irrational fears of activities,
objects, or situations.
• most frequently diagnosed
phobia is agoraphobia (“fear of
the marketplace”) No escape!
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Anxiety, Somatoform, and
Dissociative Disorders
• The DSM-V: agoraphobia and
specific phobia.
• conditioning and modeling
may explain phobias.
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Phobias
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Psychologically Based Therapies
• Systematic
desensitization
• relaxation techniques
• asked to imagine or
approach feared
situations gradually
• (Counterconditioning)
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Anxiety D/Os
Fear of being in situations that
may subject one to scrutiny
• DSM-V: Social Anxiety D/O
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Anxiety, Somatoform, and
Dissociative Disorders
• Frequent panic attacks
(which resemble heart
attacks) main symptom
of panic disorder.
• Biological and cognitive
explanations for this
disorder have been
proposed.
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OCD
• Obsessions are thoughts,
images, or impulses that occur
repeatedly;
• compulsions are irresistible,
repetitive acts (behaviors) trying
to decrease thoughts.
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Hoarding Disorder
• Persistent difficulty parting
with possessions, regardless
of their value
• Living areas become cluttered
• Parting causes extreme
distress
• New classification
Animal Hoarding
Anorexia/ Bulimia Nervosa
• Stress-related eating disorders
• Anorexia Nervosa – self-starving (<85% of
normal body weight)
• Bulimia Nervosa – binge and purge eating
• Type A Personality?
• Control?
• Identity issues?
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Anorexia Nervosa
• Hungry, but don’t eat for fear
of being fat
• Distorted image of their body
• No sign of other disease
• Weight less than minimally
normal
• Some starve themselves to
death (20% die total)
Why anorexia?
• Neurotransmitter imbalance
• Brain images-no pleasure
from food
• Societal pressures
• Low self esteem levels
• Stress and anxiety
Bulimia Nervosa
• Binge eating with loss of control,
followed by vomiting, laxatives,
exercise
• maintain normal weight, distorted
image
• @ least once a week for 3 months
Binge Eating Disorder
•
•
•
•
3 or more of the following:
Very rapid eating
uncomfortably full
Large amounts of food, but not
hungry
• Eating alone b/c embarrassment
• Disgust, guilt, depression
afterwards
• @ least once/week for 3 months
Post Traumatic Stress Disorder
• PTSD
• exposure to actual or threatened death,
serious injury or sexual violation
• Doesn’t have to happen to you!
• clinically significant distress/
dysfunction: impairment in social
interactions, capacity to work or other
important areas of functioning
PTSD
• Trauma (violence, war, crime,
disaster, etc.)
• 1st month after Trauma occurs =
acute stress d/o
• Acute or Chronic PTSD after 1 mo.
• sleep disturbances, nightmares,
flashbacks, irritability
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TREATMENT
• early intervention!!!
• -cognitive behavioral therapy:
learn about own symptoms and
disorder=control “reliving the
events”
• -anti-anxiety/anti-depressant meds
• -virtual reality/exposure therapy
Biomedical Therapies
• antianxiety drugs:
• benzodiazepines (Valium, Xanax) (GABA
agonists)
• Anti-depressants:
• SSRIs (Zoloft, Paxil, Prozac, Lexapro)
may reduce symptoms (seratonin
agonists)
• SNRIs (Cymbalta, Effexor, Pristiq)
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Anxiety, Somatoform, and
Dissociative Disorders
• Somatic symptom disorder
• Many physical symptoms w/ no
known medical causes –
(headaches, pain, digestive, etc.)
psychological factors (depression
and/or anxiety) are involved.
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Conversion Disorder
• Somatic disorder with loss of
sensory or motor function
without medical explanation.
• (blindness, deafness, paralysis)
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Illness Anxiety D/O
• Somatoform disorder with
belief of a specific, serious
disease despite repeated
medical findings to the
contrary (DSM IV:
hyponchondriac)
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Dissociative Disorders
• Dissociative disorders involve
disruptions in some function of
awareness in the mind.
• Depersonalization D/O: “The Flash”Existential moments
• dissociative amnesia: memories
cannot be recalled
• dissociative fugue: memory loss
accompanied by travel.
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Anxiety, Somatoform, and
Dissociative Disorders
• Dissociative identity disorder
(multiple personality) - presence
of two or more personalities in
one individual.
• The 3 Faces of Eve
• Sybil
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Mood Disorders
• lifetime prevalence of depression is twice
as high in women as men; prevalence rates
around the world are increasing.
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Mood Disorders
• symptoms of depression
include sadness, reduced
pleasure and energy levels,
feelings of guilt, sleep and
appetite changes (more than 2
weeks) and suicidal thinking.
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Mood Disorders
• Suicide, often associated with
depression, is a leading cause
of death in US.
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Suicide Rates
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Mood Disorders
• Medical: low levels of
norepinephrine or serotonin.
• Behavioral: learned helplessness
• Cognitive: people believe they
cannot control outcomes
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Mood Disorders
• Mood disorders tend to run in
families (genetic)
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Mood Disorders
• Mood disorder concordance
rates in twins: 65% identical vs
14% fraternal.
• Depression comorbid with
other disorders.
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Depression Disorders
Dysthymic - chronic low mood
Unipolar-Major Depression
Double Depression – Dysthymic
disorder w/ major depressive
episode
SAD- melatonin/ phototherapy
Postpartum depression-hormones
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Models on Mood Disorders
• Biological/ Medical – Concordance; SSRIs
& Lithium (seratonin & norepinepherine)
• Psychodynamic – attachment issues
• Cognitive—Explanatory styles (t/p, s/u, e/i)
optimist/ hardy, hopelessness (arbitrary
inference: conc w/o supporting evidence)
• Behavioral—Learned helplessness/
reinforcers
• Biopsychosocial – interacting factors
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Mood Disorders
• Bipolar disorder involves
swings between depression and
mania.
• symptoms of mania include
euphoria, increased energy,
poor judgment, decreased sleep,
and elevated self-esteem
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