Transcript Psychological Disorders

Week 8
Psychological
Disorders
Psychological Disorders
Atypical Behavior - different than normal
Disturbing - determined by others
Maladaptive - distressing, disabling,  risk
Unjustifiable - cannot be “rationally” justified
(Richardson, 1999)
Defining Abnormality
• Abnormality as deviation from the average
• statistically-based approach
• Abnormality as deviation from the ideal
• the standard toward which most people are striving
• Abnormality as a sense of subjective
discomfort
• psychological consequences of the behavior for the
individual
(Feldman, 1999)
Defining Abnormality
• Abnormality as the inability to function
effectively
• inability to adjust to the demands of society
• Abnormality as a legal concept
• the legal view of “insanity”
(Feldman, 1999)
Models of Abnormality
• Medical model
– suggests that physiological causes are at the
root of abnormal behavior
• Psychoanalytic model
– abnormal behavior stems from childhood
conflicts
(Feldman, 1999)
Models of Abnormality
• Behavioral model
– abnormal behavior is a learned response
• Cognitive model
– assumes cognitions (people’s thoughts and
beliefs) are central to abnormal behavior
(Feldman, 1999)
Models of Abnormality
• Humanistic model
– emphasizes people’s control and responsibility
for their own behavior
• Sociocultural model
– assumes behavior is shaped by family, society,
and culture
(Feldman, 1999)
Understanding Psych Disorders
Medical Perspective
• Mental disorders are a psychological response to stress
& inhumane conditions
• Genetic components of many disorders
• Acceptance of phys cause & search for med treatment
The Medical Model
• Mental illness
• Diagnosis of symptoms
• Cure via therapy
(Richardson, 1999)
Understanding Psych Disorders
Problem
Aren’t mental “illnesses” socially defined?
Major disorders, like depression & schizophrenia
appear to be universal,
HOWEVER
Other disorders appear to be tied to specific cultures
(anorexia nervosa & bulimia)
Bio-psycho-social
Perspective
(Richardson, 1999)
Classifying Abnormal Behavior
• Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition (DSM-IV)
– a system devised by the American Psychiatric
Association used by most professionals to
diagnose and classify abnormal behavior
(Feldman, 1999)
Classifying Abnormal Behavior
• Five axes of the DSM-IV
• DSM is designed to be primarily descriptive
and devoid of suggestions as to the
underlying causes of an individual’s
behavior and problems
(Feldman, 1999)
(Kohn & Kohn, 1998)
Classifying Disorders
Diagnostic & Statistical Manual of Mental Disorders
DSM-IV
Goals of Diagnostic Classification
 Describe a disorder
 Predict its future course
 Imply appropriate treatment
 Stimulate research into its cause
Classification describes & orders clusters of symptoms
(Richardson, 1999)
Major Disorders
• Anxiety Disorder
– the occurrence of anxiety without obvious
external cause, intruding on daily functioning
(Feldman, 1999)
Anxiety Disorders
• Phobic Disorder
– intense, irrational fears of specific objects or
situations
• Panic Disorder
– anxiety that manifests itself in the form of panic
attacks that last from a few seconds to as long
as several hours
(Feldman, 1999)
Anxiety Disorders
Generalized Anxiety Disorder
Feeling unexplainably tense & uneasy
Unavoidable because the cause can’t be identified
May develop into “Panic Attacks”
Phobic Disorders
Irrational fear of a specific object or situation
People often accept & live with phobias
Fear of snakes, high places, crowds, cats etc.
Obsessive-Compulsive Disorder
Repetitive Thoughts or Repetitive Behaviors
They interfere with the way we live or cause distress
(Richardson, 1999)
Explaining Anxiety Disorders
Learning
Psychoanalytic
Perspective
Perspective
Anxiety is based on
Early childhood
predictability of
fixation and/or
stimulus
Biological
repression
Perspective
Anxiety as
evolutionarily
adaptive + twin
studies & PET
scans
(Richardson, 1999)
Anxiety Disorders
• Obsessive-Compulsive Disorder
• Obsession
– a thought or idea that keeps recurring in one’s
mind
• Compulsion
– an urge to repeatedly carry out some act that
seems strange and unreasonable, evenif the
sufferer realizes it is unreasonable
(Feldman, 1999)
(Feldman, 1999)
Somatoform Disorders
• Somatoform disorder
– psychological difficulties that take on a
physical (somatic) form of one sort or another
(Feldman, 1999)
Somatoform Disorders
Conversion Disorders - anxiety converted into
a
physical symptom
Hypochondriasis - normal sensations interpreted
as symptoms of scary sicknesses
Disorders that involve physical
symptoms
(Richardson, 1999)
Somatoform Disorders
• Hypochondriasis
– constant fear of illness, and physical sensations
are misinterpreted as signs of disease
• Conversion disorder
– involves an actual physical disturbance, such as
the inability to use a sensory organ or the
complete or partial inability to move an arm or
leg
(Feldman, 1999)
Dissociative Disorders
• Dissociative disorder
– psychological dysfunctions characterized by the
splitting apart of critical personality facets that
are normally integrated, allowing stress
avoidance by escape
(Feldman, 1999)
Dissociative Disorders
• Dissociative identity disorder (multiple
personality)
– a disorder in which a person displays
characteristics of two or more distinct
personalities
(Feldman, 1999)
Dissociative Disorders
• Dissociative amnesia
– a failure or inability to remember past
experiences
• Dissociative fugue
– an amnesiac condition in which people take
sudden, impulsive trips, sometimes assuming a
new identity
(Feldman, 1999)
Dissociative Disorders
Sudden memory loss or change in identit
Dissociative Amnesia
 Selective forgeting
 Response to Y stress
 Temporary
Fugue
 Presumed forgetting
 Fleeing home & ID
 Temporary (Real?)
Multiple Personality Disorder
 Two or more distinct personalities
 Physio evidence for separate personalities
 popularity has lead to  diagnosed cases
 More cultural than psychological?
(Richardson, 1999)
Mood Disorders
• Mood disorder
– affective disturbances severe enough to
interfere with normal living
• Major depression
– a severe form of depression that interferes with
concentration, decision making, and sociability
(Feldman, 1999)
Mood Disorders
• Mania
– an extended state of intense euphoria and
elation
• Bipolar disorder
– a disorder in which a person alternates between
euphoric feelings of mania and bouts of
depression
(Feldman, 1999)
Mood Disorders
Major Depressive Experience prolonged
hopelessness & lethargy,
Disorders
eventually rebounding to
normality
Alternate between Bipolar Disorders
depression and mania (Manic-Depressive Disorder)
(overexcited &
hyperactive state)
(Richardson, 1999)
Major Depressive Disorder
Signs of Depression
 Poor Appetite
 Insomnia
 Lethargy
 Feelings of Worthlessness
 Loss of Interest in Family,
Friends & Activities
Last > 2 weeks w/o notable cause?
(Richardson, 1999)
Seasonal Affective Disorder
Depression
(Kohn & Kohn, 1998)
(Kohn & Kohn, 1998)
(Kohn & Kohn, 1998)
(Kohn & Kohn, 1998)
Causes of Mood Disorders
• Learned helplessness
– a state in which people conclude that
unpleasant or aversive stimuli cannot be
controlled
– a view of the world that becomes so ingrained
that they cease trying to remedy the aversive
circumstances, even if they actually can exert
some influence
(Feldman, 1999)
Schizophrenia
• Schizophrenia
– a class of disorders in which severe distortion
of reality occurs
•
•
•
•
•
•
decline from a previous level of functioning
disturbances of thought and language
delusions
perceptual disorders
emotional disturbances
withdrawal
(Feldman, 1999)
Schizophrenia
• Process schizophrenia
– symptoms develop relatively early in life,
slowly and subtly
• Reactive schizophrenia
– onset of symptoms is sudden and conspicuous
• Positive-symptom schizophrenia
• Negative-symptom schizophrenia
(Feldman, 1999)
Schizophrenic Disorders
Signs of Schizophrenia
 Disorganized Thinking
 Disturbed Perceptions
 Inappropriate Actions
 Inappropriate Emotions
 Affects ~ 1:100 people
(Richardson, 1999)
Disorganized Thinking
Delusions
Thinking is fragmented and distorted by false beliefs
“I’m a movie star, from the planet Gottu - when I finish
making the movie, the president will give me an award. Is this
room painted pink because you knew it was my favorite?”
Q: Why?
A: Impaired Attention
(Richardson, 1999)
Breakdown in selective
attention leaves you
easily distracted.
(Kohn & Kohn, 1998)
(Kohn & Kohn, 1998)
Inappropriate Emotions &
Actions
Emotions & Actions seem split off from reality
Flat Affect - zombie-like state of apparent apathy
Catatonia - period of remaining motionless followed
by state of agitation
Remember Robin Williams
in “Awakenings”?
(Richardson, 1999)
Types of Schizophrenia
Schizophrenia is a cluster of disorders
Positive Symptoms vs Negative Symptoms
•disorganized/deluded vs toneless/expressionless
•inappropriate emotions vs silence/catatonia
Chronic vs Acute Schizophrenia
• slow development/history of social inadequacy
• rapid development/reaction to particular life stress
(Richardson, 1999)
Causes of Schizophrenia
• Biological causes
– dopamine hypothesis
• schizophrenia occurs when there is excess activity in
those areas of the brain that use dopamine as a
neurotransmitter
• Environmental perspectives
– expressed emotion
• an interaction style characterized by criticism,
hostility, and emotional intrusiveness by family
members
(Feldman, 1999)
The Prevalence of Psychological
Disorders
(Feldman, 1999)
Bipolar Disorder
Signs of Bipolar Disorder
 Overtalkative
 Overactive
 Little Need for Sleep
 Elated
 Grandiose Optimism &
Self-Esteem
Mild B-D may result in  creativity
(Richardson, 1999)
(Kohn & Kohn, 1998)
(Kohn & Kohn, 1998)
Explaining Mood Disorders
Psychoanalytical
Current feeling evokes
similar childhood
feelings that turn inward
and produce depression
Social-Cognitive
Negative thoughts influence
biochemical events creating
a cycle of depression
(Richardson, 1999)
Biological
Depression involves
genetic predispositions
and neurotransmitter
abnormalities
Mood
Brain
Chemistry
Cognition
Cycle of Depression
1
Stressful
Experiences
2
Negative
Explanatory
Style
3
Depressed
Mood
4
Cognitive and
Behavioral
Changes
Causes of Mood Disorders
• Learned helplessness
– a state in which people conclude that
unpleasant or aversive stimuli cannot be
controlled
– a view of the world that becomes so ingrained
that they cease trying to remedy the aversive
circumstances, even if they actually can exert
some influence
(Kohn & Kohn, 1998)
Disturbed Perceptions
Patient experiences an altered world
and perceives things that are not there.
Dreams breaking into waking consciousness
(Richardson, 1999)
Understanding Schizophrenia
Brain Abnormalities
 Excessive dopamine (+ symptoms)
 Abnormal brain tissue
 Low activity in frontal lobes
Genetic Predisposition
 Odds are…
1:100 for general population
1:10 if sibling or parent has it
1:2 if identical twin has it
(Richardson, 1999)
Psychological Factors
Personality Disorders
• Personality disorder
– a mental disorder characterized by a set of
inflexible, maladaptive personality traits that
keep a person from functioning properly in
society
Personality Disorders
• Antisocial or sociopathic personality
disorder
• a disorder in which individuals tend to display no
regard for the moral and ethical rules of society or
the rights of others
• Borderline personality disorder
• a disorder in which individuals have difficulty in
developing a secure sense of who they are
Personality Disorders
• Antisocial or sociopathic personality
disorder
• no regard for the moral and ethical rules of society
or the rights of others
• Borderline personality disorder
• difficulty in developing a secure sense of who they
are
• Narcissistic personality disorder
• exaggerated sense of self-importance
References
• Feldman, M. (1999). McGraw Hill Company.
Retrieved May 2002 from World Wide Web at:
http://www.mcgrawhill.com.
• Kohn, A. J. & Kohn, W. (1998). The Integrator
2.0. CD-Rom. Brooks/Cole Thomson Learning.
• Richardson, K. (1999). Retrieved May 2002 from
the World Wide Web at:
http://www.monmouth.edu.