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Module 47
Introduction to
Psychological Disorders
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Medical Student Disease -- A warning
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How Can we define abnormal Behavior?
1) Clinically significant - serious enough
to warrant professional attention.
-distress
-disabling
-dangerous to the person or to others.
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2) Internal Source - stems from within
3) Involuntary Manifestations
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Labeling and Psychological Disorders
•Rosenhan and 8 mentally healthy
associates, ("pseudopatients“) were
admitted to psychiatric hospitals by
feigning auditory hallucinations (the
words "empty", "hollow", "thud“)
•None had a history of mental illness.
•After admission symptoms
disappeared and pseudopatients
asked to be released.
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• Their stays ranged from 7 to 52 days, and the
average was 19 days.
• All were discharged with a diagnosis of
schizophrenia "in remission," which Rosenhan
takes as evidence that mental illness is
perceived as an irreversible condition creating
a lifelong stigma rather than a curable illness.
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• Despite constantly and openly taking extensive
notes on the behavior of the staff and other
patients, none of the pseudopatients were
identified as impostors by the hospital staff,
although many of the other psychiatric patients
seemed to be able to correctly identify them as
impostors.
• Labels can effect perceptions of behaviors.
• Self-fulfilling prophecies
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Factors Effecting Psychological Disorders
1) Predisposing factors - in place before the
disorder begins.
(Genetic, learned, societal)
2) Precipitating Causes current stressors.
3) Maintaining Causes - rewards
(e.g., attention, avoidance of responsibilities)
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Diagnostic and Statistical Manual of Mental
Disorders (DSM -5 )
- specifies criteria (symptoms) for diagnosis.
- attempt to increase reliability of diagnosis.
DSM IV has 16 categories (each with several
sub-categories).
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Anxiety Disorders
Mood Disorders
Somatoform Disorders
Substance-related
Sleep disorders
Eating Disorders
Adjustment disorders
Factitious disorders
Personality disorders
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Psychological factors affecting medical disorders
Dissociative Disorders (Amnesia; DID)
Schizophrenia and psychotic disorders
Sexual and Gender Identity disorders
Impulse control disorders
Disorders diagnosed in childhood or adolescence
Delirium, dementia, amnesia & cognitive
disorders.
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Anxiety Disorders
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Anxiety and Avoidance Disorders
Fear - specific item, situation or thought.
Anxiety - vague, unspecified generalised fears or
future fear.
Easiest to treat (good prognosis).
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Generalized Anxiety Disorder (GAD)
• exaggerated worry and tension, often
expecting the worst, even when there is no
apparent reason for concern.
• They anticipate disaster and are overly
concerned about money, health, family, work,
or other issues.
• Free-floating anxiety
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• GAD is diagnosed when a person worries
excessively about a variety of everyday
problems for at least 6 months
• GAD develops slowly. It often starts during
the teen years or young adulthood.
• More common in women,
• Rare after age 50.
• Symptoms may get better or worse at different
times, and often are worse during times of
stress.
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Panic Disorder
• Physiological symptoms
e.g., heart racing, shortness of breath
• Psychological Symptoms
e.g., fear of losing control or dying
feeling of unreality
• Nicotine (stimulant) use doubles the risk of
having Panic disorder
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Causes
- genetics
- brain abnormalities
- mis-interpretation of physical symptoms.
- Catastrophic Thinking
Extreme case: Agoraphobia
Fear of being separated from a safe place.
- often can not leave their homes without a "safe"
person.
- more common in women.
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Phobias - intense, irrational fear of specific objects
or events.
Specific Phobias - fear of something specific
- Usually arise in middle childhood
- more common in females.
-prevalence 30 to 40%
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Some Examples
Acrophobia
Claustrophobia
Hematophobia
Gephyrophobia
Kenophobia
Aichmophobia
Aquaphobia
Cynophobia
Aerophobia
Entomophobia
Gamophobia
Ophdophobia
Xenophobia
Melissophobia
Homilophobia
Porphyrophobia
Fear of:
heights
enclosed places
blood
crossing a bridge
empty rooms
sharp pointed objects
Water
dogs
flying
insects
marriage
snakes
strangers
Bees
Sermons
Module
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the color
19
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B) Social Phobias
excessive fear of being scrutinised or evaluated
- Avg. age of onset 19
- equal for males and females
- without intervention lifelong (chronic)
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Obsessive Compulsive Disorder (OCD)
Obsessions - recurrent thoughts, impulses, or
images
-intrusive, inappropriate and cause distress.
Compulsions repetitive behaviours
Goal to reduce anxiety but not realistic prevention.
- tends to begins before age 15
- genetic
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Common Types
Checking Behavior
Cleaning Behavior
Washing
Rituals
Therapy
Exposure Therapy
Drug Therapies
Clomipramine and Prozac
- increases seratonin
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Post Traumatic Stress Disorder
-Re-experiencing of traumatic events
-dreams or thoughts
-irritability
-sleep problems
-difficulty concentrating
Video
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Treatments
- exposure therapy (systematic desensitization)
- cognitive therapy
- EMDR
Drug Therapies
Tranquilizers (Valium, Xanax)
- temporary solution
- habit forming
Clomipramine and Prozac
- increases serotonin
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