Transcript Psychological Disorders - Eric Sweetwood's PTHS Psychology

CATATONIC STUPOR
SCHIZOPHRENIA AND OTHER
PSYCHOTIC DISORDERS
• The PARANOID SCHIZOPHRENIC has
elaborate systematized delusions about
the world. Three main types of delusions
are delusions of grandeur in which one is
a famous person such as Christ, delusions
of reference in which chance events such
as thunderstorms carry important
messages and delusions of persecution
that cause the schizophrenic to feel others
are plotting against him.
Delusions of Grandeur
Delusions of Reference
Delusions of Persecution
SCHIZOPHRENIA AND OTHER
PSYCHOTIC DISORDERS
• UNDIFFERENTIATED SCHIZOPHRENIA
includes schizophrenic symptoms that do
not fit any of the other subtypes. Often
after a schizophrenic disorder, the person
returns to a more normal functioning state.
They often exhibit minor symptoms of
schizophrenia and are then classified as
RESIDUAL SCHIZOPHRENICS.
UNDIFFERENTIATED
SCHIZOPHRENIA
ANXIETY DISORDERS
• Anxiety disorders encompass the
individual’s feelings of anxiety – tension,
distress, nervousness or uncomfortable
arousal by a strong and persistent
unpleasant feeling of apprehension and
fear. Although most of us feel anxiety and
tension at times, persons suffering from
anxiety disorders are constantly
apprehensive and nervous. Their anxiety
is intense, long-standing and disruptive.
ANXIETY DISORDERS
ANXIETY DISORDERS
• Common symptoms are:
• MOTOR TENSION (unable to relax, jittery,
muscle tension),
• APPREHENSION (fear, worry, overconcern),
• AUTONOMIC HYPERACTIVITY (pounding
heart, faintness, nausea or fast breathing), and
• HYPERVIGILANCE (hyperattentive focus on
anxiety-provoking stimuli).
ANXIETY DISORDERS
ANXIETY DISORDERS
• Excessive persistent anxiety lasting over a
month that is not focused on a particular
situation or object characterizes GENERALIZED
ANXIETY DISORDER. Since the person
generally does not know the real cause of the
anxiety the tension becomes FREE-FLOATING
ANXIETY. The person is generally anxious,
tense and irritable. Unable to sleep the person
becomes fatigued and unable to concentrate
and function well.
FREE-FLOATING ANXIETY
ANXIETY DISORDERS
• The main feature of a PANIC DISORDER
is terrifying PANIC ATTACKS that are
spontaneous and recurrent. Victims are
overcome with feelings of panic and
helplessness. Anxiety attacks may include
chest pains, trembling, heart palpitations
and intense terror. Women are twice as
likely as men to suffer from these episodic
attacks of acute anxiety.
PANIC ATTACKS
ANXIETY DISORDERS
• PHOBIC DISORDER is overwhelming fear of an
object or situation not likely to be dangerous.
People with phobias recognize their irrationality
but cannot keep fear from interfering with daily
life. SIMPLE PHOBIAS are excessive irrational
fears of specific situations or things. Common
fears are acrophobia (heights), claustrophobia
(enclosed spaces,) and acrophobia (fear of
flying). Phobias usually caused by a specific
traumatic experience are fear of snakes,
darkness, insects, dogs or blood.
SIMPLE PHOBIAS
ANXIETY DISORDERS
• SOCIAL PHOBIAS are described in DSM as "fear of, and
compelling desire to avoid a situation in which the
individual is exposed to possible scrutiny by others and
fears he or she may act in a way that will be humiliating
or embarrassing". Social phobias often develop in
adolescence and include a fear of criticism, fear of
making mistakes and fear of public speaking.
AGORAPHOBIA is an extreme fear of being alone in a
public place away from the security of home. Once the
fear generalizes the person experiences an intense,
irrational fear of leaving the house.
SOCIAL PHOBIAS
OBSESSIVE-COMPULSIVE
DISORDER
• Another common type of anxiety disorder is the
OBSESSIVE-COMPULSIVE DISORDER. OBSESSIONS
are anxiety-provoking thoughts that are repetitive and
will not go away. COMPULSIONS are repetitive actions
that are carried out ritualistically to avoid some feared
situation. Common compulsions include excessive
cleansing of hands, counting things, checking locks and
straightening things up around the house. People feel
compelled to indulge in meaningless rituals
(compulsions) to control their irrational and persistent
thoughts (obsessions).
OBSESSIVE-COMPULSIVE
DISORDER
STRESS DISORDERS
• A Stress Disorder is an extreme reaction to a
highly stressful even or situation. ACUTE
STRESS DISORDER is an acute, intense, brief
reaction to stress which directly follow a
traumatic event and last less than 4 months.
POSTTRAUMATIC STRESS DISORDER is the
intense psychological reenactment of a
traumatic event that may include nightmares,
flashbacks and recurrent and painful memories.
These may be so strong that a person may
believe they are reliving the event.
POSTTRAUMATIC STRESS
DISORDER
MOOD OR AFFECTIVE
DISORDER
• When a person experiences a severe
disturbance of mood or emotional
imbalance, we call the problem a MOOD
OR AFFECTIVE DISORDER. There are
two major types, DEPRESSION (Unipolar
Disorder) and MANIC DEPRESSION
(Bipolar Disorder
DEPRESSION
MANIC DEPRESSION
DEPRESSION
• When emotions are low and the individual
is sad, hopeless, despondent and
discouraged, often overcome with feelings
of guilt or worthlessness, we call this
MAJOR DEPRESSION. Other symptoms
are becoming withdrawn, apathetic and
unresponsive while losing physical
stamina, weight and motivation. Many
experience a diminished ability to think,
concentrate or make decisions.
MAJOR DEPRESSION
Charles Whitman—University of Texas
At Austin Shooting, 1966
DEPRESSION
• DEPRESSION is the COMMON COLD OF
MENTAL DISORDERS. More than a
quarter million people are hospitalized
every year with depression. The
despondent mood, loss of interest and
pleasure in activities and/or feelings of
emptiness and worthlessness often lead to
thoughts of suicide.
DEPRESSION
DEPRESSION
• Although SUICIDE is not a disorder, it can
result from depression. Most people who
commit suicide were depressed. Over
30,000 people commit suicide every year.
For every successful suicide there are 10
or more attempts. Women are four times
as likely to attempt suicide while men are
four times as likely to commit suicide.
SUICIDE
MANIC-DEPRESSION
• DEPRESSION can occur alone as a UNIPOLAR
DISORDER, or it can alternate with episodes of
mania becoming MANIC-DEPRESSION, a
BIPOLAR DISORDER. In MANIA the person's
mood is elated and exuberant. Seemingly
tireless the manic person can become restless
and irritable in his overdrive state. Mania seldom
occurs by itself. The exciter moods of mania
generally swing to the listless moods of
depression.
BIPOLAR DISORDER
BIPOLAR DISORDER
I just HAD to include this one…
MANIC-DEPRESSION
• Manic-depressive persons in manic phase
are euphoric, excited, and full of energy
and may believe there is no limit to their
possible accomplishments and act
accordingly. Often manic-depressives are
very successful in life but suffer extreme
depressive mood swings that may lead to
suicidal thoughts.
MANIC-DEPRESSION
SOMATOFORM DISORDERS
• SOMATOFORM DISORDERS are mental
disturbances in which psychological problems
take a physical (somatic) form, even though no
physical cause may be found. Although the
symptoms are not caused physically the pain or
distress is real, not faked. These differ from
Psychosomatic Diseases, genuine physical
ailments caused in part by psychological factors
such as ulcers and asthma that have a genuine
organic basis.
SOMATOFORM DISORDERS
CONVERSION DISORDER
• The classic example, which Freud called
HYSTERIA, is CONVERSION DISORDER in
which the anxiety is "converted" into a physical
loss or impairment of sensory or motor function.
The person appears to be blind, deaf, paralyzed
or unable to speak or feel pain. Although the
physical problems have no underlying organic
basis people suffering form conversion disorders
are not MALINGERING (faking) their physical
symptoms.
Freud and Conversion Disorder
HYPOCHONDRIASIS
• HYPOCHONDRIASIS is a pervasive fear
of disease or illness. Hypochondriacs are
always checking for symptoms of various
diseases and searching for doctors that
will agree with their self-diagnosis.
Preoccupied with their bodies,
hypochondriacs are obsessed with fear of
a serious medical disease. Tiny alterations
from normal make them believe they have
contracted a disease.
Hypochondriacs
SOMATIZATION DISORDER
• A Somatization Disorder is marked by a longstanding history of diverse physical complaints
that appear to be psychological in origin. While
hypochondriacs fear illness persons suffering
from SOMATIZATION DISORDER complain of
specific physical symptoms. Common
complaints are headaches, backaches, pain,
dizziness, allergies, cramps, diarrhea, psychosexual problems, fatigue, painful menstruation,
chest pain and missed heart beats. No organic
cause can be found.
Somatization Disorder
DISSOCIATIVE DISORDERS
• In DISSOCIATIVE DISORDERS the
afflicted person dissociates from or alters
his consciousness or identity. Dissociative
disorders are usually attempts to escape
from excessive anxiety through memory
loss such as AMNESIA, through a change
of identity (FUGUE) or a dissociation of
one part of the mind from another
(MULTIPLE-PERSONALITY).
DISSOCIATIVE DISORDERS
DISSOCIATIVE AMNESIA
• In PSYCHOGENIC (produced by the
mind) AMNESIA individuals literally forget
who they are along with the conflicts they
are escaping. It is a selective amnesia.
While they lose their sense of identify they
do not forget their language or other
intellectual skills.
AMNESIA
DISSOCIATIVE FUGUE
• FUGUE, "flight", is a special form of
psychogenic amnesia in which the
dissociated person not only loses his
identity but actually flees to another
location, beginning life anew with another
identity.
FUGUE
MULTIPLE-PERSONALITY
DISORDER
• MULTIPLE PERSONALITY is a rare but striking
dissociative disorder in which two or more distinct
personalities exist within one individual. Each personality
has its own characteristics, memories, desires and
relationships. Each identity speaks, writes and acts in a
very different way. Personalities within the individual may
be aware of the existence of the others. Generally shifts
among personalities are stress-related, sudden and
dramatic. When anxiety overwhelms or threatens one
personality the multiple personality switches to another
opposite personality that can handle the particular
stress.
MULTIPLE-PERSONALITY
DISORDER
MULTIPLE-PERSONALITY
DISORDER
• Recent research contends that many issues
presented by this disorder can give researchers
a clue to sexual trauma or sexual abuse. The
person suffering MPD creates a new personality
for when the sexual abuse to “deal with” the
sexual attack. In other words, they might say “it
is not me that was hurt, it was ‘Jimmy’” and thus
create another personality. Along the same line,
many men will create women personalities and
vice versa, due to the nature of the gender of
their attacker.
MULTIPLE-PERSONALITY
DISORDER
DISSOCIATIVE DISORDERS
• All DISSOCIATIVE DISORDERS provide a
means of escape from anxiety and personal
responsibility. Amnesia and fugue are usually
precipitated by excessive stress and are a form
of fantasy escape defense against stress. By
losing one's memory one is no longer faced with
obligations, severe conflicts, anxiety or guilt. A
substantial number of people with multiplepersonality disorder have a history of child
abuse and rejection from parents.
A History Of Child Abuse
SEXUAL AND GENDER IDENTITY
DISORDERS
• The Diagnostic and Statistical Manual
includes a range of atypical sexual
behaviors or problems of adjustment.
Three major types are SEXUAL DESIRE
DISORDERS, inhibited ability or desire to
have satisfying sexual experience,
GENDER IDENTITY DISORDERS
involving our sense of maleness or
femaleness and PARAPHILIAS, unusual
and bizarre forms of sexual arousal.
GENDER IDENTITY DISORDERS
SEXUAL DESIRE DISORDERS
• Psychological factors such as fear or anxiety are
considered to be the cause for most forms of
SEXUAL DESIRE DISORDERS such as
impotence and frigidity. Problems reaching
orgasm are often linked to problems in the
relationship, depression or self-consciousness.
Sexual dysfunctions are common and often
related to emotions but may be caused by
physical factors such as fatigue, diabetes or
resulting from medication or excessive use of
alcohol.
SEXUAL DESIRE DISORDERS
GENDER IDENTITY DISORDERS
• GENDER IDENTITY DISORDERS develop in childhood
or adolescence and involve our comfort with our
maleness or femaleness. Persons who are
TRANSSEXUALS want to be the opposite sex and feel
trapped in the wrong body. They may undergo a sexchange operation to fulfill their desires. A homosexual
prefers sexual relations with persons of his or her own
sex. Formerly considered a psychosexual disorder in
DSM-II, homosexuality was eliminated in the third edition
as it was not found to be inherently harmful of self or
others. However if one is distressed and anxious about
his or her homosexuality, this is included in DSM-IV as
EGO-DYSTRONIC HOMOSEXUALITY.
GENDER IDENTITY DISORDERS
PARAPHILIAS
• PARAPHILIAS are abnormal patterns of
sexual arousal from unusual sources or
objects including fetishism, exhibitionism,
voyeurism, sadism, masochism,
transvestism, rape and pedophilia.
Exhibitionism
PERSONALITY DISORDERS
• PERSONALITY DISORDERS are maladaptive
personality styles that are developed early in life
and are very resistant to change. They become
styles of life including extreme and rigid
personality traits that involve odd or eccentric
behaviors, dramatic and impulsive behavior or
fearful or anxious behavior. Generally people
with personality disorders do not think they have
a problem but often create problems for others
and thereby can create social psychotic
reactions.
PERSONALITY DISORDERS
ANXIOUS-FEARFUL CLUSTER
• The ANXIOUS-FEARFUL cluster includes efforts
to control anxiety about social rejection.
• An AVOIDANT-PERSONALITY is sensitive to
potential social rejection and socially withdraws
in spite of real desire for acceptance from
others.
• The DEPENDENT PERSONALITY reduces the
possibility of rejection by passively allowing
others to make decisions while subordinating
one's needs to those of others.
DEPENDENT PERSONALITY
ANXIOUS-FEARFUL CLUSTER
• The PASSIVE-AGGRESSIVE
PERSONALITY does not risk direct
confrontation but indirectly resists through
procrastinating, forgetting, lying or indirect
methods.
• The OBSESSIVE-COMPULSIVE
PERSONALITY copes with anxiety by
imposing rigid rules and order to their lives
and relationships to reduce anxiety.
PASSIVE-AGGRESSIVE
PERSONALITY
ODD-ECCENTRIC CLUSTER
• People suffering from the ODD-ECCENTRIC
cluster of personality disorders remain aloof,
distrustful and shield themselves from the
anxieties of interpersonal intimacy.
• The SCHIZOID PERSONALITY socially
withdraws, has no close friendships and is
indifferent to the feelings of others.
• The SCHIZOTYPAL PERSONALITY has bizarre
beliefs, oddities in perception, speech and
behaviors similar to the schizophrenic but not as
severe.
ODD-ECCENTRIC
Ted Kaczynski, the Unibomber
SCHIZOID PERSONALITY
SCHIZOTYPAL PERSONALITY
ODD-ECCENTRIC CLUSTER
• The PARANOID PERSONALITY shows
pervasive and unwarranted mistrust of
people, is oversensitive and suspicious,
prone to jealousy.
PARANOID PERSONALITY
DRAMATIC-IMPULSIVE CLUSTER
• The DRAMATIC-IMPULSIVE cluster is divided.
Histrionics and Narcissistics share a flare for
over-dramatizing everything while borderline and
antisocial personalities are marked by
impulsiveness.
• The HISTRIONIC PERSONALITY is egocentric
and seeks attention with overly dramatic
expressions of emotion. Their emotions are
exaggerated and may border on the hysterical.
HISTRIONIC PERSONALITY
DRAMATIC-IMPULSIVE CLUSTER
• People with a NARCISSISTIC
PERSONALITY also thrive on attention.
Feeling grandiosely self-important they
demand special treatment and constant
admiration while lacking empathy.
NARCISSISTIC PERSONALITY
DRAMATIC-IMPULSIVE CLUSTER
• The BORDERLINE PERSONALITY is unstable
in their self-image, mood and interpersonal
relationships and is therefore impulsive and
unpredictable.
• The ANTISOCIAL PERSONALITY fails to agree
to social norms and violates the rights of others.
They are often exploitative, using their intellect
and social savvy to charm people to get their
way or to use people for personal gain.
ANTISOCIAL PERSONALITY
John Wayne Gacy—Serial Killer
ANTISOCIAL PERSONALITY
• Perhaps the most troubling of the
PERSONALITY DISORDERS is the
ANTISOCIAL PERSONALITY as it is
marked by chronic violation of the rights of
others. Over 4% of the male population
suffer from this disorder and are
responsible for a large amount of violent
crime as well as white-collar crime.
ANTISOCIAL PERSONALITY
Ted Bundy—Serial Killer
ANTISOCIAL PERSONALITY
• ANTISOCIAL PERSONALITIES are
irresponsible, impulsive and often unscrupulous,
callous, aggressive and often criminal. Antisocial
people rarely feel guilt and lack an adequate
conscience. They may seem to be quite
appealing and charming when we first meet
them as they are skilled at faking interest and
affection so they can exploit people. Their lack of
conscience allows them to seem carefree,
socially at ease and stress-free.
ANTISOCIAL PERSONALITY
Richard Speck—Murdered Eight Nurses
In Chicago
ANTISOCIAL PERSONALITY
• While many end up in prison because of
their amoral, callous and aggressive
behavior, many antisocial personalities
successfully channel their exploitative
behavior within boundaries of the law
becoming unprincipled, scheming, selfserving politicians, con artists, business
executives, lawyers or even evangelists.
ANTISOCIAL PERSONALITY
Herman Mudgett—Allegedly killed over 200
people in Chicago at the turn of the Century
ANTISOCIAL PERSONALITY
• Their selfish, impulsive, irresponsible,
manipulative behaviors make them
unreliable, unfaithful, undependable and
disloyal employees, mates, friends and
parents. DSM-IV reports that this is a
moderately common disorder affecting 13% of the population, mostly males.
ANTISOCIAL PERSONALITY
Saddam Hussain
OBJECTIONS TO THE
CLASSIFICATION OF MENTAL
DISORDERS
• Perhaps the most prominent critic of the
Diagnostic and Statistical Manual is
Thomas Szasz, famous for his 1960 article
that proposed "The Myth of Mental
Illness". Szasz argues that the concept of
mental illness is not only inappropriate but
also harmful.
Thomas Szasz
• He prefers to call the disorders "problems
of living." By labeling problems as a
"mental illness" we only stigmatize
persons and place them in an inferior
passive role as a "patient". Becoming a
"patient" allows a person to turn over
responsibility for a cure to a doctor and
may inhibit their personal desire to
improve.
Thomas Szasz
OBJECTIONS
• Other problems may occur in treatment as the
"patient" tries to please the psychiatrist or
hospital staff rather than find his or her own
solution to the problem. We also all know that
once labeled with a mental illness there is a
social stigma attached. People look at mentally
ill people differently and may avoid contact or
discriminate against them in employment or
friendships. The label itself may indeed do more
harm than good argued Szasz.
Labeling People
OBJECTIONS
• Rosenhan lent experimental proof of Szasz's
thesis that diagnostic labels create damaging
preconceptions and cause us to judge and
interpret the behavior of the "mentally ill" in
destructive and potentially harmful ways. In his
now classic study, "Being Sane in Insane
Places", Rosenhan coached totally normal
people to feign simple auditory hallucinations to
see if they would be admitted to mental
hospitals. They complained that they had heard
"hollow", "empty" or "thud" in the past but felt
fine now.
Being Sane in Insane Places
OBJECTIONS
• All the normal people were admitted to the
mental hospital even though they showed
no present symptoms and acted totally
normal. All the "pseudo-patients" were
diagnosed as "schizophrenic" but one who
received the label of "manic-depressive."
Being Sane in Insane Places
David Rosenhan—Being Sane in Insane Places
OBJECTIONS
• The staff treated them according to their label,
giving them medication and interpreting their
behavior of taking notes as suspicious activity.
The volunteers felt dehumanized and degraded
and found that staff avoided eye contact and
rarely interacted with them. None detected their
fake status and they had difficulty getting
released from the hospital. Rosenhan gave
credence to the idea that labels can be very
damaging.