Transcript Psychological Disorders

Chapter 14
Psychological
Disorders: Part 1
Music
“I’ll Go Crazy if I Don’t Go Crazy”
U2
“Mad World”
Adam Lambert
Today’s Agenda
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1. What is Abnormal?
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2. Anxiety Disorders:
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Somatization Disorders/ Hypochondriasis
4. Dissociative Disorders
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Generalized Anxiety/ PTSD/ Obsessive Compulsive
Disorders
3. Somatoform Disorders
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Criteria / Classification
Multiple Personality Disorder
5. Mood Disorders
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Depression/ Bipolar Disorders /Suicide
1. What IS Abnormal??
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Criteria:
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1) Distress is present:
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Person is suffering, unhappy, afraid
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2) Behaviour is maladaptive
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Impaired functioning
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Inability to meet responsibilities
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3) Socially Deviant
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Behaviour is unusual, “not normal”
Classification
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DSM-IV, p. 580 text
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Why Classify?
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Simplify and create order
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Research
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Plan treatment
Criteria for Abnormality
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Fig. 14.2 p. 608
Where is the dividing line between
normal and abnormal behavior?
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Deviation from statistical average
Deviation from cultural/societal average
1. Classification (cont’d)
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Older Distinction:
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Neurotic vs. Psychotic
Neurotic:
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Distressing problem but person is still coherent and can
function socially (once acute phase of disorder is treated).
E.g. most disorders discussed today
Psychotic:
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More bizarre, involving delusions or hallucinations.
Individual has impaired thought processes and cannot
function socially. Treatment is long term
E.g. schizophrenia (next week)
2. Anxiety Disorders
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Anxiety:
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Fear in situations that pose no objective threat
3 components:
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A) Cognitive:
 Extreme/chronic worry; fear of harm
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B) Physiological:
 Muscle tension, increased heart rate and blood pressure
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C) Behavioural:
 Shaking, jumpiness, pacing, avoidance
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Generalized Anxiety Disorders (5%)
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Symptoms of anxiety felt continuously for at least 6 months
Excessive worry, restlessness, sleep disturbance that are
difficult to control
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http://www.youtube.com/watch?v=dRmBJhtys9g
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2. Anxiety Disorders
(cont’d)
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Panic Disorders: (2-3%)
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Presence of recurrent, and unexpected panic attacks:
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May lead to Agoraphobia (fear of open spaces)
Post-Traumatic Stress Disorder
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Intense dread, shortness of breath, chest pain, choking, fear of going crazy or losing
control or dying, shaking, sweating, nausea…
Re-experiencing traumatic event (e.g. dreams, flashbacks, reliving the experience)
Avoidance of stimuli associated with the trauma (thoughts, feelings, people, places)
Difficulties with sleep, concentration, irritability
Is causing distress and impairment in functioning
http://movieclips.com/e7Xc-born-on-the-fourth-of-july-movie-the-homecoming-speech/
Social Phobia: (3-13%)
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Fear of social or performance situations
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Public speaking;
Eating, drinking, writing in public
2. Anxiety Disorders
(cont’d)
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Obsessive-Compulsive Disorders (2%)
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Obsessions:
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Compulsions:
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Rituals, behaviours that reduce anxiety
Interfere with functioning
Four different themes:
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Persistent, uncontrollable thoughts
Obsessions and checking
Symmetry and order
Cleanliness and washing
Hoarding
Case examples:
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Illustration from movie “As Good as it Gets”
 http://www.youtube.com/watch?v=48jD-ZEuB0I
Howie Mandel: Germaphobic & Hypochondriac
3. Somatoform Disorders
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Hypochondriasis:
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4-9% in medical practice
Inordinate preoccupation with health and illness
excessive anxiety about having a disease
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http://www.youtube.com/watch?v=lkIQ39538Ig&feature=related
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http://www.youtube.com/watch?v=tV_ORdpOK3g
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Somatization Disorder:
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(1-2% women)
History of diverse physical complaints for which there is NO
organic basis
Long medical history of treatments for minor physical
ailments
4. Dissociative Disorders
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Multiple Personality Disorder (very rare)
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Presence of at least 2 distinct personalities within
the same individual
Leads to sudden changes in identity and
consciousness
Each personality has its unique style and may
unaware of the existence of the other
personalities
Often related to severe abuse in early childhood
5. Mood Disorders
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Depression
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Lifetime prevalence rates
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20% in women; 10% in men
Why more common in women?
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Cost of caring
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Exposure to higher levels of stress
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Victimization, abuse
Ruminative cognitive style
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Greater burden due to nurturing roles
Also more affected by disruptions in relational ties
as opposed to distraction or taking action
Perpetuates negative mood
More likely to report symptoms
Seasonal Affective Disorders (SAD)
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Depressive symptoms related to physiological consequences of shorter winter
days
Treatable with light therapy
5. Theories of Depression
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Biological predisposition
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Concordance rates in twins:
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Identical: 65% Fraternal: 15%
G X E models (interaction of genetic and environmental contributors)
Cognitive perspective
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Beck: Negative (dysfunctional) attitudes
Seligman: Attribution Theory
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How do you explain your circumstances?
 Internal vs external
 Stable vs unstable
 Global vs specific
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Depression: internal, stable, global attributions for negative events
Diathesis-stress models
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Depression results from an interaction between personality and negative life
events
Dependency and vulnerability to loss
Self-Criticism/Perfectionism and vulnerability to perceived failure
Cognitive Risk and Depression
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Featured Study p. 629
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Students with dysfunctional attitudes and depressive attributional style were
more likely to become depressed over 2 year period.
5. Mood Disorders
(cont’d)
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Bipolar Disorders:
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Periods of depression alternate with manic episodes
Mania:
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abnormally elevated mood, inflated self-esteem, pressure of
speech, increased energy, decreased need for sleep, overactivity, lack of inhibition and impaired judgment
http://www.youtube.com/watch?v=3mJoHqmtFcQ
Prevalence rates:
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1% in men and women
Strong genetic component
 Understood as a primarily biological disorder
 Unlike unipolar depression which has cognitive,
interpersonal and environmental determinants
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Case Example: Vincent Van Gogh
5. Suicide
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University students:
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40-50% have had suicidal thoughts
15% attempt suicide
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3rd leading cause of death among 15-24 year-olds
Major Risk Factors:
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Feelings of isolation; withdrawal from friends and family
Having a serious mental or physical illness
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Experiencing a major loss or stressor
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Including depression and feelings of hopelessness
Leading aggression or feelings of shame, humiliation, failure, rejection
History of child abuse (leading to self-harm in women)
Abuse of drugs or alcohol/ impulsivity
Talking about wanting to hurt oneself/ Having a plan
Feeling trapped, like there is no way out
5. Suicide (cont’d)
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How to help:
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1) Establish communication
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2) Identify needs that have been frustrated
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Talk about suicidal wishes
Search for love, recognition, respect?
3) Broaden suicidal person’s perspective
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Impermanence of feelings
 This too will pass
 Give yourself the chance to experience a better
future
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Provide support for treatment
Resources
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Mental Health Service Information Ontario
 1-866-531-2600 http://www.mhsio.on.ca
Mood Disorders Association of Ontario
 416-486-8049 http://www.mooddisorders.on.ca
Until next week: