Transcript Personality disorder

Psychological disorders
I. Defining and diagnosing
disorders
chapter 11
Mental disorder
Any behavior or
emotional state that:
• causes a person to suffer
• is self-destructive
• seriously impairs the person’s ability
to work or get along with others
• endangers others or the community
Diagnostic and Statistical Manual
[DSM]
Axis I: Primary clinical problem
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Social and environmental
stressors
Axis V: Current and past levels of
overall functioning
Explosion of mental
disorders
Supporters of new
categories answer that it
is important to
distinguish disorders
precisely.
Critics point to
economics: diagnoses are
needed for insurance
reasons for therapists to
be compensated.
Projective tests
Projective tests
Psychological tests used to
infer a person’s motives,
conflicts, and unconscious
dynamics on the basis of the
person’s interpretation of
ambiguous stimuli
Rorschach inkblot test
A projective personality test
that asks respondents to
interpret abstract,
symmetrical inkblots
Objective tests
Inventories
Standardized objective questionnaires
requiring written responses
Typically include scales on which people
are asked to rate themselves
“Evaluating Whether You Are Depressed”
II. Mood disorders
chapter 11
Symptoms of
depression
Major depression
A mood disorder involving disturbances in:
•emotion (depressed mood, excessive sadness)
•behavior (reduced interest in one’s usual activities)
•cognition (thoughts of hopelessness, feelings of
worthlessness or guilt, reduced ability to concentrate,
recurrent thoughts of death)
•body function (fatigue, loss of appetite, significant weight
loss or gain, sleeping too much or too little)
DSM IV requires 5 of these
within the past 2 weeks
Bipolar disorder
A mood disorder in
which episodes of
depression and mania
(excessive euphoria)
occur.
AKA: manic-depressive
disorder
Genetic factors in
depression
Studies of adopted children support genetic
explanations of depression.
5-HTT is a gene that is present in either a long or
short form.
17% of individuals with the long form become severely depressed.
43% of individuals with 2 copies of the short form become depressed.
Genetics may also influence levels of serotonin and
other neurotransmitters.
Biomedical therapy is common for depression.
Major depression: Antidepressant medication
Bipolar disorder: Lithium (also antidepressants, antipsychotics)
Life experiences and
circumstances
Social explanations
emphasize the
stressful
circumstances in
people’s lives.
• Loss of or problems with
important relationships
• Women are less satisfied
with work and family and
more likely to live in poverty.
•A health psychologist might
emphasize stress reduction
Cognitive habits
Cognitive explanations
emphasize habits of thinking
and ways of interpreting
events.
Depressed people believe
their situation is permanent,
uncontrollable.
Rumination
Brooding about negative
aspects of one’s life
Cognitive therapy is often
effective in treating
depression
III. Anxiety disorders
Generalized anxiety
disorder
Continuous state
of anxiety marked
by feelings of
worry and dread,
apprehension,
difficulties in
concentration, and
signs of motor
tension
Panic disorder
An anxiety disorder
in which a person
experiences
recurring panic
attacks
Panic attack: a feeling of
impending doom or death,
accompanied by physiological
symptoms such as rapid
breathing and dizziness
Fears and phobias
Phobia
An exaggerated, unrealistic fear of a specific situation,
activity, or object
Agoraphobia
A set of phobias,
often set off by a
panic attack,
involving the basic
fear of being away
from a safe place or
person.
Posttraumatic stress
disorder
An anxiety disorder in which a person who
has experienced a traumatic or lifethreatening event has symptoms such as
psychic numbing, reliving the trauma, and
increased physiological arousal
Diagnosed only if symptoms persist for six
months or longer
May immediately follow event or occur later
Obsessive-compulsive
disorder
An anxiety disorder in
which a person feels
trapped in repetitive,
persistent thoughts
(obsessions) and
repetitive, ritualized
behaviors (compulsions)
designed to reduce
anxiety
Treatment of anxiety
disorders
•Biomedical
therapy
(antidepressant and
antianxiety medication)
•Cognitive
•Behavior
therapy
therapy
IV. Dissociative disorders
Dissociative amnesia
Involves memory loss caused by extensive
psychological stress
Dissociative identity
disorder
A controversial disorder marked by the
appearance within one person of two or
more distinct personalities, each with its
own name and traits
Commonly known as Multiple Personality Disorder
The MPD controversy
First view
•MPD
is common but often unrecognized as such.
•Starts in childhood as a means of coping
•Trauma produced a mental splitting.
Second view
•Created
through pressure and
suggestion by clinicians
•Handfuls to 10,000 since 1980
Sociocognitive explanation
MPD is an extreme form of our ability to
present many aspects of our personalities to
others.
MPD is a socially acceptable way for some
troubled people to make sense of their
problems.
Therapists looking for MPD may reward
patients with attention and praise for
revealing more and more personalities.
V. Personality disorders
Problem personalities
Personality disorder
Rigid, maladaptive patterns
that cause personal distress
or an inability to get along
with others
Narcissistic personality
disorder
Characterized by an
exaggerated sense of selfimportance and selfabsorption
Criminals and psychopaths
Antisocial personality disorder
Characterized by a lifelong pattern of irresponsible,
antisocial behavior such as lawbreaking, violence, and
other impulsive, restless acts
VI. Schizophrenia
Schizophrenia
A psychotic disorder marked by:
Delusions
Hallucinations
Disorganized, incoherent speech
Inappropriate behavior
Impaired cognitive abilities
Typical onset: adolescence to early adulthood
Delusions and
hallucinations
Delusions
False beliefs that often
accompany schizophrenia
and other psychotic
disorders
Hallucinations
Sensory experiences that
occur in the absence of
actual stimulation
Genetic vulnerability
The risk of
developing
schizophrenia
increases as the
genetic
relatedness with a
diagnosed
schizophrenic
increases.
Structural brain
abnormalities
Several abnormalities
exist:
Decreased brain weight
Decreased volume in
temporal lobe or hippocampus
Enlargement of ventricles
About 25% do not
have these
observable brain
deficiencies.
Neurotransmitter
abnormalities
Many schizophrenics have
high levels of brain
activity in areas served by
dopamine, and greater
numbers of dopamine
receptors.
Abnormalities may also
involve serotonin,
glutamate
Biomedical therapy:
antipsychotic medication
Prenatal or birth
complications
Damage to the fetal
brain increases
chances of
schizophrenia and
other mental
disorders.
Damage may occur as a
function of:
maternal malnutrition
maternal illness
brain injury
oxygen deprivation at birth