Transcript Psychological Disorders

Psychological Disorders:
More Than Everyday Problems
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Today’s class
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What is Abnormal?
Diagnostic system: DSM IV
Types of Disorders
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Dissociative
Anxiety
Schizophrenia
Mood
Personality
Work on projects, review exam
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Psychological Disorder
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The presence of a constellation of symptoms
that create significant distress; impair work,
school, family, relationships, or daily living; or
lead to significant risk or harm
Symptoms
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Cognitive
Emotional
Behavioral
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How do we decide what is
abnormal
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Class exercise
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Defining Abnormality
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Distress
Impairment
Danger
Cultural and social influences
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Historical explanations of
abnormality
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Ancient Greece – fluid imbalance
Middle ages – work of the devil
1800’s to present – Sigmund Freud
Present – Biopsychosocial model
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Explaining Abnormality
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The Brain
Genes
 Neurotransmitters
 Brain Structure and Function
 Diathesis (of the Diathesis-Stress Model)
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Explaining Abnormality
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The Person
Classical and Operant Conditioning
 Cognitive Biases
 Emotions
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Explaining Abnormality
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The Group
Culture  Conception of Disorders
 Social labeling creates disorders?
 Social factors can lead to diagnostic bias
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Causation
1. Predisposition
 In place before onset of disorder
• genetic characteristics, learned beliefs, sociocultural factors
2. Precipitating causes
 Immediate events that bring on the disorder
• Stress, Negative or positive life changes
3. Maintaining causes
 Effects of disorder that serve to perpetuate it
 depressed person may withdraw from social interactions
 Schizophrenics are reacted to strangely or violently, enhancing
their stress, which enhances the disorder
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Diagnosing Disorders
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Use diagnostic interview
Performance on Psychological Tests
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e.g., MMPI, Projective tests
Interviews with Family & Friends
Compare patient information to pre-established
psychological disorders
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Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV)
DSM IV: Agreed-upon criteria for diagnosing
psychological disorders
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Diagnosis: The first step in
treatment
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Someone
Someone
Someone
arm?
Someone
voices?
came in with a rash?
came in with a cough?
came in who couldn’t move an
came in who was hearing
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Labels and Abnormality
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Rosenhan: “On being sane in insane
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8 pseudopatients claimed to hear voices
Admitted to psychiatric hospitals
Stopped reporting symptoms
Normal behaviors were interpreted as
pathological
Doctors rarely responded to questions
Many real patients were not fooled
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Categorizing Disorders
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Diagnostic and Statistical Manual of
Mental Disorders, 4th edition (DSM-IV)
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Axis I: clinical disorders
Axis II: personality disorders and mental
retardation
Axis III: general medical conditions
Axis IV: psychosocial and environmental problems
Axis V: global assessment of functioning
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Classification Systems & Labeling:
Advantages
Advantages:
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grouping of similar symptoms may help
to identify underlying causes
facilitates communication
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Classification Systems & Labeling:
Disadvantages
 May seem dehumanizing for patients
 Better to apply diagnostic labels to the disorder
and NOT to the people themselves
 May lead clinicians to overlook unique
aspects of each case
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Label becomes a lens through which we see
and evaluate a person’s behavior
Is a label the same as a diagnosis?
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Mood Disorders
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Persistent or episodic disturbances in emotion
that interfere with normal functioning in at least
one realm of life
Major depressive disorder
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Affect
Behavior
Cognition
More common in women
Most common psychological disorder in the United
States
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Mood Disorders
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Dysthymia
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Lifetime prevalence 6%
Suicide
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Attempted by 30% of depressed people
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Mood Disorders
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Bipolar disorder
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Mania
Hypomania
 Manic episode
 Prodromal phase
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Often cycles with depression
Formerly called manic depression
Lifetime prevalence 1%
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Explaining Mood Disorders
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The brain
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The person
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Hereditary factors
Frontal lobe
Amygdala
Beck’s negative triad
Learned helplessness
Attributional style
The group
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Life stressors
Lack of social reinforcement
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Anxiety Disorders
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Generalized anxiety disorder
Panic disorder
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Panic attacks
Agoraphobia
Locus coeruleus
Anxiety sensitivity
Lifetime prevalence 3%
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Anxiety Disorders
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Phobias
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Social phobia
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Lifetime prevalence 13%
Specific phobia
Animal fears
 Blood-injection-injury fears
 Natural environment fears
 Situation fears
 Miscellaneous fears
 Lifetime prevalence 10%
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Anxiety Disorders
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Obsessive-compulsive disorder (OCD)
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Obsession
Compulsion
Checking
 Washing
 Ordering
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Lifetime prevalence 2-3%
Caudate nucleus
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Anxiety Disorders
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Posttraumatic stress disorder (PTSD)
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Traumatic event
Fear and helplessness
Symptoms
Re-experience event
 Avoidance and emotional numbing
 Heightened arousal
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Lifetime prevalence 8% (among
Americans)
Genetic predisposition
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Schizophrenia
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Positive symptoms
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Delusions
Hallucinations
Disordered behavior
Disorganized speech
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Negative symptoms
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Flat affect
Alogia
Avolition
Lifetime prevalence 1%
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Schizophrenia
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Four subtypes
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Paranoid
Disorganized
Catatonic
Undifferentiated
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Explaining Schizophrenia
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The brain
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The person
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Hereditary
Ventricle size
Stress-related hormones
The dopamine hypothesis
Emotional dampening
The group
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High expressed emotion
Social selection and social causation
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Testing yourself
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Name that disorder
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