Transcript Psychological Disorders

History of Psychological
Disorders
 Psychological disorders were once understood as
religious experiences, demonic possession, God’s
punishment
 Patients were treated as “mad,” imprisoned or
executed for abnormalities
 Medical model: the conceptualization of psychological
abnormalities as diseases that, like biological diseases,
have symptoms and causes and possible cures
Totally Legitimate Medical
Terminology
How to Classify Disorders?
 Diagnosis: determining the nature of
the disorder
 Symptoms: signs of an underlying
problem or “syndrome”
 DSM-IV-TR: a classification system
that describes the features used to
diagnose each recognized mental
disorder and indicate how the disorder
can be distinguished from other, similar
problems
What is a “Disorder”?
 DSM-IV-TR defines a disorder as
 Manifested in symptoms that involve
disturbances in behavior, thoughts, or emotions
 Symptoms are associated with significant
personal distress or impairment
 Symptoms stem from an internal dysfunction
(biological, psychological, or both)
 NOT just deviation from what is “normal”
 Lots of behaviors—including positive ones—
aren’t perfectly normal, but not all signify psych
disorders
What is a “Disorder” (Part
2)?
 Different names for disorders
 Neurosis: a condition that involves anxiety or the
inability to properly sublimate psychical energy
 Psychosis: a condition in which a person experiences
serious distortions of perception and thought that
weaken his/her grasp on reality
 Anxiety Disorders: like neuroses; each subgroup is
classified based on observable features
 Controversy
 Many diagnoses continue to depend on professional
interpretation rather than factual, quantifiable
observations
 Many still rely on self-reports, which can be misleading!
Problems with Diagnosis
 Disorders can arise from purely
psychological, environmental, or
genetic/biological factors—or some of
each
 Comorbidity: the co-occurrence of two
or more disorders in a single individual
 A person might be depressed because
their social phobia makes interaction
impossible, or a person could be
phobic about showing their depression
in public—or the disorders could be
unrelated but co-occurring
Problems with Diagnosis
(Part 2)
 Diathesis-Stress Model
 A person may be predisposed for a mental
disorder that remains unexpressed until
triggered by stress
 Predispositions & environment can work in
tandem
 Maria is predisposed to introversion, avoids
people for fear of rejection, gains a
reputation as a loner, and is therefore
rejected by others more often
 Fundamental Attribution Error
 The tendency to ascribe behavior to
INTERNAL, essential causes rather than
external, contingent ones
 Sitao comes to class with a bucket on his
head. Why?
Anxiety Disorders
 Anxiety Disorder
 The class of mental disorder in which anxiety is the
predominant feature
 Generalized anxiety disorder, phobic disorder, panic
disorder, obsessive-compulsive disorder
Generalized Anxiety
Disorder
 GAD
 Unrelenting worries that are not focused on any particular
threat
 Chronic excessive worry is accompanied by three or more of
the following symptoms
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Restlessness
Fatigue
Concentration problems
Irritability
Muscle tension
Sleep disturbances
Phobic Disorders
 Marked, persistent, excessive fear and avoidance of specific
objects, activities, or situations
 Individuals recognize that phobias are irrational but can’t
help but feel them
 Specific phobia: an irrational fear of a particular objet or
situation that markedly interferes with an individual’s ability
to study
 Common phobias: animals; natural environments; situations;
blood, injections, and injury; social phobias
 Preparedness theory!
Panic Disorder
 Different interpretations of physiological sins
of anxiety
 Sodium lactate tests
 Agoraphobia
 Extreme fear of venturing into public places
 Many are simply afraid of having panic attacks
in public
 Sudden occurrence of multiple psychological
and physiological symptoms that contribute to
a feeling of stark terror
 Shortness of breath, heart palpitations,
sweating, dizziness, depersonalization ( feeling
of being detached from one’s body) or
derealization (feeling that the world is unreal)
Obsessive-Compulsive
Disorder
 Primary symptoms are unwanted, recurrent thoughts
and actions; ritualistic behaviors (compulsions)
designed to fend off those thoughts
 Individuals are aware that symptoms are irrational
 Obsessions typically derive from concerns that could
pose a real threat (such as contamination, aggression,
disease)
 Psychotherapy is often as effective as medication
Dissociative Disorders
 A condition in which normal cognitive
processes are severely disjointed and
fragmented, creating significant disruptions in
memory, awareness, or personality that can
vary in length from a matter of minutes to
many years
 Dissociative identity disorder: the presence
within an individuals of two or more distinct
identities that at different times take control of
the individual’s behavior
 “Host” personality often does not know about
“alters,” but alters know about host and other
alters
Dissociative Disorders
(Part 2)
 Dissociative amnesia: the sudden loss of memory of
significant personal information
 Dissociative fugue: the sudden loss of memory for
one’s personal history, accompanied by an abrupt
departure from home and the assumption of a new
identity
Mood Disorders
 Mood Disorders: mental disorders that have mood disturbance
as their predominant feature
 Major Depression
 Severely depressed mood that lasts 2 or more weeks and is
accompanied by feelings of worthlessness and lack of pleasure,
lethargy, and sleep and appetite disturbances
 Not necessarily SADNESS!
 Facts
 Median lifetime risk for depression is about 16% and seems to be
increasing in younger generations
 Women are twice as likely to develop depression (hormonal?)
Mood Disorders (2)
 Bipolar Disorder
 An unstable emotional condition characterized by
cycles of abnormal, persistent high mood (mania) and
low mood (depression)
 Manic phase must last at least a week to qualify as
mania
 Elevated mood, irritability, grandiosity, decreased need
for sleep, talkativeness, racing thoughts, distractibility,
reckless behavior
 Sometimes features hallucinations and delusions
 Polygenic
 Arising from the action of many genes in an additive or
interactive fashion
Schizophrenia
 Schizophrenia
 Profound disruption of basic psychological processes; a distorted
perception of reality; altered or blunted emotion; and
disturbances in thought, motivation, and behavior
 Symptoms emerge during continuous period of at least one
month with signs of disorder persisting for at least six months
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Delusion
Hallucination
Disorganized speech
Grossly disorganized behavior
Catatonic Behavior
Negative symptoms
Delusions
 Patently false belief system, often bizarre and
grandiose, that is maintained in spite of its irrationality
 Adopted identities in schizophrenia do not alternate,
exhibit amnesia for one another, or otherwise “split”
 Delusions of persecution, paranoia
Hallucination
 A false perceptual experience
that has a compelling sense of
being real despite the absence of
external stimulation
 Hearing seeing or smelling
things that are not there or
having tactile sensations in the
absence of relevant sensory
stimulation
 65% report hearing voices
repeatedly
Disorganized Speech
 Severe disruption of verbal communication in which
ideas shift rapidly and incoherently from one to
another unrelated topic
 “I have not been a drinker for 16 years. I am taking a
mental rest after a ‘carter’ assignment of ‘quill.’ You
know, a ‘penwrap.’ I had contracts with Warner
Brothers Studios and Eugene broke phonograph
records but Mike protested. I have been with the police
department 35 years. I am made of flesh and blood—
see Doctor?”
Grossly Disorganized
Behavior
 Behavior that is inappropriate for the
situation or ineffective in attaining goals,
often with specific motor disturbances
 Improper sexual behavior, childlike behavior,
disheveled appearance, loud shouting or
swearing
 Catatonic behavior
 A marked decrease in all movement or an
increase in muscular rigidity and over
activity
Negative Symptoms
 Emotional and social withdrawal;
apathy; poverty of speech; and
other indications of the absence or
insufficiency of normal behavior,
motivation, and emotion
 Negative = things MISSING in
people
Causes of Schizophrenia
 Strong heritability coefficient
 Monozygotic twins are highly likely to
develop schizophrenia
 Prenatal Factors
 Monozygotic twins generally share same
amniotic fluid
 Viral infections, toxins in mother’s blood
could contribute
 Higher chance of being schizophrenic if
born in winter months
Personality Disorders
 Antisocial Personality Disorder
 Pervasive pattern of disregard for and violation of the
rights of others that begins in childhood or early
adolescence and continues into adulthood
 Signs before age of 15 include: aggression; destruction
of property; rule violations; deceitfulness, lying, or
stealing; repeatedly setting fires
 APD individuals are often called “sociopaths”
 May be biologically predisposed to being insensitive to
fear