Abnormal slides

Psychological Disorders

DSM – IV

Anxiety-based Disorders

Mood Disorders

Schizophrenia

Personality Disorders

Elements of Abnormality

• Suffering

• Maladaptiveness

• Irrationality

• Unpredictability

• Observer Discomfort

• Violations of Moral Standards

Diamond Perspective• Determine which perspective is being

used to explain the behavior

– Moral Model has been used to explain abnormal behavior

• Lack of will

• Not strong enough

• Something is wrong with me

DSM – IVDiagnostic & Statistical Manual of Mental

Disorders

• Axis I: Clinical Syndromes

• Axis II: Personality Disorders

• Axis III: General Medical Conditions

• Axis IV: Psychosocial and Environmental Conditions

• Axis V: Global Assessment of Functioning Scale

Concerns about the DSM

• The danger of overdiagnosis

• The power of diagnostic labels

• Confusion of serious mental disorders with normal problems

• The illusion of objectivity

Panic Disorder

• Neurotransmitters• Anxiety Sensitivity• Conditioned Fear Reactions

Suggested explanations include:

Biological relatives of people with panic disorder are 8 times more likely to develop this condition.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder:

An anxiety disorder characterized by recurrent obsessions or compulsions that are inordinately time-consuming or that cause significant distress or impairment.

Clip art copyright © 2002 www.arttoday.com. Used with permission.

Panic Disorder

• Benzodiazepines• Antidepressants• Serotonin Reuptake Inhibitors• Relaxation Training• Panic Control Therapy (PCT)

Treatments

Generalized Anxiety Disorder

Generalized Anxiety Disorder:

An anxiety disorder characterized by anxiety that is not associated with a particular object, situation, or event, but seems to be a constant feature of a person's day-to-day existence.

Specific Phobias

Specific Phobia:

An irrational and unabating fear of a particular object, activity, or situation that provokes an immediate anxiety response, disrupts functioning, and results in avoidance behavior.

Specific Phobias

Hematophobia Blood

Ephidophobia Snakes

Claustrophobia Closed spaces

Acrophobia Heights

Aerophobia Flying

Death-related phobia Funerals, corpses, and cemeteries

Examples

Specific Phobias

Ailurophobia Cats

Chionophobia Snow

Erythrophobia The color red

Metallophobia Metals

Ponophobia Work

Triskaidekaphobia The number 13

Some Less Common Phobias

Specific Phobias

• Systematic Desensitization

• Flooding

• Aversive Therapy

• Energy Psychology – tapping on specific acupuncture points

Treatments

Obsessive-Compulsive Disorder

Obsession:

Persistent and intrusive idea, thought, impulse, or image.

Compulsion:

A repetitive and seemingly purposeful behavior performed in response to uncontrollable urges or according to a ritualistic or stereotyped set of rules.

© http://office.microsoft.com

Obsessive-Compulsive Disorder

• Obsessions associated with checking compulsions.

• Need for symmetry and order.

• Obsessions about cleanliness associated with washing compulsions.

• Hoarding-related behaviors.

4 Major Dimensions

OCD

• PET Scan of brain of person with obsessive/ compulsive disorder

• High metabolic activity (red) in frontal lobe areas involved with directing attention

TRAUMA

serious accidentviolent victimization

life-threatening calamity

firesearthquakes

riots

war

abuse

witnessing tragedy

Photograph copyright © 2002 www.arttoday.com. Used with permission.

Trauma-Induced Disorders

• Intrusions and Avoidance

• Hyperarousal and Numbing

Symptoms fall into two related clusters:

Post-Traumatic Stress Disorder:

More than a month after a traumatic event, stress interferes with the individual’s ability to function.

Perspectives on Trauma-Induced Disorders

• Brain Changes• Conditioned Fear• Economic Disadvantage

Photographs copyright © 2002 www.arttoday.com. Used with permission.

Dissociative Disorders

• Amnesia– conscious awareness becomes separated

(dissociated) from previous memories, thoughts, and feelings

– Psychogenic vs Organic Origins• psychological need to escape/forget

(psychogenic)• brain injury or disease (organic)

– Psychogenic “fugue” (to escape)• Forgets entire past, identity

Dissociative Identity Disorder

• Dissociative Disorders– conscious awareness becomes separated

(dissociated) from previous memories, thoughts, and feelings

• Dissociative Identity Disorder– rare dissociative disorder in which a person

exhibits two or more distinct and alternating personalities

– formerly called multiple personality disorder

Mood Disorders

• Depression–Unipolar mood disorder

• Manic/Depression–Bipolar disorder

Dysphoric mood:

Unpleasant feelings, such as sadness or irritability.

Euphoric mood:

A feeling state that is more cheerful and elated than average, possibly even ecstatic.

Types of Depression

In episodes with melancholic features, people lose interest or pleasure in most daily activities.

Clip art copyright © 2005 www.clipart.com. Used with permission.

People with a seasonal pattern (SAD) develop a depressive episode at about the same time each year, usually 2 months in fall or winter.

BIPOLAR DISORDER

A mood disorder involving manic episodes and very disruptive experiences of heightened mood, possibly alternating with major depressive episodes.

– Suffer mania and sometimes depression– Manic episode

• Racing thoughts • Hyperactivitiy• Easily distracted• Grandiose sense of self• May hear voices• Highly energetic

BIPOLAR DISORDER

Clip art copyright © 2005 www.clipart.com. Used with permission.

Depressed state Manic state Depressed state

PET scans show that brain energy consumption rises and falls with emotional

swings

LEARNED HELPLESSNESS

Learned helplessness:

The passive resignation produced by repeated exposure to negative events that are perceived to be unavoidable.

Overgeneralizing

Selective Abstraction

Excessive Responsibility

Assuming Temporal Causality

Making Excessive Self-Reference

Catastrophizing

Dichotomous Thinking

Cognitive Distortions

Drawing erroneous or negative conclusions from experience.

Drawing erroneous or negative conclusions from experience.

Cognitive Treatment

COGNITIVE RESTRUCTURING1. Client identifies and monitors dysfunctional

automatic thoughts.2. Client learns to recognize connection

between thoughts, emotions, and actions.3. Client evaluates the reasonable of the

automatic thoughts.4. Clients learns to substitute more reasonable

thoughts.5. Client must identify and alter dysfunctional

assumptions.

COGNITIVE RESTRUCTURING1. Client identifies and monitors dysfunctional

automatic thoughts.2. Client learns to recognize connection

between thoughts, emotions, and actions.3. Client evaluates the reasonable of the

automatic thoughts.4. Clients learns to substitute more reasonable

thoughts.5. Client must identify and alter dysfunctional

assumptions.

SUICIDE

WHO COMMITS SUICIDE?– About 30,000 Americans a year.– Women attempt more often,

but male success rate is 4 times as high.– More white.– More unmarried.– Associated DSM

disorders.

Clip art copyright © 2002 www.arttoday.com. Used with permission.

Suicide Risk Factors

Demographic or Social Factors– Young or elderly male– Native American or Caucasian– Single (especially if widowed)– Economic/occupational stress– Incarceration– Gambling history– Easy access to firearm

Suicide Risk Factors

Clinical Factors– Major psychiatric illness– Personality disorder– Impulsive or violent traits– Current medical illness– Family history of suicide– Previous self-injurious acts or attempts– Anger, agitation, excessive preoccupation– Abuse of alcohol, drugs, heavy smoking– Easy access to toxins (including medicines)– Suicide plans, preparation, or note– Low ambivalence about dying vs. living

A disorder with a range of psychotic symptoms involving disturbances in content of thought, form of thought, perception, affect, sense of self, motivation, behavior, and interpersonal functioning.

Schizophrenia

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

SYMPTOMS OF SCHIZOPHRENIA

• DISTURBANCES IN:– Perception – Hallucinations

–Thoughts – Lack cohesive and logic language

–Incomprehensible actions – odd & disturbing

Positive symptoms: Negative symptoms:

SYMPTOMS

Exaggerations or distortions of normal thoughts, emotions, and behavior.

Symptoms that involve functioning below the level of normal behavior.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Type I

• delusions

• hallucinations

• disturbed speech

• disturbed behavior

Type II

• affective flattening

• catatonia

• retarded motor movement

SYMPTOMS

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Genetic Link in Schizophrenia

BIOLOGICAL THEORIES

BRAIN STRUCTURE AND FUNCTION

Lines of evidence for dopamine hypothesis Antipsychotic medications Effects of drugs like amphetamines

Cortical atrophy Reduced brain activation Dopamine hypothesis Possible serotonin deficit

Clip art copyright © 2005 www.clipart.com. Used with permission.

MRI scans show that aperson withSchizophrenia (left) is more likely than a healthy person (right) to have enlarged ventricles.

BIOLOGICAL TREATMENT

NEUROLEPTICS

• Vary in potency.

• All block dopamine receptors.

• Side effects:

– Tardive dyskinesia

– Compromise of immune system

Flu Virus

• Some flu viruses interfere with the normal migration of brain cells- Second tri-mester of pregnancy

is the critical period

Characterized by at least two bodily movement abnormalities:

• Motor immobility or stupor.• Purposeless motor activity.• Mutism or extreme negation.• Peculiarities of movement or odd

mannerisms and grimacing.• Echolalia

TYPES OF SCHIZOPHRENIA

Characterized by a combination of symptoms, including disorganized speech and behavior and flat or inappropriate affect.

Even delusions and hallucinations lack a coherent theme.

TYPES OF SCHIZOPHRENIA

Characterized by preoccupation with one or more bizarre delusions, or with auditory hallucinations that are related to a particular theme of being persecuted or harassed.

Without disorganized speech or disturbed behavior.

TYPES OF SCHIZOPHRENIA

TYPES OF SCHIZOPHRENIA

Characterized by a complex of schizophrenic symptoms that does not meet the criteria for other types of schizophrenia.

Antisocial Personality Disorder

Associated Behaviors– Deceitfulness– Impulsivity– Unlawfulness– Recklessness– Aggressiveness– Manipulative– Lacking remorse

People with APD were slow to develop classically conditioned responses to anger, pain, or shock.Such responses indicate normal anxiety.

Borderline Personality Disorder

Observed characteristics:– Intense interpersonal relationships– Splitting– Feelings of emptiness– Anger, rage– Identity confusion– Shifting goals, plans, partners– Poor boundaries with others– Risk taking, self injurious behaviors– Parasuicidal

HISTRIONIC

• Dramatic, attention-getting behavior• Fleeting, shifting emotional states• More commonly diagnosed in women• Flirtatious and seductive• Need for immediate gratification• Easily influenced by others• Lack analytical ability• Superficial relationships

Clip art copyright © 2002 www.arttoday.com. Used with permission.

NARCISSISTIC PERSONALITY

DISORDER

Named for Greek legend of Narcissus.

Personality disorder characterized by an unrealistic, inflated sense of self-importance and lack of sensitivity to other people’s needs.

• egotistical• arrogant• exploitative of others

PARANOID PERSONALITY DISORDER

• SUSPICIOUSNESS

• GUARDEDNESS

• PROJECTION OF NEGATIVITY AND DAMAGING MOTIVES ONTO OTHERS

• ATTRIBUTION OF THEIR PROBLEMS TO OTHERS

• LOW SELF-EFFICACY

• INDIFFERENCE TO SOCIAL AND SEXUAL RELATIONSHIPS

• SECLUSIVE; PREFER TO BE ALONE• NO DESIRE TO LOVE OR BE LOVED• COLD, RESERVED, WITHDRAWN• INSENSITIVE TO FEELINGS OF OTHERS

TREATMENT: Unlikely to seek or respond to therapy.

• FEAR OF ABANDONMENT• DESPONDENT WITHOUT OTHERS• UNABLE TO INITIATE ACTIVITIES• INSECURE ABOUT MAKING DECISIONS

WITHOUT OTHERS• GO TO EXTREME TO GAIN APPROVAL

OF OTHERS• DEVASTATED WHEN RELATIONSHIPS

END