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Psychological DisordersAn Introduction
Psychological Disorder
• A “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable.
What is abnormal, disturbing maladaptive and unjustifiable depends on:
•Culture
•Environmental Conditions
•Individual Person
•Time Period
Defining Psychological Disorders
Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions.
When behavior is deviant, distressful, and dysfunctional psychiatrists and
psychologists label it as disordered (Comer, 2004).
The 3 D’s
Deviant, Distressful & Dysfunctional
1.Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest.
2.Deviant behavior must accompany distress.
3. If a behavior is dysfunctional it is clearly a disorder.
In the Wodaabe tribe men wear costumes to
attract women. In Western society this would be considered
abnormal.
Carol B
eckwith
Early Theories
• Afflicted people were possessed by evil spirits.
Understanding Psychological Disorders
Ancient Treatments of psychological disorders include trephination, exorcism, being caged
like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.
Trephination (boring holes in the skull to remove evil forces)
John W. V
erano
Early Theories
• Music or singing was often used to chase away spirits.
•In some cases trephening was used:
Cutting a hole in the head of the afflicted to let out the evil spirit.
Trephening
Early Theories• Another theory was to make the body
extremely uncomfortable.
History of Mental Disorders
• In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill.
Did this mean better treatment?
They were first put in hospitals.
Early Mental Hospitals• They were nothing more than barbaric
prisons.
•The patients were chained and locked away.
•Some hospitals even charged admission for the public to see the “crazies”, just like a zoo.
Philippe Pinel
• French doctor who was the first to take the chains off and declare that these people are sick and “a cure must be found!!!”
Somatogenic
• At this time- it was believed that mental illness had a bodily cause- Somatogenic.
But Somatogenic could not explain disorders such as hysteria (now called conversion disorder).
Many disorders are psychogenic: the origin is psychological, not physical.
Medical Model
When physicians discovered that syphilis led to mental disorders, they started using medical models
to review the physical causes of these disorders.
1. Etiology: Cause and development of the disorder.
2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another.
3. Treatment: Treating a disorder in a psychiatric hospital.
4. Prognosis: Forecast about the disorder.
Current Perspectives
• Medical Perspective: psychological disorders are sicknesses and can be diagnosed, treated and cured.
Current Perspectives
• Bio-Psycho-Social Perspective: assumes biological, psychological and sociocultural factors combine to interact causing psychological disorders.
Used to be called Diathesis-Stress Model: diathesis meaning predisposition and stress meaning environment.
Classifying Psychological Disorders
The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to
describe psychological disorders.
The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400
psychological disorders compared to 60 in the 1950s.
Classifying Psychological Disorders
• DSM-IV: Diagnostic Statistical Manual of Mental Disorders: the big book of disorders.
Two Major Classifications:
Neurotic Disorders
• Distressing but one can still function in society and act rationally
Psychotic Disorders•Person loses contact with reality, experiences distorted perceptions
Multiaxial Classification
Are Psychosocial or Environmental Problems (school or housing issues) also present?
Axis IV
What is the Global Assessment of the person’s functioning?Axis V
Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present?
Axis III
Is a Personality Disorder or Mental Retardation present?
Axis II
Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present?
Axis I
Multiaxial Classification
Note 16 syndromes in Axis I
Multiaxial Classification
Note Global Assessment for Axis V
Goals of DSM
1. Describe (400) disorders.2. Determine how prevalent the
disorder is.
Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar.
Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”
Labeling Psychological Disorders
1. Critics of the DSM-IV argue that labels may stigmatize individuals.
2. Rosenthal-Being sane in insane places
Asylum baseball team (labeling)
Elizabeth E
ckert, Middletow
n, NY
. From
L. G
amw
ell and N
. Tom
es, Madness in A
merica, 1995. C
ornell University P
ress.
Labeling Psychological Disorders
2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.
Labeling Psychological Disorders
3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes.
Theodore Kaczynski(Unabomber)
Elaine T
hompson/ A
P Photo
Anxiety Disorders
a group of conditions where the primary symptoms are anxiety or
defenses against anxiety.the patient fears something awful will happen to them.
What is anxiety?• is a state of
intense apprehension, uneasiness, uncertainty, or fear.
Generalized Anxiety Disorder• An anxiety disorder in which a
person is continuously tense, apprehensive and in a state of autonomic nervous system arousal.
The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia.
Panic Disorder• An anxiety disorder marked by a
minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations.
Can cause secondary disorders, such as agoraphobia.
Phobias•A person experiences sudden episodes of intense dread.
Obsessive Compulsive Disorder
• An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions).
Common Examples of OCD
Common Obsessions:Common
Compulsions:
Contamination fears of germs, dirt, etc.
Washing
Imagining having harmed self or others
Repeating
Imagining losing control of aggressive urges
Checking
Intrusive sexual thoughts or urges
Touching
Excessive religious or moral doubt
Counting
Forbidden thoughts Ordering/arranging
A need to have things "just so" Hoarding or saving
A need to tell, ask, confess Praying
Explanations for Anxiety Disorders
• You Learn them through conditioning.
•Evolution
•Genes
•Physiology (the brain)
Dissociative Disorders
Dissociative Disorders
• Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts and feelings.
Dissociative Amnesia
• This disorder is characterized by a blocking out of critical personal information, usually of a traumatic or stressful nature.
Dissociative Amnesia
• Dissociative amnesia, unlike other types of amnesia, does NOT result from other medical trauma (e.g. a blow to the head).
Dissociative Amnesia• Localized amnesia is present in an individual who has no
memory of specific events that took place, usually traumatic. The loss of memory is localized with a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia.
• Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time. For example, an abuse victim may recall only some parts of the series of events around the abuse.
• Generalized amnesia is diagnosed when a person's amnesia encompasses his or her entire life.
• Systematized amnesia is characterized by a loss of memory for a specific category of information. A person with this disorder might, for example, be missing all memories about one specific family member.
Dissociative Fugue• An individual with dissociative fugue
suddenly and unexpectedly takes physical leave of his or her surroundings and sets off on a journey of some kind.
•These journeys can last hours, or even several days or months.
Dissociative Fugue• Individuals experiencing a dissociative
fugue have traveled over thousands of miles.
An individual in a fugue state is unaware of or confused about his identity, and in some cases will assume a new identity (although this is the exception).
Depersonalization Disorder
• is marked by a feeling of detachment or distance from one's own experience, body, or self.
One can easily relate to feeling as they in a dream, or being "spaced out."
A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.
Dissociative Identity Disorder
• A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities.
•Also known as multiple personality disorder.
Mood Disorders
Mood Disorders• Psychological Disorders
characterized by emotional extremes.
• Major Depressive Disorder
•Bipolar Disorder
•Seasonal Affective Disorder
• Dysthymic Disorder
Depression
• The common cold of psychological disorders.
It is like a warning that something is wrong.
Depression
Depression
Major Depressive Disorder
• A person, for no apparent reason, experiences two or more weeks of depressive moods.
Includes feelings of worthlessness and diminished interest or pleasure in most activities.
Dysthymic Disorder
• Suffering from mild depression every day for at least two years.
Seasonal Affective Disorder
Bipolar Disorder
• Person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.
Famous People with Bipolar
Bipolar Brain
Norepinephrine
Increases arousal and boosts moods.
Suicide
Suicide
Schizophrenia
How Prevalent?
• About 1 in every 100 people are diagnosed with schizophrenia.
Symptoms of Schizophrenia
•Disorganized thinking.
•Disturbed Perceptions
•Inappropriate Emotions and Actions
Disorganized Thinking• The thinking of a person with
Schizophrenia is fragmented and bizarre and distorted with false beliefs.
•Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information. Often causes………
Delusions (false beliefs)
•Delusions of Persecution
•Delusions of Grandeur
Disturbed Perceptions
• hallucinations- sensory experiences without sensory stimulation.
Inappropriate Emotions and Actions
•Laugh at inappropriate times.
•Flat Effect •Senseless,
compulsive acts.•Catatonia-
motionless Waxy Flexibility
Positive v. Negative Symptoms
Positive Symptoms• Presence of
inappropriate symptoms
Negative Symptoms
• Absence of appropriate ones.
Types of Schizophreni
a
Paranoid Schizophrenia
• preoccupation with delusions or hallucinations.
• Somebody is out to get me!!!!
Disorganized Schizophrenia
• disorganized speech or behavior, or flat or inappropriate emotion.
Catatonic Schizophrenia
• parrot like repeating of another’s speech and movements
Undifferentiated Schizophrenia
• Many and varied Symptoms.
Personality Disorders
Psychological disorders characterized by inflexible and enduring behavior
patterns that impair social functioning.
Paranoid Personality Disorder
• Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.
Paranoid Personality Disorder
• They search for hidden meanings in everything and read hostile intentions
into the actions of others. •They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges.
Antisocial Personality Disorder
• antisocial personality disorder is characterized by a lack of conscience
•People with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of. They tend to lie and steal
Antisocial Personality Disorder
• they are careless with money and take action without thinking about consequences
They are often aggressive and are much more concerned with their own needs than the needs of others.
Borderline Personality Disorder
• characterized by mood instability and poor self-image
People with this disorder are prone to constant mood swings and bouts of anger.
Borderline Personality Disorder
• they will take their anger out on themselves, causing themselves injury
Suicidal threats and actions are not uncommon
They are quick to anger when their expectations are not met.
Histrionic Personality Disorder
• constant attention seekers
They need to be the center of attention all the time, often interrupting others in order to dominate the conversation.
Histrionic Personality Disorder
• They may dress provocatively or exaggerate illnesses in order to gain attention.
They also tend to exaggerate friendships and relationships, believing that everyone loves them
Narcissistic Personality Disorder
•characterized by self-centeredness
They exaggerate their achievements, expecting others to recognize them as being superior
Narcissistic Personality Disorder
They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend.
They are generally uninterested in the feelings of others and may take advantage of them.
Schizoid Personality Disorder
• People with schizoid personality disorder avoid relationships and do not show much emotion
They genuinely prefer to be alone and do not secretly wish for popularity.
Schizoid Personality Disorder
• They tend to seek jobs that require little social contact
Their social skills are often weak and they do not show a need for attention or acceptance
They are perceived as humorless and distant and often are termed "loners."
Schizotypal Personality Disorder
• characterized by a need for social isolation, odd behavior and thinking, and often unconventional beliefs such as being convinced of having extra sensory abilities.
• Some people believe that schizotypal personality disorder is a mild form of schizophrenia.
Avoidant personality disorder
• characterized by a pervasive pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation.
• consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed or humiliated.
Dependent personality disorder
• characterized by a pervasive psychological dependence on other people.
• has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
Obsessive Compulsive Personality Disorder
• characterized by a general psychological inflexibility, rigid conformity to rules and procedures, perfectionism, and excessive orderliness.
• people with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things aren't "right".
