Psychological Disorders

Unit 14

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Introduction Psychological DisordersAnxiety DisordersMood DisordersPersonality DisordersDissociative DisordersSomotoform DisordersPsychotic Disorders

Introduction to Psychological Disorders

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• Psychological Disorder– A harmful dysfunction in which behavior is

judged to be• Atypical

• Disturbing

• Maladaptive

• and Unjustifiable

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Causes

Historical Perspective

• Perceived Causes– Movements of the sun or moon.

• Full moon == lunacy– Evil spirits

• Ancient Treatments– Exorcism, caged like animals, beaten, burned,

castrated, mutilated, blood replaced with animal’s blood.

Biological Perspective

• “The Medical Model”– Mental disorders as physical – Brain abnormalities– Chemical imbalances– Birth difficulties– High heritability

Psychodynamic perspective

• Sigmund Freud• Unconscious conflicts and drives• Early childhood trauma• Therapy helps person become aware of

underlying conflicts

• Cognitive Perspective

– Conscious thoughts

– Learned maladaptive thought patterns cause mental disorders

• Behavioral Perspective

– Learned maladaptive patterns of behavior cause mental disorder

Socio-Cultural Perspective

• Larger culture important to development of mental disorders

• Supporting evidence from “culture-bound syndromes”

– Anorexia and Bulimia in North America and Western Europe

• Bio-Psycho-Social Perspective– assumes that

biological, sociocultural, and psychological factors combine and interact to produce psychological disorders

Biological

SociologicalPsychological

Psychological disorder

Multiple-Causation• Predisposing causes

– In place before onset– Make person

susceptible– Inherited characteristics– Learned beliefs– Sociocultural beliefs

• Precipitating causes– Immediate events that

bring on the disorder– Loss– Perceived threat– When predisposition

high, precipitating event may be small

• Maintaining causes– Consequences of the disorder keep disorder going once it begins

• Sometimes positive consequences, like extra attention from friends, family & care professionals

• Sometimes negative consequences, like loss of friends, stigma, etc

Classifying Disorders

• DSM-IV– Neurotic disorders

• Disorders that are distressing, but still allow one to function in society

– Psychotic disorders• A person loses contact with reality, experiencing

irrational ideas and distorted perceptions

Rates of Psychological Disorders

• 2.1 million inpatient admissions to US hospitals and psychiatric units.

• Another 2.4 million have sought outpatient care.

• 15% of Americans are judged by health care professionals as needing some psychiatric help in the course of a year.

Rates of Psychological Disorders

• No known culture is free of schizophrenia and depression.

• WHO reports that 400 million worldwide suffer from a psychological disorder.

• Incidence of serious psychological disorders is doubly high among those below the poverty line.

Rates of Psychological Disorders

• 75% of people who will ever have a psychological disorder experience the first symptoms by age 24.– Antisocial personality disorder and phobias

appear by a median age of 8 and 10.

Anxiety Disorders

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• Generalized Anxiety Disorder– A person is continually tense, apprehensive,

and in a state of autonomic nervous system arousal

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anxiety

• Panic Disorder– Anxiety disorder marked by minutes-long

episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations

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• Phobias– A persistent, irrational fear and avoidance of a

specific object or situation.

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phobias

Afraid of it Bothers slightly Not at all afraid of it

Beingclosed in,

in a smallplace

Being alone In a

houseat night

Percentageof peoplesurveyed

100908070605040302010

0Snakes Being

in high,exposedplaces

Mice Flyingon an

airplane

Spidersand

insects

Thunderand

lightning

Dogs Drivinga car

Being In a

crowdof people

Cats

• Obsessive-Compulsive Disorder– Characterized by unwanted repetitive thoughts

(obsessions) and/or actions (compulsions)– Obsessions

• Concern with dirt, germs of toxins - 40%• Something terrible happening (fire, death, etc) – 24%• Symmetry, order, or exactness – 85%

– Compulsions• Excessive hand washing/ cleaning – 85%• Repeating rituals – 51%• Checking doors, locks, etc – 46%

Explaining Anxiety Disorders

• Learning Perspective

– Fear Conditioning

– Stimulus Generalizations

– Reinforcement

– Observational Learning

• Biological Perspective

– Evolution/ Natural Selection

– Genes/ temperament

– Physiology

–anterior cingulate cortex

–amygdala

Dissociative and Personality Disorders

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Personality Disorders

• Disorders characterized by inflexible and enduring behavior patterns that impair social functioning.– Histrionic Personality Disorder– Narcissistic Personality Disorder– Borderline Personality Disorder– Antisocial Personality Disorder

• Histrionic Personality Disorder– characterized by a pattern of excessive

emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood.

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• Narcissistic Personality Disorder– "a pervasive pattern of grandiosity, need for

admiration, and a lack of empathy."

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• Borderline Personality Disorder– "a pervasive pattern of instability of

interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts."

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• Antisocial Personality Disorder– "The essential feature for the diagnosis is a

pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."

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• Dissociative Amnesia– Loss of memory.– Selective memory loss often brought on by

extreme stress• Dissociative Fugue

– Flight from one’s home & identity accompanies amnesia

• Skeptics wonder if it’s strategic

Dissociative Disorders

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Dissociative Disorders

• Dissociative Identity Disorder– Person exhibits two or more distinct and

alternating personalities (dba. Multiple-Personality Disorder)

– Supporting evidence• Distinct brain & body states, handedness changes, different

vision– Contrary evidence

• Increasing diagnoses, increasing personalities

Somotoform Disorders

• Physical disorders which have psychological causes.

– Hypochondria

– Conversion Reactions

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hypochondria

Mood Disorders

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Suicide• More than 32,000 suicides a year;

425,000 self-inflicted injuries per year

• 40-50% of college students have thought about suicide.15% have attempted suicide.

• 1 out of 80 college students is the survivor of a loved one’s suicide.

• 78% of all suicides are by men– Firearms are most common for men; poison for women

• 17% of high school students have thought about suicide

• 2nd leading cause of death for 25-34 year-olds;3rd leading cause of death for 15-24 year-olds

Common Characteristics

1. Unendurable psychological pain

2. Frustrated psychological need

3. The search for a solution

4. Helplessness and Hopelessness

5. An attempt to end consciousness

6. Constrictions of options

7. Ambivalence

8. Communication of intent (80%)

9. Departure

10. Lifelong coping patterns

Warning Signs of Suicide• Talking about suicide• Statements about

hopelessness, helplessness, or worthlessness

• Preoccupation with death

• Suddenly happier, calmer

• Loss of interest in things one cares about

• Visiting or calling people that one cares about but hasn’t communicated with recently

• Making arrangements; setting one’s affairs in order

• Giving things away

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Mood Disorders

• Major Depressive Disorder

– A person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

• Prevalence:10-25% chance for women; 5-12% for men.

• Median age of onset: 25

• Average Duration: 9 months

• 70% recurrence w/i 5 yrs;80% chance w/i 8 yrs

• 76% of patients respond to anti-depressants

Mood Disorders• Bipolar Disorder

– Major depression is sometimes followed by a manic episode: hyperactive, wildly optimistic state

– dba. Manic Depressive

Depressed state Manic state Depressed state

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Explaining Mood Disorders

• Biological Perspective– Genetic influences

• 50% chance twin will have similar mood disorder

– The Brain• High norepinephrine

during manic state; low norepinephrine during depression

• Low serotonin during depression

• Smaller frontal lobes in depressed people

• Social-Cognitive Perspective

– Negative thoughts feed negative moods

– Negative mood feeds negative thoughts

Schizophrenia

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Psychotic Disorders

• Schizophrenia– Symptoms

• Disorganized thinking• Disturbed perceptions• Inappropriate emotions and actions

– Types• Positive & Negative• Chronic & Acute

Compare to Infantile Autism

• Social isolation• Stereotyped behaviors• Resistance to any change• Abnormal responses to sensory stimuli• Insensitivity to pain• Inappropriate emotional expression• Disturbances of movement• Poor development of speech• Specific, limited intellectual problems

Psychotic DisordersSchizophrenia

Subtypes of Schizophrenia

Paranoid: Preoccupation with delusions or hallucinations

Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion

Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements

Undifferentiated Schizophrenia symptoms without fitting one of the or residual: above types

Understanding Schizophrenia

• Brain abnormalities– Dopamine overactivity

• More receptors; extra dopamine can induce (ie cocaine)

– Brain anatomy• Low frontal lobe activity• Spaces in brain filled with fluid• Smaller than average thalamus

Understanding Schizophrenia

• Genetic factors– 1 in 100 chance of developing schizophrenia.– 1 in 10 if parent or sibling developed.– 1 in 2 if identical twin develops it.