chapter 18— psychological disorders
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Chapter 18— Psychological Disorders. Are these statements true or false?. Abnormal behaviors are always bizarre. A clear distinction can be drawn between “normal” and “abnormal” behaviors. As a group, former mental patients are unpredictable and dangerous. - PowerPoint PPT PresentationTRANSCRIPT
Chapter 18—Chapter 18—Psychological DisordersPsychological Disorders
Are these statements true or false?Are these statements true or false?1.1. Abnormal behaviors are always bizarre.Abnormal behaviors are always bizarre.2.2. A clear distinction can be drawn between A clear distinction can be drawn between
“normal” and “abnormal” behaviors.“normal” and “abnormal” behaviors.3.3. As a group, former mental patients are As a group, former mental patients are
unpredictable and dangerous.unpredictable and dangerous.4.4. Mental disorders indicate a fundamental Mental disorders indicate a fundamental
deficiency in personality, and are thus shameful.deficiency in personality, and are thus shameful.5.5. Because mental illness is so common, there is Because mental illness is so common, there is
reason to be fearful of one’s own vulnerability.reason to be fearful of one’s own vulnerability.6.6. Geniuses are particularly prone to emotional Geniuses are particularly prone to emotional
disorders.disorders.7.7. Most mental disorders are incurable.Most mental disorders are incurable.
Using your group’s definition of Using your group’s definition of abnormal, decide if these are abnormal, decide if these are
examples of psychological disorders.examples of psychological disorders.
Z has a hard time getting out of bed three or four days every week. She has lost interest in playing basketball and seeing her friends, two activities
that she used to really enjoy.
X hears voices in her head telling her to do dangerous things.
R has a house that is neon green, a car that is olive green, and a mailbox that is forest
green. She wears only green clothing. When asked why she replies, “I like green.”
INTRODUCTION TO INTRODUCTION TO PSYCHOLOGICAL PSYCHOLOGICAL DISORDERSDISORDERS
Section 1Section 1
We will discuss the following We will discuss the following disorders…disorders…anxiety disordersanxiety disorderssomotoform disorderssomotoform disordersdissociative disordersdissociative disordersmood disordersmood disordersschizophreniaschizophreniapersonality disorderspersonality disorders
What is a psychological What is a psychological disorder?disorder?
behavior patterns or mental processes behavior patterns or mental processes that cause serious personal suffering or that cause serious personal suffering or interfere with a person’s ability to cope interfere with a person’s ability to cope with everyday lifewith everyday life
““normal” often means what is average normal” often means what is average for most people, therefore, “abnormal” for most people, therefore, “abnormal” is usually a deviation from the majorityis usually a deviation from the majority
How do we determine if a How do we determine if a psychological disorder is psychological disorder is
present?present?typicality- normality of a behavior or
mental process
maladaptivity-a maladaptive behavior is one that impairs
an individual’s ability to function in everyday life or is hazardous to oneself/others
emotional discomfort- feelings of helplessness, hopelessness and extreme sadness. Lose interest in everything
socially unacceptable behavior- violates a society’s accepted norms might indicate a psychological disorder
Culture-Bound Syndromes: Clusters of symptoms that define or describe an illness.
Does this man have a Does this man have a psychological disorder?psychological disorder?
Alan’s performance at work has suffered Alan’s performance at work has suffered because he has been drinking alcohol to because he has been drinking alcohol to excess. Several co-workers have suggested excess. Several co-workers have suggested that he seek help for his problem, but he that he seek help for his problem, but he thinks that they’re getting alarmed over thinks that they’re getting alarmed over nothing. “I just enjoy a good time once in a nothing. “I just enjoy a good time once in a while,” he says. while,” he says.
Monica has gone away to college and feels Monica has gone away to college and feels lonely, sad, and dejected. Her grades are lonely, sad, and dejected. Her grades are fine, and she gets along okay with the other fine, and she gets along okay with the other students in the dormitory, but inside she’s students in the dormitory, but inside she’s choked with gloom, hopelessness, and choked with gloom, hopelessness, and despair.despair.
Boris believes that he’s Napoleon reborn. Boris believes that he’s Napoleon reborn. He believes that he is destined to lead the He believes that he is destined to lead the U.S. military forces into a great battle to U.S. military forces into a great battle to recover California from space aliens.recover California from space aliens.
Natasha panics with anxiety whenever she Natasha panics with anxiety whenever she leaves her home. Her problem escalated leaves her home. Her problem escalated gradually until she was absent from work so gradually until she was absent from work so often that she was fired. She hasn’t been often that she was fired. She hasn’t been out of her house in nine months and is out of her house in nine months and is deeply troubled by her problem.deeply troubled by her problem.
The DSM IV (1994)The DSM IV (1994)Diagnostic and Statistical Manual of Mental Diagnostic and Statistical Manual of Mental
DisordersDisorders
18 different categories18 different categories categorized by observable signs and symptoms.categorized by observable signs and symptoms.
TYPES OF ANXIETY TYPES OF ANXIETY DISORDERSDISORDERS
Section 2Section 2
AnxietyAnxiety refers to a general state of dread or refers to a general state of dread or
uneasiness that occurs in response to a vague uneasiness that occurs in response to a vague or imagined dangeror imagined danger
different from fear, which is different from fear, which is a response to a a response to a real danger or threatreal danger or threat
Anxiety disorders are characterized by…Anxiety disorders are characterized by…1.1. nervousnessnervousness2.2. inability to relaxinability to relax3.3. concern about losing controlconcern about losing control4.4. physical signs or symptomsphysical signs or symptoms
such as: trembling; sweating; rapid heart rate; such as: trembling; sweating; rapid heart rate; shortness of breath; increased blood pressure; shortness of breath; increased blood pressure; flushed face; feelings of faintness/light-flushed face; feelings of faintness/light-headednessheadedness
**Anxiety based disorders are among the most **Anxiety based disorders are among the most common.**common.**
Types of Anxiety DisordersTypes of Anxiety Disorders1.1. Phobic Disorders-Phobic Disorders-
a.a. phobiaphobia— “fear”— “fear”
b.b. simple phobiasimple phobia- persistent excessive or irrational fear - persistent excessive or irrational fear of a particular object or situation; most common of of a particular object or situation; most common of all anxiety disordersall anxiety disorders
to be diagnosed, the fear must to be diagnosed, the fear must lead to avoidance behaviorlead to avoidance behavior that interferes with the affected person’s normal lifethat interferes with the affected person’s normal life
c.c. social phobiasocial phobia—characterized by persistent fear of —characterized by persistent fear of social situations in which one might be exposed to social situations in which one might be exposed to the close scrutiny of others and therefore might be the close scrutiny of others and therefore might be observed doing something embarrassing or observed doing something embarrassing or humiliatinghumiliating
Most common types of phobic Most common types of phobic disorders:disorders:
~zoophobia~zoophobia(fear of animals)(fear of animals)
~claustrophobia~claustrophobia(fear of enclosed spaces)(fear of enclosed spaces)
~acrophobia~acrophobia(fear of heights)(fear of heights)
~arachnophobia~arachnophobia(fear of spiders)(fear of spiders)
What do people fear?What do people fear?MenMen
1.1. Fear of being Fear of being buried aliveburied alive
2.2. Fear of heightsFear of heights3.3. Fear of snakesFear of snakes4.4. Fear of drowningFear of drowning5.5. Fear of public Fear of public
speakingspeaking
WomenWomen1.1. Fear of snakesFear of snakes2.2. Fear of being Fear of being
bound or tied upbound or tied up3.3. Fear of being Fear of being
buried aliveburied alive4.4. Fear of heightsFear of heights5.5. Fear of public Fear of public
speakingspeaking
Do you experience…Do you experience…
acrophobia?acrophobia?mikrophobia?mikrophobia?aquaphobia?aquaphobia?ophidiophobia?ophidiophobia?arachnophobia?arachnophobia?claustrophobia?claustrophobia?
triskaidekaphobiatriskaidekaphobia??
uxoriphobia?uxoriphobia?Santa Santa
Claustrophobia?Claustrophobia?panaphobia?panaphobia?phobophobia?phobophobia?
Panic Disorder and AgoraphobiaPanic Disorder and Agoraphobia1.1. those with a panic disorder have those with a panic disorder have recurring/ recurring/
unexpectedunexpected panic attacks panic attacks2.2. panic attackpanic attack—relatively short period of intense —relatively short period of intense
fear or discomfort, characterized by fear or discomfort, characterized by shortness of breath, dizziness, rapid heart rate, shortness of breath, dizziness, rapid heart rate,
trembling, shaking, sweating, choking, nauseatrembling, shaking, sweating, choking, nausea
3.3. many who suffer from panic disorder also many who suffer from panic disorder also have have agoraphobiaagoraphobia, or the fear of , or the fear of places/ places/ situations where escape may be situations where escape may be difficultdifficult
Generalized Anxiety DisorderGeneralized Anxiety Disorderexcessive or unrealistic worry about life excessive or unrealistic worry about life
circumstances, for 6 or more monthscircumstances, for 6 or more monthsworries tend to focus on worries tend to focus on
finances,work, interpersonal problems, finances,work, interpersonal problems, accidents, illnessaccidents, illness
Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder (OCD)(OCD)a.a. obsessions-obsessions- unwanted thoughts, unwanted thoughts,
ideas or mental images that occur over ideas or mental images that occur over and over; often senselessand over; often senseless
b.b. compulsions-compulsions- repetitive ritual repetitive ritual behaviors; often involve checking or behaviors; often involve checking or cleaningcleaning
c.c. people are usually aware that people are usually aware that obsessions are obsessions are unjustifiedunjustified which which distinguishes them from distinguishes them from delusionsdelusions
Obsessive-Compulsive Obsessive-Compulsive BehaviorsBehaviorscheckingchecking
““Did I lock the door? I know I checked, but I better check Did I lock the door? I know I checked, but I better check one more time. OK, it’s locked. I’m satisfied. But maybe I one more time. OK, it’s locked. I’m satisfied. But maybe I better open the door and start over. Lock it again.”better open the door and start over. Lock it again.”
washingwashing ““My hands are a little raw, but I can’t help feeling that My hands are a little raw, but I can’t help feeling that
they could be a little cleaner, that I might have missed a they could be a little cleaner, that I might have missed a spot where bacteria can grow.”spot where bacteria can grow.”
hoardinghoarding ““I don’t need the things that I save, I know that. But I don’t need the things that I save, I know that. But
what if I throw something away that I’ll need later? Of what if I throw something away that I’ll need later? Of course there are some things I know I won’t need. For course there are some things I know I won’t need. For instance, I’ve been giving myself haircuts lately so that I instance, I’ve been giving myself haircuts lately so that I can save the hair.”can save the hair.”
harmingharming ““I used to enjoy smoking, but I can’t help thinking that I used to enjoy smoking, but I can’t help thinking that
the matches I throw out will start a fire and hurt the matches I throw out will start a fire and hurt someone. Or when I’m in a car and I hit a bump, I someone. Or when I’m in a car and I hit a bump, I sometimes worry that I’ve hit someone.”sometimes worry that I’ve hit someone.”
countingcounting ““I do it mainly when I’m bored: I count ceiling tiles, I do it mainly when I’m bored: I count ceiling tiles,
floor tiles, letters on billboards and street signs. floor tiles, letters on billboards and street signs. Sometimes I’ll even divide the letters into groups of Sometimes I’ll even divide the letters into groups of three or four. I try to stop, but I can’t help myself.”three or four. I try to stop, but I can’t help myself.”
performing ritualsperforming rituals ““When I walk through a doorway, I need to make sure When I walk through a doorway, I need to make sure
that there are six inches between each shoulder and that there are six inches between each shoulder and the door jamb. If I walk through and I don’t think I’ve the door jamb. If I walk through and I don’t think I’ve accomplished this, I’ll walk out and try again.”accomplished this, I’ll walk out and try again.”
Stress DisordersStress Disorderspost-traumatic stress disorder-post-traumatic stress disorder- intense, intense,
persistent feelings of anxiety caused by persistent feelings of anxiety caused by traumatic experiencestraumatic experiences
Examples of traumatic events: rape, severe Examples of traumatic events: rape, severe childhood abuse, assault, accidents, nautral childhood abuse, assault, accidents, nautral disasters, wardisasters, war
Symptoms: flashbacks, nightmares, numbness or Symptoms: flashbacks, nightmares, numbness or feeling, avoidance, increased tensionfeeling, avoidance, increased tension
can occur can occur 6 or more months6 or more months after the event and after the event and tend to last for tend to last for years/decadesyears/decades
acute stress disorder-acute stress disorder- short-term symptoms short-term symptoms similar to PTSD; follows a traumatic eventsimilar to PTSD; follows a traumatic event
differs from PTSD because symptoms occur differs from PTSD because symptoms occur immediatelyimmediately and they last for and they last for a few days to a a few days to a few weeksfew weeks
DISSOCIATIVE DISORDERSDISSOCIATIVE DISORDERSSection 3Section 3
dissociationdissociation- separation of certain - separation of certain personality components or mental personality components or mental processes from conscious thoughtprocesses from conscious thought
ex: daydreamingex: daydreaming
When is it considered to be a sign of When is it considered to be a sign of a psychological disorder?a psychological disorder?when it occurs as a way to avoid when it occurs as a way to avoid
stressful events or feelingsstressful events or feelings
Have you ever experienced Have you ever experienced these dissociative these dissociative
experiences?experiences? Suddenly realizing, when you are driving Suddenly realizing, when you are driving
the car, that you don’t remember what the car, that you don’t remember what has happened during all or part of the has happened during all or part of the trip.trip.
Suddenly realizing, when you are listening Suddenly realizing, when you are listening to someone talk, that you did not hear to someone talk, that you did not hear part or all of what the person said.part or all of what the person said.
Having the experience of being in a Having the experience of being in a familiar place but finding it strange and familiar place but finding it strange and unfamiliar.unfamiliar.
Becoming so absorbed in watching Becoming so absorbed in watching television or a movie that you are unaware television or a movie that you are unaware of other events happening around you.of other events happening around you.
Talking out loud to yourself when you are Talking out loud to yourself when you are alone.alone.
Finding that you cannot remember Finding that you cannot remember whether or not you have just done whether or not you have just done something or perhaps had just thought something or perhaps had just thought about doing it.about doing it.
Feeling sometimes as if you were looking Feeling sometimes as if you were looking at the world through a fog such that at the world through a fog such that people and objects appear faraway or people and objects appear faraway or unclear.unclear.
SOMATOFORM SOMATOFORM DISORDERSDISORDERS
Section 4Section 4
somatizationsomatization- expression of - expression of psychological distress through psychological distress through physical symptomsphysical symptoms
What are the symptoms?What are the symptoms?psychological problems and unexplainable psychological problems and unexplainable
physical symptomsphysical symptoms
MOOD DISORDERSMOOD DISORDERSSection 5Section 5
What do all these people What do all these people have in common?have in common?
True or False?????True or False????? Every year more than 32,000 Americans Every year more than 32,000 Americans
commit suicide.commit suicide. Approximately once every 16 minutes a Approximately once every 16 minutes a
suicide occurs in the United States.suicide occurs in the United States. More women than men attempt suicide.More women than men attempt suicide. Of those who attempt suicide, more men Of those who attempt suicide, more men
than women succeed.than women succeed. Suicide is most common among the elderly.Suicide is most common among the elderly. Suicide is the second most common cause Suicide is the second most common cause
of death among college students.of death among college students. Individuals who threaten suicide or make an Individuals who threaten suicide or make an
unsuccessful attempt usually are serious.unsuccessful attempt usually are serious.
Approximately 70% of suicide victims threaten to Approximately 70% of suicide victims threaten to kill themselves sometime during the three kill themselves sometime during the three months preceding the suicide.months preceding the suicide.
Suicide rates among youth have nearly tripled Suicide rates among youth have nearly tripled since the 1950’s.since the 1950’s.
A firearm is used in over 60% of all suicides.A firearm is used in over 60% of all suicides. Fewer than 5% of elderly suicide victims had Fewer than 5% of elderly suicide victims had
been diagnosed with a terminal illness when they been diagnosed with a terminal illness when they committed suicide.committed suicide.
Nevada consistently has the highest suicide rate Nevada consistently has the highest suicide rate in the United States.in the United States.
States with stricter gun control laws have lower States with stricter gun control laws have lower suicide rates.suicide rates.
The suicide rate for children ages 10 to 14 more The suicide rate for children ages 10 to 14 more than doubled between 1985 and 2000.than doubled between 1985 and 2000.
Edvard MunchEdvard Munch born December 12, 1863—Loten, Norway born December 12, 1863—Loten, Norway Norwegian painter and printmakerNorwegian painter and printmaker played an important role in the played an important role in the
development of German expressionismdevelopment of German expressionism parents, brother and sister died when he parents, brother and sister died when he
was youngwas young his work often displayed themes such as his work often displayed themes such as
misery, sickness, deathmisery, sickness, death
““Sickness and Sickness and insanity and death insanity and death
were the black angels were the black angels that hovered over my that hovered over my cradle and have since cradle and have since
followed me followed me throughout my life.”throughout my life.”
Self-Portrait with Burning Cigarette,
1895
The Scream (or The Cry),
1893
Death in the Sickroom, 1895
Two categories of mood disorders:
•depression-typically involves feelings of helplessness, hopelessness, worthlessness, guilt, great sadness•bipolar disorder-involves a cycle of mood changes from depression to wild elation and back again
Types of Mood Disorder:Types of Mood Disorder:Major Depression Major Depression To be diagnosed, you must exhibit 5 of the To be diagnosed, you must exhibit 5 of the
following 9 symptoms for at least 2 weeks, nearly following 9 symptoms for at least 2 weeks, nearly every day.every day.
One of the 5 symptoms must be #1 or #2One of the 5 symptoms must be #1 or #21.1. persistent depressed mood for most of the daypersistent depressed mood for most of the day2.2. loss of interest or pleasure in all, or almost all loss of interest or pleasure in all, or almost all activitiesactivities
The remaining 4 symptoms can be any of The remaining 4 symptoms can be any of these…these…
3. significant weight loss/gain due to changes in 3. significant weight loss/gain due to changes in appetiteappetite4. sleeping more or less than usual4. sleeping more or less than usual5. speeding up or slowing down of physical and 5. speeding up or slowing down of physical and emotional reactionsemotional reactions6. fatigue or loss of energy6. fatigue or loss of energy7. feelings of worthlessness or unfounded guilt7. feelings of worthlessness or unfounded guilt8. reduced ability to concentrate or make meaningful 8. reduced ability to concentrate or make meaningful decisionsdecisions9. recurrent thoughts of death or suicide9. recurrent thoughts of death or suicide
Bipolar DisorderBipolar Disorder Characterized by dramatic ups and downs in Characterized by dramatic ups and downs in
moodmood
manic phasemanic phase- characterized by a mood that is - characterized by a mood that is persistently and abnormally elevated and by persistently and abnormally elevated and by some of the following: some of the following: inflated self-esteem; inability to sit still or sleep inflated self-esteem; inability to sit still or sleep
restfully; pressure to keep talking and switching restfully; pressure to keep talking and switching from topic to topic; racing thoughts; difficulty from topic to topic; racing thoughts; difficulty concentratingconcentrating
Robert, a dentist, awoke one morning with the idea that he was the most gifted dental surgeon in his tristate area.
He decided that he should try to provide services to as many people as possible, so that more people could
benefit from his talents. Thus, he decided to remodel his two-chair dental office, installing 20 booths so that he could simultaneously attend to 20 patients. That same
day he drew up plans for this arrangement, telephoned a number of remodelers, and invited bids for the work.
Later that day, impatient to get rolling on his remodeling, he rolled up his sleeves, got himself a sledgehammer, and
began to knock down the walls In his office. Annoyed when that didn’t go so well, he smashed his dental tools, washbasins, and X-ray equipment. Later, Robert’s wife became concerned about his behavior and summoned
two of her adult daughters for assistance. The daughters responded quickly, arriving at the family home with their
husbands. In the ensuing discussion, Robert—after bragging about his sexual prowess—made advances toward his daughters. He had to be subdued by their
husbands. (Adapted from Kleinmuntz, 1980, p. 309)
Characteristics
Manic Episode Depressive Episode
Emotional elated, euphoric, very sociable, impatient at any hindrance
gloomy, hopeless, socially withdrawn, irritable
Cognitive characterized by racing thoughts, flight of ideas, desire for action, and impulsive behavior; talkative, self-confident; experiencing delusions of grandeur
characterized by slowness of thought processes, obsessive worrying, inability to make decisions, negative self-image, self-blame and delusions of guilt and disease
Motor hyperactive, tireless, requiring less sleep than usual, showing increased sex drive and fluctuating appetite
less active, tired, experiencing difficulty in sleeping, showing decreased sex drive and decreased appetite
Personality DisordersPersonality DisordersSection 7Section 7
What is a personality disorder?What is a personality disorder? patterns of inflexible traits that disrupt patterns of inflexible traits that disrupt
social life or work and/or distress the social life or work and/or distress the affected individualaffected individual
What is the difference between personality What is the difference between personality disorders and other psychological disorders and other psychological
disorders?disorders? other disorders are “episodes of illness other disorders are “episodes of illness
that an individual experiences”; P.D. are that an individual experiences”; P.D. are “enduring traits that are major “enduring traits that are major components of the individual’s components of the individual’s personality”personality”
Types of Personality Types of Personality DisordersDisorders
Paranoid Personality Disorder:Paranoid Personality Disorder:people tend to be distrustful and people tend to be distrustful and suspicious of others; perceive others’ suspicious of others; perceive others’ behavior is threatening/insultingbehavior is threatening/insulting
Schizoid Personality Disorder:Schizoid Personality Disorder:no interest in relationships with other no interest in relationships with other people; lack normal emotional people; lack normal emotional responsivenessresponsiveness
Antisocial Personality Disorder:Antisocial Personality Disorder:behavior pattern of disregard for/ behavior pattern of disregard for/ violation of the rights of others; does violation of the rights of others; does not feel guilt or remorsenot feel guilt or remorse(less than 1% to almost 10% of the population)(less than 1% to almost 10% of the population)
Avoidant Personality Disorder:Avoidant Personality Disorder:desire relationships, but prevented desire relationships, but prevented from forming them by tremendous from forming them by tremendous fear of disapproval of othersfear of disapproval of others
SchizophreniaSchizophreniaSection 6Section 6
““schism” or “split mind”schism” or “split mind” usually considered most usually considered most
seriousserious characterized by a loss characterized by a loss
of contact with realityof contact with reality usually first appears in usually first appears in
young adulthoodyoung adulthood often worsens over timeoften worsens over time affects approximately affects approximately
1% of the world’s 1% of the world’s populationpopulation
characterized by characterized by disorganized and delusional disorganized and delusional
thinkingthinkingdisturbed perceptions disturbed perceptions inappropriate emotions and inappropriate emotions and
actionsactions
Paranoid SchizophreniaParanoid Schizophreniadelusions or hallucinations relating to delusions or hallucinations relating to
a single themea single theme
less disordered thoughts and bizarre less disordered thoughts and bizarre behavior, but may be agitated, behavior, but may be agitated, confused, afraidconfused, afraid
Disorganized SchizophreniaDisorganized Schizophrenia incoherent in their thought and incoherent in their thought and
speech; disorganized in their speech; disorganized in their behaviorbehavior
fragmented and unconnected fragmented and unconnected delusions and hallucinationsdelusions and hallucinations
emotionless/inappropriate emotionsemotionless/inappropriate emotionsmay neglect appearance/hygienemay neglect appearance/hygiene
Catatonic SchizophreniaCatatonic Schizophrenia disturbance of disturbance of
movementmovement may hold unusual, may hold unusual,
uncomfortable uncomfortable body positions for body positions for long periods of long periods of timetime
How do we treat How do we treat psychological disorders?psychological disorders?
Two categories of therapy:Two categories of therapy:1. 1. psychotherapypsychotherapy-involves verbal -involves verbal interactions between a trained interactions between a trained professional and person seeking helpprofessional and person seeking help
2. 2. biologically basedbiologically based- involves using - involves using drugs and other medical procedures to drugs and other medical procedures to treat psychological disorderstreat psychological disorders