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Psychological Disorders
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What do you think?
Write a definition for a psychological disorder.
Do not give examples or define specific disorders- what does it mean to have a psychological disorder?
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–distressing & harmful; disruptive
–behavior is uncontrollable
–Unjustified, Irrational
Psychological Disorder
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Psychological Disorders
Must have personal distress and impaired functioning
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Personal DistressThe behavior/symptoms
causes significant personal distress to the patient (may not realize)–Potential harm to self or others
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Impairs FunctioningDaily life functioning
is impaired (one or both)–Work/School life–Home life–Varies throughout time/ culture
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Ancient causes of Ancient causes of “madness”“madness”
–movements of sun or moon
lunacy- full moon (lunar)
–evil spirits
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Ancient “cures”–Exorcism
–Caged like animals, beaten, burned, castrated, mutilated – blood
replaced with animal’s blood!
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Diagnosis DSM-VDiagnostic and Statistical Manual
of Mental Disorders describes specific symptoms
and diagnostic guidelines for psychological disorders
– Provides a common language & comprehensive guidelines to help diagnose
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DSM-V vs DSM-IV 5 axis diagnostic system now simplified – a
single diagnostic of all factors that could contribute to the patients well-being (physical, social, emotional, etc)
Reduction in the amount of time symptoms must be present to be diagnosed with a disorder. (for example, instead of 6 months with the symptoms now its only 3 months)
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Insanity legal
definition only
unable to determine between right & wrong or understand consequences
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Anxiety
An unpleasant emotional state characterized by general, vague feelings of tension, fear and apprehension
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Generalized Anxiety Disorder (GAD)
Constant worry about many issues w/o cause, seriously interferes with functioning–Physical symptoms
headachesstomach achesmuscle tensionirritability
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Panic Disorder Panic attacks—
sudden episode of helpless terror with high physiological arousal (increased blood pressure, heart beat, temp., sweating) Very frightening —sufferers live
in fear of having them
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Agoraphobia often develops
NOT FEAR OF OUTDOORS Fear of being in situations in which escape might be difficult, they don’t feel safe- public places, crowds, wide open spaces–Mostly confined to homes- they are safe there
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Specific Phobias
Intense, irrational fears that may focus on …….
Inappropriate response to ………..
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Natural environment
type•the fear of heights (acrophobia) • the fear of lightning and thunderstorms (astraphobia).
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Situational type–the fear of small confined spaces
(claustrophobia) – being "afraid of the dark," (nyctophobia).
–Monophobia—fear of being alone–Gephyrophobia - Fear of crossing bridges.
–Ligyrophobia — Fear of loud noises. –Xenophobia — Fear of strangers, foreigners, or aliens.
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Blood/injection/injury type
– the fear of medical procedures including needles and injections (aichmophobia)
Algobphobia—fear of pain Pyrophobia—fear of fire Emetophobia — Fear of vomiting. Radiophobia— Fear of radiation or x-
rays Hemophopia (Haemophobia) — Fear
of blood
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Animal type–the fear of spiders (arachnophobia)
–the fear of snakes (ophidiophobia).
Ailurophobia—fear of cats Myrmecophobia — Fear of ants. Cynophobia — Fear of dogs or of
rabies. Mottephobia — Aversion to moths
and butterflies.
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Other– the fear of the number 13
(triskaidekaphobia)– the fear of clowns
(coulrophobia). Anthropophobia—fear of men Ephebiphobia — Fear/dislike of
teenagers. Zapatophobia - Fear of shoes,
socks, or sandals.
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Common and uncommon fears
Afraid of it Bothers slightly Not at all afraid of it
Beingclosed in,
in a smallplace
Being alone
In a house
at night
Percentageof peoplesurveyed
100
90
80
70
60
50
40
30
20
10
0Snakes Being
in high,exposedplaces
Mice Flyingon an
airplane
Spidersand
insects
Thunderand
lightning
Dogs Drivinga car
Being In a
crowdof people
Cats
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Follows events that produce intense horror or helplessness (traumatic episodes)
Actual or threatened death and/or injury–War, Rape, Accidents, Attacks, Abuse, Rescue workers
May be delayed after event- onset with trigger
Posttraumatic Stress Disorder (PTSD)
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–Avoidance of situations that trigger recall of the event
–Increased physical arousal associated with stress
Core symptoms include:–Frequent recollection of traumatic event, often intrusive and interfering with normal thoughts
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Obsessive-Compulsive Disorder
Obsessions—irrational, disturbing thoughts that intrude into consciousness (getting sick)
Compulsions—repetitive actions performed to alleviate obsessions (washing hands)
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The compulsions (actions) help to keep away the obsessions (thoughts)
If the actions are not performed==anxiety
Observable or mental compulsions
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Common Obsessions and Compulsions AmongPeople With Obsessive-Compulsive Disorder
Thought or Behavior Percentage*Reporting Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins 40
Something terrible happening (fire, death, illness) 40
Symmetry order, or exactness 24
Excessive hand washing, bathing, tooth brushing, 85or grooming
Compulsions (repetitive behaviors)
Repeating rituals (in/out of a door, 51up/down from a chair)
Checking doors, locks, appliances, 46car brake, homework
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Borderline Personality Disorder
Instability of self-image, relationships
Self-destructive behaviors, impulsive
Fear of abandonment
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Dependent Personality Disorder
Unable to make decisions or do things on own
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Narcissistic Personality Disorder
self importance, success fantasies, need for ^ attention, envy arrogance – others are inferior
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Antisocial Personality
DisorderMight start as conduct disorder (children)
Manipulative, charming, “con man”
Cruel, destructiveLacking “conscience”, no guilt, no responsibility
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What’s the difference between a psychopath and a sociopath?
Not much…both technically have Anti-Social Personality Disorder, but there are a few differences…– 1 – The cause The cause – many sociopaths get that way due to environmental
(or “social” circumstances (abuse, poverty, neglect, etc)
– 2 – The attachment The attachment – many sociopaths can emotionally attach to others and feel remorse when hurting those they are attached to, psychopaths do not.
– 3 – The presentation The presentation – The psychopath cons and manipulates others “pretending” to be “normal”. They are aware that what they are doing is wrong – they just don’t care. Conversely, the sociopath is less organized in his or her demeanor; he or she might be nervous, easily agitated, and quick to display anger. A sociopath is more likely to act out of impulse.
So which do you feel best describes the “Iceman”?
Psychopath or
Sociopath?
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Dissociative Amnesia
Memory loss the only symptom…but no “organic” cause!
Often selective loss surrounding traumatic events–person still knows identity and most of their past
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Dissociative Amnesia
Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers.
Margie was unable to recall Margie was unable to recall any details from the time of any details from the time of the accident until four days the accident until four days later.later.
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Fugue State Considered by the DSM-V to be a “sub-category” of
Dissociative Amnesia
Amnesia with a journeyjourney involved – often with identity replacement
– leaves home– develops a new identity– apparently no recollection of former life
If fugue wears off– old identity recovers– new identity is totally forgotten
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Dissociative Fugue
Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man.
Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married.
http://www.msnbc.msn.com/id/21134540/vp/15384724#15384724
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Dissociative Identity Disorder (DID)
NormaNorma has frequent memory gaps and cannot account for her whereabouts
during certain periods of time. While being interviewed by
a clinical psychologist,
she began speaking in a
childlike voice. She claimed
that her name was Donna Donna and
that she was only six years
old.
Moments later, she seemed to revert to her
adult voice and had no no
recollection recollection of speaking in a childlike voice
or claiming that her name
was Donna.
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Dissociative Identity Disorder
Most report recall of torture or sexual abuse as children and show symptoms of PTSD
Pattern typically starts prior to age 10 (childhood)
2 or more distinct personalities manifested by the same person at different times, VERY rare and controversial disorder
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“Psychotic” loss of contact w/reality- irrational, distorted
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Symptoms of Schizophrenia
–HallucinationsSeeing & hearing things that are not there
Command (something/ someone giving orders)
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Symptoms of Schizophrenia
–DelusionsPersecution/Paranoid (they’re out to get me’)
Grandeur (“God” complex)
Being Controlled (CIA is controlling my brain with a radio waves)
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Symptoms of Schizophrenia
Disorganized Speech (e.g., word salad)– jumping from idea to idea without the benefit of logical association
–Paralogic—on the surface, seems logical, but seriously flawede.g., Jesus was a man with a beard, I am a
man with a beard, therefore I am Jesus
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Symptoms of SchizophreniaDisorganized behavior
–behavior is inappropriate for the situatione.g., wearing sweaters and overcoats on hot days
–Emotion is inappropriately expressedno emotion at all in face or speech, laughing at very serious things, crying at funny things
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-Catatonia unresponsive
to surroundings
parrot-like speech
immobility for extended periods
Symptoms of Schizophrenia
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Example of Schizophrenia (Heather)
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Early Causes:
Genetic Predisposition
Prenatal Factors
Vulnerability:
•Cognitive impairments
•Social Anxiety
•Odd ideas
Reinforcement:
Social stress
Isolation
Drug/Alcohol abuse
PSYCHOSIS!
WHERE DOES IT COME FROM?
Nature AND Nurture!
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Major Depression
extreme and persistent feelings of despondency, worthlessness and hopelessness that disturb everyday functioning
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Symptoms of Major Depression
Emotional—sadness, hopelessness, guilt, turning away from others
Behavioral—tearfulness, dejected facial expression, loss of interest in normal activities, slowed movements and gestures, withdrawal from social activities
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Cognitive—difficulty thinking and concentrating, global negativity, preoccupation with death/suicide
Physical—appetite and weight changes, excessive or diminished sleep, loss of energy, global anxiety, restlessness
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treatment
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Seasonal Affective Disorder
Episodes of depression occur in fall and winter then subside in spring and summer
(Seasonal regularity)
Considered by the DSM-V to be a “sub-category” of Major Depression
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Dysthymic Disorder
Chronic, low-grade depressed feelings that are not severe enough to be major depression
May develop in response to trauma, but does not decrease with time
Usually does not severely impair functioning
Over two years
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Bipolar Disorders
Mood levels swing from severe depression to extreme euphoria (mania), can have “normal” in between
No regular relationship to time of year (SAD)
Can vary in length of time for depression and mania
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Must have at least one manic episode– Supreme
self-confidence
– Grandiose ideas and movements, little effort in carrying out plans
– Flight of ideas
Aggressive, hostile, wild, incomprehensible, violent
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Depressed state Manic state Depressed state
PET scans show that brain energy consumption rises and falls with emotional swings
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There are over 250 identifiable types of psychotherapy, though the most influential are:– Psychoanalytical Therapies– Humanistic Therapies– Cognitive Therapies– Behavior Therapies– Group and Family Therapies– Psychosurgery– Psychopharmacology
Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy
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Therapeutic Perspectives
Psychoanalysis - assumes that many psychological problems are fueled by the childhood repression of impulses and conflicts
Humanistic - goal is to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.
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Therapeutic Perspectives
Cognitive - attempt to teach people new, more adaptive ways of thinking and acting
Behaviorists - believe that problem behaviors are the problem, and the goal is to simply eliminate or unlearn the problem behavior
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Types of Behavior Therapies
Systematic Desensitization attempt to gradually substitute a positive response for a negative response to a harmless stimulus.
Implosive Therapy floods patients with their worst fears first, in hopes that by confronting them, they’ll overcome them.
Aversive conditioning replace a positive response to a harmful stimulus with a negative response.
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Benefits: others have same
disorder share therapy ideas receive feedback you are not alone
Group therapy is generally for people experiencing family conflicts or those whose behavior is distressing to others.
Therapeutic Perspectives
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Methods:– Usually groups of six to ten individuals– Averaging up to 90 minutes per week
– Family Therapy promotes the idea that families are a unit that depends on each member to be positive and to communicate
Therapeutic Perspectives
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Psychosurgery:– Surgery that removes or destroys brain tissue in
an effort to change behavior.– Once popular, but no more, a lobotomy cuts the
nerves that connect the frontal lobe to the emotion-controlling centers in the inner-brain.
Therapeutic Perspectives
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Psychopharmacology:
– The study of the effects of drugs on the mind and behavior
– Introduced in the 1950’s– Greatly reduced those confined to a
hospital– currently applied to just about
anything
Therapeutic Perspectives
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Types of DrugsAntianxiety Drugs:
– Are used for the purpose of alleviating the symptoms stemming from frightening situations and fear-inducing stimuli
– IE. Xanax, Valium
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Types of Drugs Antipsychotic Drugs:
–Drugs used for the purpose of calming psychotic patients; those patients with fundamental mental derangement (such as schizophrenia)
–IE. Thorazine, Clozaril, Haldol
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Types of Drugs
Antidepressant Drugs–The purpose is to lift people up from a state of depression
– IE. Prozac, Paxil, Zoloft–Lithium is an anti-depressant used mainly for manic-depressives (bipolar)
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Some Criticisms of Drug Therapy:
–Doesn’t address the root causes of behavior disorders
–May cause addiction
–Increased risks for suicide with some drugs?
–May cause other symptoms, disorders or diseases
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Alternative Therapies
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A practitioner moves their hands a few inches from a patient’s body, purportedly “pushing energy fields into balance”
Therapeutic Touch:
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Eye Movement Desensitization
Reprocessing (EMDR):– Usually for disorders associated with
trauma and anxiety.
– A patient is asked to close their eyes and to think about a traumatic scene from their life.
– A therapist waves their hand in front of their eyes as they are thinking, causing rapid eye movement
Does this Does this resemble the resemble the
stress-less stress-less REM of sleep?REM of sleep?
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– Especially for seasonal affective disorder, or depression brought on seasonal changes from summer to winter (less light). The therapy includes timed doses of intense light in “light boxes”.
Light Exposure Therapy:
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Electroconvulsive Therapy:
– Patients are given an anesthetic so that they are not conscious, and a muscle relaxant to prevent any injuries that may occur from convulsions.
–Patient’s brains are given momentary shock treatments, generally for about 30 seconds.
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Electroconvulsive Therapy:–Used in cases of deep depression, but historically used for almost anything determined to be abnormal behavior.