Psychological Disorders

Defining Psychological

Disorders a “harmful dysfunction” in which behavior is judged to be: maladaptive--harmful unjustifiable--sometimes there’s a

good reason Must include:

Personal discomfort (inner distress) Change in life Functioning (success in

meeting expectations for performance in work or school and social relationships)

Historical Views

• Supernatural view– Mysterious actions indicated

supernatural powers– Madness was a sign of possession– Punishment: Burning at the stake

• Naturalistic View– Hippocrates– Madness was a sickness- treat with care

Theories of Nature, Cause, and Treatment• Biological Model

– Physiological malfunctions• Psychoanalytic Model

– Result of unconscious internal conflict• Cognitive-Behavioral

– Result of learning (learned inferiority)• Diathesis-stress (integration)

– Biological predisposition combined with stressful situation• Systems approach (integration)

– Biological, psychological, and social combination (biopsychosocial model)

Classification - DSM-IV

DSM-IV American Psychiatric Association’s

Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)

a widely used system for classifying psychological disorders

presently distributed as DSM-IV-TR (text revision)

Prevalence and Uses

• 15% experience mental disorder– Top three: Anxiety, phobias, mood

• 6% substance abuse• Incidence: new cases in a given time• Prevalence: frequency of a case• “Insanity”- a legal term used in court to

avoid holding the ill accountable for unjust actions

Mood Disorders Definition: characterized by

emotional extremes• Difference between sadness and

clinical depression?– Normal = response to real-world

situation, lasts for a short period, typical reaction

Mood Disorders

Major Depressive Disorder a mood disorder in which 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

Mood Disorders• MDD Symptoms

– Depressed mood• Feeling sad or empty for most of the day, nearly every

day– Loss of interest in pleasure– Significant weight loss or gain– Sleep disturbances– Disturbances in motor activity– Fatigue– Worthlessness or self guilt– Trouble concentration– Recurrent thoughts of death

Mood Disorders

• Dysthymia– Less intense sadness that persists for

2 years or more

Mood Disorders

•Bipolar Disorder– Disorder in which an individual alternates

between feelings of MANIA (EUPHORIA) & DEPRESSION

– Mania- active, talkative, high self-esteem, potentially aggressive• Ben Stiller, Catherine Zeta-Jones, Brittney

Spears, DMX, Charlie Sheen– Manic-Depressive Disorder (Kelsey and Chase)

Mood Disorders - Bipolar

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

Depressed state Manic state Depressed state

Causes of Mood Disorders

• Biological Factors– Identical Twin more likely to be

depressed than Fraternal – Neurotransmitters– Medications can treat (SSRIs)

• Psychological Factors– Cognitive Distortions- “Twisting” a

situation and misinterpreting it severly

Depression & Women

Depression Rates

Depression & Suicide

Anxiety Disorders

Defined as: distressing, persistent anxiety (don’t know cause or is inappropriate) or maladaptive behaviors that reduce anxiety

Anxiety Disorders

Generalized Anxiety Disorder Prolonged vague but intense fears-

person is tense, apprehensive, and in a state of autonomic nervous system arousal (unable to relax, constantly restless, rapid heart, trouble sleeping)

“Free floating” anxiety

Anxiety Disorder Panic Disorder

marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation

No reasonable cause Dread of having another panic attack is

stressful (agoraphobia?)

Anxiety Disorders Specific Phobia

persistent, irrational fear of a specific object or situation

– Acerophobia - Fear of itching – Acrophobia - Fear of heights – Aerophobia - Fear of flying – Agoraphobia- Fear of open spaces (or being separated from

sources of security)– Atelophobia - Fear of imperfection – Autophobia - Fear of being alone – Lygophobia - Fear of darkness– Arachniphobia – Fear of spiders– Arachibutyrophobia – Fear of peanut butter sticking to the roof of

your mouth– Social Phobia- Fear of public situations (public speaking)

Anxiety Disorders

Obsessive-Compulsive Disorder unwanted repetitive thoughts

(obsessions) and/or actions (compulsions)

May experience anxiety if behavior is stopped

Hoarding

Anxiety Disorders

• Post Traumatic Stress Disorder (PTSD)– Disorder in which victims of traumatic

events experience the original event in the forms of dreams or flashbacks long after the event

– Acute stress- immediately after– A Soldier's Struggle with PTSD

Psychosomatic and Somatoform

Disorders• Psychosomatic- “mind” and “body”– Real illnesses that have a psychological cause– Ex: Tension headaches, High Blood Pressure

exacerbated by stress– Joe Paterno?

• Somatoform- Believe they are physically ill– Problem is somatic (physical) in appearance

with no evidence of illness

SomatoformSomatization disorder- Vague, recurring physical

symptoms with no cause (back pain, dizziness, stomach pains, etc.)

Conversion Disorder -Conversion of emotional difficulties into the loss of a specific physiological functionIf stuck with a pin, a limb will have no feelingglove anesthesia- lack of feeling from the hand down“Hysterical Blindness”

Hypocondriasis - A person who is in good health becomes preoccupied with imaginary ailments (a cough becomes a serious disease

BDD- Body Dysmorphic Disorder- imagined ugliness

Dissociative Disorders

• Dissociative Disorder - a disorder in which a person experiences alterations in memory, identity, or consciousness

• Part of the person is dissociated from the rest (memory, identity, etc.)

• i.e. Dissociative Amnesia- memory of war victims is incomplete (selectively forgotten)

Dissociative Fugue

A person suddenly and unexpectedly travels away from home or work and is unable to recall the past- rare

This person will assume an entirely new identity

DID- Dissociative Identity Disorder

•Formerly Multiple Personality•A person exhibits two or more

personality states, each with its own patterns of thinking and behaving

• A.k.a. Multiple Personality• http://www.youtube.com/watch?

v=s5a2PxSgZ28

Case Study

• “In general demeanor, Maud was quite different from Sara. She walked with a swinging, bouncing gait contrasted to Sara’s sedate one. While Sara was depressed, Maud was ebullient and happy… Insofar as she could Maud dressed different from Sara… Sara used no make-up. Maud used a lot of rough and lipstick…”

• Sara was mature (19.2 mental age, IQ 128), while Maud was childish (6.6, IQ of 43)

Depersonalization

• Person suddenly feels changed or different in a strange way

• Is common during adolescence, but when this becomes long-term or chronic it is classified as a dissociative disorder

Sexual Disorders

• Sexual Dysfunction- loss or impairment of physical responses

• Sexual Desire Disorder- lack of interest• Paraphilias- Unconventional sex objects or

situations to obtain sex arousal (fantasies)– Fetishism- repeated use of nonhuman object

to achieve arousal– Exhibitionism, Pedophilia, Frotteurism,

Sexual Sadism, Masochism, Transvestic Fetishism

Gender Identity Disorders

• Desire to become a member of the other biological sex

• Many times this is resolved by adulthood• If not, sexual reassignment surgery is an

option• Cause: Biological?• Two sexes is not enough to encompass

human sexuality?

Schizophrenia Schizophrenia

literal translation “split mind”a group of severe disorders characterized by:disorganized and delusional thinking

disturbed perceptionsinappropriate emotions and actions

Schizophrenia

Psychosis: A loss of touch from reality Delusions

false beliefs, often of persecution or grandeur, that may accompany psychotic disorders

Hallucinations sensory experiences without sensory

stimulation

Subtypes of Schizophrenia

Giggling, Grimacing, Active but aimless

- Then overactive

Being chased by Russian spies, evil clowns, etc.- “Normal”

Genetics & Schizophrenia

Fluid-filled Brain - Schizophrenia

Dopamine & Diathesis-Stress

Hypothesis• Dopamine Hypothesis -An

excess of dopamine at selected synapses is related to a diagnosis of schizophrenia

• Diathesis-Stress Hypothesis - Individual may have inherited a predisposition toward schizophrenia

Personality Disorder

Personality Disordersdisorders characterized by inflexible and enduring behavior patterns that impair social functioning

usually without anxiety, depression, or delusions

Types of Personality

Disorder• Antisocial- lie, cheat, steal, kill with no regret • Dependent- Unable to make decisions on their own • Histrionic - Excessive emotions; Seeks attention • Paranoid – Suspicious and mistrustful, hypersensitive to

threats• Schizotypal, or Schizoid - Intense discomfort in close

relationships, lack desire to form social relationships• Borderline- Instability in self-image, mood, and interpersonal

relationships; impulsive• Narcissistic –grandiose sense of self-importance and

preoccupation with fantasies of success • Avoidant- timid, anxious, and fearful of rejection, but wants

close relationships

Personality Disorder

Antisocial Personality Disorder disorder in which the person

(usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members

may be aggressive and ruthless or a clever con artist

Childhood Disorders

• ADHD (Attention-Deficit/hyperactivity disorder)- lack ability to focus in a sustained way

• Biological factors in central nervous system

• Treatment- psychostimulants to “slow down” hyperactive children

Autistic Disorder• 1/500 Children• 4x in boys• Fail to form normal attachments, distant

and withdrawn, delayed speech or develop echolalia (repetition of words said to them)

• Strange motor behavior• Precise cause unknown• “Autism: The Musical”