Chapter 18— Psychological Disorders

1. Chapter 18—Psychological Disorders

2. 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. • Mental disorders indicate a fundamental deficiency in personality, and are thus shameful. • Because mental illness is so common, there is reason to be fearful of one’s own vulnerability. • Geniuses are particularly prone to emotional disorders. • Most mental disorders are incurable.

3. Using your group’s definition of abnormal, decide if these are examples of psychological disorders. X hears voices in her head telling her to do dangerous things. 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. 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.”

4. Section 1 Introduction to psychological disorders

5. We will discuss the following disorders… • anxiety disorders • somotoform disorders • dissociative disorders • mood disorders • schizophrenia • personality disorders

6. What is a psychological disorder? • behavior patterns or mental processes that cause serious personal suffering or interfere with a person’s ability to cope with everyday life • “normal” often means what is average for most people, therefore, “abnormal” is usually a deviation from the majority

7. How do we determine if a psychological disorder is 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

8. 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.

9. Does this man have a psychological disorder?

10. Alan’s performance at work has suffered because he has been drinking alcohol to excess. Several co-workers have suggested that he seek help for his problem, but he thinks that they’re getting alarmed over nothing. “I just enjoy a good time once in a while,” he says. • Monica has gone away to college and feels lonely, sad, and dejected. Her grades are fine, and she gets along okay with the other students in the dormitory, but inside she’s choked with gloom, hopelessness, and despair.

11. Boris believes that he’s Napoleon reborn. He believes that he is destined to lead the U.S. military forces into a great battle to recover California from space aliens. • Natasha panics with anxiety whenever she leaves her home. Her problem escalated gradually until she was absent from work so often that she was fired. She hasn’t been out of her house in nine months and is deeply troubled by her problem.

12. The DSM IV (1994) Diagnostic and Statistical Manual of Mental Disorders • 18 different categories • categorized by observable signs and symptoms.

13. Section 2 Types of anxiety disorders

14. Anxiety • refers to a general state of dread or uneasiness that occurs in response to a vague or imagined danger • different from fear, which is a response to a real danger or threat

15. Anxiety disorders are characterized by… • nervousness • inability to relax • concern about losing control • physical signs or symptoms • such as: trembling; sweating; rapid heart rate; shortness of breath; increased blood pressure; flushed face; feelings of faintness/light-headedness **Anxiety based disorders are among the most common.**

16. Types of Anxiety Disorders • Phobic Disorders- • phobia— “fear” • simple phobia- persistent excessive or irrational fear of a particular object or situation; most common of all anxiety disorders • to be diagnosed, the fear must lead to avoidance behavior that interferes with the affected person’s normal life • social phobia—characterized by persistent fear of social situations in which one might be exposed to the close scrutiny of others and therefore might be observed doing something embarrassing or humiliating

17. Most common types of phobic disorders: ~zoophobia (fear of animals) ~claustrophobia (fear of enclosed spaces) ~acrophobia (fear of heights) ~arachnophobia (fear of spiders)

18. What do people fear? • Men • Women Fear of being buried alive Fear of heights Fear of snakes Fear of drowning Fear of public speaking Fear of snakes Fear of being bound or tied up Fear of being buried alive Fear of heights Fear of public speaking

19. Do you experience… • acrophobia? • mikrophobia? • aquaphobia? • ophidiophobia? • arachnophobia? • claustrophobia? • triskaidekaphobia? • uxoriphobia? • Santa Claustrophobia? • panaphobia? • phobophobia?

20. Panic Disorder and Agoraphobia • those with a panic disorder have recurring/ unexpected panic attacks • panic attack—relatively short period of intense fear or discomfort, characterized by shortness of breath, dizziness, rapid heart rate, trembling, shaking, sweating, choking, nausea • many who suffer from panic disorder also have agoraphobia, or the fear of places/ situations where escape may be difficult

21. Generalized Anxiety Disorder • excessive or unrealistic worry about life circumstances, for 6 or more months • worries tend to focus on • finances,work, interpersonal problems, accidents, illness

22. Obsessive-Compulsive Disorder (OCD) • obsessions- unwanted thoughts, ideas or mental images that occur over and over; often senseless • compulsions- repetitive ritual behaviors; often involve checking or cleaning • people are usually aware that obsessions are unjustified which distinguishes them from delusions

23. Obsessive-Compulsive Behaviors • checking • “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 better open the door and start over. Lock it again.” • washing • “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 spot where bacteria can grow.” • hoarding • “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 course there are some things I know I won’t need. For instance, I’ve been giving myself haircuts lately so that I can save the hair.”

24. harming • “I used to enjoy smoking, but I can’t help thinking that 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 sometimes worry that I’ve hit someone.” • counting • “I do it mainly when I’m bored: I count ceiling tiles, floor tiles, letters on billboards and street signs. Sometimes I’ll even divide the letters into groups of three or four. I try to stop, but I can’t help myself.” • performing rituals • “When I walk through a doorway, I need to make sure that there are six inches between each shoulder and the door jamb. If I walk through and I don’t think I’ve accomplished this, I’ll walk out and try again.”

25. Stress Disorders • post-traumatic stress disorder- intense, persistent feelings of anxiety caused by traumatic experiences • Examples of traumatic events: rape, severe childhood abuse, assault, accidents, nautral disasters, war • Symptoms: flashbacks, nightmares, numbness or feeling, avoidance, increased tension • can occur 6 or more months after the event and tend to last for years/decades • acute stress disorder- short-term symptoms similar to PTSD; follows a traumatic event • differs from PTSD because symptoms occur immediately and they last for a few days to a few weeks

26. Section 3 Dissociative Disorders

27. dissociation- separation of certain personality components or mental processes from conscious thought • ex: daydreaming • When is it considered to be a sign of a psychological disorder? • when it occurs as a way to avoid stressful events or feelings

28. Have you ever experienced these dissociative experiences? • Suddenly realizing, when you are driving the car, that you don’t remember what has happened during all or part of the trip. • Suddenly realizing, when you are listening to someone talk, that you did not hear part or all of what the person said. • Having the experience of being in a familiar place but finding it strange and unfamiliar.

29. Becoming so absorbed in watching television or a movie that you are unaware of other events happening around you. • Talking out loud to yourself when you are alone. • Finding that you cannot remember whether or not you have just done something or perhaps had just thought about doing it. • Feeling sometimes as if you were looking at the world through a fog such that people and objects appear faraway or unclear.

30. Section 4 Somatoform Disorders

31. somatization- expression of psychological distress through physical symptoms • What are the symptoms? • psychological problems and unexplainable physical symptoms

32. Section 5 Mood Disorders

33. What do all these people have in common?

34. True or False????? • Every year more than 32,000 Americans commit suicide. • Approximately once every 16 minutes a suicide occurs in the United States. • More women than men attempt suicide. • Of those who attempt suicide, more men than women succeed. • Suicide is most common among the elderly. • Suicide is the second most common cause of death among college students. • Individuals who threaten suicide or make an unsuccessful attempt usually are serious.

35. Approximately 70% of suicide victims threaten to kill themselves sometime during the three months preceding the suicide. • Suicide rates among youth have nearly tripled since the 1950’s. • A firearm is used in over 60% of all suicides. • Fewer than 5% of elderly suicide victims had been diagnosed with a terminal illness when they committed suicide. • Nevada consistently has the highest suicide rate in the United States. • States with stricter gun control laws have lower suicide rates. • The suicide rate for children ages 10 to 14 more than doubled between 1985 and 2000.

36. Edvard Munch • born December 12, 1863—Loten, Norway • Norwegian painter and printmaker • played an important role in the development of German expressionism • parents, brother and sister died when he was young • his work often displayed themes such as misery, sickness, death

37. “Sickness and insanity and death were the black angels that hovered over my cradle and have since followed me throughout my life.”

38. Self-Portrait with Burning Cigarette,1895

39. The Scream (or The Cry), 1893

40. Death in the Sickroom, 1895

41. 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

42. Types of Mood Disorder: Major Depression • To be diagnosed, you must exhibit 5 of the following 9 symptoms for at least 2 weeks, nearly every day. • One of the 5 symptoms must be #1 or #2 • persistent depressed mood for most of the day • loss of interest or pleasure in all, or almost all activities

43. The remaining 4 symptoms can be any of these… 3. significant weight loss/gain due to changes in appetite 4. sleeping more or less than usual 5. speeding up or slowing down of physical and emotional reactions 6. fatigue or loss of energy 7. feelings of worthlessness or unfounded guilt 8. reduced ability to concentrate or make meaningful decisions 9. recurrent thoughts of death or suicide

44. Bipolar Disorder • Characterized by dramatic ups and downs in mood • manic phase- characterized by a mood that is persistently and abnormally elevated and by some of the following: • inflated self-esteem; inability to sit still or sleep restfully; pressure to keep talking and switching from topic to topic; racing thoughts; difficulty concentrating

45. 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)

47. Section 7 Personality Disorders

48. What is a personality disorder? • patterns of inflexible traits that disrupt social life or work and/or distress the affected individual What is the difference between personality disorders and other psychological disorders? • other disorders are “episodes of illness that an individual experiences”; P.D. are “enduring traits that are major components of the individual’s personality”

49. Types of Personality Disorders Paranoid Personality Disorder: people tend to be distrustful and suspicious of others; perceive others’ behavior is threatening/insulting Schizoid Personality Disorder: no interest in relationships with other people; lack normal emotional responsiveness

50. Antisocial Personality Disorder: behavior pattern of disregard for/ violation of the rights of others; does not feel guilt or remorse (less than 1% to almost 10% of the population) Avoidant Personality Disorder: desire relationships, but prevented from forming them by tremendous fear of disapproval of others