Psychological Disorders

Ch. 16 Psychological Disorders

Introduction to Disorders • Psychopathology: pattern of emotions, behaviors, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals (also known as psychological disorders, mental illnesses, or mental disorders)

Introduction to Disorders • Early Theories: • Afflicted people were possessed by evil spirits • Music or singing was often used to chase away spirits • Trephining: drilling holes in the skull to let the spirits escape

Introduction to Disorders • History: • Early mental hospitals • Barbaric prisons • Patients chained and locked away- seen as criminals • Shutter Island • Philippe Pinel- French psychologist who took a more humane look at patients

Introduction to Disorders • When diagnosing a psychological disorder, clinicians look for three classic syndromes: 1. Hallucinations: false sensory experiences that may suggest mental disorder. • Ex: feeling a crawling sensation on your skin, hearing voices when no one has spoken

2. Delusions: extreme disorders of thinking, involving persistent false beliefs. • Ex: Thinking you are the president of the United States (yet you are not) 3. Affective Disturbances: emotional or mood characteristics • those who display no emotion have other possible signs

Introduction to Disorders • Indicators of Abnormality: • Distress: prolonged levels or unease or anxiety? • Maladaptiveness: acting in ways that are fearful/harmful to one’s well-being? • Irrationality: acting or talking in ways that are irrational or incomprehensible to others • Unpredictability: behaving erratically/inconsistently at one time vs. another • Unconventionality and undesirable behavior: behaving in ways that are statistically rare and violate norms

Introduction to Disorders • Medical Model: • Psychological disorders are diseases of the mind and can be diagnosed on the basis of its symptoms and cured through therapy. • Perceived those with psychological problems as “sick” rather than possessed or immoral • Many patients improved or thrived on rest, contemplation and simple but useful work in asylums

Introduction to Disorders • Biopsychosocial Model: • Assumes that all behavior, whether called normal or disordered, arises from the interaction of nature and nurture • Genetic/physiological factors and past/present experiences • Recognizes that the mind and body are inseparable

Introduction to Disorders • DSM-IV: American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; widely used system to classifying psychological disorders. • Now updated to the DSM-V in a text revision. Appears this year!

Introduction to Disorders • How are Psychological Disorder diagnosed? (pg. 645) • There are 5 levels (or Axes) that are answered in order to diagnose a disorder: • Axis 1: Is there a Clinical Syndrome present? • Axis 2: Is a personality disorder of mental retardation present?

Introduction to Disorders • Axis 3: Is a general medical condition (i.e. diabetes, hypertension, or arthritis) present? • Axis 4: Are psychosocial or environmental problems (school or housing problems) also present? • Axis 5: What is the global assessment of this person’s functioning? • Clinicians assign a code from 0-100. • Assessment Scale

Introduction to Disorders • Labeling Psychological Disorders: • Labeling these disorders can create preconceptions that guide our perceptions and our interpretations. Some say it is better to study the roots of specific syndromes than catchall categories.

Introduction to Disorders • Blind Pig Syndrome: diagnosing ourselves. Identifying with symptoms of different disorders. • Some symptoms may apply; however, this does not automatically qualify you as one with a disorder.

Introduction to Disorders • 2 Major Classifications: • Neurosis: a label for subjective distress or self-defeating behavior that did not show signs of brain abnormalities or grossly irrational thinking. - Someone who might be unhappy or dissatisfied but not considered dangerously ill or out of touch with reality.

Introduction to Disorders • Psychosis: disorder involving profound disturbances in perception, rational thinking, or affect. - The three signs (hallucinations, delusions, affect [emotions]) - Loss of contact with reality

Introduction to Disorders • Pros and Cons of Labeling: • C- labels affect how others perceive us; may lead to stigmatization • C- biasing power of diagnostic labels can lead to assumptions of disorders • P- helps professionals communicate about their cases and do research • P- helps professionals to comprehend underlying causes w/ effective treatments

Anxiety Disorders • Disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety • These include: • Generalized anxiety disorders • Panic disorder • Phobias • Obsessive-compulsive disorder

Anxiety Disorders • Generalized Anxiety Disorder: disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. • Common, not persistent • Continually tense and jittery, worry, muscle tension, agitation, sleeplessness • Anxiety is free-floating

Anxiety Disorders • Panic Disorder: disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other sensations. • Can advance to panic attacks • Attempt to avoid situations where attacks have struck

Anxiety Disorders • Phobia: anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object or situation. • Include fears of animals, heights, storms, social situations • Agoraphobia- fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes- Homebound • Social Phobia- fear of being scrutinized by others, avoiding social interactions such as eating out or going to parties

Anxiety Disorders • Other phobias include triskaidekaphobia (number 13), uxoriphobia (one’s wife), Santa Claustrophobia (getting stuck in chimneys), panphobia (everything), phobophobia (fear of fear), anthophobia (flowers), trichophobia (hair), Pteronophobia (fear of being tickled by feathers)

Anxiety Disorders • Obsessive-Compulsive Disorder (OCD): anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions). • Become a disorder when they are so persistent that they interfere with everyday living and cause distress • As Good as It Gets • The Aviator

Anxiety Disorders • Common Obsessions- concern with dirt or germs, something terrible happening, symmetry • Common Compulsions- excessive hand washing or bathing, repeated rituals (in/out of a door), checking locks on doors, appliances, homework

Anxiety Disorders • Post-Traumatic Stress Disorder: anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for weeks or more after a traumatic experience. • Common in combat veterans, accident or disaster survivors, and sexual assault victims • Develop a learned helplessness

Anxiety Disorders • Develop a learned helplessness • Civilians exhibit a stress dose-response relationship • Can lead to post-traumatic growth- victims with challenging crisis lead to report increased appreciation of life, more meaningful relationships, changed priorities, etc. • Coping with PTSD

Explaining Anxiety Disorders • The Learning Perspective: • Fear conditioning- general anxiety has been linked with classical conditioning of fear • After experiencing a traumatic event, fears may increase • Stimulus generalization occurs when one fear develops into more broad of fears • A fear of heights can lead to a fear of flying • Observational Learning- observing others’ fears • Parents may transmit their fears off on their children

Explaining Anxiety Disorders • The Biological Perspective: • Natural Selection- biologically prepared to fear threats faced by our ancestors • Most consist of objects (spiders, snakes, closed spaces, the dark, storms, etc.) • Genes- genetics can create predisposed fears and high anxiety

Explaining Anxiety Disorders • The Biological Perspective: • Vulnerability to anxiety disorders can rise when a relative is an identical twin • Twins may develop similar phobias • The Brain- anxiety can be measured as an overarousal of brain areas involved in impulse control and habitual behaviors • The anterior cingulated cortex monitors actions and checks for errors, is extremely hyperactive in OCD patients

Mood Disorders • Mood Disorders: disorders characterized by emotional extremes • Depression is the number 1 reason people seek mental services • Mild depression (as we all experience occasionally) is adaptive—when times are tough, depression slows us down, forces us to reassess our lives, and evokes support • Depression is considered a mental illness when it ceases to be adaptive—when the behavior interferes with our survival

Mood Disorders • Major Depressive Disorder • Signs of depression (feelings of worthlessness, loss of interest in family, friends, and activities, lethargy, change in eating patterns, thoughts of death, inability to concentrate, sense of hopelessness, dissatisfaction with your life) last 2 weeks or more. • Usually goes away (even without treatment, although treatment can speed up recovery) in under 6 months

Mood Disorders • Facts About Depression • Depression tends to be self-sustaining • Women are twice as likely to report depression than men • Stressful events often precede depression • Rates of depression have increased with each generation (not just in America) • Depression strikes at a younger age now than in previous generations (not just in America)

Mood Disorders • Indication is that increase is real, and not just that people are more likely to report depression than before • Young adults (18-24) are at the highest risk for developing depression, particularly those who have been depressed before • Ironically, few people commit suicide in the midst of depression because they lack initiative and energy. Suicide risk is highest when people first start to recover

Mood Disorders • Bipolar Disorder: • person alternates between periods of major depression and mania • behaviors associated with manic episodes- excessively talkative • over reactive, • elated, • irritable, • little need for sleep,

often say their minds are “racing” and jump around from subject to subject when talking, easily distracted, fewer sexual inhibitions; • VERY high self-esteem and optimism lead to poor judgment (spending a lot of money on a shopping spree, taking unnecessary risks) • in manic episodes, there is a high amount of norepinephrine

Mood Disorders • Bipolar Disorder: • occurs in less than 1% of population • occasionally associated with psychosis (such as hallucinations and delusions); severe forms like these are occasionally misdiagnosed as schizophrenia

Mood Disorders • For each of the following words, write a sentence that describes an experience you had that is associated with that respective word… • Train • Ice • House • Meeting • Machine • Road • Rain • Tunnel

Mood Disorders • For each experience you wrote down, rate whether the experience was pleasant or unpleasant • After you have rated all experiences, tally the total number of pleasant and unpleasant experiences

Mood Disorders • How have you felt today? • Happy? Sad? Somewhat depressed? • The number of pleasant vs. unpleasant experiences you recalled should be related to your mood today. • When we are in certain moods, we remember these events as more pleasant or unpleasant depending on our mood during that time.

Mood Disorders • Biological Perspective • mood disorders run in families • twin studies indicate genetic influence on the disease • decreased levels of norepinephrine, serotonin, and dopamine are all associated with depression • drugs that alleviate mania reduce norepinephrine levels

Mood Disorders • Biological Perspective: • drugs that alleviate depression increase levels of one or all three: • “tricyclic”—class of anti-depressants that increase levels of all 3 • “SSRI’s”—(selective serotonin reuptake inhibitors) increase serotonin specifically (Prozac, Zoloft, Paxil)

Mood Disorders • Physical exercise (which reduces depression) increases serotonin levels • Frontal lobe activity is decreased in depressed patients and increased in manic patients

Mood Disorders • Social Cognitive Perspective: • depression causes negative thinking AND negative thinking causes depression. • Self –defeating beliefs (we believe we are worthless, we begin to act like we are worthless) • May arise from learned helplessness

Mood Disorders • Attributions—depressed people are more likely to explain bad events in terms that are stable (it’s going to last forever), global (it affects everything), and internal (it’s my fault)

Mood Disorders • Depression is less common in collectivist cultures—possibly because of social supports or maybe because people are less likely to feel individually responsible for bad events • Depressed people respond to bad events in an especially self-focused, self-blaming way women tend to overthink.

Mood Disorders • Mood-Congruent Memory- (negative mood causes negative thoughts) • Interesting experiment- after losing their basketball game, fans were more likely (than after a win) to predict not only that the team would fare poorly in future games, but also that they would fare poorly at several tasks (throwing darts, solving puzzles, getting a date)

Dissociative Disorders • disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. • May sense themselves to being separated from their body • Can occur when situations become overly stressful

Dissociative Disorders • Dissociative Identity Disorder: rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities (also known as Multiple Personality Disorder) • Two or more distinct identities that alter behavior • Cause memory impairment

Dissociative Disorders • Opposite characters, conversations, and feelings • Skeptics believe that it was created in a certain social context (these multiple personalities show up after beginning therapy) • Psychoanalysts view the disorder as a defense against anxiety (Freud’s defense mechs.) while learning theorists see the behaviors as reinforcers to reduce anxiety

Dissociative Disorders • Dissociative Amnesia: psychologically induced loss of memory for personal information, such as one’s identity or residence. • Ex: Sybil, Jason Bourne

Psychological Disorders