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Psychological Disorders:Part 1. Music : “Crazy” By Seal “Crazy” By Gnarles Barkley. Agenda. 1. What is Abnormal? Criteria / Classification 2. Anxiety Disorders: Generalized Anxiety/ Phobias/ Obsessive Compulsive Disorders 3. Somatoform Disorders

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Psychological Disorders:Part 1

Music: “Crazy”

By Seal

“Crazy”

By Gnarles Barkley


Agenda

  • 1. What is Abnormal?

    • Criteria / Classification

  • 2. Anxiety Disorders:

    • Generalized Anxiety/ Phobias/ Obsessive Compulsive Disorders

  • 3. Somatoform Disorders

    • Somatization Disorders/ Hypochondriasis

  • 4. Dissociative Disorders

    • Multiple Personality Disorder

  • 5. Mood Disorders

    • Depression/ Bipolar Disorders /Suicide

  • 6. Tutorial


1. What IS Abnormal??

  • Criteria:

    • 1) Distress is present:

      • Person is suffering, unhappy, afraid

    • 2) Behaviour is maladaptive

      • Impaired functioning

      • Inability to meet responsibilities

    • 3) Socially Deviant

      • Behaviour is unusual, “not normal”

  • Classification

    • DSM-IV, p. 580

    • Why Classify?

      • Simplify and create order

      • Research

      • Plan treatment


Criteria for Abnormality

  • Fig. 14.2 p. 578


1. Classification (cont’d)

  • Older Distinction:

    • Neurotic vs. Psychotic

  • Neurotic:

    • Distressing problem but person is still coherent and can function socially (once acute phase of disorder is treated).

    • E.g. most disorders discussed today

  • Psychotic:

    • More bizarre, involving delusions or halucinations. Individual has impaired thought processes and cannot function socially. Treatment is long term

    • E.g. schizophrenia (next week)


2. Anxiety Disorders

  • Anxiety:

    • Fear in situations that pose no objective threat

    • 3 components:

      • A) Cognitive:

        • Extreme/chronic worry; fear of harm

      • B) Physiological:

        • Muscle tension, increased heart rate and blood pressure

      • C) Behavioural:

        • Shaking, jumpiness, pacing, avoidance

  • Generalized Anxiety Disorders (5%)

    • Symptoms of anxiety felt continuously for at least 6 months

    • Excessive worry, restlessness, sleep disturbance that are difficult to control


2. Anxiety Disorders (cont’d)

  • Panic Disorders: (2-3%)

    • Presence of recurrent, and unexpected panic attacks:

      • Intense dread, shortness of breath, chest pain, choking, fear of going crazy or losing control or dying, shaking, sweating, nausea…

    • May lead to Agoraphobia (fear of open spaces)

  • Phobic Disorders: (10%)

    • Fear of a particular object, animal or context which is irrational

    • Is causing distress and impairment in functioning

  • Social Phobia: (3-13%)

    • Fear of social or performance situations

      • Public speaking;

      • Eating, drinking, writing in public


2. Anxiety Disorders (cont’d)

  • Obsessive-Compulsive Disorders (2%)

    • Obsessions:

      • Persistent, uncontrollable thoughts

    • Compulsions:

      • Rituals, behaviours that reduce anxiety

      • Interfere with functioning

    • Thoughts and behaviours are not under voluntary control


3. Somatoform Disorders

  • Somatization Disorder:

    • (1-2% women)

    • History of diverse physical complaints for which there is NO organic basis

    • Long medical history of treatments for minor physical ailments

  • Hypochondriasis:

    • 4-9% in medical practice

    • Inordinate preoccupation with health and illness

    • excessive anxiety about having a disease


4. Dissociative Disorders

  • Multiple Personality Disorder (very rare)

    • Presence of at least 2 distinct personalities within the same individual

    • Leads to sudden changes in identity and consciousness

    • Each personality has its unique style and may unaware of the existence of the other personalities

    • Often related to severe abuse in early childhood


5. Mood Disorders

  • Depression

    • Lifetime prevalence rates

      • 20% in women; 10% in men

    • Why more common in women?

      • Cost of caring

        • Greater burden due to nurturing roles

        • Also more affected by disruptions in relational ties

      • Ruminative cognitive style

        • as opposed to distraction or taking action

        • Perpetuates negative mood

      • More likely to report symptoms

  • Seasonal Affective Disorders (SAD)

    • Depressive symptoms related to physiological consequences of shorter winter days

    • Treatable with light therapy


5. Theories of Depression

  • Biological predisposition

    • Concordance rates in twins:

      • Identical: 65%

      • Fraternal: 15%

  • Cognitive Perspective

    • Beck: Negative (dysfunctional) attitudes

    • Seligman: Attribution Theory

      • How do you explain your circumstances?

        • Internal vs external

        • Stable vs unstable

        • Global vs specific

      • Depression: internal, stable, global attributions for negative events

    • Diathesis-stress models

      • Depression results from an interaction between personality and negative life events

        • Dependency and vulnerability to loss

        • Self-Criticism/Perfectionism and vulnerability to perceived failure


Cognitive Risk and Depression

  • Featured Study p. 596

    • Those with dysfunctional attitudes and depressive attributional style were more likely to become depressed over 2 year period.


5. Mood Disorders (cont’d)

  • Bipolar Disorders:

    • Periods of depression alternate with manic episodes

    • Mania:

      • abnormally elevated mood, inflated self-esteem, pressure of speech, increased energy, decreased need for sleep, over-activity, lack of inhibition and impaired judgment

    • Prevalence rates:

      • 1% in men and women

      • Strong genetic component

        • Understood as a primarily biological disorder

        • Unlike unipolar depression which has cognitive, interpersonal and environmental determinants


Comparison of symptoms of depression and mania (p. 592)


5. Suicide

  • University students:

    • 40-50% have had suicidal thoughts

    • 15% attempt suicide

  • Major Risk Factors:

    • Drug or alcohol use including cigarette smoking

    • A prior attempt

    • Depression/ hopelessness (pessimism)

    • Aggressiveness or impulsivity

    • Family history

    • Shame, humiliation, failure or rejection


5. Suicide (cont’d)

  • How to help:

    • 1) Establish communication

      • Talk about suicidal wishes

    • 2) Identify needs that have been frustrated

      • Search for love, recognition, respect?

    • 3) Broaden suicidal person’s perspective

      • Impermanence of feelings

        • It won’t last

      • Other solutions?


6. Tutorial

  • Until next week:

be well...


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