Unit 5 Notes

1. Unit 5 Notes Module 22: Assessment and Anxiety Disorders

2. Causes of Mental Disorders • Medical Model Approach • Looking for biochemical, neurological, or genetic causes of behavior • Mental disorders are similar to a physical illness • Psychiatrists use drugs (psychoactive) to treat mental disorders • Cognitive-Behavioral Approach

3. Disorders result from deficits in cognitive processes (faulty thoughts, attitudes, and beliefs) and behavioral problems (deficits in skills and abilities) • Treatment focuses on hanging a person’s maladaptive thoughts and behaviors • Psychoanalytic (dynamic) Approach • Disorders are due to unconscious (repressed) conflicts or problems with unconscious conflicts at one of Freud’s psychosexual stages

4. Treatment centers on the therapist’s helping the patient identify and solve his/her unconscious conflicts

5. Defining Mental Disorders: 3 Approaches • Statistical Frequency • A behavior may be considered abnormal if it occurs rarely or infrequently in relation to behaviors of the general people • Social Norms • Abnormal behavior deviates greatly from accepted social standards, values, or norms • Norms change over time (men wearing earrings and thin women)

6. Maladaptive Behavior • Abnormal behavior interferes with the individual’s ability to function in his/her personal life or in society • Mental health professionals find this the most useful definition of abnormal behavior

7. Assessing Mental Disorders • Clinical assessment: systematic evaluation of an individual’s various psychological, biological, and social factors • Identifying past and present problems, stresses, or other systems

8. 3 Methods of Assessment • Neurological Tests • Check for brain damage or malfunction (MRI) • Evaluate reflexes, motor coordination and brain structures/functions • Clinical Interviews • Gathering information about a person’s past and current behaviors, beliefs, attitudes, emotions, and problems • Structured interviews follow a standard format of questions

9. Unstructured interviews have no set questions • Psychological Tests • Objective: specific statements of questions (self-report questionnaires-MMPI) • Projective: ambiguous stimuli that a person interprets or makes up a story about (Ink-blot and TAT)

10. DSM-IV-TR • Diagnostic and Statistical Manual of Mental Disorders-IV-Test Revision • Describes a uniform system for assessing specific symptoms and matching them to almost 400 different mental disorders • 3 Advantages • Helps professionals communicate • Researchers use the classification system to study and explain mental disorders

11. Therapists use the classification system to design a treatment program that best fits their client’s needs • Steps in Making a Clinical Diagnosis • 1) Clinical Interview, Personality tests, and neurological test • 2) Clinical Assessment: Identify symptoms • 3) DSM-IV-TR: Use symptoms to diagnose mental disorders

12. Anxiety Disorders • 1) Generalized Anxiety Disorder (5% of adults) • Characterized by excessive or unrealistic worry about almost everything or feeling that something bad is about to happen • Anxious feelings occur on most days for at least 6 months • Symptoms • Psychological: being irritable, poor concentration, constant worrying

13. Physical: restlessness, easily fatigued, sweating, flushing, pounding heart, insomnia, clammy hands, headaches, and muscle tension/aches • Treatment • Psychotherapy • Drugs (benzodiazepines-tranquilizers) • 2) Panic Disorders • Characterized by recurrent and unexpected panic attacks

14. Intense worrying interferes with normal psychological functioning • Symptoms • Pounding heart, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, fear of losing control or dying • Treatment (a combo of) • Benzodiazepines (tranquilizers), antidepressants and psychotherapy • May take 3-8 months

15. 3) Phobias • Characterized by an intense and irrational fear that is out of all proportion to the possible danger of the object or situation • Fear is accompanied by physiological arousal • Person goes to great lengths to avoid the feared object/event • Types • Social – characterized by irrational, marked, and continuous fear or performing in social situations

16. Individuals fear they will humiliate or embarrass themselves • Ex. Speaking in public, to strangers, eating in public, etc… • Specific – marked and persistent fears that are unreasonable and triggered by anticipation of, or exposure to, a specific object or situation • Ex. Bugs, snakes, etc…, heights, water, closed places

17. Agoraphobia – anxiety about being in places or situations from which escape might be difficult or embarrassing • Ex. Public transportation, bridges or tunnels, crowds, going out by one’s self, elevators, etc… • Treatment • Cognitive-Behavior Therapy • Changing negative or distorted beliefs by substituting positive, healthy, realistic beliefs

18. Changing limiting or descriptive behaviors by learning and practicing new skills to improve function • Exposure Therapy (combined with Cognitive-Behavior Therapy) • Gradually exposing the person to real anxiety producing situations or objects • When the combination therapy doesn’t help, use drug therapy or virtual reality therapy

19. Drug Treatment • Benzodiazepines (tranquilizers) • Anti-depressants • 4) Obsessive-Compulsive Disorder (OCD) (3%) • Having continued thoughts/urges about performing a certain act over and over again • Symptoms • Obsessions: repeated thoughts/urges a person can’t control • Compulsions: repeated actions of some senseless behaviors or rituals over and over

20. Ex. Hand washing, checking things, counting, putting things in order, cleaning, hoarding, perfectionists, harming obsession • Evidence suggests that an imbalance of brain chemicals (serotonin) may be at the root of OCD • Treatment • Exposure therapy • Anti-depressant drugs • Book: Brain Lock • Videos: What About Bob?, As Good As It Gets

21. Somatoform Disorders (Freud called this Hysteria) • A pattern of recurring, multiple and significant bodily symptoms that extend over several years • Bodily symptoms are believed to be caused by psychological factors • These disorders are rare

22. Somatoform Disorder- multiple symptoms appearing before age 30 that have no physical cause, but are believed to be triggered by psychological problems or disorders • Women are 5 times more likely to report than to men

23. Conversion Disorder- Psychological trauma triggers a physical dysfunction • These parents aren’t faking it • Symptoms: blindness, paralysis, deafness, etc…

24. Mass Hysteria- a condition experienced by a group of people who, through suggestion, observation, or other psychological processes, develop similar fears, delusions, abnormal, behavior, or physical symptoms

25. Hypochondriasis- excessive concern about one’s health Ex. Slight headache = brain cancer Sniffles = pneumonia • Spend a lot of time in the doctor’s office

26. Module 23: mood disorder and schizophrenia • Mood Disorders- prolonged and disturbed emotional states that affect most all of a person’s thoughts, feelings, and behaviors

27. Kinds of Mood Disorders • Major Depression -Marked by at least 2 weeks of continually being in a bad mood, having no interest in anything and getting no pleasure from activities

28. Must have at least 4 of the following symptoms: • Problems with eating, sleeping, thinking, concentrating, or making decisions, lacking energy, thinking about suicide, feeling worthless or guilty

29. Bipolar I Disorder (manic depressive disorder) • Marked by fluctuations between episodes of depression and mania • A manic episode: • Goes on for at least a week • Person is usually euphoric • Has great self esteem, little need for sleep, speaks rapidly, easily distracted, has racing thoughts, and pursues pleasurable activities

30. Dysthymic Disorder (Moderate Depression) • Affects about 6% of the population • Being chronically, but not continually depressed for a period of 2 years (“down in the dumps”) • While depressed, person experiences at least 2 of the following symptoms: Poor appetite, insomnia, fatigue, low self-esteem, poor concentration, and feelings of hopelessness

31. Causes of Mood Disorders • Biological Theory Of Depression • Emphasize underlying genetic, neurological or physiological factors that may predispose a person to develop a mood disorder

32. Genetic Factors • Identical Twins 80% • Fraternal Twins 16% • Neurological Factors • Chemical defect in the brain-serotonin (helps keep brain active in people)

33. Excessive Levels = Mania • Low levels = depression • Brain Scans • Prefrontal cortex (planning and deciding functions) was about 40% smaller and less active in depressed patients

34. 2.) Psychosocial Factors • Are believed to interact with biological factors that combine to put one at risk for developing a mood disorder • They include: personality traits (social dependent personality and achievement personality), amount of social support and ability to deal with stresses

35. 3.) Beck’s Cognitive Theory Of Depression • When we are feeling down, automatic, negative thoughts that we rarely notice occur continually throughout the day • The negative thoughts distort how we perceive and interpret the world • As a result, the negative thoughts contribute to feeling depressed

36. Major Depression and Dysthymic Disorder: Treatment • Antidepressant Drugs • Act by increasing levels of a specific group of neurotransmitters (such as monoamines, serotonin) that is believed to be involved in the regulation of emotions and moods

37. SSRIs (selective Serotonin Reuptake Inhibitors) • Raise levels or serotonin • Prozac

38. Psychotherapy • For patients with less severe depression, this was as effective as antidepressant drugs • For patients with more severe depression, a combination of antidepressant drugs and psychotherapy as more effective than either one alone

39. Electroconvulsive therapy (ECT) • Involves placing electrodes on the skull and administering a mile electrical shock that passes through the brain and causes seizures • Usual treatment consists of 10-12 ECT sessions, 3 times per week

40. Memory loss is a serious side effect • Used as a “last resort” • Reduces depressive symptoms in about 60-80% of patients

41. Bipolar I Disorder: Treatment • Lithium • A naturally occurring mineral salt • Most effective treatment for Bipolar I because it reduces or prevents manic episodes

42. Personality Disorders • Inflexible, long-standing, maladaptive traits that cause significantly impaired functioning or great distress in one’s personal and social life

43. Antisocial Personality Disorder • Chronic delinquents up to serial killers • Patterns of disregarding the rights of others without feeling guilt or remorse • Known as psychopaths or sociopaths

44. 2 Characteristics • Pattern or disregard for or violation of the rights or properties of others (they may steal, harass, or beat people, destroy property, kidnap, or kill) • Dishonesty, lying or deceitful manipulation of others • Don’t learn from experience

45. Psychopaths: Causes and treatments • Psychological Factors • Aggressive and antisocial as a child • Parents found child almost impossible to control • Physical or sexual abuse in childhood

46. Biological Factors • Twin and adoption studies show that genetic factors contribute 30-50% to the development of antisocial personality disorders • Evidence from neurobiological factors comes from brain scans that show fewer brain cells in the prefrontal cortex of people with antisocial personality disorder

47. Treatment • Psychotherapy has been ineffective • Antidepressant drugs help reduce aggressive behaviors, but once medications stop, aggressiveness resurfaces

48. *Borderline Personality Disorder • *Char.’s: these people form intense relationships • -they are very dependent and clingy (emotionally needy), but they deny it • -they sabotage relationships • They are self-destructive (accidents, suicidal gestures) • -they are manipulatives • Ex. Girl Interrupted, Cable Guy

49. Schizophrenia • Affects about 2% of the population • About 30% or mental hospital admissions are for this disorder (the highest percent fo any disorder) • Involves loss of contact with reality

50. Serious mental disorder that lasts for at least 6 months • Includes at least two of the following symptoms: