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PSYCHOPATHOLOGY. DIAGNOSIS AND TREATMENT STRATEGIES. ANXIETY, SOMATOFORM, AND DISSOCIATIVE DISORDERS. Disorder. Subtypes. Major Symptoms. InRev15a. Anxiety disorders Somatoform disorders Dissociative disorders. Phobias Generalized anxiety disorder Panic disorder

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psychopathology

PSYCHOPATHOLOGY

DIAGNOSIS

AND

TREATMENT STRATEGIES

slide2

ANXIETY, SOMATOFORM, AND DISSOCIATIVE DISORDERS

Disorder

Subtypes

Major Symptoms

InRev15a

Anxiety disorders

Somatoform disorders

Dissociative disorders

Phobias

Generalized anxiety disorder

Panic disorder

Obsessive-compulsive disorder

Conversion disorder

Hypochondriasis

Somatization disorder

Pain disorder

Amnesia/fugue

Dissociative identity disorder (multiple personality disorder)

Intense, irrational fear of objectively nondangerous situations or things, leading to disruptions of behavior.

Excessive anxiety not focused on a specific situation or object; free-floating anxiety.

Repeated attacks of intense fear involving physical symptoms such as faintness, dizziness, and nausea.

Persistent ideas or worries accompanied by ritualistic behaviors performed to neutralize the anxiety-driven thoughts.

A loss of physical ability (e.g., sight, hearing) that is related to psychological factors.

Preoccupation with or belief that one has serious illness in the absence of any physical evidence.

Wide variety of somatic complaints that occur over several years and are not the result of a known physical disorder.

Preoccupation with pain in the absence of physical reasons for the pain.

Sudden, unexpected loss of memory, which may result in relocation and the assumption of a new identity.

Appearance within same person of two or more distinct identities, each with a unique way of thinking and behaving.

anxiety disorders
ANXIETY DISORDERS
  • PANIC DISORDER
  • GENERALIZED ANXIETY DISORDER
  • PHOBIAS
  • OBSESSIVE-COMPULSIVE DISORDER
  • POST-TRAUMATIC STRESS DISORDER
slide4

PANIC DISORDER

Experience reoccurring episodes of anxiety attacks; unpredictable;

some situations might become related to it.

Anxiety attack: 5 needed may last a couple of minutes to hours

heart palpitations

tense muscles, especially chest muscles often misinterpreted for heart attack,

choking sensation from tight neck muscles,

faint or dizzy feeling,

increase sweat,

hot or cold flashes.

A. Panic Disorder experience reoccurring episodes of anxiety attacks; unpredictable; some situations might become related to it.

Anxiety attack; 5 needed may last a couple of minutes to hours

heart palpitations, tense muscles, especially chest muscles which are often misinterpreted for heart attack, choking sensation from tight neck muscles, faint or dizzy feeling, increase sweat, hot or cold flashes.

slide5

GENERALIZED ANXIETY

DISORDER

Persistent level of anxiety lasting at least one month Symptoms:

Motor: Tension of muscles: shakes, tremble,

unable to relax, twitch, startle easily

Autonomic hyperactivity: Sweat, increased heart

rate, cold hands, hot, cold flashes, light headed

and dizzy

Apprehension--worry constantly

Vigilance and scanning: hyperattentive to things in

the environment, distractible, hard to

concentrate, impatient, irritable.

slide6

PHOBIA

Irrational fear response of specific stimuli

SOCIAL PHOBIAS

AGORAPHOBIA

SPECIFIC PHOBIAS

slide7

OBSESSIVE-COMPULSIVE

DISORDER

Marked by overt ritualistic

behavior and persistent

intruding thoughts

Occurs at a frequency so high

as to interfere with daily

functioning

somatoform disorders
SOMATOFORM DISORDERS
  • HYPOCHONDRIASIS
  • CONVERSION HYSTERIA
slide9

HYPOCHONDRIASIS

Preoccupation with body and illness

No relief if given healthy diagnosis

Just as tense--travel and search for new physicians

slide10

CONVERSION DISORDER

Individual has dramatic physical symptoms with no organic cause.

1. Paralysis of legs/arms/ total

2. Anesthesia--lost sense of touch with parts of body

3. Analgesia--feel no pain

4. Other common experiences: nausea, lower back pain, dizziness,

hysterical blindness, deafness, unexplained headaches

5. Unusually INDIFFERENT to symptoms

6 .Secondary gain for having symptoms

7. May disappear while asleep or under hypnosis

8. Craft Paralysis: symptoms selective to job--paralyzed hands of

violinist or tennis player.

9. Symptoms make no common sense neurologically

dissociative disorders
DISSOCIATIVE DISORDERS
  • DISSOCIATIVE AMNESIA
  • DISSOCIATIVE FUGUE
  • DISSOCIATIVE IDENTITY DISORDER
slide12

DISSOCIATIVE AMNESIA

Memory for certain events from 1 hour to 3 months is lost

Person is not distressed by loss of memory--intellectual and skills still there.

Theorized as a loss of memory (repression) for traumatic event

slide13

DISSOCIATIVE FUGUE

Amnesia for entire life & self

Starts a new life in a new location

-called travelling amnesiac

Cause: extreme stress & need to flee

Can last for days, weeks, years.

Extremely rare except on Soaps!

slide14

DISSOCIATIVE IDENTITY

DISORDER

Dominance of 2 or more distinct

personalities

Generally amnesic for existence of others

Controversial Diagnosis

slide15

Fig131

Diathesis Stress Model of Disorders

affective disorders
AFFECTIVE DISORDERS
  • MAJOR DEPRESSION
  • DYSTHYMIC DISORDER
  • BIPOLAR DISORDER
  • CYCLOTHYMIC DISORDER
  • SEASONAL AFFECTIVE DISORDER
slide17

CLINICAL DEPRESSION

Emotions major disturbing problem but also problem in cognition (self-defeating thoughts)

1. Dysphoric mood for a minimum of 2 weeks

plus 4 of following:

Change in appetite usually decrease

Change in sleep--insomnia or hypersomnia

Change in amount of psychomotor activity-slow or agitated

Fatigue or loss of energy

Feelings of worthlessness, self critical or inappropriate guilt

Poor concentration

Suicide or suicidal ideation

slide18

BIPOLAR DISORDER

MANIC-DEPRESSION

Elevated mood-elation and mania alternating with depressive thoughts

Mania:

inflated self esteem: too self confident

talkative w/flight of ideas

increased activity, interests, social

decreased need of sleep, distracted

concern that will harm selves

not judge consequences of actions

shopping spree--self destructive buying pattern

incidence of depression

57

INCIDENCE OF DEPRESSION

Fig147

Major depression

Bipolar disorder

80

70

60

50

Risk

40

30

20

10

Prevalence in

Prevalence in

general population

general population

Fraternal twins

Fraternal twins

Identical twins

Identical twins

schizophrenia
SCHIZOPHRENIA
  • PARANOID
  • CATATONIA
  • DISORGANIZED HEBEPHRENIA
  • SIMPLE
  • RESIDUAL
slide23

15_05

Schizophrenic

behavior

Normal

behavior

Fig15_5

C

Max

A

Threshold

Challenging

events

D

B

Min

Low

High

Vulnerability

slide25

Fig15_5

Type

Typical Features

Paranoid

Schizoid

Schizotypal

Depedent

Obsessive-compulsive

Avoidant

Histrionic

Narcissistic

Borderline

Antisocial

Suspiciousness and distrust of others, all of whom are assumed to be hostile.

Detachment from social relationship; restricted range of emotion.

Detachment from, and great discomfort in, social relationships; odd perceptions, thoughts, beliefs, and behaviors.

Helplessness; excessive need to betaken care of; submissive and clinging behavior; difficulty in making decisions.

Preoccupation with orderliness, perfection, and control.

Inhibition in social situations; feelings of inadequacy; oversensitivity to criticism.

Excessive emotionality and preoccupation with being the center of attention; emotional shallowness; overly dramatic behavior.

Exaggerated ideas of self-importance and achievements; preoccupation with fantasies of success; arrogance.

Lack of stability in interpersonal relationships, self-image, and emotion; impulsivity; angry outbursts; intense fear of abandonment; recurring suicidal gestures.

Shameless disregard for, and violation of, other people's rights.

Tab15_5

slide26

PSYCHO-SEXUAL DISORDERS

Fetishism

Zoophilia

Sadism

Masochism Exhibitionism

Pedophilia

slide27

DEVELOPMENTAL

DISORDERS

Autism

Academic Skills Disorder

Attention Deficit Disorder

w/hyperactivity

Senile Dementia

treatment

TREATMENT

PSYCHOANALYSIS

BEHAVIOR

HUMANISTIC

COGNITIVE

BIOMEDICAL

sigmund freud psychoanalysis
SIGMUND FREUDPSYCHOANALYSIS

Resistance

Catharsis

Transference

Interpretation

Insight

carl rogers client centered
CARL ROGERSCLIENT CENTERED

UNCONDITIONAL POSITIVE REGARD

electro convulsive shock treatment ect
ELECTRO-CONVULSIVE SHOCK TREATMENT (ECT)
  • Single most effective treatment for psychotic depression
  • Used as treatment of last resort
  • Actual understanding of how it works is not complete--disrupts electrical impulses of brain
  • Within two to four weeks many see profound mood elevation
  • Side Effects include memory loss (usually short term)
psychosurgery
PSYCHOSURGERY
  • PREFRONTAL LOBOTOMY
    • Removal of brain tissue to relieve symptoms
    • Pre-frontal lobotomy first used on gorillas and found to calm aggression; applied to patients in mental institutions beginning in the 1950’s
    • Often used on schizophrenics bringing flat affect
    • Today smaller amount of tissue can be removed from specific areas showing malfunction--cingulotomy
    • Can be very effective at removing tumor and other tissue causing abnormal behaviors
biomedical treatments
BIOMEDICAL TREATMENTS
  • Drug Treatment Options:
  • Anti-Anxiety Xanax
    • GABA neurotransmitter
  • Anti-Depressant drugs Prozac
    • Serotonin and Norepinephrine
  • Anti-Psychotic drugs Thorazine
    • Dopamine
slide41

Average

Average

untreated

treated

person

person

Number

of

people

80% of

untreated

persons

No improvement

Outstanding

improvement

PSYCHOTHERAPY VS NONE