XII. Psychological Disorders

1. XII. Psychological Disorders

2. A. Who is mentally ill?What is “disordered” behavior? • Psychological disorder: typically includes constellation of cognitive, emotional, and behavioral symptoms that create significant stress (impair work, relationships, etc.) • 1. Characteristics of disordered behavior. • Atypical, but... • Disturbing, but particularly worrisome when ... • Maladaptive • Unjustifiable • Involuntary

3. A. Who is mentally ill?What is “disordered” behavior? • 2. Diagnosing disordered behavior. • 230 possible diagnoses. a. Development of the DSM (Diagnostic and Statistical Manual for Mental Disorders) First edition 1952: too subjective. Third edition 1980: created objective criteria. Today - Fourth Edition - How it is used Important today for insurance.

4. A. Who is mentally ill?What is “disordered” behavior? • ii. The DSM and labeling. - Can giving people a label be problematic? - Rosenhan et al., (1973) - Stigma associated with mental illness.

5. B. Why are people mentally ill? • 1. Historically (1600-1700’s): • Supernatural, witch craft. • Treatment? • Bleeding, magic, drill holes in skull • Institutions like zoos

6. B. Why are people mentally ill? • 2. Medical Model • In reaction to maltreatment. • First scientific approach to disorders. • Psychological disorders are caused by physical conditions that can be cured. (disease not depravity).

7. B. Why are people mentally ill? • 3. Bio-Psycho-Social Perspective - More contemporary. • Considers more influences. • Biological (genes, brain chemistry) • Environment (stress, roles, expectations) • Culture - Reflects the nature/nurture perspective.

8. C. Anxiety Disorders • 1. General Description • experience extreme/intense fear, panic, anxiety • most treatable, best prognosis • 2. Generalized Anxiety Disorder • Unfocused, free-floating anxiety • 5% of N. Americans experience disorder at some point in life. • Symptoms: physiological psychological visual **Must occur for more days than not for 6 month period.

9. C. Anxiety Disorders • 2. Generalized Anxiety Disorder Causes: Genetic predisposition Hyper-vigilance/Over-arousal in brain Environment Can lead to panic attacks, panic disorder.

10. C. Anxiety Disorders • 3. Phobias • Focus anxiety on specific source. - Examples… - Causes: Learning approach: Classical conditioning Observational learning Genetic (amygdala) Freud

11. C. Anxiety Disorders • 4. Obsessive Compulsive Disorder - Trapped in endless cycle of repetitive thoughts (obsessions) and actions (compulsions). - Possibly 4 million people have OCD at one time in life. • Examples...

12. C. Anxiety Disorders • Symptoms: • Severe, prolonged, disrupts normal living • Consumes more than one hour a day. • Causes similar to generalized anxiety. • Post-Traumatic Stress Disorder – see text.

13. D. Dissociative Disorders • 1. General Description - Most controversial of disorders. - Experience sudden loss of memory or change identity. - “Dissociate” in response to stressful event.

14. D. Dissociative Disorders • 2. Dissociative Amnesia - Selective memory loss in response to intolerable psychological stress. - Cannot remember distant/recent past name, identity

15. D. Dissociative Disorders • 3. Dissociative Fugue - Flight from one’s home and identity accompanies memory loss. (take on complete new identity in different place).

16. D. Dissociative Disorders • 4. Dissociative Identity Disorder - Previously called multiple personality. - People have two or more distinct personalities that alternately control behavior. - Why is this disorder so controversial?

17. D. Dissociative Disorders Causes: - natural, protective response - often women who were abused as kids - may be encouraged by inborn, biological capacity Or - contrived fantasy? Or - created by therapist?

18. E. Schizophrenia • 1. General Description and Symptoms. - Accounts for higher % of patient population in mental hospitals than any other disorder.

19. E. Schizophrenia • 1. Symptoms: Disorganized Thinking: no organization, fragmented, includes delusions. Disturbed Perceptions: perceive things that aren’t there, hallucinations. (typically auditory “hear voices”) Inappropriate Emotions & Actions: Strike out, cry when should laugh, flat affect, movement - rocking, rubbing, motionless

20. E. Schizophrenia • 2. Types of Schizophrenia Positive - disorganized, deluded, acting out Negative - mute, catatonic, expressionless Chronic or Process - develops gradually, long history, recovery doubtful. Acute or Reactive - develops in reaction to life stress, recovery more likely.

21. E. Schizophrenia • Causes: Genetic: Many genes involved Brain: Excess number of dopamine receptors. Abnormal brain tissue. Low brain activity in frontal lobes. Environment?:need to have predisposition.

22. F. Mood Disorders Mood: • Prolonged emotional state that colors many (or all) aspects of thoughts & behavior. • Spans from severe sad/bad (depression) to unbridled elation, happiness (mania). Depression: - Number one reason people seek mental health services.

23. F. Mood Disorders • 1. Depression Symptoms: focused on negative absence of pleasure, hopelessness self-blame, worthlessness affects sleep, speech, movement, eating

24. F. Mood Disorders • 1. Major Depressive Disorder - 2 levels: Dysthymic Disorder - sad mood, low energy, difficulty concentrating. Major Depressive Disorder - more disabling, possibly with suicidal thoughts.

25. F. Mood Disorders • 1. Major Depressive Disorder • Causes - Brain: neurotransmitters - Genetic: twin studies

26. F. Mood Disorders • 1. Major Depressive Disorder • Causes: - Socio-Cognitive Perspective Influence of interpreting events & coping. Attribution process for negative events: internal, stable, global Ruminate, develop hopelessness and learned helplessness.

27. F. Mood Disorders • 2. Bipolar Disorder - Was manic depressive disorder. - Alternate between hopelessness (dep) and overexcitedness (mania). Symptoms: overtalkative, easily irritated, little need for sleep, loud speech, high opinion of self, reckless, fewer sexual inhibitions

28. F. Mood Disorders • 2. Bipolar Disorder Causes: - genetic: 7 in 10 chance for twins. - brain: neurotransmitters abundant during mania - environmental influence unclear.

29. Disorders – rates are increasing • 1 in 6 Americans • Symptoms by age 24

30. G. Personality Disorders – see text • Inflexible and enduring patterns of behavior that impair one’s social functioning. 1. Histrionic: shallow, attention-getting 2. Narcissistic: unwarranted sense of self-importance, cannot accept criticism, demand for constant attention.

31. G. Personality Disorders • 3. Antisocial: socio or psychopath. Typically male, lack of conscience. Lie, steal, fight, unrestrained sexual behavior, fear and feel for few, no guilt. • 4. Borderline: unstable identity, relationships, and emotions.

32. C. Anxiety Disorders • 5. Posttraumatic Stress Disorder – see text - Only anxiety disorder directly tied to experiencing or witnessing traumatic event(s). - Symptoms: nightmares, reliving events sleeplessness, irritability, guilt emotional numbing, depression - Importance of social support/genetics.