Chapter 15 Psychological Disorders

1. Chapter 15 Psychological Disorders

2. Chapter Preview Defining/Explaining Abnormal Behavior Anxiety Disorders Mood Disorders Dissociative Disorders Schizophrenia Personality Disorders Psychological Disorders and Health and Wellness

3. Abnormal Behavior Behavior that is… • deviant (atypical) • maladaptive (dysfunctional) • personally distressing (despair)

4. Theoretical Approaches Biological Approach: Medical Model • disorders with biological origins Psychological Approach • experiences, thoughts, emotions, personality Sociocultural Approach • social context Biopsychosocial Model • interaction of biological, psychological and sociocultural factors

5. DSM-IV Classification System Advantages • provides a common basis for communication • helps clinicians make predictions • naming the disorder can provide comfort Disadvantages • stigma (shame, negative reputation) • medical terminology implies internal cause • focus on weaknesses ignores strengths

6. DSM-IV-TR Axes Multiaxial System Axis I and II: Psychological Disorders Axis III: General Medical Conditions Axis IV: Psychosocial/Environmental Problems Axis V: Current Level of Functioning

7. DSM-IV-TR Axes Multiaxial System Axis I: 312.9 Disruptive Behavior Disorder 305.20 Cannabis Abuse Axis II: V71.09 No Diagnosis Axis III: Asthma, Diabetes Axis IV: Ecomonic, Education, Single mx Axis V: 51

8. Global Assessment of Functioning

9. Anxiety Disorders …uncontrollable fears that are disproportionate and disruptive generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder

10. Generalized Anxiety Disorder Diagnosis and Symptoms • persistent anxiety for at least 6 months • inability to specify reasons for the anxiety Etiology • biological factors - genetic predisposition, GABA deficiency, respiration • psychological and sociocultural factors - harsh self-standards, critical parents, negative thoughts, trauma

11. Panic Disorder Diagnosis and Symptoms • recurrent, sudden onsets of intense terror that often occur without warning Etiology • biological factors: genetic predisposition • psychological factors: misinterpret arousal • sociocultural factors: gender differences

12. Phobic Disorder Diagnosis and Symptoms • an irrational, overwhelming, persistent fear of a particular object or situation (e.g., social phobia) Etiology • biological factors: genetic disposition • psychological factors: learned

13. Examples of Phobic Disorders

14. Social Phobias in the U.S.

15. Obsessive-Compulsive Disorder Diagnosis and Symptoms • persistent anxiety-provoking thoughts and/or urges to perform repetitive, ritualistic behaviors to prevent or produce a situation Etiology • biological factors: genetic predisposition • psychological factors: life stress

16. Post-Traumatic Stress Disorder Diagnosis and Symptoms Symptoms develop as a result of exposure to a traumatic event, oppressive situation, natural or unnatural disasters -flashbacks - constricted ability to feel emotions - excessive arousal - difficulties with memory and concentration - feelings of apprehension - impulsive outbursts

17. Post-Traumatic Stress Disorder Etiology • trauma - combat and war-related - sexual abuse and assault - natural and unnatural disasters • vulnerability - previous history of trauma - genetic predispositions

18. Mood Disorders …disturbance of mood that affects entire emotional state Symptoms may include • cognitive, behavioral, or physical symptoms • interpersonal difficulties Types • major depressive disorder, dysthymic disorder • bipolar disorder

19. Major Depressive Disorder (MDD) Diagnosis and Symptoms • significant depressive episode that lasts for at least two weeks • defined by presence of at least 5 out of 9 symptoms • daily functioning is impaired

20. Dysthymic Disorder (DD) Diagnosis and Symptoms • chronic depression - unbroken depressed mood lasting at least two years (adult) or one year (child) • fewer symptoms than MDD - defined by presence of 2 out of 6 symptoms

21. Major Depressive Disorder (MDD) Etiology • biological factors: genetic disposition - underactive prefrontal cortex - regulation of neurotransmitters • psychological factors: - learned helplessness - ruminating on negative, self-defeating thoughts - pessimistic attribution • sociocultural factors - poverty - gender differences

22. Bipolar Disorder Characterized by extreme mood swings • Bipolar I and Bipolar II Frequency and separation of episodes • usually separated by 6 months to a year Etiology • strong genetic component • swings in metabolic activity in cerebral cortex • levels of neurotransmitters

23. Suicide Prevalence • over 32,000 in year 2004 • one completion for every 8 to 25 attempts • 3rd leading cause of death in early adolescence

24. Suicide Biological factors • low levels of serotonin • poor health Psychological Factors • mental disorders • trauma (recent/immediate and highly stressful) • substance abuse Sociocultural Factors • chronic economic hardship • cultural and religious norms • gender differences

25. When Someone is Threatening Suicide

26. Dissociative Disorders …sudden loss of memory or change in identity Dissociation • protection from extreme stress or shock • problems integrating emotional memories Types • dissociative amnesia • dissociative fugue • dissociative identity disorder (DID)

27. Dissociative Disorders Dissociative Amnesia • individuals experience extreme memory loss caused by extensive psychological stress Dissociative Fugue • individuals experience amnesia, unexpectedly travel away, and sometimes assume a new identity

28. Dissociative Identity Disorder Diagnosis and Symptoms • the same individual possesses two or more distinct personalities • each personality has unique memories, behaviors, and relationships • only one personality is dominant at a time • personality shifts occur under distress Etiology • extraordinarily severe abuse in early childhood • social contagion • mostly women • runs in families

29. Schizophrenia highly disordered thought • split from reality (psychotic) • typically diagnosed in early adulthood • high suicide risk

30. Symptoms of Schizophrenia Positive Symptoms • hallucinations and delusions • thought disorders and disorders of movement Negative Symptoms • flat affect Cognitive Symptoms • attention difficulties and memory problems • impaired ability to interpret information and make decisions

31. Etiology of Schizophrenia Biological Factors • genetic predisposition • structural brain abnormalities • regulation of neurotransmitters Psychological Factors • diathesis-stress model Sociocultural Factors • influence how disorder progresses

32. Personality Disorders • Cluster A • Paranoid, Schizoid, and Schizotypal • odd and eccentric • Cluster B • Antisocial, Borderline, Histrionic, and Narcissistic • dramatic, emotional, or erratic • Cluster C • Avoidant, Dependent, and Obsessive-Compulsive • anxious or fearful

33. Personality Disorders …chronic maladaptive cognitive-behavioral patterns Antisocial Personality Disorder Diagnosis and Symptoms -guiltless lawbreaking, violence, deceit - impulsive, irritable, reckless, irresponsible Etiology -biological factors (genetic, brain, and ANS differences)

34. Personality Disorders Borderline Personality Disorder Diagnosis and Symptoms • instability in interpersonal relationships & self-image • impulsive, insecure, unstable & extreme emotions Etiology • genetic • childhood abuse • irrational belief one is powerless, unacceptable, and that others are hostile

35. Psychological Disorders andHealth and Wellness Stereotypes and Stigma • Rosenhan’s study - fake psychiatric patients • negative attitudes toward mentally ill • physical health risk • successfully functioning individuals with mental illness reluctant to “come out”

36. Chapter Summary Discuss the characteristics, explanations, and classifications of abnormal behavior. Distinguish among the various anxiety disorders. Compare the mood disorders and specify risk factors for depression and suicide. Describe the dissociative disorders. Characterize schizophrenia. Identify behavior patterns typical of personality disorders. Explain the impact of the stigma associated with mental illness.

37. Chapter Summary Abnormal Behavior • deviant, maladaptive, or personally distressing Theoretical Approaches • biological, psychological, and sociocultural • biopsychosocial Classifying Abnormal Behavior • DSM-IV-TR Axes • advantages and disadvantages

38. Chapter Summary Anxiety Disorders • generalized anxiety disorder • panic disorder • phobic disorder • obsessive-compulsive disorder • post-traumatic stress disorder

39. Chapter Summary Mood Disorders • major depressive disorder • dysthymic disorder • bipolar disorder • suicide Dissociative Disorders • dissociative amnesia • dissociative fugue • dissociative identity disorder

40. Chapter Summary Schizophrenia • positive, negative and cognitive symptoms • etiology (biological, psychological, sociocultural) Personality Disorders • antisocial personality disorder • borderline personality disorder Psychological Disorders and Health & Wellness • stigmas and stereotypes