Chapter 12_ Psychological Disorders - Faculty Server Contact

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					Chapter 12: Psychological
        Disorders
    Lectures 15 & 16
              Learning Outcomes

• Define psychological disorders and describe
  their prevalence.

• Describe the symptoms, types, and possible
  origins of schizophrenia.
              Learning Outcomes

• Describe the symptoms and possible origins of
  mood disorders.

• Describe the symptoms and possible origins of
  six types of anxiety disorders.
              Learning Outcomes

• Describe the symptoms and possible origins of
  somatoform disorders.

• Describe the symptoms and possible origins of
  dissociative disorders.

• Describe the symptoms and possible origins of
  personality disorders.
               Truth or Fiction?

qIn the Middle Ages, innocent people were
 drowned as a way of proving that they were not
 possessed by the Devil.

qPeople with schizophrenia may see and hear
 things that are not really there.
                Truth or Fiction?

qFeeling elated may not be a good thing.

qSome people have more than one personality
 dwelling within them, and each one may have
 different allergies and eyeglass prescriptions.

qSome people can kill or maim others without
 feelings of guilt.
What is Normal?
  1. When Behavior Is Abnormal/Disordered?

• Several Questions can help determine when
  behavior is abnormal
   – Is the behavior considered strange within the
     person’s own culture?
   – Does the behavior cause personal distress?
   – Is the behavior maladaptive?
   – Is the person a danger to self or others?
   – Is the person legally responsible for his or her
     act?
     2. What Are Psychological Disorders?

• Mental processes and/or behavior patterns that
  cause emotional distress and/or substantial
  impairment in functioning
      3. Explaining Psychological Disorders

• Biological Perspective
   – Genetics, evolution, the brain,
     neurotransmitters, hormones
• Treatment
   – Diagnose and treat like any other physical disorder
     (drugs, electroconvulsive therapy, or psychosurgery)
     4. Explaining Psychological Disorders

• Biopsychosocial perspective
  – From combination of biological, psychological, & social
• Treatment
  – An eclectic approach employing treatments that include
    both drugs and psychotherapy
     5. Explaining Psychological Disorders

• Psychodynamic perspective
   – Disorders are symptoms of underlying
     unconscious processes that stem from
     childhood conflicts
• Treatment
  – Bring disturbing repressed material to consciousness
    and help patient work through unconscious conflicts
     6. Explaining Psychological Disorders

• Learning perspective
  – Abnormal thoughts, feelings, & behaviors are learned
    and sustained like any other behaviors, or there is a
    failure to learn appropriate behavior
• Treatment
  – Use classical & operant conditioning & modeling to
    extinguish abnormal behavior and to increase adaptive
    behavior (behavior therapy, behavior modification)
  7. Explaining Psychological Disorders

– Cognitive Perspective
  • Faulty thinking or distorted perceptions can cause
    psychological disorders
– Treatment
  • Change faulty, irrational, &/or negative thinking
    (Beck’s cognitive therapy, rational-emotional
    therapy)
     8. Classifying Psychological Disorders

• Diagnostic and Statistical Manual (DSM)
  – Includes information on medical conditions,
    psychosocial problems and global assessment
    of functioning
  – Concerns about reliability and validity of the
    standards
     • Predictive validity
   9. Prevalence of Psychological Disorders

• 50% of us will experience a psychological disorder
  at some time
   – Most often starts in childhood or adolescence
• 25% will experience a psychological disorder in
  any given year,
• More than 44 million adults, are diagnosed with
  mental disorder of some kind (NIMH, 2001)
                    10.Schizophrenia
• DSM-IV
•   Characterized by the presence of psychotic symptoms, including
    hallucinations, delusions, disorganized speech, bizarre behavior, &
    loss of contact with reality
• Severe psychological disorder characterized by
  disturbances in
   – Thoughts, language & memory
   – perception and attention
   – motor activity
   – mood
   – social interaction & communication

• Play Etta Video
Schizophrenia




    PLAY
    VIDEO
                11. Schizophrenia

• Afflicts nearly 1% of the population worldwide
• Onset occurs relatively early in life
• Adverse effects tend to endure
    12. Positive Versus Negative Symptoms

• Positive symptoms
  – Excessive symptoms
     • Hallucinations, delusion, looseness of
       association
• Negative symptoms (look in my book)
  – Deficiencies
     • Lack of emotional expression and motivation
     • Social withdrawal
     • Poverty of speech
    13. Positive Versus Negative Symptoms

• Positive symptoms
  – More likely an abrupt onset
  – Retain intellectual abilities
  – More favorable response to antipsychotic
    medication
    14. Positive Versus Negative Symptoms

• Negative symptoms
  – More likely a gradual onset
  – Severe intellectual impairments
  – Poorer response to antipsychotic medication
           15. Types of Schizophrenia

• Paranoid Schizophrenia
  – Systematized delusions
• Disorganized Schizophrenia
  – Incoherence; extreme social impairment
• Catatonic Schizophrenia
  – Motor impairment; waxy flexibility
• Undifferentiated Schizophrenia
  – When symptoms do not conform to the criteria of any of
    one type of sch. Or conform to more than one type
          16. Origins of Schizophrenia
            Biological Perspectives

• Brain abnormality
• Risk factors
  – Heredity, major part
  – Complications during pregnancy and birth
  – Birth during winter
• Dopamine theory of schizophrenia
17. The Biopsychosocial Model of
          Schizophrenia
    18. Probability of Developing Schizophrenia

•   Identical twins                  •   Sibling
     – If one has schizophrenia,          – Less than 10%
         the other twin has 46%      •   Nephew/niece
         chance also to develop it        – 2-3%
•   In fraternal twins               •   SPOUSE
     – 14% chance                         – 2%

•   One parent schizophrenic         •   Unrelated person
                                          – Less than 1%
     – 13% chance
•   Both parents
     – 46 % chance
     Data from Nicol & Gottesman
         (1983)
Mood Disorders
              19. Mood Disorders

• Characterized by extreme and unwarranted
  disturbances in emotion or mood
            20. Types of Mood Disorders

• Major Depressive Disorder (1 person in 5 or 6 over
  the course of lifetime)
  – Persistent feelings of sadness, loss of interest,
    feelings of worthlessness or guilt, and inability
    to concentrate
  – Psychomotor retardation
• Bipolar disorder (1.2 % of the U.S. population)
  – Mood swings from ecstatic elation to deep
    depression
Expression of Mood




       PLAY
       VIDEO
              21. Origins of Mood Disorders

• Biological
  – Genetic factors
• Psychological (cognitive factors)
  – Learned helplessness
  – Perfectionism and unrealistic expectations
  – Ruminating about depression
  – Attributional styles (internal/external/global/specific/stable/unstable)
• Biopsychosocial
  – Biologically predisposed interact with self-
    efficacy expectations and attitudes
                22. Risk Factors in Suicide

• 31,000 American commit suicide each year.
• Feelings of depression, hopelessness
•   What psychological problems are common for suicidal adolescents?
•   Stressful life events
•   Anxiety over “discovery”
•   Poor problem solver
•   Familial experience with psychological disorders
    and/or suicide
      23. Sociocultural Factors in Suicide

• Third leading cause of death among young people
  aged 15 to 24
• More common among college students than
  people of the same age who do not attend college
• Older people are more likely to commit suicide
  than teenagers
      24. Sociocultural Factors in Suicide

• One in six Native Americans has attempted
  suicide
• African Americans are least likely to attempt
  suicide
• Three times as many females attempt suicide
• Four times as many males succeed in suicide
             25. Myths about Suicide

• Individuals who threaten suicide are only seeking
  attention
• People who would take their own lives are insane
• Discussing “suicide” with a depressed person…
Anxiety Disorders
              26. Anxiety Disorders

• Phobias, panic disorder, generalized anxiety,
  OCD, & stress disorders.
• Psychological features of anxiety
  – Worrying, fear of worst case scenario,
    nervousness, inability to relax
• Physical features of anxiety
  – Arousal of sympathetic branch of autonomic
    nervous system
                     27. Phobias

• Specific phobias
  – Irrational fears of specific objects or situations
• Social phobias
  – Persistent fears of scrutiny by others
• Claustrophobia
• Agoraphobia
  – Fear of being in places from which it would be
    difficult to escape or receive help
                28. Panic Disorder

• Abrupt attack of acute anxiety not triggered by a
  specific object or situation
   – Physical symptoms
      • Shortness of breath, heavy sweating,
        tremors, pounding of the heart
      • Other symptoms that may “feel” like a heart
        attack
Panic Disorder: Symptoms




          PLAY
          VIDEO
        29. Generalized Anxiety Disorder

• Persistent anxiety
  – Cannot be attributed to object, situation, or
    activity
• Symptoms include
  – Motor tension
  – Autonomic overarousal
  – Excessive vigilance
      30. Obsessive-Compulsive Disorder

• Obsessions
  – Recurrent, anxiety-provoking thoughts or
    images that seem irrational and beyond control
• Compulsions
  – Thoughts or behaviors that tend to reduce the
    anxiety connected with obsessions
  – Irresistible urges to engage in specific acts,
    often repeatedly
Obsessive-Compulsive Disorder




            PLAY
            VIDEO
               31. Stress Disorders

• Posttraumatic stress disorder (PTDS)
  – Caused by a traumatic event
  – May occur months or years after event
• Acute stress disorder, within a month (2-4 wks)
  – Unlike PTDS, occurs within a month of event
    and lasts 2 days to 4 weeks
32. Sleep Problems Among Americans Before
        and After September 11, 2001
        33. Origins of Anxiety Disorders

• Biological
  – Genetic factors
• Psychological and Social
  – Phobias as conditioned fears
  – Cognitive bias toward focusing on threats
• Biopsychosocial
  – Interaction between biological, psychological,
    social factors
Somatoform Disorders
           34. Somatoform Disorders

• Physical problems (such as paralysis, pain, or
  persistent belief of serious disease) with no
  evidence of a physical abnormality

• Conversion disorder, hypochondriasis, & body
  dysmorphic disorder
             35. Conversion Disorder

• “convert” a source of stress into a physical
  difficulty
• Major change in, or loss of, physical functioning,
  although there are no medical findings to explain
  the loss of functioning.
   – Not intentionally produced
   – Loss of vision at night (pilots), paralyzed legs,
     loss of hearing, etc.
               36. Hypochondriasis

• Insistence of serious physical illness, even though
  no medical evidence of illness can be found
• May seek opinion of one doctor after another
         37. Body Dysmorphic Disorder

• Preoccupation with a fantasized or exaggerated
  physical defect in their appearance
• May assume others see them as deformed
      38. Origins of Somatoform Disorders

• Biopsychosocial perspective
  – Psychologically, the disorder has to do with
    what one focuses on to the exclusion of
    conflicting information
  – Self-hypnosis
  – Tendencies toward perfectionism and
    rumination (heritable)
Dissociative Disorders
            39. Dissociative Disorders

• Disorders in which, under unbearable stress,
  consciousness becomes dissociated from a
  person’s identity or her or his memories of
  important personal events, or both
• Trauma, usually psychological.
• Dissociation- the loss of one’s ability to integrate
  all the components of self into a coherent
  representation of one’s identity.
      40. Types of Dissociative Disorders

• Dissociative Amnesia
  – Suddenly unable to recall important personal
    information; not due to biological problems
• Dissociative Fugue
  – Abruptly leaves home or work and travels to
    another place, no memory of previous life
       41. Types of Dissociative Disorders

• Dissociative Identity Disorder
  – Two or more identities, each with distinct traits,
    “occupy” the same person
     • Formerly known as multiple personality
       disorder
• Play Video (CD#2;31)
Personality Disorders
             42. Personality Disorder

• A long standing, inflexible, maladaptive pattern of
  behaving and relating to others, which usually
  begins in early childhood or adolescence.
• Impair personal or social functioning
• The most common of mental disorder (10-15%)
• Cause unknown, & treatment options are few
• Source of distress
• Paranoid, schizotypal, schizoid, borderline,
  antisocial, & avoidant personality disorder
           43. Cluster A: Odd Behavior

• Paranoid Personality Disorder
  – Interpret other’s behavior as threatening or
    demeaning (Stalin)
• Schizotypal Personality Disorder
  – Odd appearance, unusual thought patterns,
    perceptions, or behavior, lack of social skills
• Schizoid Personality Disorder
  – Indifference to relationships and flat emotional
    response; isolates self from others
 44.Cluster B: Erratic, overly dramatic behavior

• Narcissistic, Histrionic, BPD, & Antisocial
• Borderline Personality Disorder
  – Instability in relationships, self-image, and mood
• Antisocial Personality Disorder
  – Persistently violate the law
  – Show no guilt or remorse and are largely
    undeterred by punishment
     45. Cluster C: Anxious, fearful behavior

• Obsessive-Compulsive; Dependant
• Avoidant Personality Disorder
  – Avoid relationships for fear of rejection
          46. Origins of Personality Disorders

•   Biological
     – Genetic factors
         • Personality traits that may be inherited
         • Antisocial personality – less gray matter in prefrontal cortex
•   Psychological
     – Learning theory
         • Childhood experiences
     – Cognitive
         • Misinterpretation of other people’s behaviors
•   Sociocultural
     – Borderline personality – may reflect the fragmented society in
        which one lives
            Warning Signs of Suicide

• Changes in eating and sleeping patterns
• Difficulty concentrating on school or the job
• A sharp decline in performance and attendance at
  school or on the job
• Loss of interest in previously enjoyed activities
• Giving away prized possessions
• Complaints about physical problems when no
  medical basis for problems can be found
              Warning Signs of Suicide

•   Withdrawal from social relationships
•   Personality or mood changes
•   Talking or writing about death or dying
•   Abuse of drugs or alcohol
•   An attempted suicide
•   Availability of a handgun
•   A precipitating event
            Warning Signs of Suicide

• In the case of adolescents, knowing or hearing
  about another teenager who has committed
  suicide (which can lead to “cluster” suicides)
• Threatening to commit suicide

				
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