Psychological Disorders

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Chapter 16

• Psychological Disorders
• (Part 1)

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Announcements
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Chapter 16 Roadmap

• Basics of the DSM
• Models and History of Models
• ADD, ADHD, IQ, and Behaviorism
• Anxiety Disorders (and Possibly Phobias)
• Mood Disorders (Depression Bipolar)
• Schizophrenia
• Personality Disorders (Especially Antisocial
  and Borderline)
• Incidence Rates

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DSM

• Diagnostic and Statistical Manual of Mental
  Disorders

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DSM

• The DSM has five Axes (Multiaxial Classification
  System)
• Axis I Mental Disorders (Clnical Syndromes) and
  V Codes (Such as Schizophrenia)
• Axis II Personality Features (and Developmental
  Disorders such as Mental Retardation)
• Axis III Physical Disorders and Conditions (such
  as Hypertension)
• Axis IV Psychosocial Stressors (such as Legal or
  Financial Problems)
• Axis V GAF (Global Adaptive Functioning)

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DSM (Textbook Version)
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders 16 syndromes) present?
Axis I
Is a Personality Disorder or Mental Retardation
present?
Axis II
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis III
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis IV
What is the Global Assessment of the persons
functioning?
Axis V
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DSM

• According to the class lecture, the DSM, or
  Diagnostic and Statistical Manual for Mental
  Illness, have Five Axes (The "Multiaxial
  Evaluation System"). Which of the Following is
  NOT a DSM Axis?
• Axis I Mental Disorders and V Codes (Such as
  Schizophrenia)
• Axis II Personality Features (and Mental
  Retardation)
• Axis III Physical Disorders and Conditions (such
  as Hypertension)
• Axis V Interaction with External Systems (such
  as Law Enforcement)

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DSM

• Probably the single greatest influence on the
  development of the DSM in recent decades has been
  statistics and the development of tests based on
  statistics (such as the MMPI, which was built
  using Factor Analysis and Discriminant Analysis).
• The second most important influence would be
  modern pharmaceuticals, such as SSRIs.

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DSM

• Per class lecture, starting with DSM-III, and
  beyond, what was the single most influential
  "force" in psychology on the development of the
  DSM?
• Neo-Freudian Psychodynamics and the Development
  of Ego Psychology
• Statistics, and the development of tests such as
  the MMPI using Factor Analysis and related
  statistics
• Pharmaceutical development of newer medications
  such as SSRI's
• Behaviorism, especially Operant Conditioning

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DSM Axis I Disorders

• A few typical Axis I Disorders
• Schizophrenia
• Major Depressive Disorder
• Bipolar Disorder
• Organic Mental Disorders (such as Alzheimers
  Dementia)
• Anxiety Disorders and Phobias
• Psychoactive Substance Use Disorders
• Eating Disorders

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DSM Axis I Disorders
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DSM Axis II Disorders

• A few typical Axis II Disorders
• Mental Retardation
• Autism
• ADD and ADHD
• Conduct Disorder (under Age 18)
• Antisocial Personality Disorder (formerly known
  as sociopathy or psychopathy 18 or older)
• Borderline Personality Disorder
• Multiple Personality Disorder

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DSM Movies Characters

• Which Axis?
• A Beautiful Mind?
• Mr. Jones? (Richard Gere)
• Arachnophobia?
• Vertigo? (Hitchcock)
• Hanibal Lecter?
• Fatal Attraction? (Glenn Close)
• Forrest Gump?
• Rainman? (Hoffman / Cruise)
• Dream Team? (Michael Keaton et al)

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DSM A Possible TQ

• Which of the following is an Axis II Disorder?
• Schizophrenia
• Bipolar Disorder (Manic Depressive)
• Anxiety Disorder(s) (Panic)
• Borderline Personality Disorder (Fatal Attraction)

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Abnormal Behavior What is it?
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Abnormal Behavior What is it?

• Two Key Ways to Identify Abnormal
• Is the behavior deviant statistically?
• Is the behavior adaptive or maladaptive?

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Abnormal Behavior What is it?

• Statistically Deviant Behavior
• Remember Mean, Median, Mode, Range, Standard
  Deviation from Chapter One?
• Statistically Deviant Behavior is behavior that
  is further away from the center (near the tails
  of the distribution)

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Abnormal Behavior What is it?

• Statistically Deviant Behavior
• Can be a measure for abnormal behavior
• What about the following?
• Abnormally low IQ (Mental Retardation)
• Abnormally violent / angry behavior (sociopathy)
• Radical Mood Swings?
• So, in some areas, statistically-based models can
  model abnormal (deviant) behavior.

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Abnormal Behavior What is it?

• Statistically Deviant Behavior
• But, is statistically deviant behavior
  necessarily bad?
• What about the following?
• Albert Einstein (A Physicist)
• Martin Scorsese (A Movie Maker)
• Michael Debakey (A Surgeon and Teacher)
• Are any of these three statistically average in
  their fields?

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Abnormal Behavior What is it?

• Statistically Deviant Behavior
• By itself, simple statistical models based on
  notions of central tendency are not enough.
• What was normal in Nazi Germany?
• Psychologists also ask if behavior is adaptive
  or maladaptive
• But, what is adaptive and what is maladaptive

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Abnormal Behavior Adaptive Behavior (What is
it?)

• Adaptive Behavior possibilities
• Allows the person (or organism) to react to a
  specific situation in a way that prolongs the
  life of the individual and/or
• Conserves or increases resources available to the
  person or organism and/or
• Honors or dignifies human (and other) life and/or
• Does these same things for the family or
  community surrounding the person (or organism)
• May (should?) take into account the larger global
  community
• Is often described as prosocial)

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Abnormal Behavior Adaptive Behavior (What is
it?)

• Maladaptive Behavior possibilities
• Demonstrates a narrow focus that does not
  consider larger consequences
• Demonstrates an incapacity to respond to the
  environment, especially novel situations
• Demeans or destroys other human beings or other
  life
• Causes damage or harm to the surrounding family
  or community
• Causes short or long term harm to the global
  community
• Is sometimes described as antisocial)

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Abnormal Behavior Adaptive Behavior (What is
it?)

• Whatever adaptive behavior might or might not
  be, it is invariably defined by the surrounding
  culture.

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Abnormal Behavior A Possible TQ

• Which of the following is true concerning
  abnormal behavior?
• a. Definitions of abnormal behavior are based on
  physiological factors.
• b. A behavior cannot be defined as abnormal
  unless it is considered harmful to society.
• c. Abnormal behavior can be defined as any
  behavior that is distressful.
• d. Definitions of abnormal behavior are
  culture-dependent.

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Abnormal Behavior Adaptive Behavior (What is
it?)

• On p. 640, the textbook mentions that (at one
  time) homosexuality was classified as an illness.
  Remember the M-F scale on the MMPI?

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Behavior Disorders Basics

• Statistically deviant and maladaptive
• Or, could be described as
• Deviant
• Distressful (usually subjective)
• Dysfunctional (usually objective)

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Abnormal Behavior A Possible TQ

• Behavior is described as disordered when it is
• Deviant
• Distressful
• Dysfunctional
• All of the above

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Behavior Disorders

• History

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Behavior Disorders History (p. 640)

• Prior to the work of the reformers of the 1800s
  mental illness was attributed to demon
  possession (evil spirits)
• Ever hear of demon rum?
• How was mental illness treated?
• Exorcism
• Beating
• Burning
• Read the text

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Abnormal Behavior A Possible TQ

• Our early ancestors commonly attributed
  disordered behavior to
• Bad Blood
• Brain Injury
• Laziness
• Evil Spirits

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Behavior Disorders History (p. 640)

• The medical model was introduced in 1800s
• Associated with certain reformers
• Philippe Pinel
• Sigmund Freud

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Behavior Disorders History (p. 640)

• Though not mentioned by the text, popularizing
  the medical model may be the single most
  important thing that Sigmund Freud did.

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Behavior Disorders History (p. 640)

• When physicians discovered that syphilis led to
  mental disorders, they started using medical
  models to review the physical causes of these
  disorders.
• Some Concepts from the Medical Model
• Etiology Cause and development of the disorder.
• Diagnosis Identifying (symptoms) and
  distinguishing one disease from another.
• Treatment Treating a disorder in a psychiatric
  hospital.
• Prognosis Forecast about the disorder.

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Biopsychosocial Approach (p. 643)

• Todays psychologists contend that all behavior,
  whether called normal or disordered, arises from
  the interaction of nature (genetic and
  physiological factors) and nuture (past and
  present experiences).

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Biopsychosocial Approach (p. 643)
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Biopsychosocial Model A Possible TQ

• The fact that disorders such as schizophrenia are
  universal and influenced by heredity, whereas
  other disorders such as anorexia nervosa are
  culture-bound provides evidence for the
  ____________ model of psychological disoders
• Evil Spirit Model
• Medical Model
• Constellation Based
• Biopsychosocial Model

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Behavior Disorders Legal System

• What is insanity?
• Should the insane be punished for crimes
  resulting from the insanity?
• What is the status of insanity in Texas?
• Medicate the insane to execute them?
• Execute the mentally retarded?

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Behavior Disorders Legal System

• Mentally Ill estimated prison population 283,000
  (per textbook)
• Mentally Ill estimated hospital population
  183,000 (per textbook)
• Should Non-Axis II mentally Ill be housed with
  other offenders?
• Bipolar Diagnosis?
• Sociopathy (Axis II)?
• Schizophrenic Offenders?

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Behavior Disorders Legal System

• What about Ted?

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Behavior Disorders How Different are
Psychopaths?
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Anxiety Disorders
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Anxiety Disorders

• Generalized anxiety disorders
• Phobias
• Panic disorders
• Obsessive-compulsive disorders

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Anxiety DisordersGeneralized Anxiety D/O
Generalized Anxiety Disorder Symptoms

• Persistent and uncontrollable tenseness and
  apprehension.

2. Autonomic arousal. (Sympathetic Nervous)
3. Inability to identify or avoid the cause of
certain feelings.
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Anxiety DisordersPanic D/O
Panic Disorder Symptoms

• Minute-long episodes of intense dread which may
  include feelings of terror, chest pains, choking,
  or other frightening sensations.

Anxiety is a component of both disorders. It
occurs more in the panic disorder, making people
avoid situations that cause it.
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Anxiety DisordersPhobia D/O

• Marked by a persistent and irrational fear of an
  object or situation that disrupts behavior.

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Anxiety DisordersPhobia D/O
Phobia of open places.
Agoraphobia
Phobia of heights.
Acrophobia
Phobia of closed spaces.
Claustrophobia
Phobia of blood.
Hemophobia
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Anxiety Disorders A Possible TQ

• Phobias and obsessive-compulsive behaviors are
  classified as
• Developmental Disorders
• Personality Disorders
• Reciprocal Determinism
• Anxiety Disorders

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Next Time

• Be prepared for a PopQuiz
• Review Learning Theory related to PTSD(Post
  Traumatic Stress Disorder)
• Chapter 16 (Wrapup)

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Finis