PSYCHOPATHOLOGY

1
PSYCHOPATHOLOGY

• DIAGNOSIS
• AND
• TREATMENT STRATEGIES

2
ANXIETY, SOMATOFORM, AND DISSOCIATIVE DISORDERS
Disorder
Subtypes
Major Symptoms
InRev15a
Phobias Generalized anxiety disorder Panic
disorder Obsessive-compulsive
disorder Conversion disorder Hypochondriasis
Somatization disorder Pain disorder Amnesia/fu
gue Dissociative identity disorder (multiple
personality disorder)
Anxiety disorders Somatoform
disorders Dissociative disorders
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.
3
ANXIETY DISORDERS

• PANIC DISORDER
• GENERALIZED ANXIETY DISORDER
• PHOBIAS
• OBSESSIVE-COMPULSIVE DISORDER
• POST-TRAUMATIC STRESS DISORDER

4
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.
5
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.
6
PHOBIA Irrational fear response of
specific stimuli SOCIAL PHOBIAS AGORAPHOBIA
SPECIFIC PHOBIAS
7
OBSESSIVE-COMPULSIVE
DISORDER Marked by overt ritualistic
behavior and persistent intruding thoughts
Occurs at a frequency so high as to
interfere with daily functioning
8
SOMATOFORM DISORDERS

• HYPOCHONDRIASIS
• CONVERSION HYSTERIA

9
HYPOCHONDRIASIS Preoccupation with body and
illness No relief if given healthy
diagnosis Just as tense--travel and search for
new physicians
10
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
11
DISSOCIATIVE DISORDERS

• DISSOCIATIVE AMNESIA
• DISSOCIATIVE FUGUE
• DISSOCIATIVE IDENTITY DISORDER

12
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
13
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!
14
DISSOCIATIVE IDENTITY
DISORDER Dominance of 2 or more distinct
personalities Generally amnesic for
existence of others Controversial Diagnosis
15
Fig131
16
AFFECTIVE DISORDERS

• MAJOR DEPRESSION
• DYSTHYMIC DISORDER
• BIPOLAR DISORDER
• CYCLOTHYMIC DISORDER
• SEASONAL AFFECTIVE DISORDER

17
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
18
BIPOLAR DISORDER MANIC-DEPRESSION Elevat
ed 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
19
INCIDENCE OF DEPRESSION
57
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
20
Creativity and Madness
21
SCHIZOPHRENIA

• PARANOID
• CATATONIA
• DISORGANIZED HEBEPHRENIA
• SIMPLE
• RESIDUAL

22
(No Transcript)
23
15_05
Fig15_5
C
Max
A
Threshold
Challenging events
D
B
Min
Low
High
Vulnerability
24
PERSONALITY DISORDERS
25
Fig15_5
Type
Typical Features
Paranoid Schizoid Schizotypal Depedent Obse
ssive-compulsive Avoidant Histrionic Narcissis
tic 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
26
PSYCHO-SEXUAL DISORDERS Fetishism
Zoophilia Sadism Masochism
Exhibitionism Pedophilia
27
DEVELOPMENTAL DISORDERS
Autism Academic Skills Disorder Attention
Deficit Disorder w/hyperactivity Senile
Dementia
28
TREATMENT

• PSYCHOANALYSIS
• BEHAVIOR
• HUMANISTIC
• COGNITIVE
• BIOMEDICAL

29
SIGMUND FREUDPSYCHOANALYSIS
Resistance Catharsis Transference Interpretation
Insight
30
DEINSTITUTIONALIZATION
31
(No Transcript)
32
CARL ROGERSCLIENT CENTERED
UNCONDITIONAL POSITIVE REGARD
33
HUMANISTIC THERAPY
34
ROLLO MAYEXISTENTIAL THERAPY
35
ALBERT BANDURAMODELING

36
BEHAVIOR AND COGNITIVE
37
(No Transcript)
38
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)

39
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 1950s
• Often used on schizophrenics bringing flat affect
• Today smaller amount of tissue can be removed
  from specific areas showing malfunction--cinguloto
  my
• Can be very effective at removing tumor and other
  tissue causing abnormal behaviors

40
BIOMEDICAL TREATMENTS

• Drug Treatment Options
• Anti-Anxiety Xanax
• GABA neurotransmitter
• Anti-Depressant drugs Prozac
• Serotonin and Norepinephrine
• Anti-Psychotic drugs Thorazine
• Dopamine

41
Average
Average
untreated
treated
person
person
Number of people
80 of
untreated
persons
No improvement
Outstanding
improvement
42
THE END