Title: Introduction to Psychology
1PSYCHOLOGICAL DISORDERS
2Rate this person using the following scale1
Basically OK Psychotherapy is not
necessary2Mild Disturbance. Psychotherapy
should be considered3 Significant disturbance.
Psychotherapy is definitely required4 Severe
disturbance. Hospitalize!
- Jim was vice president of the freshman class at a
local college and played on the schools football
team. Later that year he dropped out of these
activities and gradually became more and more
withdrawn from friends and family. Neglecting to
shave and shower, he began to look dirty and
unhealthy. He spent most of his time alone in his
room and sometimes complained to his parents that
he heard voices in the curtains and in the
closet. In his sophomore year he dropped out of
school entirely. With increasing anxiety and
agitation, he began to worry that the Nazis
were plotting to kill his family and kidnap him.
3Rate this person using the following scale1
Basically OK Psychotherapy is not
necessary2Mild Disturbance. Psychotherapy
should be considered3 Significant disturbance.
Psychotherapy is definitely required4 Severe
disturbance. Hospitalize!
- Mary is a 30 year old musician who is very
dedicated and successful in her work as a teacher
in a local high school and as a part time member
of local musical groups. Since her marriage five
years ago, which ended in divorce after six
months, she has dated very few men. She often
worries that her time is running out for
establishing a good relationship with a man,
getting married, and raising a family. Her
friends tell her that she gets way too anxious
around men, and that she needs to relax a little
in general.
4Its All a Matter of Degree
5Historical Perspective
- Perceived Causes
- movements of sun or moon
- lunacy--full moon
- evil spirits
- Ancient Treatments
- exorcism, caged like animals, beaten, burned,
castrated, mutilated, blood replaced with
animals blood
6Trephination-holes drilled into skulls ostensibly
to let evil spirits to escape (found in
prehistoric human remains during the Neolithic
times)
Procedure had survived and continued through the
Middle Ages and Renaissance.
7Psychological Disorders
- Philippe Pinel (1745-1846)
- French reformer insisted that madness was not
demon possession, but a sickness in response to
severe stresses and inhumane conditions. - Proposed moral treatment whereby doctors
would unchain the patients and talk to them.
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9Psychological Disorders
- Medical Model
- concept that diseases have physical causes
- can be diagnosed, treated, and in most cases,
cured - assumes that these mental illnesses can be
diagnosed on the basis of their symptoms and
cured through therapy, which may include
treatment in a psychiatric hospital
10Psychological Disorders
- Thomas Szasz
- believes that mental illnesses are socially, not
medically, defined.
11Psychological Disorders
- Psychological Disorder
- a harmful dysfunction in which behavior is
judged to be - atypical--not enough in itself
- disturbing--varies with time and culture
- maladaptive--harmful
- unjustifiable--sometimes theres a good reason
- Three Ds dysfunction, deviance,
- distressful
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13Psychological Disorders--Etiology
- DSM-IV
- American Psychiatric Associations Diagnostic and
Statistical Manual of Mental Disorders (Fourth
Edition) - a widely used system for classifying
psychological disorders - presently distributed as DSM-IV-TR (text revision)
14Labeling Psychological Disorders
- Once we label a person, we view that person
differently. - Labels create preconceptions that guide our
perceptions and our interpretations.
15Labeling Psychological Disorders (David Rosenhan)
- David Rosenhan and seven others went to mental
hospital admissions offices, complaining of
hearing voices that were saying empty,
hollow, and thud. Apart from this complaint
and giving false names and occupations, they
answered all the questions truthfully. All eight
were diagnosed as mentally ill.
16Psychological Disorders
- Bio-Psycho-Social Perspective
- assumes that biological, sociocultural, and
psychological factors combine and interact to
produce psychological disorders
17Psychological Disorders
18Prevalence
- Approximately 48 of adults experienced symptoms
at least once in their lives - Approximately 80 who experienced symptoms in the
last year did NOT seek treatment - Most people seem to deal with symptoms without
complete debilitation - Women have higher prevalence of depression and
anxiety - Men have higher prevalence of substance abuse and
antisocial personality disorder
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20Psychological Disorders- Etiology
- Neurotic Disorder (term seldom used now)
- usually distressing but that allows one to think
rationally and function socially - Psychotic Disorder
- person loses contact with reality
- experiences irrational ideas and distorted
perceptions
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22Anxiety Disorders
- Anxiety Disorders
- distressing, persistent anxiety or maladaptive
behaviors that reduce anxiety - Generalized Anxiety Disorder
- person is tense, apprehensive, and in a state of
autonomic nervous system arousal
23Model of Development of GAD
- GAD has some genetic component
- Related genetically to major depression
- Childhood trauma also related to GAD
24Generalized Anxiety Disorder (GAD)
- More or less constant worry about many issues
- The worry seriously interferes with functioning
- Physical symptoms
- headaches
- stomach aches
- muscle tension
- irritability
25Anxiety Disorders
- Panic Disorder
- marked by a minutes-long episode of intense dread
in which a person experiences terror and
accompanying chest pain, choking, or other
frightening sensation
26Anxiety Disorders
- Phobia
- persistent, irrational fear of a specific object
or situation - Obsessive-Compulsive Disorder
- unwanted repetitive thoughts (obsessions) and/or
actions (compulsions)
27Phobias
- Intense, irrational fears that may focus on
- Natural environmentheights, water, lightening
- Situationflying, tunnels, crowds, social
gathering - Injuryneedles, blood, dentist, doctor
- Animals or insectsinsects, snakes, bats, dogs
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30Anxiety Disorders
- Common and uncommon fears
31Anxiety Disorders
32Anxiety Disorders
- PET Scan of brain of person with Obsessive/
Compulsive disorder - High metabolic activity (red) in frontal lobe
areas involved with directing attention
33The Learning Perspective
- The Learning Perspective
- sees anxiety disorders as a product of learned
helplessness or fear conditioning - Fear Conditioning
- Researchers have linked general anxiety with
classical conditioning of fear.
34The Learning Perspective
- Stimulus Generalization
- Conditioned fears may remain long after we
have forgotten the experiences that produced
them. - Stimulus generalization may occur when a
person who fears heights after a fall may be
afraid of airplanes without ever having flown.
35The Learning Perspective
- Reinforcement
- Once phobias and compulsions arise,
reinforcement helps maintain them. Avoiding or
escaping the feared situation reduces anxiety,
thus reinforcing the phobic behavior.
36The Learning Perspective
- Observational Learning
- We learn fear through observing others.
Parents transmit their fears to their children.
37The Biological Perspective
- The Biological Perspective
- Considers possible evolutionary, genetic, and
physiological influences. - Natural Selection
- Phobias focus on dangers faced by our
ancestors. Compulsive acts typically exaggerate
behaviors that contributed to our species
survival.
38The Biological Perspective
- Genes
- Some people seem genetically predisposed to
particular fears and high anxiety. Identical
twins often develop similar phobias, even when
raised separately.
39The Biological Perspective
- Physiology
- General anxiety, panic attacks, and even
obsessions and compulsions are biologically
measurable as an overarousal of brain areas
involved in impulse control and habitual
behaviors. (PET scans)
40Post-Traumatic Stress Disorder
- Post-Traumatic Stress Disorder Traumatic stress
(experiencing or witnessing severely threatening,
uncontrollable events with a sense of fear,
helplessness, or horror) can produce PTSD,
symptoms of which include haunting memories and
nightmares, numbed social withdrawal, jumpy
anxiety, and insomnia.
41POST-TRAUMATIC STRESS DISORDER
- Some experts estimate that as many as 200,000
World War II veterans continue to suffer from
PTSD. - Currently, about 19 of Iraqi veterans and 11 of
Afghanistan veterans return home with mental
health problems. - Children can also suffer from PTSD
42Somatoform Disorders
- Psychological disorders in which the symptoms
take a somatic (bodily) form without apparent
physical cause. - In Freuds day, called hysteria. In 1970s,
- hysteria as an independent diagnostic entity
- was deleted from the official manuals of
- medical diagnosis.
43Somatoform Disorders
- Conversion Disorders
- a rare somatoform disorder in which a person
experiences very specific genuine physical
symptoms for which no physiological basis can be
found.
44Somatoform Disorders
- Hypochondriasis
- a somatoform disorder in which a person
misinterprets normal physical sensations as
symptoms of a disease.
45Dissociative Disorders
- conscious awareness becomes separated
(dissociated) from previous memories, thoughts,
and feelings - Dissociative Identity Disorder
- rare dissociative disorder in which a person
exhibits two or more distinct and alternating
personalities - formerly called multiple personality disorder
46Dissociative Disorders
Amnesia
Fugue
Memories related to a trauma disappear and the
person starts life all over.
Memories related to a trauma disappear.
Identity Disorder
A person will have several personalities that
are unique.
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48Dissociative Amnesia
- Also known as psychogenic amnesia
- Memory loss the only symptom
- Often selective loss surrounding traumatic events
- person still knows identity and most of their
past - Can also be global
- loss of identity without replacement with a new
one
49Dissociative Amnesia
- Margie and her brother were recently victims of a
robbery. Margie was not injured, but her brother
was killed when he resisted the robbers. Margie
was unable to recall any details from the time of
the accident until four days later.
50Dissociative Fugue
- Also known as psychogenic fugue
- Global amnesia with identity replacement
- leaves home
- develops a new identity
- apparently no recollection of former life
- called a fugue state
- If fugue wears off
- old identity recovers
- new identity is totally forgotten
51Dissociative Fugue
- Jay, a high school physics teacher in New York
City, disappeared three days after his wife
unexpectedly left him for another man. Six
months later, he was discovered tending bar in
Miami Beach. Calling himself Martin, he claimed
to have no recollection of his past life and
insisted that he had never been married.
52Dissociative Identity Disorder
(DID)
- Originally known as multiple personality
disorder - 2 or more distinct personalities manifested by
the same person at different times - VERY rare and controversial disorder
- Examples include Sybil, Trudy Chase, Chris
Sizemore (Eve) - Has been tried as a criminal defense
53Dissociative Identity Disorder
- Pattern typically starts prior to age 10
(childhood) - Most people with disorder are women
- Most report recall of torture or sexual abuse as
children and show symptoms of PTSD
54Dissociative Identity Disorder (DID)
- Norma has frequent memory gaps and cannot
account for her whereabouts during certain
periods of time. While being interviewed by a
clinical psychologist, she began speaking in a
childlike voice. She claimed that her name was
Donna and that she was only six years old.
Moments later, she seemed to revert to her adult
voice and had no recollection of speaking in a
childlike voice or claiming that her name was
Donna.
55Causes of Dissociative Disorders?
- Repeated, severe sexual or physical abuse
- However, many abused people do not develop DID
- Combine abuse with biological predisposition
toward dissociation? - people with DID are easier to hypnotize than
others - may begin as series of hypnotic trances to cope
with abusive situations
56The DID Controversy
- Some curious statistics
- 193060 2 cases per decade in USA
- 1980s 20,000 cases reported
- many more cases in US than elsewhere
- varies by therapistsome see none, others see a
lot - Is DID the result of suggestion by therapist and
acting by patient?
57Moderate depression that will go away without
therapy
Restlessness, inability to concentrate, and
rapid speech
Dysthymic Disorder
Mania
Mood Disorders
Major Depression
Bipolar
Lasting from a couple of weeks to months
Swings of mania and depression
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59Major Depression
- A mood disorder characterized by extreme and
persistent feelings of despondency, worthlessness
and hopelessness
- Prolonged, very severe symptoms
- Passes without remission for at least 2 weeks
- Global negativity and pessimism
- Very low self-esteem
60Symptoms of Major Depression
- Emotional sadness, hopelessness, guilt, turning
away from others - Behavioral tearfulness, dejected facial
expression, loss of interest in normal
activities, slowed movements and gestures,
withdrawal from social activities - Cognitive difficulty thinking and concentrating,
global negativity, preoccupation with
death/suicide - Physical appetite and weight changes, excess or
diminished sleep, loss of energy, global anxiety,
restlessness
61Dysthymic Disorder
- Chronic, low-grade depressed feelings that are
not severe enough to be major depression - May develop in response to trauma, but does not
decrease with time - Can have co-existing major depression
62Seasonal Affective Disorder
(SAD)
- Cyclic severe depression and elevated mood
- Seasonal regularity
- Unique cluster of symptoms
- intense hunger
- gain weight in winter
- sleep more than usual
- depressed more in evening than morning
63Prevalence and Course
- Most common of psychological disorders
- Women are twice as likely as men to be diagnosed
with major depression - Untreated episodes can become recurring and more
serious - Seasonal affective disorder (SAD)onset with
changing seasons
64Mood Disorders
- Bipolar Disorder (Manic depression)
- a mood disorder in which the person alternates
between the hopelessness and lethargy of
depression and the overexcited state of mania - formerly called manic-depressive disorder
- Manic Episode
- a mood disorder marked by a hyperactive, wildly
optimistic state
65Prevalence and Course
- Bipolar Disorder
- Onset usually in young adulthood
- (early twenties)
- Mood changes more abrupt than in major
depression - No sex differences in rate of bipolar disorder
- Commonly recurs every few years
- Can often be controlled by medication (lithium)
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67- Canadian depression rates
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69Suicide
- National differences
- England, Italy, Spain little more than half
rate of Canada, U.S. Australia while Austria and
Finland higher - Racial differences-
- white Americans about twice as likely as black
Americans - Gender differences-
- More women attempt suicide while men are four
times more likely to succeed
70- PET scans show that brain energy consumption
rises and falls with emotional switches
71- Altering any one component of the
chemistry-cognition-mood circuit can alter the
others
72- The vicious cycle of depression can be broken at
any point
73Explaining Mood Disorders
- Neurotransmitter theories (Biology)
- dopamine
- norepinephrine
- serotonin
- Genetic component
- more closely related people show similar
histories of mood disorders
74Causes
- Use linkage analysis- look for genes that may put
people at risk for depression and points to
chromosome neighborhoods - Association studies- look for correlations among
these genes and a larger population trait. - Norepinephrine and serotonin are both scarce in
depression and in excess in mania - Lower levels of omega-3 fatty acid
- Left frontal lobe less active during depressed
states -
75Situational Bases for Depression
- Positive correlation between stressful life
events and onset of depression - Does life stress cause depression?
- Most depressogenic life events are losses
- spouse or companion
- long-term job
- health
- income
76Cognitive Bases for Depression
- A.T. Beck depressed people hold pessimistic
views of - themselves
- the world
- the future
- Depressed people distort their experiences in
negative ways - exaggerate bad experiences
- minimize good experiences
77Cognitive Bases for Depression
- Hopelessness theory
- depression results from a pattern of thinking
- person loses hope that life will get better
- negative experiences are due to stable, global
reasons - e.g., I didnt get the job because Im stupid
and inept vs. I didnt get the job because the
interview didnt go well
78MOOD DISORDERS
- MANIA Symptoms
- Elation, euphoria, desire for action
- Impatience, distractibility
- Inflated self-esteem
- Grandiosity
- Impulsiveness
- Hyperactivity
- Decreased need for sleep
- Sexual indiscretion
- Increased appetite
79Flight of ideas
-a nearly continuous flow of rapid speech that
jumps from topic to topic. Most commonly seen
in manic episodes.
80Schizophrenia
- Schizophrenia
- literal translation split mind
- a group of severe disorders characterized by
- disorganized and delusional thinking
- disturbed perceptions
- inappropriate emotions and actions
81What is Schizophrenia?
- Comes from Greek meaning split and mind
- split refers to loss of touch with reality
- not dissociative state
- not split personality
- Equally split between genders, males have
earlier onset - 18 to 25 for men
- 26 to 45 for women
82 IF YOU TALK TO GOD, YOURE PRAYING IF
GOD TALKS TO YOU, YOU HAVE
SCHIZOPHRENIA Thomas Szasz
83Schizophrenic Disorders
Symptoms
Disorganized Thoughts Hallucinations Delusions Gar
bled Speech Word Salad Clanging
84Symptoms of Schizophrenia
- Positive symptoms
- hallucinations
- delusions
- Negative symptoms
- absence of normal cognition or affect (e.g., flat
affect, poverty of speech) - Disorganized symptoms
- disorganized speech (e.g., word salad)
- disorganized behaviors
85Frequency of positive and negative symptoms in
individuals at the time they were hospitalized
for schizophrenia. Source Based on data
reported in Andreasen Flaum, 1991.
86Symptoms of Schizophrenia
- Chronic or process
- schizophrenia is a slow-developing process
recovery is doubtful. - Acute or reactive
- schizophrenia develops rapidly recovery is
much more likely.
87Schizophrenia
- Delusions
- false beliefs, often of persecution or grandeur,
that may accompany psychotic disorders - In a psychiatrist's waiting room two patients are
having a conversation. One says to the other,
"Why are you here?"The second answers, "I'm
Napoleon, so the doctor told me to come
here."The first is curious and asks, "How do you
know that you're Napoleon?"The second responds,
"God told me I was."At this point, a patient on
the other side of the room shouts, "NO I DIDN'T!"
88Symptoms of Schizophrenia
- Delusions of persecution
- theyre out to get me
- paranoia
- Delusions of grandeur
- God complex
- megalomania
- Delusions of being controlled
- the CIA is controlling my brain with a radio
signal
89Symptoms of Schizophrenia
- Hallucinations
- hearing or seeing things that arent there
- contributes to delusions
- command hallucinations voices giving orders
- Disorganized speech
- Over-inclusionjumping from idea to idea without
the benefit of logical association - Paralogicon the surface, seems logical, but
seriously flawed - e.g., Jesus was a man with a beard, I am a man
with a beard, therefore I am Jesus
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91Disorganized Thinking
- Word Salad
- jumping from one idea to another even within
sentences. - Clang Associations
- rhyming the last word of a sentence.
92Disorganized Thinking
93Symptoms of Schizophrenia
- Disorganized behavior and affect
- behavior is inappropriate for the situation
- e.g., wearing sweaters and overcoats on hot days
- affect is inappropriately expressed
- flat affectno emotion at all in face or speech
- inappropriate affectlaughing at very serious
things, crying at funny things - catatonic behavior
- unresponsiveness to environment, usually marked
by immobility for extended periods
94Schizophrenia
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96Schizophrenia
97Chemical Factors in Schizophrenia
1. Dopamine is a neurotransmitter found in the
brain.
2. Schizophrenics have very high levels of
dopamine.
3. They report that they feel agitated, talk
rapidly, and their thoughts are racing.
4. Some schizophrenics report that lower levels
of dopamine make them feel better.
98The Dopamine Theory
- Drugs that reduce dopamine reduce symptoms
- Drugs that increase dopamine produce symptoms
even in people without the disorder - Theory Schizophrenia is caused by excess
dopamine - Dopamine theory not enough other
neurotransmitters involved as well
99Genetic Factors
- 1 in 100 odds of any person being diagnosed with
schizophrenia. - 1 in 10 chance among those who have an
afflicted sibling or parent. - 1 in 2 chance among those who have an
afflicted identical twin.
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101Schizophrenia
102Biological Bases of Schizophrenia
- Other congenital influences
- difficult birth (e.g., oxygen deprivation)
- prenatal viral infection
- Brain chemistry
- neurotransmitter excesses or deficits
- dopamine theory
103Other Biological Factors
- Brain structure and function
- enlarged cerebral ventricles and reduced neural
tissue around the ventricles - PET scans show reduced frontal lobe activity
- Early warning signs
- nothing very reliable has been found yet
- certain attention deficits can be found in
children who are at risk for the disorder - Fathers ageolder men are at higher risk for
fathering a child with schizophrenia
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105Family Influences on Schizophrenia
- Family variables
- parental communication that is disorganized,
hard-to-follow, or highly emotional - expressed emotion
- highly critical, over-enmeshed families
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107Cultural Differences in Schizophrenia
- Prevalence of symptoms is similar no matter what
the culture - Less industrialized countries have better rates
of recovery than industrialized countries - families tend to be less critical of the patients
- less use of antipsychotic medications, which may
impair full recovery - think of it as transient, rather than chronic and
lasting disorder
108Summary of Schizophrenia
- Many biological factors seem involved
- heredity
- neurotransmitters
- brain structure abnormalities
- Family and cultural factors also important
- Combined model of schizophrenia
- biological predisposition combined with
psychosocial stressors leads to disorder - Is schizophrenia the maladaptive coping behavior
of a biologically vulnerable person?
109Personality Disorders
- Personality Disorders
- disorders characterized by inflexible and
enduring behavior patterns that impair social
functioning - usually without anxiety, depression, or delusions
110Personality Disorders
Borderline Personality Disorder
These people have unstable and intense
relationships with others. They are dependent on
others and yet, sabotage those relationships.
They have problems controlling their impulses
their perceptions and thoughts are distorted.
111Borderline Personality Disorder
- Chronic instability of emotions, self-image,
relationships - Self-destructive behaviors
- Intense fear of abandonment and emptiness
- Possible history of childhood physical,
emotional, or sexual abuse - 75 of diagnosed cases are women
112Paranoid Personality Disorder
- Pervasive mistrust and suspiciousness of others
are the main characteristic - Distrustful even of close family and friends
- Reluctant to form close relationships
- Tend to blame others for their own shortcomings
113Histrionic Personality Disorder
- displays a shallow, attention-getting
emotionality. - Histrionic individuals go to great length to
gain others praise and reassurance.
114Narcissistic Personality Disorder
- exaggerate their own importance, aided by success
fantasies. - They find criticism hard to accept, often
reacting with rage or shame.
115- Antisocial Personality Disorder
- disorder in which the person (usually man)
exhibits a lack of conscience for wrongdoing,
even toward friends and family members - may be aggressive and ruthless or a clever con
artist - These people consistently come into conflict with
the law and show little or no concern, guilt, or
anxiety.
116Personality Disorders
- PET scans illustrate reduced activation in a
murderers frontal cortex
117Personality Disorders
118Rates of Psychological Disorders
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