Psychological disorders

1
Psychological disorders
chapter 11
2
Overview
chapter 11

• Defining and diagnosing disorder
• Anxiety disorders
• Mood disorders
• Personality disorders
• Drug abuse and addiction
• Dissociative identity disorder
• Schizophrenia

3
Dilemmas of definition
chapter 11

• Possible models for defining disorders
• As the violation of cultural standards
• As emotional distress
• As behavior harmful to oneself or others

4
Mental disorder
chapter 11

• Any behavior or emotional state that causes a
  person to suffer, is self-destructive seriously
  impairs the persons ability to work or get along
  with others or endangers others or the community

5
Your turn
chapter 11

• Psychopaths are often happy, functional people,
  but they manipulate and harm others without
  conscience. On what basis are psychopaths said
  to have a mental disorder?
• A mental disorder is any behavior or mental state
  that
• (1) causes a person to suffer, is
  self-destructive
• (2) seriously impairs the persons ability to
  work or get along with others
• (3) or endangers others or the community.

6
Your turn
chapter 11

• Psychopaths are often happy, functional people,
  but they manipulate and harm others without
  conscience. On what basis are psychopaths said
  to have a mental disorder?
• A mental disorder is any behavior or mental state
  that
• (1) causes a person to suffer, is
  self-destructive
• (2) seriously impairs the persons ability to
  work or get along with others
• (3) or endangers others or the community.

7
Diagnostic and Statistical Manual
chapter 11

• Axis I Primary clinical problem
• Axis II Personality disorders
• Axis III General medical conditions
• Axis IV Social and environmental stressors
• Axis V Global assessment of overall functioning

8
Explosion of mental disorders
chapter 11

• Supporters of new categories answer that it is
  important to distinguish disorders precisely.
• Critics point to economics diagnoses are needed
  for insurance reasons for therapists to be
  compensated.

9
Concerns about diagnostic system
chapter 11

• The danger of over-diagnosis
• The power of diagnostic labels
• Confusion of serious mental disorders with normal
  problems
• The illusion of objectivity and universality

10
Advantages of the DSM
chapter 11

• When the manual is used correctly and diagnoses
  are made with valid objective tests, the DSM
  improves the reliability of and agreement between
  clinicians.
• The DSM-IV included for the first time a list of
  culture-bound syndromes.

11
Projective tests
chapter 11

• Projective tests
• Psychological tests used to infer a persons
  motives, conflicts, and unconscious dynamics on
  the basis of the persons interpretation of
  ambiguous stimuli
• Rorschach inkblot test
• A projective personality test that asks
  respondents to interpret abstract, symmetrical
  inkblots

12
Objective tests
chapter 11

• Inventories
• Standardized objective questionnaires requiring
  written responses
• Typically include scales on which people are
  asked to rate themselves
• MMPI
• Most widely used personality instrument
• Clinical and employment settings
• Measures aspects of personality that, if extreme,
  suggest a problem

13
Generalized anxiety disorder
chapter 11

• Continuous state of anxiety marked by feelings of
  worry and dread, apprehension, difficulties in
  concentration, and signs of motor tension

14
Posttraumatic stress disorder
chapter 11

• An anxiety disorder in which a person who has
  experienced a traumatic or life-threatening event
  has symptoms such as psychic numbing, reliving
  the trauma, and increased physiological arousal
• Diagnosed only if symptoms persist for six months
  or longer
• May immediately follow event or occur later

15
Panic disorder
chapter 11

• An anxiety disorder in which a person experiences
  recurring panic attacks
• Panic attack a feeling of impending doom or
  death, accompanied by physiological symptoms such
  as rapid breathing and dizziness

16
Fears and phobias
chapter 11

• Phobia
• An exaggerated, unrealistic fear of a specific
  situation, activity, or object

17
Agoraphobia
chapter 11

• A set of phobias, often set off by a panic
  attack, involving the basic fear of being away
  from a safe place or person.

18
Obsessive-compulsive disorder
chapter 11

• An anxiety disorder in which a person feels
  trapped in repetitive, persistent thoughts
  (obsessions) and repetitive, ritualized behaviors
  (compulsions) designed to reduce anxiety
• Person understands that the ritual behavior is
  senseless but guilt mounts if the behavior is not
  performed.

19
Your turn
chapter 11

• If you have the persistent thought that gremlins
  are sabotaging any airplane you are on or will be
  on, then you have a _____. If you cannot stop
  asking for more water during flights, then you
  have a _____.
• 1. Obsession compulsion
• 2. Compulsion obsession
• 3. Phobia obsession
• 4. Plane ticket pet camel

20
Your turn
chapter 11

• If you have the persistent thought that gremlins
  are sabotaging any airplane you are on or will be
  on, then you have a _____. If you cannot stop
  asking for more water during flights, then you
  have a _____.
• 1. Obsession compulsion
• 2. Compulsion obsession
• 3. Phobia obsession
• 4. Plane ticket pet camel

21
Depression
chapter 11

• Major depression
• A mood disorder involving disturbances in emotion
  (excessive sadness), behavior (loss of interest
  in ones usual activities), cognition (thoughts
  of hopelessness), and body function (fatigue and
  loss of appetite)

22
Symptoms of depression
chapter 11

• Depressed mood
• Reduced interest in almost all activities
• Significant weight gain or loss
• Sleeping too much or too little
• Fatigue
• Feelings of worthlessness or guilt
• Reduced ability to think, concentrate
• Recurrent thoughts of death

DSM IV requires 5 of these within the past 2 weeks
23
Bipolar disorder
chapter 11

• A mood disorder in which episodes of depression
  and mania (excessive euphoria) occur.

24
Biological theories of depression
chapter 11

• Studies of adopted children support genetic
  explanations of depression
• 5-HTT is a gene that is present in either a long
  or short form.
• 17 of individuals with the long form become
  severely depressed.
• 43 of individuals with 2 copies of the short
  form become depressed.
• Genetics may also influence levels of serotonin
  and other neurotransmitters.

25
Life experiences and circumstances
chapter 11

• Social explanations emphasize the stressful
  circumstances in peoples lives.
• Loss of or problems with important relationships
• Psychologists investigating sex differences in
  depression have ruled out hormones and genetics
  and are now investigating life circumstances.
  Women are less satisfied with work and family and
  more likely to live in poverty.

26
Cognitive habits
chapter 11

• Cognitive explanations emphasize habits of
  thinking and ways of interpreting events.
• Depressed people believe their situation is
  permanent, uncontrollable.
• Rumination
• Brooding about negative aspects of ones life

27
Problem personalities
chapter 11

• Personality disorder
• Rigid, maladaptive patterns that cause personal
  distress or an inability to get along with others
• Paranoid personality disorder
• Characterized by habitually unreasonable and
  excessive suspiciousness and jealousy
• Narcissistic personality disorder
• Characterized by an exaggerated sense of
  self-importance and self-absorption

28
Criminals and psychopaths
chapter 11

• Antisocial personality disorder
• Characterized by a lifelong pattern of
  irresponsible, antisocial behavior such as
  lawbreaking, violence, and other impulsive,
  restless acts
• Psychopathy
• Characterized by a lack of remorse, empathy,
  anxiety, and other social emotions the use of
  deceit and manipulation, and impulsive thrill
  seeking

29
Causes of APD and psychopathy
chapter 11

• Abnormalities in the central nervous system
• Impaired frontal-lobe functioning
• Genetic influences

30
Biology and addiction
chapter 11

• The biological model holds that addiction is due
  primarily to a persons biochemistry, metabolism,
  and genetic predisposition.
• More evidence comes from twin studies.

31
The addicted brain
chapter 11
32
Learning, culture, and addiction
chapter 11

• Addiction patterns vary according to cultural
  practices and the social environment.
• Policies of total abstinence tend to increase
  addiction rates rather than reduce them.
• Not all addicts have withdrawal symptoms when
  they stop taking a drug.
• Addiction depends on both the drug and the reason
  for taking it.

33
Dissociative identity disorder
chapter 11

• A controversial disorder marked by the appearance
  within one person of two or more distinct
  personalities, each with its own name and traits
• Commonly known as Multiple Personality Disorder

34
The MPD controversy
chapter 11

• First view
• MPD is common but often unrecognized as such.
• Starts in childhood as a means of coping
• Trauma produced a mental splitting.
• Second view
• Created through pressure and suggestion by
  clinicians
• Handfuls to ten thousand since 1980

35
Sociocognitive explanation
chapter 11

• MPD is an extreme form of our ability to present
  many aspects of our personalities to others.
• MPD is a socially acceptable way for some
  troubled people to make sense of their problems.
• Therapists looking for MPD may reward patients
  with attention and praise for revealing more and
  more personalities.

36
Symptoms of schizophrenia
chapter 11

• Bizarre delusions
• Hallucinations and heightened sensory awareness
• Disorganized, incoherent speech
• Grossly disorganized and inappropriate behavior
• Impaired cognitive abilities

37
Delusions and hallucinations
chapter 11

• Delusions
• False beliefs that often accompany schizophrenia
  and other psychotic disorders
• Hallucinations
• Sensory experiences that occur in the absence of
  actual stimulation

38
Genetic vulnerability
chapter 11

• The risk of developing schizophrenia increases as
  the genetic relatedness with a diagnosed
  schizophrenic increases.

39
Structural brain abnormalities
chapter 11

• Several abnormalities exist, especially when
  disease has primarily negative symptoms.
• Decreased brain weight
• Decreased volume in temporal lobe or hippocampus
• Enlargement of ventricles
• About 25 do not have these observable brain
  deficiencies.

40
Neurotransmitter abnormalities
chapter 11

• Include serotonin, glutamate, dopamine
• Many schizophrenics have high levels of brain
  activity in areas served by dopamine, and greater
  numbers of dopamine receptors.
• Similar abnormalities are found in depression and
  alcoholism.

41
Prenatal or birth complications
chapter 11

• Damage to the fetal brain increases chances of
  schizophrenia and other mental disorders.
• May occur as a function of maternal malnutrition
  or illness
• May also occur if brain injury or oxygen
  deprivation occurs at birth

42
Adolescent abnormalities in brain development
chapter 11

• Normal pruning of excessive synapses in the brain
  occurs during adolescence.
• In schizophrenics, a greater number of synapses
  are pruned away.
• May explain why first episode occurs in
  adolescence or early adulthood