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Psychological disorder

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Title: Psychological disorder


1
Psychological disorder
  • What is abnormal behavior? What is
  • meant by a psychological disorder?
  • A harmful dysfunction judged to be
  • Atypical outside of norms (deviance model)
  • Disturbing - varies with time and culture
  • Maladaptive
  • Harmful
  • Unjustifiable
  • Resource Discovering Psychology Updated Edition

2
Historical Perspective
  • Demonological view
  • Possession by evil spirits.
  • Movement of moon (lunacy)
  • Treatments
  • Exorcism, beaten, trephined, castrated,
    mutilated, and killed
  • Later mental asylums were used like prisons to
    keep the afflicted away from society (bethlehem
    bedlam)

3
Psychological Disorders
  • Formerly two major divisions
  • 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

4
Psychological Models
  • Medical/Biological model
  • Physiological or biochemical basis
  • Concept that diseases have physical cause
  • Psychoanalytic model
  • Disorders are the result of unconscious conflicts
  • Cognitive-Behavioral model
  • Disorders are the result of learning maladaptive
    ways of behaving and thinking
  • Diathesis-Stress model
  • Biological predisposition to disorder which is
    triggered by stress
  • Systems theory (BioPsychoSocial model)
  • Biological, psychological, and socio-cultural
    risk factors combine to produce psychological
    disorders

5
Prevalence of Disorders Some Stats
  • Harvard Medical School estimates 46 of Americans
    will experience a psychological disorder in their
    lifetime (appx 150 million Americans), Kessler
    and Wang, 2008

6
Psychological Disorders--Etiology
  • DSM-V
  • American Psychiatric Associations Diagnostic and
    Statistical Manual of Mental Disorders-5 recently
    replaced the DSM-IV-TR
  • Widely used system for classifying psychological
    disorders into major categories Clinical guide
  • Major Criticisms?
  • Diagnostic labeling (Rosenhan Study)
  • Pathologizing normal behaviors (thresholds for
    diagnosis)?
  • Overdiagnosis

7
DSM-5
  • The DSM-5 replaced the Multi-Axial System and now
    has 3 sections
  • Section 1 Introduction and instructions on how to
    use the new version
  • Section 2 Diagnostic categories
  • Section 3 Conditions that need additional
    research, a glossary of terms, and other
    important information
  • The DSM 5

8
Some Disorder Categories in DSM-5
  • Anxiety Disorders
  • Obsessive-Compulsive and Related Disorders
  • Trauma and Stressor-Related Disorders
  • Depressive Disorders
  • Bipolar and Related Disorders
  • Neurodevelopmental Disorders- Intellectual
    disability categories (eliminates use of mental
    retardation)
  • Schizophrenic Spectrum and other Psychotic
    Disorders
  • Disassociative Disorders
  • Somatic Symptom Disorder
  • Personality Disorders

9
Anxiety Disorders
  • Anxiety Disorders Any disorder in which anxiety
    or avoidance of anxiety motivates abnormal
    behavior
  • Generalized Anxiety Disorder Tension,
    apprehension, and state of autonomic arousal
  • Panic Disorder Acute episodes of intense dread.
    Terror, accompanying chest pain, choking, or
    other frightening sensations
  • Phobia Persistent, irrational fear of a specific
    object or situation. Common phobias?
  • Agoraphobia
  • Social Anxiety
  • Separation Anxiety
  • Selective Mutism

10
Anxiety Disorders
  • Common and uncommon fears

11
Explaining Anxiety Disorders
  • Freudian view (Psychodynamic) Repression of
    painful and intolerable ideas, feelings, and
    thoughts, results in anxiety
  • Learning perspective Conditioning causes anxiety.
    Anxiety becomes associated with other objects or
    events through observation (and generalization)
    and is reinforced.
  • Cognitive perspective Misinterpretation and
    errors in cognition
  • Biological perspective
  • Genes may be partly responsible for developing
    fears and anxiety. (Twin studies and temperament)
  • Evoutionary/Natural Selection has led our
    ancestors to learn to fear snakes, spiders, and
    other animals. Fear preserves the species
  • Neuroscientific explanations. Brain regions and
    chemistry

12
Obsessive Compulsive Disorder
  • Obsessive-Compulsive and Related Disorders (New
    Chapter/Category in DSM-5)
  • Characterized by obsessions (repetitive thoughts)
    and/or compulsions (repetitive behaviors)
  • Four new OC disorders were added to DSM-5
    including Hoarding and Excoriation Disorder
  • Body Dysmorphic Disorder and Trichotillomania
    now fall under OCDRD
  • Trauma and Stressor Related Disorders (New
    Chapter)
  • Post Traumatic Stress Disorder - Recurring
    episodes of anxiety following a stress event
    symptoms include haunting memories, withdrawal,
    anxiety, and depression
  • Reactive Attachment, Acute Stress, and Adjustment
    D/Os

13
Depressive Disorders (formerly under Mood
Disorders)
  • Major Depressive Disorder A person experiences
    two or more weeks of depressed moods, feelings of
    worthlessness, and diminished interest or
    pleasure in most activities
  • Depression is the common cold of psychological
    disorders - 5.8 of men and 9.5 of women report
    depression worldwide a year (WHO, 2002)
  • Usually goes away in time (even without
    treatment, although treatment can speed up
    recovery)
  • Persistent Depressive Disorder (formerly
    Dysthymic Disorder)

14
Persistent Depressive Disorder (formerly
Dysthymic Disorder)
  • A long-term, low-level depression while not
    debilitating, it is characterized by low
    self-esteem and a persistent sense of
    hopelessness for a period of two years. People
    with PDD may also experience low energy,
    indecisiveness, insomnia or excessive sleeping,
    and a change in appetite.

15
Perspectives on Depression
  • Genetic Influences Depressive disorders run in
    families. Rates of depression are much higher in
    identical (50) than fraternal twins (20)
  • Biological perspective Brain and
    neurotransmitters the role of serotonin,
    dopamine and epinephrine
  • Social-Cognitive Depression causes negative
    thinking AND negative thinking causes depression

16
Neurotransmitters Depression
A deficit of serotonin, (norepinephrine and
dopamine) has been found in depression
Pre-synaptic Neuron
Serotonin
Norepinephrine
Post-synaptic Neuron
17
Social-Cognitive Perspective
The social-cognitive perspective suggests that
depression arises partly from self-defeating
beliefs and negative explanatory styles
18
Bipolar Disorder and Related Disorders (New
Chapter-formerly a Mood DO)
  • Bipolar Disorder (Condition in which a person
    alternates between the hopelessness and lethargy
    of depression and the overexcited state of mania
    (once aka manic-depressive disorder). See
    handout
  • Manic Episode A disorder marked by a hyperactive,
    wildly optimistic state
  • New diagnosis Disruptive Mood Disregulation
    Disorder for children up to 18

19
Neurodevelopmental Disorders
  • Various categories marked by neurological and
    developmental issues (new and revised conditions)
  • Intellectual Disability (no longer mental
    retardation)
  • Communication Disorders
  • Autism Spectrum Disorders
  • Global Developmental Disorder
  • Tic Disorders (Tourettes, e.g.)
  • Attention Deficit Hyperactivity Disorder
  • Disruptive, Impulse Control and Conduct Disorders
    (new category) characterized by problems in
    emotional and behavioral self-control

20
Dissociative Disorders
  • Dissociative Disorders Conscious awareness
    becomes separated (dissociated) from previous
    memories, thoughts, and feelings (See handout)
  • Dissociative amnesia
  • Dissociative fugue
  • Depersonalization disorder
  • Dissociative Identity Disorder Rare disorder in
    which a person exhibits two or more distinct and
    alternating personalities (once multiple
    personality disorder)

21
Somatic Symptom and Related Disorders (formerly
Somatoform)
  • Physical symptoms without any physical cause.
    Person experiences symptoms as real (Pain
    disorder)
  • Conversion disorder (hysteria)
  • La belle indifference
  • Freud/Psychodynamic - Symptoms related to
    traumatic experience in the past
  • Cognitive-Social - Ways in which the behavior is
    being rewarded
  • Biological perspective - Real physical illnesses
    that are misdiagnosed or overlooked. Many
    disorders eliminated from DSM 5 to avoid overlap
    with medical conditions

22
Schizophrenic Spectrum and Other Psychotic
Disorders
  • Schizophrenia literal translation split mind,
    therefore often it is often confused with DID
    (formerly MPD). Severe disorders characterized by
  • Disorganized and delusional thinking and
    hallucinations
  • Disturbed perceptions
  • Inappropriate emotions and actions
  • The Brain

23
Schizophrenic Spectrum and Other Psychotic
Disorders
  • DSM-5 Revisions
  • Subtypes under DSM-IVTR are eliminated
  • Symptoms required for diagnosis have been changed

24
Schizophrenia Interesting facts
Nearly 1 in a 100 suffer from schizophrenia.
Worldwide over 24 million people suffer from this
disease (WHO, 2002)
Schizophrenia strikes young people as they mature
into adults (adult onset). It affects men and
women equally, but men suffer from it more
severely than women
  • When schizophrenia is slow to develop
    (chronic/process) recovery is doubtful. Such
    schizophrenics usually display negative symptoms

When schizophrenia rapidly develops
(acute/reactive) recovery is better. Such
schizophrenics usually show positive symptoms
25
Symptoms of Schizophrenia
  • Schizophrenics have inappropriate symptoms
    (hallucinations, disorganized thinking,
    delusional thinking) that are not present in
    normal individuals. These are called positive
    symptoms

Schizophrenics also have an absence of
appropriate symptoms or behaviors (apathy,
expressionless faces flat affect, rigid bodies)
that are present in normal individuals. These
are called negative symptoms worse prognosis,
less responsive to drugs
26
Schizophrenia
27
Understanding Schizophrenia
  • Schizophrenia is a disease of the brain exhibited
    by the symptoms of the mind

Dopamine Overactivity Researchers have found that
schizophrenic patients express higher levels of
dopamine D4 receptors in their brains
28
AP Essay 2007
  • Often misunderstood, schizophrenia is a
    psychological disorder affecting one percent of
    the population. In addition to treating the
    disorder psychologists work to identify its
    nature and origins.
  • Identify two characteristic symptoms used to
    diagnose schizophrenia.
  • Discuss a research finding that supports a
    genetic basis for schizophrenia.
  • What is the dopamine hypothesis regarding the
    origins of schizophrenia?
  • Describe how medications used to treat
    schizophrenia affect the actions of
    neurotransmitters at the synapses.
  • Identify a risk inherent in using medications
    in the treatment of schizophrenia
  • People sometimes confuse schizophrenia with
    disassociative identity disorder (DID). Identify
    two key characteristics that differentiate DID
    from schizophrenia.

29
Personality Disorders
  • All PDs are characterized by inflexible and
    enduring behavior patterns that impair social
    functioning
  • The DSM-5 retained a hybrid methodology
    emphasizing six personality disorder types
  • Borderline Personality Disorder
  • Obsessive-Compulsive Personality Disorder
  • Avoidant Personality Disorder
  • Schizotypal Personality Disorder
  • Antisocial Personality Disorder
  • Narcissistic Personality Disorder
  • Personality Disorders Fact Sheet (DSM5)

30
Personality Disorders
  • Antisocial Personality Disorder
  • Disorder in which the person exhibits a lack of
    conscience for wrongdoing, even toward friends
    and family members
  • May be aggressive and ruthless or a clever con
    artist.
  • Patients formerly referred to as psychopaths or
    sociopaths

31
Personality Disorders
  • Cluster A (odd or eccentric disorders)
  • Paranoid personality disorder
  • Schizoid personality disorder
  • Schizotypal personality disorder
  • Cluster B (dramatic, emotional, or erratic
    disorders)
  • Antisocial personality disorder
  • Borderline personality disorder
  • Histrionic personality disorder
  • Narcissistic personality disorder
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