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PSYCHOPATHOLOGY

PSYCHOPATHOLOGY. DIAGNOSIS AND TREATMENT STRATEGIES. ANXIETY, SOMATOFORM, AND DISSOCIATIVE DISORDERS. Disorder. Subtypes. Major Symptoms. InRev15a. Anxiety disorders Somatoform disorders Dissociative disorders. Phobias Generalized anxiety disorder Panic disorder

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PSYCHOPATHOLOGY

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  1. PSYCHOPATHOLOGY DIAGNOSIS AND TREATMENT STRATEGIES

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

  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 Elevated 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. 57 INCIDENCE OF DEPRESSION 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. 15_05 Schizophrenic behavior Normal behavior Fig15_5 C Max A Threshold Challenging events D B Min Low High Vulnerability

  23. PERSONALITY DISORDERS

  24. Fig15_5 Type Typical Features Paranoid Schizoid Schizotypal Depedent Obsessive-compulsive Avoidant Histrionic Narcissistic 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

  25. PSYCHO-SEXUAL DISORDERS Fetishism Zoophilia Sadism Masochism Exhibitionism Pedophilia

  26. DEVELOPMENTAL DISORDERS Autism Academic Skills Disorder Attention Deficit Disorder w/hyperactivity Senile Dementia

  27. TREATMENT PSYCHOANALYSIS BEHAVIOR HUMANISTIC COGNITIVE BIOMEDICAL

  28. SIGMUND FREUDPSYCHOANALYSIS Resistance Catharsis Transference Interpretation Insight

  29. DEINSTITUTIONALIZATION

  30. CARL ROGERSCLIENT CENTERED UNCONDITIONAL POSITIVE REGARD

  31. HUMANISTIC THERAPY

  32. ROLLO MAYEXISTENTIAL THERAPY

  33. ALBERT BANDURAMODELING

  34. BEHAVIOR AND COGNITIVE

  35. 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)

  36. 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 1950’s • Often used on schizophrenics bringing flat affect • Today smaller amount of tissue can be removed from specific areas showing malfunction--cingulotomy • Can be very effective at removing tumor and other tissue causing abnormal behaviors

  37. BIOMEDICAL TREATMENTS • Drug Treatment Options: • Anti-Anxiety Xanax • GABA neurotransmitter • Anti-Depressant drugs Prozac • Serotonin and Norepinephrine • Anti-Psychotic drugs Thorazine • Dopamine

  38. Average Average untreated treated person person Number of people 80% of untreated persons No improvement Outstanding improvement PSYCHOTHERAPY VS NONE

  39. THE END

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