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Psychological Disorders

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This overview delves into psychological disorders, highlighting that approximately 26% of American adults are affected yearly, with around 450 million worldwide. It outlines the medical model, defining traits of psychological disorders as deviant, distressful, and dysfunctional. The biopsychosocial approach emphasizes the interplay of genetic, physiological, psychological, and social factors. Key disorders such as anxiety disorders, obsessive-compulsive disorder, and dissociative identity disorder are discussed, along with perspectives on their causes, including biological and learning theories.

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Psychological Disorders

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  1. Psychological Disorders Myers Chapter 14

  2. Psychological Disorders • 26% of adult Americans suffer a diagnosable mental disorder in a given year • 450 million worldwide • Rates of disorder vary across the world • Depression & Schizophrenia in all cultures

  3. Defining Psychological Disorders • Ongoing patterns of thoughts, feelings, and actions that are • Deviant • Distressful and/or • Dysfunctional

  4. Defining Psychological Disorders • Deviance varies by context and culture • Drinking rules • Homosexuality • ADHD Defined by those with power

  5. Defining Psychological Disorders • Distress • Not understanding • Feeling loss of control • Dysfunction • Interferes with work & leisure, relationships

  6. Perspectives • Medical model: psychological disorders are mental illnesses • Psychopathology • Diagnosis • Symptoms • Treatment • Hospitals

  7. Medical Model • Critics • May not reflect a deep internal problem • Alternative causes: • Difficulty in environment • Interpretation of events • Bad habits • Poor social skills

  8. Biopsychosocial approach • All behavior comes from the interaction of nature and nurture • Reject the “sickness” view • Disorders are influenced by • Genetic predispositions • Physiological states • Psychological dynamics • Social & cultural circumstances

  9. DSM-IV-TR • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision (2000) • American Psychiatric Association

  10. DSM-IV-TR • Predict future course • Appropriate treatment • Research regarding causes • Insurance billing

  11. DSM-IV-TR • Axis I: Clinical Syndromes/Disorders • Axis II: Personality Disorders / Cognitive Impairment • Axis III: General Medical Condition • Axis IV: Psychosocial and Environmental Problems • Axis V: Global Assessment of Functioning (GAF), 0-100

  12. Rosenhan (1973) • “On being sane in insane places”

  13. Labels are powerful • -Stigma • +Describe disorders • +Allow communication • +Comprehension of causes • +Effective treatments

  14. Anxiety Disorders • Characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety • Generalized anxiety • Panic disorder • Phobias • Obsessive-Compulsive disorder • Post-traumatic stress disorder

  15. Generalized anxiety disorder • Continually tense • Apprehensive • Autonomic nervous system arousal • Cannot identify causeRare by age 50

  16. Panic Disorder • Sudden escalation of anxiety • Panic attack:minutes long episode of intense dread • Terror • Chest pain, choking, other sensations

  17. Phobias Persistent, irrational fear of a specific object, activity, or situation

  18. Phobias • Social phobia: extreme shyness • Social timidity & inhibition • Avoidance of social situations • Social comparison & social ineptness contribute (Turner, et al., 2003) • Agoraphobia • Panic attacks

  19. Obsessive-Compulsive Disorder • OCD • Unwanted repetitious thoughts (obsessions) and/or actions (compulsions)

  20. Post-Traumatic Stress Disorder • PTSD • Haunting memories, nightmares, social withdrawal, jumpy anxiety, insomnia • 4 weeks or more • Follows a traumatic experience

  21. Anxiety Disorders - Perspectives on Causes • Freud: Beginning in childhood, people repress intolerable impulses, ideas and feelings • This submerged mental energy sometimes produces symptoms, such as anxiety

  22. Anxiety Disorders - Learning Perspective • Fear conditioning • Stimulus generalization • Reinforcement of fearful behaviors • Observational learning of others’ fears

  23. Anxiety Disorders - Biological Perspective • Evolutionary perspective • Individuals who did not display appropriate fear would not survive to pass on their genes • Biological preparedness • Compulsions: adaptive responses gone awry

  24. Anxiety Disorders - Biological Perspective • Few people develop lasting phobias • Some individuals are more vulnerable • Genetic predisposition • Twin studies • 17 genes identified • Neurotransmitter regulation • Serotonin • Glutamate

  25. Anxiety Disorders - Biological Perspective • Neuroscientific evidence • Overarousal - impulse control & habitual behaviors • Anterior cingulate cortex • Amygdala

  26. Somatoform Disorders • Symptoms take a somatic (bodily) form without apparent physical cause • Conversion disorder • Hypochondriasis • Factitious disorder • Body dysmorphic disorder

  27. Dissociative Disorders • Sudden • Loss of memory • Change in identity • Response to overwhelmingly stressful situation • Conscious awareness separated from painful memories, thoughts, feelings

  28. Dissociative Identity Disorder • Massive dissociation of self from ordinary consciousness • Two or more personalities alternately control the person’s behavior • Formerly multiple personality disorder

  29. Dissociative Identity Disorder • A genuine disorder? • Extension of normal capacity? • Late 20th century dramatic rise • Less prevalent outside North America • Fantasy prone? • Therapist constructed? • Support • Distinct brain and body states

  30. Mood Disorders • Characterized by emotional extremes • Major depression • Bipolar disorder (manic-depressive illness)

  31. Mood Disorders • Major depression • At least five signs including • Lethargy • Feelings of worthlessness • Loss of interest in family, friends, and activities • Last two or more weeks • Not caused by drugs or a medical condition

  32. Mood Disorders • Cognitive errors in depression • Overgeneralizing • Selective abstraction • Personalization • Magnification & minimization • Arbitrary inference • Dichotomous thinking

  33. Mood Disorders

  34. Mood Disorders • Bipolar disorder: alternation between depression and mania • Mania: hyperactive, wildly optimistic state • Less common than major depression, but more debilitating

  35. Mood Disorders

  36. Mood Disorders • Recovery • 50% repeat within 2 years • Permanent: • Later first episode • Longer remission • Fewer previous episodes • Less stress experienced • More social support

  37. Mood Disorders – Biological Perspective • Genetic Influences • Heritability 35-40% • Risk increases if parent or sibling express • Twins • Major depression: identical = 1 in 2 chance Bipolar disorder: identical = 7 in 10 chance Fraternal twins = 2 in 10

  38. Mood Disorders – Biological Perspective • The depressed brain • Imaging • Neurotransmitters • Norepinephrine: increases arousal and boosts mood • Serotonin: gene-environment interaction

  39. Mood Disorders –Social-Cognitive Perspective • Explores the roles of thinking and acting

  40. Mood Disorders –Social-Cognitive Perspective

  41. Schizophrenia • A group of severe disorders characterized by • Disorganized and delusional thinking • Disturbed perceptions • Inappropriate emotions and reactions • “Split mind” (from reality)

  42. Schizophrenia • Positive symptoms: • Hallucinations • Delusions • Thought distortions • Negative symptoms: • Loss of interest, warmth, humor • Lack of expression • Flat tone of voice

  43. Schizophrenia • Subtypes • Paranoid: preoccupation with delusions or hallucinations (persecution and grandiosity) • Disorganized: disorganized speech or behavior, flat affect or inappropriate emotions • Catatonic: immobility, extreme negativism, and/or echolalia of speech or movement

  44. Schizophrenia • Subtypes • Undifferentiated: many and varied symptoms • Residual: withdrawal after hallucinations and delusions have disappeared

  45. Schizophrenia • Chronic (process) • Develops gradually • Emerges from a long history of social inadequacy • Recovery unlikely • Acute (reactive) • Develops rapidly • In response to life stresses • Recovery more likely

  46. Schizophrenia • Brain abnormalities • Increased dopamine receptors • Impaired glutamate activity • Disrupted neuronal networks • Enlarged, fluid filled areas • Shrinkage of the cerebral tissue • Smaller thalamus

  47. Schizophrenia

  48. Schizophrenia • Warning signs • Mother with severe, enduring schizophrenia • Birth complications • Separation from parents • Short attention span • Poor muscle coordination • Disruptive or withdrawn behavior • Emotional unpredictability • Poor peer relations and solo play

  49. Personality Disorders • Characterized by inflexible and enduring behavior patterns that impair social functioning • Avoidant: expresses anxiety • Schizoid: eccentric behaviors • Histrionic and Narcissistic: dramatic or impulsive behaviors

  50. Personality Disorders • Characterized by inflexible and enduring behavior patterns that impair social functioning • Avoidant: expresses anxiety • Schizoid: eccentric behaviors • Histrionic and Narcissistic: dramatic or impulsive behaviors

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