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Psychological Disorders

Psychological Disorders. Myers Chapter 14. 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. Defining Psychological Disorders.

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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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