Understanding Psychological Disorders: A Comprehensive Guide

1. Unit 12:Abnormal Psychology

2. Perspectives on Psychological Disorders

3. Questions… • How should we define psychological disorders? • How should we understand disorders? • How should we classify psychological disorders?

4. Gender Dysphoria • Oppositional Defiant Disorder • Kleptomania • Pyromania • Gambling Disorder • Voyeuristic Disorder • Exhibitionist Disorder • Frotteuristic Disorder • Intellectual Disability • Learning Disorder • Tourette’s Disorder • Pica • Rumination • Binge Eating • Enuresis • Encopresis • Nightmare Disorder • Erectile Disorder • Female Orgasmic Disorder Caffeine Use Disorder Non-suicidal Self-Injury Internet Addiction Disorder

5. Disorders We Need To Know… • Dissociative Disorders • Dissociative Identity Disorder • Dissociative Disorders • Mood Disorders • Major depressive disorder • Mania • Bipolar Disorder • Schizophrenia • Personality • Personality disorders • Antisocial • Anxiety Disorders • Anxiety • Generalized Anxiety • Panic • Phobias • OCD • PTSD • Somatic Symptom Disorders • Somatoform • Conversion • Illness anxiety disorder (hypochandriasis)

6. Defining Psychological Disorders • Psychological disorders • clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior • Dysfunctional:maladaptive – interfere with day-to-day life • Distressful • Deviant(different) behavior (from one’s culture) Japan: hissing is polite way to show respect for superiors Among the Karaki of New Guinea a man is considered abnormal if he has not engaged in sex with a man before marriage Thailand: PDA between men & women unacceptable; but men holding hands is a sign of friendship…& use of straws is considered vulgar

7. Understanding Psychological DisordersThe Medical Model Demon possession as cause for mental illness …led to harsh and ineffective remedial treatment • Philippe Pinel (1745-1826) • reform inhumane conditions of mentally ill patients • Medical model • Idea that mental illness has physical causes that can be diagnosed based on symptoms & sometimes cured through therapy in a hospital. psychopathology Contrast this with the biopsychosocial approach to disordered behavior. trephining

8. Perspectives – Causes of Disordered Behavior Psychoanalytic Humanistic Cognitive Behavioral Biopsychosocial unconscious conflict / childhood no UPR /people putting CW on you faulty thinking faulty environment eclectic approach

9. Understanding Psychological DisordersThe Biopsychosocial Approach Mind & body are inseparable; negative emotions contribute to physical illness, and physical abnormalities contribute to negative emotions. Why would it be difficult to explain anorexia nervosa occurring mostly in Western cultures in terms of the medical model? self-focused rumination rejection from others low serotonin levels psycho social bio

10. Classifying Psychological Disorders • DSM-IV-TR DSM-5 • Diagnostic & Statistical Manual (5th Revision) • What does it do? Why have it? *DESCRIBES DISORDER / DOES NOT EXPLAIN* • reliability of diagnoses by different psychologists (83%) • focuses treatment • common language • preconception & stereotypes can stigmatize • self-fulfilling prophecy + -

11. Rosenhan Study • Use link on calendar to skim through or do your own internet search to find the answers to the following: • What was the purpose of the Rosenhan study? • What was the methodology? • What were the results? • Criticism of study?

12. Labeling Psychological Disorders • Rosenhan’s study Do the characteristics that lead to psychological diagnoses reside in the patients themselves or in the environments in which observers find them? • “pseudopatients” • “empty” “hollow” “thud” • Schizophrenia • Up to them to gain their release • “note taking behavior” • Average stay = 19 days (52) Pseudopatient: “Pardon me Dr.___, when will I be allowed ground priveileges? Dr.: Good morning Dave. How are you today? Potential dangers and benefits of using diagnostic labels.

13. Anxiety Disorders Read pages 569-576

14. Anxiety Disorders Feeling & cognition • Anxiety disorders – distressing persistent worry / maladaptive behaviors that reduce the worry • Generalized anxiety disorder • Panic disorder • Phobia • Obsessive-compulsive disorder • Post-traumatic stress disorder

15. Generalized Anxiety Disorder • Generalized anxiety disorder • Continual worry • No physical problem but can manifest itself physically or lead to physical problem • jittery; agitated; sleep issues • Women 2xs likely • Often accompanied by depression free-floating

16. 300.02 3 of 6 need to be present

17. Panic Disorder 300.01

18. Panic Disorder • Panic disorder • Panic attacks (1 in 75) • Strikes suddenly, minutes long, intense dread • Heart palpitations, shortness of breath, choking sensations, trembling or dizzy smokers have double risk panic disorder

19. Phobias • Phobias • Irrational fear causes person to avoid some object, activity or situation • Specific phobia • Focus on animals, insects, heights, small spaces – specific trigger • Social Anxiety Disorder (social phobia) • Agoraphobia • Fear of situations where escape may be impossible or where panic attack happened before Go to lengths to avoid situation

20. Understanding Anxiety DisordersThe Learning Perspective • Fear conditioning • Anxious people are hyperaware to possible threats • Stimulus generalization • Reinforcement (negative) • Observational learning • Parents communicate fear to children • Two ways to understand anxiety disorders: • Learning Perspective • Biological Perspective

21. Understanding Anxiety DisordersThe Biological Perspective • Natural selection • phobias focus on fears faced by our ancestors/compulsive acts exaggerate behaviors that helped survival • Genes • Runs in families / identical twins • anxiety gene • Glutamate & Serotonin • The Brain • Over-arousal in brain areas – impulse control & habitual behaviors • Anterior cingulate cortex (frontal lobe) / (amygdala)

22. Obsessive-Compulsive Disorder • Obsessive-Compulsive disorder • Consistently interfere with everyday • An obsession vs a compulsion • Hoarders • Checkers • Counters • Cleaners https://youtu.be/LON36XhpdDs DBS 5 min https://youtu.be/3lvbcShuz14 Pediatric OCD 4 min http://www.youtube.com/watch?v=dSZNnz9SM4g https://youtu.be/OXjxbFQraL4 Afraid of Mom 1 min

23. Post-Traumatic Stress Disorder • PTSD • Numbed social withdrawal, anxiety, insomnia • “shellshock” or “battle fatigue” • Not just due to a war situation • 10%-32% of those who experience trauma will develop • Greater one’s stress during event • Sensitive limbic system (stress hormones) • 1/10 women & 1/20 men • Post-traumatic growth “benefit finding” https://www.youtube.com/watch?v=7frOWBiU8D4 PTSD

24. Somatoform Disorders Somatic Symptom Disorder • mental illnesses that cause bodily symptoms, including pain. • may/may not be traced back to any physical cause. • not result of substance abuse or another mental illness. • not faking their symptoms. • Doctors need to perform many tests to rule out other possible causes before they diagnosis

25. https://youtu.be/6xhypWbI0bk Conversion Disorder http://www.youtube.com/watch?v=T9RPs_ysYgE Conversion Disorder Today Show Conversion disorder • Weakness or paralysis • Abnormal movement, such as tremors or difficulty walking • Loss of balance • Difficulty swallowing or "a lump in the throat" • Seizures or convulsions • Episode of unresponsiveness • anxiety converted into physical symptoms • Illness Anxiety Disorder Hypochondriasis • preoccupation with and fear of having or acquiring a serious disorder. • move from doctor to doctor (reinforcing) • factitious disorders • Munchasuen (Munchasuen by Proxy) Cause: stressful event triggers At Risk: females; trauma; genetic

26. Cause Somatic Symptom Disorder • Psychoanalytic: manifestation of unresolved conflict • Behaviorist: reinforced for behavior

27. Dissociative Disorders http://www.youtube.com/watch?v=0tITzDjPf4g Intro to DID – Inside (5:05) https://youtu.be/n2atzoaA2NI 20 personalites (5 min)

28. DID • Dissociative disorders • 2+ distinct identities or personality states are present, each w/ own relatively enduring pattern relating to the environment and self. • Amnesia must occur, defined as gaps in the recall of everyday events, important personal information and/or traumatic events. (dissociative fugue) • The disturbance is not part of normal cultural or religious practices. • This DID criterion is to eliminate diagnosis in cultures or situations where multiplicity is appropriate.

29. Understanding Dissociative Identity Disorder • Handedness & Shifting visual acuity • Brain activity is different • Result of trauma (PTSD/Freud) or reinforcing b/c reduces anxiety? • Genuine disorder or not? • losing oneself in a role? • hypnotizable • DID rates • 1930s-60s = 2 per decade • 1980s = 20,000 • Therapist’s creation?

30. Mood Disorders http://www.youtube.com/watch?v=2rxeFgKIS9s Brain Imaging http://www.youtube.com/watch?v=InNhDfDfl5c Synapse Review

31. depression #1 reason seeking help • Mood disorders– emotional extremes • Major depressive disorder(unipolar depression) • 2+ weeks of • depressed mood • sleep disturbance • appetite disturbance • lack of energy • feelings of worthlessness • loss of interest in family and friends • loss of interest in activities • women 2xs as likely w/o clear reason women twice as likely Dysthymic Disorder – depressive state lasting more than 2 yrs.

32. Major Depressive Disorder Women more likely to attempt, men more likely to succeed

33. Diagnosis of young boys has skyrocketed Afflicts men & women equally in adults. Bipolar Disorder • Bipolar Disorder • Alternate between hopelessness & lethargy of depression & overexcited mania • Over-talkative, overactive, elated, little need for sleep, etc. (agitated/restless) • Bipolar disorder and creativity Excessive risk taking / poorly though out plans

34. Understanding Mood Disorders • Trapped in depressed mood = inactive & unmotivated; when mood lifts, these behavior & cognitive accompaniments disappear • Very common = causes are probably common too • Women are more vulnerable to disorders involving internalized state (men tend to have external disorders = alcohol, antisocial conduct, impulse control) Gender gap starts in adolescence • Therapy speeds recovery but many return to “normal” w/o professional help. Permanent if 1st episode strikes later in life. • Risk of depression less than 1% w/o stressful life event • Increase is probably authentic = more come forward

35. Mood Disorders Genetic: • Runs in families (twin studies) • 35-40% heritable Brain • Hippocampus vulnerable to stress • Less activity in frontal lobe (left) Biochemical • Serotonin • Norepinephrine • Prozac, Zoloft, Paxil / exercise

36. The Social-Cognitive Perspective • Self-defeating beliefs & negative explanatory style • Susan Nolan-Hoeksemesays women over-think– “ruminate” • Aaron Beck says that there is a “cognitive triad” – negative view of self, circumstance, future • Martin Seligman says depressed patients have a negative explanatory style Stable, global, internal explanations • Aaron Beck – Cognitive Triad • self – circumstance -future • xxx learned helplessness

37. Understanding Mood DisordersExplanatory Style

38. Understanding Mood DisordersExplanatory Style

39. Understanding Mood DisordersExplanatory Style

40. Understanding Mood DisordersExplanatory Style

41. Understanding Mood DisordersExplanatory Style

42. Understanding Mood DisordersExplanatory Style

43. Understanding Mood DisordersExplanatory Style

44. Understanding Mood DisordersExplanatory Style

45. Understanding Mood DisordersExplanatory Style DEPRESSION Successful Coping

46. Understanding Mood DisordersThe Vicious Cycle of Depression

47. Understanding Mood DisordersThe Vicious Cycle of Depression

48. Understanding Mood DisordersThe Vicious Cycle of Depression

49. Understanding Mood DisordersThe Vicious Cycle of Depression

50. Schizophrenia http://www.youtube.com/watch?v=nL_OTM7I3C0 Childhood Schizophrenia (4:59)