Ch 14. Psychological Disorders Ch. 15 Psychological Therapies

1. Ch 14. Psychological Disorders & Ch. 15 Psychological Therapies Dr. Ashlea Smith

2. Defining Abnormal Behavior First, list and share synonyms for the word �mental illness� Second, work in small groups or with the people at your tables to construct a definition of abnormality or mental illness v. define normal or mentally healthy behavior Third, pick a group spokesperson to share the groups definitions with the class

3. The Obsessive Compulsive Test1-none or a little of the time2-some of the time3-A good part of the time4-most of the time 1234 I prefer things to be done my way. 1234 I am critical of people who don�t live up to my standards or expectations 1234 I stick to my principles, no matter what. 1234 I am upset by changes in the environment or in the behavior of people. 1234 I am meticulous and fussy about my possessions. 1234 I get upset if I don�t finish a task. 1234 I insist on full value for everything I purchase. 1234 I like everything I do to be perfect. 1234 I follow an exact routine for everyday tasks. 1234 I do things precisely to the last detail. 1234 I get tense when my day�s schedule is upset. 1234 I plan my time so that I won�t be late

4. The Obsessive Compulsive Test1-none or a little of the time2-some of the time3-A good part of the time4-most of the time 1234 It bothers me when my surroundings are not clean and tidy. 1234 I make lists for my activities. 1234 I think that I worry about minor aches and pains. 1234 I like to be prepared for any emergency. 1234 I am strict about fulfilling every one of my obligations. 1234 I think that I expect worthy moral standards in others. 1234 I am badly shaken when someone takes advantage of me. 1234 I get upset when people do not replace things exactly as I left them. 1234 I keep used or old things because they might be useful. 1234 I think that I am sexually inhibited. 1234 I find myself working rather than relaxing. 1234 I prefer being a private person. 1234 I like to budget myself carefully and live on a cash and serve basis.

5. Professionals Psychiatrists, psychologists, and other health professionals who work with these patients are often portrayed as �arrogant and ineffectual,� �cold-hearted and authoritarian,� �passive and apathetic,� or �shrewd and manipulative�. (Wedding & Niemiec, 2003).

6. Stereotype of the homicidal maniac Sling Blade (1996), a well-intentioned and sympathetic film about a man with mental retardation who commits a second murder after leaving a psychiatric hospital. Mental illness and mental retardation are dangerous

7. Violence Friday the 13th (1980) and Nightmare on Elm Street (1984) both perpetuate the myth that people who leave psychiatric hospitals are violent and dangerous; Movies such as the Exorcist (1973) suggest to the public that mental illness is the equivalent of possession by the devil; and Movies such as One Flew Over the Cuckoo�s Nest (1975) make the case that psychiatric hospitals are simply prisons

8. Schizophrenogenic parent Agnes of God (1985), Face to Face (1976), Sybil (1980), Carrie (1976), Frances (1982), Fear Strikes Out (1957), and Shine(1995) �Insanity runs in my family. It practically gallops.� Cary Grant in Arsenic and Old Lace (1944).

9. Panic Attacks Panic attacks result in extreme fear and discomfort, and the individual experiencing the attack may believe that he or she is literally going to lose control, go crazy or die Accompanying symptoms such as palpitations, accelerated heart rate, sweating, trembling, shortness of breath, a feeling of choking or smothering, chest pain, nausea, dizziness, lightheadedness, derealization or depersonalization, fear of losing control, fear of dying, numbness or tingling sensations, and/or chills or hot flashes

10. Panic Attacks When panic attacks occur on a regular and unpredictable basis, a diagnosis of panic disorder may be appropriate. Robet DeNiro plays a mob boss with panic disorder (without agoraphobia) who meets with a psychiatrist, played by Billy Chrystal in both Analyze This (1999) and Analyze That (2002)

11. Panic Attacks The Sopranos, New Jersey gangster Tony Soprano (James Gandolfini) is treated for panic attacks by psychiatrist Jennifer Melfi (Lorraine Bracco). In Something�s Gotta Give (2003) Jack Nicholson experiences panic attacks on two separate occasions

12. Specific phobia occurs when a person has an excessive or unreasonable fear of an object or situation and the anxiety-provoking stimulus is avoided.

13. Phobia Sean Connery�s character William Forrester in Finding Forrester (2000) could probably be diagnosed with Panic Disorder with Agoraphobia (he also has characteristics of Avoidant Personality, an often challenging differentiation to make with Anxiety Disorders).

14. Obsessive � Compulsive Disorder Obsessions are defined as � recurrent and persistent thoughts, impulses, or images that are experienced� as intrusive and inappropriate and cause marked anxiety or distress� Compulsions are repetitive behaviors or thoughts that serve to reduce the discomfort associated with obsession.

15. Obsessive � Compulsive Disorder Jack Nicholson plays in As Good As It Gets (1997). Melvin plays a misogynist and a homophobe, and he has a pronounced obsession with cleanliness. As Good As It Gets presents a realistic presentation of the disorder (with the possible exception that a patient with an obsession about cleanliness as severe as that present in Nicholson�s character would be unlikely to handle a small dog).

16. PTSD The individual with a post � traumatic stress disorder must have personally witnessed or experienced some event that involved actual or threatened death or serious injury and must have responded with �intense fear, helplessness, or horror� (DSM-IV-TR). Born on the Fourth of July (1988). Kovic�s guilt about the death of his buddy �Wilson� is an example of survivor guilt.

17. PTSD The Manchurian Candidate (2004), director Jonathon Demme updates the film by including contemporary politics and more recent wartime experiences. Denzel Washington plays a Major who returns from the Gulf war with PTSD, paranoia, nightmares, and memories he cannot understand.

18. PTSD PTSD symptoms are also displayed by Nicole Kidman�s character in The Human Stain (2003), Open Hearts (2003), The Princess and The Warrior (2000), and The Pawnbroker (1965). Most Woody Allen comedies will include at least one character with an anxiety disorder, and many depict characters with generalized anxiety disorder (usually played by Woody Allen, himself).

19. Dissociative Identity Disorder The essential feature is the presence of two or more distinct identities, or alter personality states, that assume control over behavior. Amnesia is present in one or more of the personalities.

20. Dissociative Identify Disorder Psycho, Alfred Hitchcock�s 1960 film, describes a young man who assumed the personality of his mother after he murdered her and her lover. This film is regarded by many as Hitchcock�s finest film . It is a superb movie; unfortunately, it also contributes to the negative stereotype of persons with mental illness.

21. Dissociative Amnesia Dissociative amnesias are characterized by an inability to recall important personal information, usually of a traumatic or stressful nature (e.g., the death of a child).

22. Dissociative Amnesia Amnesia allows a spoiled, self-centered, rich women to experience life at the other end of the social ladder in the comedy Overboard (1987), directed by Garry Marshall. Dissociative amnesia is also illustrated in the classic films Spellbound (1945) and Suddenly, Last Summer (1959).

23. Dissociative Identify Disorder Secret Window (2004) manipulates the viewer and it is not until the conclusion of the film that the protagonist�s dissociative identity disorder is revealed. The film Primal Fear (1996) should also be seen to provide a certain degree of skeptical balance as it portrays a man (Edward Norton) who feigns DID in attempt to evade murder charges.

24. Hypochondria The hypochondriac is preoccupied with thoughts of disease, infirmity, and death. This person worries that simple, benign body sensations or symptoms may be indicative of a serious disease.

25. Body Dysmorphic Disorder When somebody becomes so obsessed with a perceived physical imperfection that he or she is unable to function successfully interpersonally, or on the job, a diagnosis of body dysmorphic disorder may be appropriate.

26. Body Dysmorphic Disorder Cyrano de Bergerac in the 1990 French film by the same name. Cyrano is deeply in love with his cousin Roxanne but cannot profess his love because he is too ashamed of his long ( and to him) deformed nose.

27. Somatoform Patients with somatoform disorders will often experience some amount of secondary gain as a result of their medical problems, such as extra care and attention from others, worker�s compensation benefits, reduced expectations from family, or avoidance of difficult activities.

28. Malingering and Factitious Disorders In malingering, a person deliberately �fakes� his or her symptoms in order to achieve a clearly understood goal Factitious disorders, a completely separate diagnosis category, involve feigning illness with the specific intent of assuming the sick role.

29. Munchausen Factitious disorders by proxy occurs when symptoms are intentionally produced in another person, the classic example being the mother who makes her child sick so the child can assume the �sick role.�