Psychological Disorders:Part 1

1. Psychological Disorders:Part 1 Music: “Crazy” By Seal “Crazy” By Gnarles Barkley

2. Agenda • 1. What is Abnormal? • Criteria / Classification • 2. Anxiety Disorders: • Generalized Anxiety/ Phobias/ Obsessive Compulsive Disorders • 3. Somatoform Disorders • Somatization Disorders/ Hypochondriasis • 4. Dissociative Disorders • Multiple Personality Disorder • 5. Mood Disorders • Depression/ Bipolar Disorders /Suicide • 6. Tutorial

3. 1. What IS Abnormal?? • Criteria: • 1) Distress is present: • Person is suffering, unhappy, afraid • 2) Behaviour is maladaptive • Impaired functioning • Inability to meet responsibilities • 3) Socially Deviant • Behaviour is unusual, “not normal” • Classification • DSM-IV, p. 580 • Why Classify? • Simplify and create order • Research • Plan treatment

5. Criteria for Abnormality • Fig. 14.2 p. 578

6. 1. Classification (cont’d) • Older Distinction: • Neurotic vs. Psychotic • Neurotic: • Distressing problem but person is still coherent and can function socially (once acute phase of disorder is treated). • E.g. most disorders discussed today • Psychotic: • More bizarre, involving delusions or halucinations. Individual has impaired thought processes and cannot function socially. Treatment is long term • E.g. schizophrenia (next week)

8. 2. Anxiety Disorders • Anxiety: • Fear in situations that pose no objective threat • 3 components: • A) Cognitive: • Extreme/chronic worry; fear of harm • B) Physiological: • Muscle tension, increased heart rate and blood pressure • C) Behavioural: • Shaking, jumpiness, pacing, avoidance • Generalized Anxiety Disorders (5%) • Symptoms of anxiety felt continuously for at least 6 months • Excessive worry, restlessness, sleep disturbance that are difficult to control

9. 2. Anxiety Disorders (cont’d) • Panic Disorders: (2-3%) • Presence of recurrent, and unexpected panic attacks: • Intense dread, shortness of breath, chest pain, choking, fear of going crazy or losing control or dying, shaking, sweating, nausea… • May lead to Agoraphobia (fear of open spaces) • Phobic Disorders: (10%) • Fear of a particular object, animal or context which is irrational • Is causing distress and impairment in functioning • Social Phobia: (3-13%) • Fear of social or performance situations • Public speaking; • Eating, drinking, writing in public

10. 2. Anxiety Disorders (cont’d) • Obsessive-Compulsive Disorders (2%) • Obsessions: • Persistent, uncontrollable thoughts • Compulsions: • Rituals, behaviours that reduce anxiety • Interfere with functioning • Thoughts and behaviours are not under voluntary control

11. 3. Somatoform Disorders • Somatization Disorder: • (1-2% women) • History of diverse physical complaints for which there is NO organic basis • Long medical history of treatments for minor physical ailments • Hypochondriasis: • 4-9% in medical practice • Inordinate preoccupation with health and illness • excessive anxiety about having a disease

12. 4. Dissociative Disorders • Multiple Personality Disorder (very rare) • Presence of at least 2 distinct personalities within the same individual • Leads to sudden changes in identity and consciousness • Each personality has its unique style and may unaware of the existence of the other personalities • Often related to severe abuse in early childhood

13. 5. Mood Disorders • Depression • Lifetime prevalence rates • 20% in women; 10% in men • Why more common in women? • Cost of caring • Greater burden due to nurturing roles • Also more affected by disruptions in relational ties • Ruminative cognitive style • as opposed to distraction or taking action • Perpetuates negative mood • More likely to report symptoms • Seasonal Affective Disorders (SAD) • Depressive symptoms related to physiological consequences of shorter winter days • Treatable with light therapy

14. 5. Theories of Depression • Biological predisposition • Concordance rates in twins: • Identical: 65% • Fraternal: 15% • Cognitive Perspective • Beck: Negative (dysfunctional) attitudes • Seligman: Attribution Theory • How do you explain your circumstances? • Internal vs external • Stable vs unstable • Global vs specific • Depression: internal, stable, global attributions for negative events • Diathesis-stress models • Depression results from an interaction between personality and negative life events • Dependency and vulnerability to loss • Self-Criticism/Perfectionism and vulnerability to perceived failure

15. Cognitive Risk and Depression • Featured Study p. 596 • Those with dysfunctional attitudes and depressive attributional style were more likely to become depressed over 2 year period.

16. 5. Mood Disorders (cont’d) • Bipolar Disorders: • Periods of depression alternate with manic episodes • Mania: • abnormally elevated mood, inflated self-esteem, pressure of speech, increased energy, decreased need for sleep, over-activity, lack of inhibition and impaired judgment • Prevalence rates: • 1% in men and women • Strong genetic component • Understood as a primarily biological disorder • Unlike unipolar depression which has cognitive, interpersonal and environmental determinants

17. Comparison of symptoms of depression and mania (p. 592)

18. 5. Suicide • University students: • 40-50% have had suicidal thoughts • 15% attempt suicide • Major Risk Factors: • Drug or alcohol use including cigarette smoking • A prior attempt • Depression/ hopelessness (pessimism) • Aggressiveness or impulsivity • Family history • Shame, humiliation, failure or rejection

19. 5. Suicide (cont’d) • How to help: • 1) Establish communication • Talk about suicidal wishes • 2) Identify needs that have been frustrated • Search for love, recognition, respect? • 3) Broaden suicidal person’s perspective • Impermanence of feelings • It won’t last • Other solutions?

20. 6. Tutorial • Until next week: be well...