Psychological Disorders

1. Psychological Disorders

2. Just Weirdo, Creep? • TLC "Extreme Cheapskates": • "Roy" of Huntington, Vt., who reuses dental floss • Jeff Yeager of Accokeek, Md., who combs butcher shops for odd animal parts about to be discarded • "Victoria" of Columbus, Ohio, who specializes in Dumpster-diving and infrequent toilet flushes that involve, according to one report, personalized urine jars. • "Kay," from New York, who is shown on camera demonstrating the nonessential nature of toilet paper by wiping herself with soap and water while seated on the throne.

3. Or, Disorder ?

4. How to define “disorder”

5. Criteria for Diagnosis • Atypical • Disturbing • Maladaptive

6. Atypical • Statistically rare • deviates from cultural norms for acceptable behavior

7. Atypical not Enough • Not all statistically rare behaviors are abnormal • Some abnormal behaviors are not rare • Cultural norms change

8. Disturbing • Behavior causes discomfort and concern to one’s self or to others • Impairs a person’s social relationships

9. Disturbing not Enough

10. Maladaptive • Interferes with daily functioning • Self-destructive

11. DSM- 5: Describes disorders by observable symptoms

12. DSM-5: Categorizing Disorders • Three sections: • Introduction with instructions • Diagnostic criteria • Similar disorders grouped together • Guide for future research • Lists conditions not yet classified as disorders

13. Problems with DSM • Doesn’t account for overlap or co-morbidity between disorders • Categorical Diagnosis: either/or-, not on a continuum • Diagnosis can be subjective • Labels can affect perceptions

15. Rosenhan Study: On Being Sane in Insane Places

16. Results • All “pseudopatients” were admitted & diagnosed • All had exact symptoms, yet had different diagnoses • Normal behavior was ignored, or interpreted as abnormal • Requests for release led to anti-psychotic drugs, agreement with psychiatrists • Average time in hospital: 19 days

17. BBC: “How mad are you?” • 10 subjects: 5 with previously diagnosed mental health conditions; 5 without • Observed by 3 experts • Challenge: identify 5 with diagnoses • Results: • correctly diagnosed 2/5; incorrectly diagnosed 2 healthy as those with mental health problems

18. Assessment of Psychological Disorders • Typically involves: a mental status exam or clinical interview • Goal: make a diagnosis so that appropriate treatment can be provided. • Prognosis: course and probable outcome

19. Observation and Types of Testing • Behavioral Observation: demeanor, etc. • Psychological tests : • Beck Depression Inventory • Minnesota Multiphasic Personality Inventory (MMPI) • Projective Tests: Rorschach; TAT

20. Beck Depression Inventory

21. Rorschach Test

22. Thematic Apperception Test

23. Subjective Assessments Problem: Individual clinicians often choose assessment procedures based on their subjective beliefs and training rather than based on scientific studies • Non-Valid Assessments: • Projective tests: have not been shown to be helpful in predicting the kinds of treatments that are useful

24. Evidence-Based Assessments • an approach to clinical evaluation in which research guides evaluation • Valid Assessment: • Beck Depression Inventory

25. Diathesis-stress model disorder may develop when an underlying vulnerability is coupled with a precipitating event

27. Possible Vulnerabilities • Genetics • Prenatal problems: • malnutrition, • exposure to toxins • maternal illness • Childhood events: • environmental toxins and malnutrition • Trauma; stress • Differences in brain structure or activity

29. Sex Differences in Mental Disorders • Internalizing disorders: characterized by negative emotions (e.g., major depression, generalized anxiety disorder, panic disorder) • More common in females • Externalizing disorders:characterized by disinhibition (e.g., alcoholism, conduct disorders, antisocial behavior) • More common in Males

31. Anxiety Disorders Characterized by excessive anxiety in the absence of true danger

32. Charlie Beljan, Nov 2012

33. Eventual Winner

34. Anxiety Disorders Overview • Rates: 25% Lifetime Prevalence • Types of Disorders: • Specific Phobia • Social anxiety Disorder • Generalized Anxiety Disorder • Panic Disorder • Gender Differences: • More common in Women

35. Specific Phobia • fear of a specific object or situation • 12-13% of population

37. Social Anxiety Disorder • fear of being negatively evaluated by others • public speaking • meeting new people • eating in front of others

39. Generalized Anxiety Disorder • Generalized anxiety disorder (GAD):a diffuse state of constant anxiety not associated with any specific object or event • 6% of population • Hypervigilance: • results in distractibility, fatigue, irritability, and sleep problems, as well as headaches, restlessness, light-headedness, muscle pain

40. Panic Disorder • sudden, overwhelming attacks of terror • Linked with increased suicide risk • Can be triggered by marijuana use • 3 % of the population

41. Panic Disorder & Agoraphobia • Fear of not being able to escape situation • Fear of leaving home

42. Anxiety disorders share some causal factors • Cognitive: perception/memory of events or objects • Situational: learned factors • Biological: genetic temperament; brain activity

43. Cognitive Components • Perception: see neutral or ambiguous situations as threatening • Attention: Focus excessive attention on perceived threats and • Selective Memory: • Recall threatening events more easily than nonthreatening events • Exaggerate their perceived magnitude and frequency

44. Situational Components • Pavlovian or Observational Learning • Learned fear can generalize to other situations

45. Biological Components • Genetics • Inhibited temperamental style • Seen early in life • tend to avoid unfamiliar people and novel objects • Brain differences: Greater activation of the amygdala while viewing novel faces

47. Obsessive-Compulsive Disorder Obsessive-compulsive disorder (OCD): characterized by frequent intrusive thoughts and compulsive action

48. Obsessions: recurrent, intrusive, and unwanted thoughts or ideas or mental images • Compulsions: particular acts that the OCD patient feels driven to perform over and over again • 1-2% of the population

50. Causes of OCD • Learning: • Anxiety is paired to a specific event through classical conditioning • the person then engages in behavior to reduce the anxiety • behavior is negatively reinforced through operant conditioning