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Understanding Psychological Disorders: Disorder or Just Weird Behavior?

Explore the criteria for diagnosing psychological disorders such as atypical, disturbing, and maladaptive behaviors. Learn about the DSM-5 categorization, challenges in diagnosis, and the impact of labeling. Discover how psychological disorders are assessed and tested, and understand sex and gender differences. Dive into anxiety disorders, including types like specific phobia, social anxiety, generalized anxiety, and panic disorder. Examine the prevalence, symptoms, and gender variations in anxiety disorders.

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Understanding Psychological Disorders: Disorder or Just Weird Behavior?

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  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

  14. Rosenhan Study: On Being Sane in Insane Places

  15. 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

  16. 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

  17. 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

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

  19. Beck Depression Inventory

  20. Rorschach Test

  21. Thematic Apperception Test

  22. 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

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

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

  25. 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

  26. 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

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

  28. Charlie Beljan, Nov 2012

  29. Eventual Winner

  30. 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

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

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

  33. 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

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

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

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

  37. 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

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

  39. 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

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

  41. 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

  42. 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

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