Unit 6 – Adjustment & Breakdown

1. Unit 6 – Adjustment & Breakdown Psychological Disorders

2. Psychological Disorders • Normal or Abnormal? • What most people (majority) do is normal Deviation is abnormal • Getting along on the world is normal Failure to adjust physically, emotionally or psychologically is abnormal • Striving for ideal psychological functioning (self-actualization) is normal

3. Abnormal Behavior • Is normal better than abnormal? • Oppression, stonings, tax evasion, speeding, smoking, drinking, late assignments, skipping class, … • Why study abnormal behavior? • Harmful behaviors (crime, drug use, violence) might be changed / stopped (i.e. BAU)

4. Abnormal Behavior • Depends on situation - where/ when ??

6. Abnormal Behavior • Depends on situation - where/ when ?? • (comfort in environment, clothes for season / venue, urgency) • Cultural differences ?? • (hand holding, men kissing, bowing, evil spirits) • Occasional abnormal behavior does not mean a psychological disorder (TRY IT)

7. Failure to adjust • Does abnormal behavior cause difficulty getting along in the world? • (can’t leave house…can’t work) • Everyone strives toward ideal functioning = self-actualization

8. Sanity • Legal definition – far too simple for psychologists • “most people labelled mentally ill are not ill at all” (Szasz)…simply have problems with daily living • Convenient to label people ill and hospitalize them

9. Classification • DSM (Diagnostic and Statistical Manual of Mental Disorders) – classify mental illness • DSM IV uses 5 major axes (dimensions): • Explicitly defined categories (mood, schizophrenia & other psychotic, eating…) • Developmental or long standing personality disorders • Physical disorders or medical conditions • Measures stress level • Highest level of adaptive functioning

11. Mental Illness • Who is affected? • Mental illness indirectly affects all Canadians at some time through a family member, friend or colleague. • 20% of Canadians will personally experience a mental illness in their lifetime. • Mental illness affects people of all ages, educational and income levels, and cultures. • Approximately 8% of adults will experience major depression at some time in their lives. • About 1% of Canadians will experience bipolar disorder (or “manic depression”).

12. Mental Illness • How common is it? • Schizophrenia affects 1% of the Canadian population. • Anxiety disorders affect 5% of the household population, causing mild to severe impairment. • Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds. • Suicide is one of the leading causes of death in both men and women from adolescence to middle age. • The mortality rate due to suicide among men is four times the rate among women. http://www.cmha.ca/media/fast-facts-about-mental-illness/

13. The Issues • How many undiagnosed / misdiagnosed? • Problem getting better or worse? Why? • Are awareness campaigns successful? • Why is there still such a stigma?

14. Section Quiz 16-1

15. Types of Disorders • Mood • Schizophrenia • Somatoform • Dissociative • Personality • Drug Addiction • Anxiety

16. Mood Disorders • Types ?? • Major depressive disorder – feelings of worthlessness and diminished pleasure • Case study: Kari • Bipolar disorder – cycle between alternating phases: manic (euphoria / frantic action) and depressive (deep despair) • Case study: Moira

17. Mood Disorders • Seasonal Affective Disorder (SAD) – melatonin high (sleep) + serotonin low (mood) • Post partum depression (PPD) – 3-4 weeks after birth, cause may be hormone shift, may lead to other depressive disorders

18. Mood Disorders • Causes ?? • Self-esteem, social support, coping with stress • Draw illogical conclusions about self (Beck) • Learned helplessness (Seligman) • No control – useless to try • Reduced serotonin and/or noradrenaline • Therefore, both biological & psychological • Risk of suicide (3rd leading cause of death for teens)

20. Schizophrenia • Chronic, severe, disabling brain disease • Confused and disconnected thoughts, emotions, & perceptions, decline in functioning, diverted attention • Incidence: • 1% (10% if family history) • Typical onset late teens / early 20s

22. Schizophrenia • Types: • Paranoid (“positive” symptoms) • Delusions = false belief despite contrary evidence: • Grandeur (supreme power) • Persecution (suspicions) • Hallucinations = perceptions with no direct external cause (all 5 senses) • Case study: Tara, John Nash

23. Schizophrenia • Disorganized (“negative” symptoms): • Incoherent language (word salad) • Case study: Nathaniel Ayers Jr • Disturbed affect (inappropriate emotional expression) • Disorganized movements • Diverted attention • Catatonic = motionless / deteriorated movement

24. Schizophrenia • Causes: • Heredity • Chemical imbalance (dopamine ++) • Deteriorated brain tissue (CAT / MRI)

26. Schizophrenia • Causes: • Heredity • Chemical imbalance (dopamine ++) • Deteriorated brain tissue (CAT / MRI) • Diasthesis hypothesis = inherit a predisposition + exposure to stressors (i.e. pathogenic / unhealthful family) • Maternal infection • Birth trauma

27. Schizophrenia • Prognosis: • No cure – recovery (remission possible) • Long term institutionalization in mental hospital -> burnout (inability to function in society)

29. Section Quiz 16-4

30. Somatoform Disorders • Somatoform disorder (Freud’s hysteria) = physical symptoms with no apparent cause: • Conversion disorder: emotional difficulties -> loss of physical function (paralysis / blindness…) calm acceptance (la belle indifference) suggests psychological • Hypochondriasis: imaginary symptoms (young adults, WebMD)

31. Dissociative Disorders • Experience alterations in memory, identity, consciousness • Examples ?? • Dissociative Amnesia = lost memory of personal events / info, no biological / physiological explanation, traumatic event • Dissociative Fugue = amnesia + active flight / travel away from home

32. Dissociative Disorders • Dissociative Identity Disorder (DID): • 2+ distinct personalities (patterns of thinking and behaving) • Usually suffered abuse as children • Formerly multiple personality disorder • Case study: Bill Green

33. Section quiz 16-3

34. Personality Disorders • Maladaptive or inflexible ways of dealing with other people or situations • Types ?? • Antisocial (a.k.a. sociopath, psychopath) – shallow emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers

35. Infamous Serial Killers

36. Personality Disorders • Maladaptive or inflexible ways of dealing with other people or situations • Types ?? • Antisocial (a.k.a. sociopath, psychopath) – shallow emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers • Dependent – submissiveness, excessive need for care • Histrionic – excessive emotions, attention seeking • Obsessive-compulsive – intense interest in order, perfection, control (no anxiety – not OCD) • Paranoid – suspicion of evil motives, distrust (no hallucinations – not schizophrenia) • Schizotypal – intense discomfort in close relationships

37. Drug Addiction • Addiction = ? • Psychical dependence – overwhelming and compulsive desire to obtain and use a drug • Psychological dependence – feeling nervous and anxious without the drug

38. Drug Addiction • Tolerance = ? • Physical adaptation to a drug so that the person needs an increased amount in order to produce the original effect

39. Drug Addiction • Withdrawal = ? • Symptoms that occur after an addicted person discontinues using the drug • Nausea, the “shakes”, hallucinations, convulsions, coma, death

40. Drug Addiction • Most serious drug problem ?? • Alcoholism • 3 stages: • Social – reduce tension, boost self confidence, reduce social pressure • Psychological dependence, tolerance + physical addiction (heavy drink, hide habit, blackouts) • Compulsive drink, eating less, sick when sober, health deteriorates

41. Alcohol Addiction • Effect of alcohol entering the bloodstream depends on weight, quantity, speed of consumption • Treatment: • Antabuse (Rx) + alcohol ->violent illness • Psychotherapy

42. Section quiz 16-5

43. Anxiety Disorders • Excessive fear, generalized apprehension, reaction to vague or imagined dangers • Types?? • Social Anxiety Disorder (SAD) • Case study: Marley

44. Anxiety Disorders • Excessive fear, generalized apprehension, reaction to vague or imagined dangers • Types?? • Social Anxiety Disorder (SAD) • Case study: Marley • Generalized Anxiety Disorder (GAD): • Environmental factors, role of learning, heredity • Physical symptoms – muscle tension, inability to relax, tense face • Case study: Alana

46. Anxiety Disorders • Specific Phobia: • Extreme fear of a specific object, person, or event • Cope by avoiding the source: • Agoraphobia – public / outdoors • Claustrophobia – small / enclosed spaces • Arachnophobia - spiders • Panic disorder: • Sudden unexplainable attacks of intense anxiety • Breathing difficulty, faintness, dizziness, nausea, chest pains

47. Anxiety Disorders • Post Traumatic Stress Disorder (PTSD): • Re-experience original trauma – nightmares or flashbacks • War veterans, survivors of natural disaster / human aggression • Case study: Tom, Chris

48. Anxiety Disorders • Obsessive Compulsive Disorder (OCD): • Obsession – uncontrollable thoughts, can’t stop even if unpleasant • Compulsion – repeated performance of an irrational action (coping behavior) • Case study: Jason, Tricia

49. Section quiz 16-2

50. Famous People