Psychological Disorders

1. Psychological Disorders Ch 13 Psyc103 J. Wright

2. T/F: 40% of people develop some type of mental disorder in their lifetime • Mental disorders • 2nd greatest contributor to shortened life • source of significant human suffering throughout the ages • of patient • of family • of community • Madness – lunacy – insanity • thought by some • to be a curse (and/or gift) from god(s) • to be a source of criminality (moral insanity) • to be a natural symptom of a sick society

3. T/F: Only recently has mental illness become viewed as disorder or disease (medical model). • Benefits? • Have natural causes • Have symptoms • Worthy of care • (potentially) curable • Downsides?

4. what is abnormal? • All mental disorders involve abnormal mental states and behaviors. • That is, they deviate in some way from the norm. • But, not all mental states/behaviors that deviate from the norm should be considered mental disorders. • With 40% of population developing disorder – what is the norm and what isn’t? • Szaz – The Myth Of Mental Illness • Not a good definition (at least not by itself)

5. key elements of mental disorders • Mental states/behaviors that deviate from norms AND • Involves disturbances in behavior, thought, or emotion • Stems from internal dysfunction • biological, psychological, both

6. Q: When is something a disturbance? When is it a dysfunction? • Involves significant personal distress or impairment. • What if the person isn’t distressed? • e.g. Camille Claudel • Historically, what has mattered more is other people’s distress.

7. GAF Global Assessment of Functioning • Lack of self-care • Inability to communicate • Inability to interact • Impaired judgment • Can’t function in daily society • Work, school, friends • Danger to self/others • Avoided by others

8. Categories of Metal Disorders • Distortion of • Sensation • Perception • Emotions • Levels • States • Behavioral outcomes

9. Issues concerning classification • Co-morbidity • Consequence of labeling • Self-fulfilling prophecy • Social stigma

10. issues concerning causation • Diathesis-stress model • Gene/environment interaction • Diathesis: internal predisposition • Stress: external trigger • Epigenetics • Environmental influence on genetic expression

11. anxiety disorders • Generalized anxiety disorder (GAD) • 2x as many women • General fear – no specific source • Social anxiety disorder • Separation anxiety disorder • Which of the following is not a form of anxiety disorder? • A) Panic disorder • B) Phobic disorder • C) Obsessive-compulsive disorder • D) Post-traumatic stress disorder • E) none of the above

12. Panic disorder • Attacks of intense terror • High sensitivity to anxiety • Agoraphobia • Phobic disorder • Strong fear and avoidance of particular objects/situations • Obsessive-compulsive disorder • Overcome with obsessive thoughts/compulsive actions • Highly ritualized behaviors as coping mechanisms • Contamination • Order/Organization

14. PTSD • Post-traumatic stress disorder • Prevalent in high stress situations • Poverty • Discrimination • Abuse • War zones • Unpredictable traumatic experiences • Imbalance in neurotransmitters • Damage to hippocampus

17. mood disorders • Major depressive disorder • Intense feelings of despair/helplessness, lethargy, gloom, lack of interest, lack of pleasure • 3-6 months in duration • Categories: Melancholic, Psychotic, Catatonic • Postpartum, Seasonal affective disorder • Dysthymia • Common factors involved in depression • A) biological • B) genetic • C) psychological • D) all of the above

18. contributors • Biological factors • Neurotransmitters – norepinephrine/serotonin • Neurological processing of emotions • Reduced activation in left dorsolateral PFC • Increased activation in right dorsolateral PFC • Problems with negative emotion regulation • Psychological factors • Helplessness theory • Negative attributes/experiences • Internal, stable, global • Q: Does depression cause negative thoughts? Or do negative thoughts cause depression?

19. analytic-rumination hypothesis • “Pain or suffering of any kind…is well adapted to make a creature guard itself against any great or sudden evil…leading to the course of action which is most beneficial.” –Darwin • Depression is like a fever that helps the immune system fight off infection. • Withdrawal from distractions • Extended rumination about problem • Hyperactivation of left ventolateral PFC leads to increased analytic attention – intense, focused deliberation • Negative moods lead to better decision making

20. analytic-rumination hypothesis • Heightened creativity & problem-solving • artists/writers/philosophers 8x more likely to suffer from depression • depression intertwined with creative “cognitive style” • persistence, obsessive/relentless focus • “Unfortunately, this type of thinking is often inseparable from the suffering…If you’re on the cutting edge, then you’re going to bleed.” • Nancy Andreasen, neuroscientist • Problems with this view?

21. Bipolar disorder • Mix of manic and depressive episodes • Intense highs/intense lows • Causes unclear • Probably genetic • Early trauma/abuse • Triggers • Stress • Substance abuse • Brain imbalance

22. dissociative disorders • Loss or fragmentation of “self” • Cognition, emotion, perception, memory • Coping mechanism for traumatic events • Depersonalization disorder • Feeling of disconnection from self; unreality • Dissociative amnesia • Impairment of recall resulting from emotional trauma • Retrograde vs. anterograde amnesia • Dissociative fugue • Impaired recall of past, abandonment of past • Assumption of new identity

23. Dissociative identity disorder • T/F: Same thing as multiple personality disorder • http://www.youtube.com/watch?v=gfiB82OUXf0&NR=1&feature=fvwp • http://www.youtube.com/watch?v=7iHJfIH20TY • Cause? • Severe childhood trauma/abuse • Split/dissociation • Not associated with SES (middle-income families)

24. Schizophrenia • Eugen Bleuler (1857-1939) – Schizophrenia • Abnormalities in perception and expression of reality • Hallucinations • Delusions • Disorganized speech, thinking, and behavior • Onset typically occurs in young adulthood • Contributory factors • Genetics • Neurobiology: increased dopamine • Reduction in brain mass (5-10% over a decade) • Early environment (trauma)

25. Subtypes of schizophrenia • Paranoid • Delusions, hallucinations • Catatonic • Stupor or disorganized, purposeless behavior • Disorganized • Thought disorder, flat affect • Child-onset schizophrenia • Related to puberty induced brain development

27. Schizophrenia

28. Personality disorders • Antisocial personality disorder • "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."[ • history of conduct disorder • sociopath and psychopath • one study of 22,790 prisoners • 47% of men and 21% of women were diagnosed with APD • less activity in amygdala and hippocampus to words that elicit fear in non-APD

29. Behavioral markers • Even though antisocial personality disorder cannot be diagnosed before adulthood, the presence of three behavioral markers, known as the Macdonald triad, can be found in some children who go on to develop ASPD. • Bedwetting • Abuse of animals • Pyromania

30. Diagnosis • Three or more of the following are required: • Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest; • Deceitfulness, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure; • Impulsivity or failure to plan ahead; • Irritability and aggressiveness, as indicated by repeated physical fights or assaults; • Reckless disregard for safety of self or others; • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations; • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

31. Characteristics • Persistent lying or stealing • Superficial charm • Apparent lack of remorse or empathy; inability to care about hurting others • Inability to keep jobs or stay in school • Impulsivity and/or recklessness • Lack of realistic, long-term goals -- an inability or persistent failure to develop and execute long-term plans and goals • Inability to make or keep friends, or maintain relationships such as marriage • Poor behavioral controls -- expressions of irritability, annoyance, impatience, threats, aggression, and verbal abuse; inadequate control of anger and temper • Narcissism, elevated self-appraisal or a sense of extreme entitlement • A persistent agitated or depressed feeling (dysphoria) • A history of childhood conduct disorders • Recurring difficulties with the law • Tendency to violate the boundaries and "rights" of others • Substance abuse • Aggressive, often violent behavior; prone to getting involved in fights • Inability to tolerate boredom • Disregard for the safety of self or others • People with a diagnosis of antisocial personality disorder often experience difficulties with authority figures.