Psychological Disorders

1. Psychological Disorders Unit 6 Notes Your notes are yellow

2. Defining Disorders • Psychological disorder- a harmful dysfunction in which thoughts, feelings, or behaviors are maladaptive, unjustifiable, disturbing, and atypical • In order for something to be considered a disorder, it MUST have all four characteristics • Lets look at each one and compare to our scenarios…

3. Defining Disorders • Maladaptive- destructive to oneself or others • Nude bather? • Might be weird, but its not hurtful to himself or others (NO) • Woman afraid of snakes? • Keeps her from living a normal life (YES) • Teenage boy? • Temperatures are dangerous to be exposed to (YES) • Teenage girl? • Not eating or sleeping is not good for her health (YES)

4. Defining Disorders • Unjustifiable- without a rational basis • Background info may be necessary in order to determine • Nude bather? • Is actually Ben Franklin and the practice of air bathing was a common practice during his time (NO) • Woman afraid of snakes? • There are no poisonous snakes in her area (YES) • Teenage boy? • He is a member of the Santee Sioux and a vision quest is part of his spirituality (NO) • Teenage girl? • Entire family died in a house fire three days ago (NO)

5. Defining Disorders • Disturbing- troublesome to others • Nude bather? • No one saw him, so no one was disturbed (NO) • Woman afraid of snakes? • Husband was very concerned about her (YES) • Teenage boy? • Right of passage most likely pleased his family (NO) • Teenage girl? • Those close to her were probably quite concerned (YES)

6. Defining Disorders • Atypical- so different that is violates the norm • Behavior is NOT like other people’s behavior AND violates a rule for accepted and expected behavior in a particular culture • Nude bather? • Today? Yes. During the 1700s? No • Woman afraid of snakes? • Most people aren’t afraid of pretend snakes is not acting normally (YES) • Teenage boy? • Santee culture would consider his behavior normal (NO) • Teenage girl? • Most people would act in a similar manner in a similar situation (NO)

7. Understanding Disorders • Cultures have tried to explain psychological disorders for hundreds of years • Ancient Babylonians viewed disorders as demonic possession and treated them with prayer • Ancient Hebrews saw disorders as punishment for sin and also used prayer to heal • 15th Century Europeans tortured and executed those with disorders as it was believed they were caused by Satanic possession • Today, disorders are most commonly explained through either the medical or bio-psycho-social model

8. Understanding Disorders • Medical Model- concept that mental diseases have physical causes that can be diagnosed, treated, and in most cases, cured • Developed from the practices of French physician Philippe Pinel, who saw psychological disorders as sickness, not demonic possession • While the medical model has proven to lead to treatment of some disorders, it ignores all other factors that may play a role in needed treatment

9. Understanding Disorders • Bio-psycho-social Model- assumes biological, psychological, and social factors combine and interact to produce psychological disorders • Biological includes our genetic disposition for a disorder • Psychological includes our thoughts and thinking patterns • Social includes cultural beliefs that can affect our behaviors

10. Classifying Disorders • Clinical psychologists and psychiatrists classify psychological disorders according to their symptoms to do the following: • Describe the disorder • Predict the future course of the disorder • Treat the disorder properly • Provide a springboard for research into the disorder’s causes • DSM-V: The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, is a widely used system for classifying psychological disorders

11. Classifying Disorders • Notes about the DSM-V • Replaced the DSM-IV-TR in May of 2013 • Has gone through significant changes • Anorexia wasn’t in the 1st edition; homosexuality was dropped in the DSM-III • Is widely accepted, but not universally accepted

13. Anxiety Disorders • Anxiety- vague feeling of apprehension and nervousness • Feeling nervous is perfectly normal behavior- it only becomes a disorder when it take control and dominates your life!

14. Anxiety Disorders • There are five kinds of anxiety disorders: • Generalized Anxiety Disorder • Panic Disorder • Phobia • Obsessive-Compulsive Disorder (OCD) • Post-Traumatic Stress Disorder (PTSD)

15. Anxiety Disorders • Generalized Anxiety Disorder- characterized by disruptive levels of persistent unexplained feelings of apprehension and tenseness • Must display at least three of the following symptoms: • Restlessness • Feeling on edge • Difficulty concentrating or mind going blank • Irritability • Muscle tension • Sleep disturbance • Symptoms are longer lasting and are not tied to any specific event to those with this disorder

16. Anxiety Disorders • Panic Disorders- characterized by sudden bouts of intense, unexplained anxiety, often associated with physical symptoms like choking sensations or shortness of breath • Attacks happen several times a day and all your energy is directed at regaining control

17. Anxiety Disorders • Phobia- characterized by disruptive, irrational fears of objects, activities, or situations • True phobias are irrational and disruptive • Focus anxiety onto a feared object, activity, or situation

18. Anxiety Disorders • Obsessive-Compulsive Disorder (OCD)- characterized by unwanted, repetitive thoughts and actions • Most common obsessions: • Concern with dirt, germs, or toxins • Something terrible happening • Symmetry, order, or exactness • Most common compulsions: • Excessive hand washing, bathing, tooth brushing, or grooming • Repeating rituals • Checking doors, locks, appliances, homework, etc.

19. Anxiety Disorders • Post-Traumatic Stress Disorder (PTSD)- characterized by reliving a severely upsetting event in unwanted, recurring memories and dreams • Usually triggered by intense stress • Symptoms can include nightmares, persistent fear, difficulty relating to others, and troubling memories of or flashbacks to the traumatic event • One study showed that ¼ of all US vets from Iraq and Afghanistan were diagnosed with PTSD

20. Anxiety Disorders • Biological causes: • Heredity- some people have a predisposition for developing an anxiety disorder • Brain function • Those with OCD have more activity in their frontal lobes than those without • Those with phobias have unusual activity in their amygdala • Evolution • We have learned what is dangerous and should be feared over generations

21. Anxiety Disorders • Learning Factors: • Conditioning • If we are bit by a dog as a child, we can develop a fear of dogs that lasts into adulthood • Observational Learning: • If our parents or siblings are afraid of something, we can develop the same fear • Reinforcement • Someone with OCD and feels the need to wash their hands feels better when they wash they’re hands- the behavior has been reinforced

22. Mood Disorders • Disturbances of emotions- magnifications of our normal reactions • Magnified states are mania and depression • Mania- period of abnormally high emotion and activity • Depression- feeling down, sad or drained of energy • Two major disorders: Major Depressive Disorder and Bipolar Disorder

23. Mood Disorders • Major Depressive Disorder- a person, for no apparent reason, experiences at least two weeks of depressed mood, diminished interest in activities, and other symptoms such as feelings of worthlessness • Diagnosed when 5 of these 9 symptoms are present for for two or more weeks: • Depressed mood most of the day, nearly every day** • Little interest or pleasure in almost all activities** • Significant changes in weight or appetite • Sleeping more or less than usual • Agitated or decreased level of activity • Fatigue or loss of energy • Feelings of worthlessness or inappropriate guilt • Diminished ability to thing or concentrate • Recurrent thoughts of death or suicide

24. Mood Disorders • Bipolar Disorder- person alternates between the hopelessness of depression and the overexcited and unreasonably optimistic state of mania • During mania phases, the person may go long periods without sleeping and may experience racing thoughts, be easily distracted, and set impossible goals

25. Mood Disorders • Biological Factors: • Heredity- • Many mood disorders run in families (if one twin has bipolar disorder, the other is 70% more likely to develop it) • Brain function- • PET scans show less active brain functioning during major depression • Certain neurotransmitters (serotonin and norepinephrine) are lacking during depression

26. Mood Disorders • Social-Cognitive Factors: • Learned helplessness- • When bad things happen, some people tend to give up trying to improve their situation • May be why women suffer higher rates of depression than men • Attributions- • When things go wrong, we try to explain them • Depressed people tend to explain things as stable, internal, and global

27. Dissociative Disorders • The sense of self has become separated (dissociated) from previous memories, thoughts, or feelings • Quite rare and usually represent a response to overwhelming stress • Three specific types: • Dissociative Amnesia • Dissociative Fugue • Dissociative Identity Disorder

28. Dissociative Disorders • Dissociative Amnesia- Characterized by the loss of memory in reaction to traumatic event • Unlike other memory loss, it MUST be tied to a traumatic event • Example: combat solider not remembering events before or after his platoon is hit by a roadside bomb

29. Dissociative Disorders • Dissociative Fugue- characterized by loss of identity and travel to a new location • Can last anywhere from a few hours to even years • In extreme cases, the person can form new friendships, completely new identities, and even work in a completely different career field

30. Dissociative Disorders • Dissociative Identity Disorder- rare and controversial disorder in which an individual exhibits two or more distinct and alternating personalities • Formally known as multiple personality disorder • Personalities can differ in age, race, gender, even handedness • Controversial because was once extremely rare (less than 100 cases before the 1970s to over 20,000 during the 1980s) and because number of personalities has increased, on average, from 3 to 12

31. Somatoform Disorders • Symptoms take a bodily form without apparent physical cause • Hypochondriasis- imagined symptoms of illness • Example- athlete physically has severe knee pain after an awkward fall, but doctors cannot find any medical reason for the pain • Pretending to be sick is NOT hypochondriasis

32. Personality Disorders • Lasting and rigid behavior patterns that disrupt social functioning • Antisocial personality disorder- person (usually male) shows a lack of conscience for wrongdoing and a lack of respect for the rights of others • Also known as psychopathic personality disorder • Common amongst severe criminals

33. Schizophrenic Disorders • Schizophrenia- series of disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and behaviors • NOT split personalities- the person is split from reality • Occurs in about 1% of the world’s population

34. Schizophrenic Disorders • Symptoms: • Delusions- false beliefs • Grandeur- false beliefs that you are more important that you really are (believing you are Jesus or Buddha, for example) • Persecution- false beliefs that people are out to get you (believing that the CIA is listening to all of you phone calls, for example) • Sin or Guilt- false beliefs of being responsible for some misfortune (earthquake happens because you didn’t do your chores) • Influence- false beliefs of being controlled boy outside forces (“the devil made me do it”)

35. Schizophrenic Disorders • Symptoms (continued): • Hallucination- false perception • Hearing voices, seeing non-existent objects, feeling a burning sensation that isn’t there • Inappropriate emotions or behaviors • Laughing during a sad moment

36. Schizophrenic Disorders • Causes: • Biological: • Genetics- chances increase if a relative has it • Brain structure- smaller amounts of brain tissue and larger, fluid- filled spaces around the tissue. Thalamus can also be smaller • Brain function- PET scans show that the frontal lobes have less activity than normal brains. Also, more receptor sites for dopamine • Prenatal viruses- if the mother has the flu, it MAY increase risk

37. Therapy • There are many ways to treat psychological disorders- some are more widely accepted than others • It is important to note that there is NO ONE SINGLE correct treatment for any disorder

38. Psychotherapy • An interaction between a trained therapist and someone who is seeking to overcome psychological difficulties or achieve personal growth • Depending on the patient, the type of therapy may vary • Examples: • Psychoanalysis • Client-centered therapy • Behavior therapy • Cognitive therapy • Family and Group Therapy

39. Biomedical Therapy • Treatment of psychological disorders by changing the brain’s functioning with prescribed drugs, electroconvulsive therapy, or surgery

40. Drug Therapy • Introduction of drugs allowed for record numbers of patients to become deinstitutionalized (released from mental hospitals and back into the community) • Drugs fall into three categories: • Antipsychotic • Antianxiety • Antidepressant

41. Drug Therapy • Antipsychotic drugs- • Primarily used to treat schizophrenia • Reduce the number and severity of delusions and hallucinations by blocking the activity of dopamine • Thorazine is the most common • Negative side effects are strong enough that some people discontinue use

42. Drug Therapy • Antianxiety Drugs- • Treat people with high levels of stress or anxiety disorders • Boost GABA in the brain • Valium, Librium, and Xanax are common • Patients can become dependent on the drugs- need to be used with other forms of therapy

43. Drug Therapy • Antidepressants – • Boost serotonin levels in the brain to treat major depression • Prozac, Zoloft, and Paxil (Lithium for Bipolar) • In 2008, 1:20 men, 1:10 women had a prescription

44. ECT • Electroconvulsive Therapy (ECT) • Therapy for major depression in which a brief electric current is sent through the brain of a patient • Can be more effective than drug therapy • Can cause minor memory loss • There is no clear cut reason why the procedure works

45. Psychosurgery • Lobotomy- once used to control emotionally unstable or violent patients by cutting the nerves that connect the front lobes to the deeper emotional centers of the brain • Surgery is only used as a last resort in treating psychological disorders