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  • Psychological disorders - Behaviors or mental processes There are various kinds of distress or impaired functioning. What makes them diagnosable is that they are not expectable responses to specific events. Maladaptive reaction – when normal feelings of loneliness, mild depression and anxiety occur after a stressor it is normal adjustments, but when emotional complaints exceed the expected level, or when ability to function is impaired (for example: difficulty getting out of bed or attending classes,
  • What constitutes abnormal? These are some standards that psychologists have based it off of. Unusualness – behavior that is out of the ordinary (okay to have panic before a test, but not full-fledged panic attacks that come out of the blue). Faulty perception – hallucinations and ideals of persecution.
  • DSM IV is used mostly in hospitals and for insurance purposes. It also helps in developing treatment plans. Usually have provisional diagnosis and also label when primary and secondary when have more than one diagnosis (ie. Substance abuse and Depression) DSM IV is consistently revised.
  • Axis IV: Problems w/ primary support group, problems related to social environment, educational problems, occupational problems, housing problems, economic problems, problems with access to healthcare, problems related to legal and criminal justice system, and other psychosocial and environmental problems. Axis V: 1-100 scale
  • Social Phobia- have fear of doing something that will be humiliating or embarrassing. Ex. Fear of public speaking Impact both social and occupational spaces. Agoraphobia – Fear of being in places where it might be difficult to escape or which help might not be available if they experience panicky symptoms. Often refuse to leave home. Example in book.
  • Motor tension: shakiness, inability to relax, furrowed brow, fidgeting. Autonomic overarousal: sweating, dry mouth, racing hear, light-headedness, frequent urination, diarrhea.
  • Recurrent, troubling obsession, compulsions or both. Obsessions – so compelling and recurrent that they disrupt daily life. Include doubts about whether locked the doors and shut the windows, images such (children getting injured on the way home). Contamination of hands (fear of germs). Compulsion-impulse is recurrent and forceful, interfering with daily life. Temporarily reduce anxiety connected with obsessions but the obessional thoughts typically return leading to a vicious cycle.
  • PTSD may not begin for many months or years after the trauma, but it may last for years or even decades afterward. Anxiety related symptoms (rapid heart rate and feelings of anxiety and helplessness. Traumatic event is revisited in the form of intrusive memories, recurrent dreams ,and flashbacks. People try to avoid thoughts and activities connected to the trauma. Find it more difficult to enjoy life and may have sleep problems, irritable outbursts, difficulty concentrating, extreme vigilance, and an exaggerated “startle” response to sudden noise.
  • Psychological Views: Learning theorists would point out that some phobias may be learned on the basis of classical conditioning and by observational learning. Psychodynamic theorists believe that phobias symbolize unconscious conflicts originating in childhood. Cognitive theorists suggest that anxiety is maintained by exaggerating the consequences of threatening events. Biological Views: There is much evidence to support the role that biological factors play in anxiety disorders. For example, Genetic factors may account for faulty regulation of levels of serotonin and norepinephrine in the brain, leading to unusually high levels of anxiety in response to particular threats. Ultimately though, while genetics may cause a tendency towards certain disorders, whether the person actually develops the disorder depends on many other factors (such as a warm and loving family, level of stressful events, coping ability, etc.).
  • Dissociative disorders are uncommon and rare.
  • Depersonalization Disorder experience changes in attention and perception, making it difficult for them to focus clearly on events. As a result, they may feel as though they are functioning on automatic pilot or as in a dream.
  • The great majority of people who have been diagnosed with dissociative disorders have suffered terrible sexual or physical abuse in childhood, usually before the age of 5.
  • Conversion – people show indifference to their symptoms,
  • More often in men than women.
  • Paranoid: Delusions of grandeur and persecution but they may also have delusions of jealousy, in with they believe a lover or spouse is unfaithful. Agitation, confusion, and fear and may experience vivid hallucinations that are consistent with their delusions. Disorganized: loosening of associations, disorganized behavior, and flattened or highly inappropriate emotional responses. Silliness, giddiness of mood, giggling, and nonsensical speech. Neglect appearance and personal hygiene and lose control of their bladder and bowels.
  • Dopamine is a type of neurotransmitter. It is a chemical messenger that is similar to adrenaline and affects the brain processes that control movement, emotional response, and the capacity to feel pleasure and pain. Dopamine is vital for performing balanced and controlled movements. A shortage of dopamine can cause a lack of controlled movements such as those experienced in Parkinson disease.
  • Paranoid: general suspiciousness of the motives and intentions of others and a tendency to interpret other people’s behavior as threatening. Do not show grossly disorganized thinking of paranoid schizophrenia. Mistrustful of others and their relationships suffer for it and relationships suffer for it. Overly suspicious of coworkers and supervisors, but their behavior is organized well enough for them to be able to maintain employment. Schizoid: social isolation and lack of interest in social relationships. “loners” Do not develop warm, tender feelings for others. Have few friends, experience strong emoitons sucah as anger, joy or sadness. Schizotypal: peculiarities of thought, perception, or behavior, such as expcessive fantasy and suspiciousness; feelings of being unreal; odd usage of words. Have peculiar behaviors such as believing that they can foretell the future) but their thoughts and behavior are not as disturbed as those of people with schizophrenia.
  • Borderline personality disorder P-paranoid ideas R-relationship instability A- angry outbursts, affective instability, abandonment fears I- Impulsive behaviors, identity disturbance S- Suicidal behavior E – Emptiness
  • Narcissistic: Need constant admiration and praise, lest their self-esteem plummet. ASPD/sociopath- * Glibness and Superficial Charm, Manipulative and Conning Grandiose Sense of Self Pathological Lying Lack of Remorse, Shame or Guilt A deep seated rage. Does not see others around them as people, but only as targets and opportunities. Instead of friends, they have victims and accomplices who end up as victims. Shallow Emotions When they show what seems to be warmth, joy, love and compassion it is more feigned than experienced and serves an ulterior motive. Outraged by insignificant matters, yet remaining unmoved and cold by what would upset a normal person. Since they are not genuine, neither are their promises. Incapacity for Love Need for Stimulation Living on the edge. Verbal outbursts and physical punishments are normal. Promiscuity and gambling are common. Callousness/Lack of Empathy Unable to empathize with the pain of their victims, having only contempt for others' feelings of distress and readily taking advantage of them. Poor Behavioral Controls/Impulsive Nature Rage and abuse, alternating with small expressions of love and approval produce an addictive cycle for abuser and abused, as well as creating hopelessness in the victim. Believe they are all-powerful, all-knowing, entitled to every wish, no sense of personal boundaries, no concern for their impact on others. Early Behavior Problems/Juvenile Delinquency Usually has a history of behavioral and academic difficulties, yet "gets by" by conning others. Problems in making and keeping friends; aberrant behaviors such as cruelty to people or animals, stealing, etc. Irresponsibility/Unreliability Not concerned about wrecking others' lives and dreams. Oblivious or indifferent to the devastation they cause. Does not accept blame themselves, but blames others, even for acts they obviously committed. Promiscuous Sexual Behavior/Infidelity Promiscuity, child sexual abuse, rape and sexual acting out of all sorts. Lack of Realistic Life Plan/Parasitic Lifestyle Tends to move around a lot or makes all encompassing promises for the future, poor work ethic but exploits others effectively.
  • Avoidant Personality Disorder: systematic avoidance of social contacts and any situation which might result in embarrassment or anxiety. Even with people who are close, he or she avoids a more intimate involvement. The permanent expectations of being ridiculed, criticized, rejected puts the person constantly at the borderline of suffering anxiety attacks. Then he develops a permanent scheme of self-protection against anxiety. – They tend to live alone – Contact with family and friends can be enjoyable, but only for a short period of time (minute or hours) and anxiety can be aroused at any moment. – They avoid contact with strangers. They are extremely kind when such contact occurs and they do everything possible to make sure that such contact is brief. – They develop at least one phobia (for animals or objects) whose origin is connected with the earlier appearance of anxiety attacks in social situations. The animal or object connected with such situations unleashes the anxiety and this assumes phobic characteristics. – They are aware that they have abdicated certain experiences in life in order to avoid suffering. – They often fantasize about the situations they avoid and yet would like to experience – in their fantasies they exclude the anxiety-provoking stimuli. – They can be professionally successful, but they could be even more successful if they did not turn their backs on opportunities. Dependent Personality Disorder is a condition characterized by an over-reliance on others that leads to submissive and clinging behavior and fears of separation. The dependent and submissive behaviors arise from feeling unable to cope without the help of others. This disorder is only diagnosed when these behaviors become persistent and very disabling or distressing. This diagnosis should be used with great caution, if at all, in children and adolescents, for whom dependent behavior may be developmentally appropriate. Obsessive-Compulsive Personality Disorder is a condition characterized by a chronic preoccupation with rules, orderliness, and control. This disorder is only diagnosed when these behaviors become persistent and disabling. The individual with this disorder often becomes upset when control is lost. The individual then either emotionally withdraws from these situations, or becomes very angry. The individual usually expresses affection in a highly controlled or stilted fashion and may be very uncomfortable in the presence of others who are emotionally expressive. The person often has difficulty expressing tender feelings, and rarely pays compliments.

Chapter 8 powerpoint Chapter 8 powerpoint Presentation Transcript

  • Psychological Disorders Chapter 8
  • What Are Psychological Disorders?
    • Range from mild disorders (such as adjustment disorders) to more severe and chronic disorders, such as schizophrenia and bipolar disorder.
    • Adjustment disorder:
      • A maladaptive reaction to an identified stressor
      • occurs shortly following exposure to the stressor
      • Characterized by academic, occupational, or social problems that exceed those normally caused by stressor.
      • Resolved if person learns how to cope or stressor is removed
      • Examples: (end of relationship, life transitions,
  • Criteria for Determining “Abnormal” Behavior
    • 1. Unusualness
    • 2. Faulty perception or interpretation of reality
    • 3. Significant personal distress
    • 4. Self-defeating behavior
    • 5. Dangerousness
    • 6. Social unacceptability in a given culture
  • Classifying Psychological Disorders
    • Psychological disorders are classified via the Diagnostic and Statistical Manual 4 th Edition –Text Revision (DSM-IV-TR).
    • The DSM-IV-TR uses a multiaxial system of assessment. It provides information about a person’s overall functioning (not just a diagnosis).
  • 5 Axis of DSM-IV-TR
    • Axis 1: Clinical Syndromes/Psychological Disorders that Impair Functioning
    • Axis II: Personality Disorders
    • Axis III: Medical Conditions
    • Axis IV: Psychosocial and environmental factors
    • Axis V: Global assessment functioning (GAF)
  • Anxiety Disorders
    • Phobias
      • Specific Phobia
      • Social Phobia
      • Agoraphobia
    • Panic Disorder
    • Generalized Anxiety Disorder
    • Obsessive Compulsive Disorder
    • Post-Traumatic Stress Disorder
    • Acute Stress Disorder
    • Specific Phobia: an excessive, irrational fear of a specific object or situation, such as snakes or heights. Examples include claustrophobia (fear of tight or enclosed spaces) and acrophobia (fear of heights).
      • Example (Arachnophobia):
    • Social Phobia: Also called Social Anxiety Disorder, a social phobia is a persistent fear of social interactions in which one might be scrutinized or judged negatively by others.
    • Agoraphobia: Fear of open or crowded places.
  • Panic Disorder
    • Panic Disorder: Recurrent experiencing of attacks of extreme anxiety in the absence of external stimuli that usually elicit anxiety.
    • Attacks seem to come “out of the blue” but may become associated with certain cues over time.
    • Strong physical symptoms : shortness of breath, heavy sweating, tremors, and pounding of the heart.
    • Investigators estimate that 1% to 4% of the adult population is affected by panic disorder at some point in their lives.
  • Generalized Anxiety Disorder
    • Disorder involving persistent feelings of worry accompanied by states of bodily tension and heightened arousal.
    • The anxiety is not focused on a specific object, situation or activity.
    • Symptoms may include motor tension, autonomic overarousal, feelings of dread and foreboding and excessive worrying and vigilance.
    • Example (What About Bob):
      • (0-1:33)
  • Obsessive-Compulsive Disorder
    • Obsessive-Compulsive Disorder: A disorder characterized by the presence of obsessions, compulsions or both.
    • Obsession: A recurring thought or image that seems beyond one’s ability to control.
    • Compulsion : An apparently irresistible urge to repeat an act or engage in ritualistic behavior such as hand washing.
    • Example (As Good As It Gets):
  • Posttraumatic Stress Disorder and Acute Stress Disorder
    • Posttraumatic Stress Disorder (PTSD): A prolonged maladaptive reaction to a traumatic event that is characterized by intense fear , avoidance of stimuli associated with the event, and re-living of the event .
      • Example (Law and Order – SVU):
      • (0-1:20)
    • Exposure to trauma in the form of physical attacks, combat, medical emergencies, accidents, terrorist attacks or witnessing a death can lead to PTSD.
    • Acute Stress Disorder: Characterized by feelings of intense anxiety and feelings of helplessness during the first month following exposure to a traumatic event.
  • Causal Factors in Anxiety Disorders.
    • Psychological Views:
      • classical conditioning and by observational learning .
      • unconscious conflicts originating in childhood.
      • anxiety is maintained by exaggerating the consequences of threatening events.
    • Biological Views : Genetic factors
      • genetics may cause predisposition but development of disorder depends on many other factors (such as a warm and loving family, level of stressful events, coping ability, etc.).
  • Dissociative and Somatoform
    • Dissociative Disorders: A class of psychological disorders involving changes in consciousness or self-identity .
    • Somatoform Disorders: A class of psychological disorders in which people have physical complaints that cannot be explained medically or attribute their physical problems to grave causes despite lack of medical evidence.
    • Role of disorders is to shield self from anxiety.
  • Dissociative and Somatoform Disorders
    • Dissociative Disorders
      • Dissociative Amnesia
      • Dissociate Fugue
      • Dissociative Identity Disorder
      • Depersonalization Disorder
    • Somatoform Disorders
      • Conversion Disorder
      • Hypochondirasis
  • Dissociative Disorders
    • Dissociative Amnesia : Loss of personal memories or self-identity; skills and general knowledge are usually retained. The loss of memory is not due to an organic problem (such as a blow to the head).
      • Ex. a soldier who, following a stressful combat experience, cannot remember what happened for several hours.
    • Dissociative Fugue: Dissociative disorder in which one experiences amnesia, then flees to a new location. The new personality is often more outgoing than the “real” identity. Following recovery, the events are not recalled.
    • Example of Dissociative Amnesia and Fugue (Nurse Betty):
      • (0-2:00 and 4:15-4:40 and 5:38-6:20)
  • Dissociative Disorders
    • Dissociative Identity Disorder (DID): a person appears to have two or more distinct identities which may alternate in controlling them. Some psychologists feel that people with DID have constructed these alternate personalities as roles they play to act out confusing emotions.
      • Example (Sybil):
    • Depersonalization Disorder: one experiences persistent or recurrent feelings that one is not real or is detached from one’s own experiences or body.
  • Causal Factors in Dissociative Disorders
    • Suffered terrible sexual or physical abuse in childhood, usually before the age of 5.
    • Psychodynamic theorists: dissociative disorders are a result of massive repression
    • Learning theorists : learned to redirect their thinking away from troubling memories in order to avoid feelings of shame, anxiety and guilt.
  • Somatoform Disorders
    • Conversion Disorder: A disorder in which anxiety or unconscious conflicts are “converted” into physical symptoms that often have the effect of helping the person cope with anxiety or conflict.
    • Example (The Piano)
      • (0:38)
    • Hypochondriasis: A disorder characterized by the persistent belief that one has a serious medical disorder despite lack of medical finding.
      • Example (Donald Duck cartoon):
      • (2:20-4:25)
  • Causal Factors in Somatoform Disorders
    • Psychodynamic theory: Hysterical symptoms symbolize underlying psychological conflict.
    • Learning theory: Conversion symptoms represent learned responses that are reinforced by avoidance of painful or anxiety-evoking situations.
    • Cognitive factors: Evidence is emerging that points to cognitive factors such as distorted thinking patterns.
  • Mood Disorders
    • Major Depression
    • Major Depression with Psychotic Features
    • Bipolar Disorder
  • Mood Disorders
    • Major Depression : A mood disorder in which the person may have a dampened mood, changes in appetite and sleep patterns, and lack of interest or pleasure. In extreme cases, people suffering from major depression may experience psychotic behaviors.
    • Psychotic: Relating to a break with reality, as manifested by delusional thinking or hallucinations.
    • Example (Girl Interrupted) : (1:45-3:15)
  • Mood Disorders
    • Women are two times more likely to be diagnosed with depression than men.
    • Women have greater stress than men (multiple demands of childbearing, childrearing and financial support of the family).
    • Hormonal differences can also contribute to the differences between men and women.
    • Societal norms for gender roles may also impact our ability to detect depression in men and children (ex. Irritability and anger rather than sadness).
  • Mood Disorders
    • Bipolar Disorder: A mood disorder in which mood alternates between two extreme poles (elation or manic and depression).
    • In the manic phase , the person may show excessive excitement or silliness, engage in risky behaviors, experience a flight of ideas and speak very rapidly.
    • Example (Mr. Jones):
      • (4:08 – 6:54)
    • In the depression phase , people have a downcast mood, often sleep more than usual, and feel lethargic.
      • Example:
    • In order to avoid the depressive phase, some people suffer from bipolar disorder may attempt suicide when the mood shifts from elation towards depression.
  • Causal Factors in Mood Disorders
    • Psychological Factors :
      • Psychodynamic perspective - depression is anger turned inward.
      • Learning theorists - depressed people lack sufficient reinforcement in their lives to maintain their mood and behavior.
      • Cognitive theorists - ways we interpret life events leads to emotional disorders such as depression.
    • Biological Factors: Genetic factors in major depression and bipolar disorder.
      • Irregularities in the use of serotonin in the brain (Prozac works to increase the level of serotonin in the brain).
  • Schizophrenia
    • Schizophrenia: A severe and persistent psychological disorder characterized by a break with reality , disturbances in thinking , and a disturbed behavior and emotional responses .
    • About 2.5 million Americans are diagnosed with schizophrenia, with about 1 in 3 requiring hospitalization. 1% of population in US and worldwide.
    • People with schizophrenia have problems with memory, attention and communication. Their thinking becomes unraveled and their speech jumbled.
    • Many people with schizophrenia have delusions. Others may enter a stuporous state or become wildly agitated.
    • Example (A Beautiful Mind):
  • Schizophrenia
    • Paranoid Schizophrenia
    • Disorganized Schizophrenia
    • Catatonic Schizophrenia
  • Schizophrenia
    • Paranoid Schizophrenia: A type of schizophrenia characterized primarily by delusions —commonly of persecution—and by vivid hallucinations.
    • Example (Donnie Darko):
    • Disorganized Schizophrenia: A type of schizophrenia characterized by incoherent speech, disorganized or fragmentary delusions, and vivid hallucinations.
    • Catatonic Schizophrenia: A type of schizophrenia characterized by striking impairment of motor activity. These individuals may show waxy flexibility and/or mutism
    • Example for Disorganized and Catatonic (Patch Adams):
      • (0-0:38)
  • Causal Factors in Schizophrenia
    • Genetic Factors: Heredity plays a key role in schizophrenia. The more closely related two people are by blood, the more likely they are to share the disorder.
    • Other Biological Factors: Complications during childbirth, being born during the winter (predictive of viral infection) and poor maternal nutrition are also linked to schizophrenia.
    • Dopamine Theory: According to the dopamine theory, people with schizophrenia overutilize the neurotransmitter dopamine.
  • Personality Disorders
    • Personality Disorders: Enduring patterns of maladaptive behaviors that are sources of distress to the individual or others. Diagnosed after age 18.
    • Personality disorders cause difficulties in social, personal or occupational functioning.
    • The DSM-IV-TR lists 10 specific types of personality disorders that are organized in three clusters: Odd or eccentric (Cluster A) behavior, behavior that is overly dramatic , emotional or erratic (Cluster B) and behavior that is anxious or fearful (Cluster C).
  • Cluster A: Personality Disorders
    • Paranoid Personality Disorder
    • Schizoid Personality Disorder
    • Schizotypal Personality Disorder
    • Features: Odd or eccentric behavior.
  • Personality Disorders
    • Paranoid personality disorder : A personality disorder characterized by persistent suspiciousness, but not involving the disorganization of paranoid schizophrenia.
      • Example (Conspiracy Theory)
    • Schizoid personality disorder : A personality disorder characterized by social detachment or isolation.
      • Example (Punch Drunk Love):
        • (4:10)
    • Schizotypal personality disorder: A personality disorder characterized by difficulty forming close relationships and oddities of thought and behavior, but not involving bizarre behaviors associated with schizophrenia .
  • Cluster B: Personality Disorders
    • Borderline Personality Disorder
    • Histrionic Personality Disorder
    • Narcissistic Personality Disorder
    • Anti-Social Personality Disorder
    • Features: Overly dramatic, emotional or erratic behaviors
  • Personality Disorders
    • Borderline Personality Disorder : A personality disorder characterized by failure to develop a stable self-image, by a pattern of tumultuous moods and stormy relationships with others, and by difficulties controlling impulsive behaviors.
    • Example (Fatal attraction) : (0:30-1:47).
    • Histrionic Personality Disorder : A personality disorder characterized by overly dramatic and emotional behavior; by excessive needs to be the center of attention; and by constant demands for reassurance, praise, and approval.
    • Example (Jessica Rabbit):
  • Personality Disorders
    • Narcissistic Personality Disorder : A personality disorder characterized by an inflated or grandiose self-image and extreme needs for admiration.
    • Example (Charles Manson):
    • Antisocial Personality Disorder : A personality disorder characterized by a pattern of antisocial and irresponsible behavior, a flagrant disregard for the interests and feelings of others, and lack of remorse for wrongdoing.
    • Example (Silence of The Lambs):
      • (5:35-7:10)
  • Cluster C: Personality Disorders
    • Avoidant Personality Disorder
    • Dependent Personality Disorder
    • Obsessive-Compulsive Personality Disorder
    • Features: Anxious and fearful behaviors
  • Personality Disorders
    • Avoidant personality disorder: A personality disorder in which the person is generally unwilling to enter relationships without assurance of acceptance because of extreme fears of rejection and criticism.
    • Example (UP):
    • (0-0:48)
    • Dependent personality disorder : A personality disorder characterized by excessive dependence on others and difficulties making independent decisions.
    • Obsessive-compulsive personality disorder: A personality disorder described by excessive needs for attention to detail and demands for orderliness, as well as perfectionism and highly rigid ways of relating to others.
  • Causal Factors in Personality Disorders
    • Most of the theoretical explanations come from the psychodynamic model. Traditional Freudian theory focuses upon faulty resolution of the Oedipal complex.
    • Learning theorists suggest the childhood experiences can contribute to maladaptive ways of relating to others in adulthood.
    • Cognitive theorists find that antisocial adolescents interpret social information in ways the bolster their misdeeds.
    • Genetic factors are implicated in some personality disorders such as schizoid personality disorder.
  • Preventing Suicide
    • Suicide is the 8 th leading cause of death in the United States.
    • Most suicides are linked to mood disorders, especially depression and bipolar disorder. Other factors include feelings of hopelessness, serious medical illness and schizophrenia.
    • High risk groups include teenagers and young adults, college students, women, European Americans (versus African Americans), Native-American teenagers and older people who are separated or divorced.
  • Tips if a person refuses to seek help:
    • Keep the person talking.
    • Be a good listener.
    • Suggest that something other than suicide might solve the problem, even if it is not evident at the time.
    • Emphasize as concretely as possible how the person’s suicide would be devastating to you and to other people who care.
    • Ask how the person intends to commit suicide.
    • Do not tell people threatening suicide that they’re acting stupid or crazy.
    • Suggest that the person go with you to obtain professional help now.