Psychological Disorders What does it mean to be normal??
What is ABNORMAL? <ul><li>As defined by the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) </li></ul><ul><li>- “bible” of mental disorders </li></ul><ul><li>- classifies disorders by categories </li></ul><ul><li>Abnormal is: </li></ul><ul><li>Deviation from Normality- doing something that is not what most people do. </li></ul><ul><li>(Ex: showering once a week, wearing shorts in the winter.) </li></ul><ul><li>Adjustment- not being able to function on a day to day basis without assistance from others. (Ex: Raymond in Rainman ) </li></ul><ul><li>3) Psychological Health- people who do not think in the “proper” manner . </li></ul>
NORMAL? <ul><li>There is a fine line between “Abnormal” and “Normal”. </li></ul>What is normal for one person might be considered abnormal to someone else. Ex: “Close talkers”, Shaking hands longer than normal, singing in the car . *It is much harder to classify mental disorders than physical ones, b/c the symptoms are not as clear cut.
Anxiety Disorders <ul><li> 20% of adults have endured symptoms of anxiety disorders. </li></ul><ul><li>Characteristics of : </li></ul><ul><ul><li>Feelings of nervousness </li></ul></ul><ul><ul><li>Constant worrying </li></ul></ul><ul><ul><li>Physical symptoms (headaches, sweating, muscle tightness, fatigue) </li></ul></ul><ul><ul><li>Mood swings </li></ul></ul>
Generalized Anxiety Disorder <ul><li>What is it? </li></ul><ul><li>“ always feeling anxiety” </li></ul><ul><li>What is anxiety ? </li></ul><ul><ul><li>Generalized apprehension towards something </li></ul></ul><ul><ul><li>Vague feeling of danger/nervousness </li></ul></ul>How common? 5% of the population
Generalized Anxiety Disorder What does a person with this disorder do? They create vague and imagined dangers. They fear unknown circumstances, became unable to enjoy life. They create a cycle of worrying- the more they worry, the more difficult things become, then they worry more. Does it create physical problems? It is accompanied by muscular tension, an inability to relax, poor appetite, difficulty sleeping, indigestion.
Generalized Anxiety Disorder <ul><li>Examples : </li></ul><ul><ul><li>3) Playing out situations in your head and making them turn out poorly, causing you to avoid the situation altogether. </li></ul></ul><ul><ul><li>2) Fearing a class because you don’t know the material would cause you to try to avoid the class or participating in the class. </li></ul></ul><ul><ul><li>Being anxious on a date, causes a person to have a fear of dates in general, which causes them to avoid dates. </li></ul></ul>
Phobic Disorder Phobia - Severe anxiety focused on a particular object, anxiety, or event that seems out of proportion to the danger involved.
Phobic Disorder <ul><li>SIMPLE PHOBIA- </li></ul><ul><li>can focus on anything, mainly one object </li></ul>EX: Acrophobia- “ fear of high places” Claustrophobia- “ fear of enclosed spaces” Coulrophobia- “ fear of clowns” Prevalence? About 10% of the population
Phobic Disorder Social Phobia- Fear that a person will embarrass themselves in front of others. <ul><li>have trouble with public speaking </li></ul><ul><li>do not like eating in public, using public facilities </li></ul><ul><li>have trouble meeting new people, first dates </li></ul><ul><li>feel like everyone is judging or watching them </li></ul><ul><li>causes them to go into withdrawal and avoid going out </li></ul>Ricky Williams Prevalence? ~12% of population
Phobic Disorder Agoraphobia- “ fear of crowds, crowded places” <ul><li>They avoid places where a lot of people are present. (i.e. shopping malls, movies, restaurants, etc.) </li></ul>- They do not leave their houses, in extreme cases.
Phobic Disorder HOW DO PEOPLE DEAL WITH THEIR FEARS? --- AVOID THEM!!! WHAT DOES THIS BEHAVIOR CAUSE? --- REINFORCES BEHAVIOR, BECOMES LEARNED AND MAINTAINED WHAT IS THE BEST TREATMENT OF PHOBIAS? --- PROVIDING THE PERSON WITH OPPORTUNITIES TO EXPERIENCE THEIR FEAR IN SAFE/ CONTROLLED CONDITIONS
Phobic Disorder What do you fear? Rank the top 5 things that you fear from this list: Bridges Fire Death Heights Enclosed Spaces Spiders Snakes Open Spaces Darkness Ghosts Clowns Germs Being Alone Insects Blood Strangers Airplanes Needles
PANIC Disorder What is a panic attack? A sudden an unexplainable attack of intense fear. <ul><li>Leads a person to feel a sense of doom, or that they are about to die. </li></ul><ul><li>Not just worrying about a test, it is very extreme. </li></ul>What are the symptoms of a panic attack? <ul><li>Sense of smothering </li></ul><ul><li>Choking </li></ul><ul><li>Difficulty breathing </li></ul><ul><li>Dizziness </li></ul><ul><li>Chest pains </li></ul>How long does an attack last? <ul><li>Usually a few minutes, some can last for 45-60 minutes. </li></ul>
OCD What does OCD mean? Obsessive-Compulsive Disorder What is an OBSESSION? Thinking the same thoughts over and over, uncontrollable pattern of thoughts. Examples: thoughts about death, thoughts about a person, or hobby, etc.
OCD What is a compulsion? Repeatedly performing irrational actions over and over. Repeatedly performing irrational actions over and over. Repeatedly performing irrational actions over and over . Examples: Washing hands 20-30x’s a day. Avoiding cracks on the sidewalk. Constantly adding up numbers you see.
OCD When does OCD become a problem? Most people can function day to day with minor obsessions and compulsions. Only when they interfere daily routines is it a problem. Example: Checking and re-checking information at work that causes a person to not be able to finish their work. Why do people develop obsessions and compulsions? To avoid other fears, to feel like they are in control of things.
PTSD Post-traumatic Stress Disorder- Severe and long-lasting aftereffects associated with a traumatic event. The event overwhelms their ability to cope with reality and can affect their day to day life. What are the symptoms and effects of PTSD? Symptoms- “flashbacks”, nightmares Effects- experience ordeal, insomnia, feelings of guilt
PTSD - military veterans (i.e. Vietnam vets) - survivors of natural disasters (Tsunami victims) - victims of human aggressions, crimes (Rape victims) - unnatural catastrophes (plane crashes, car accidents) Who suffers from it?
SOMATOFORM DISORDERS -- Anxiety creates physical symptoms for which there is no apparent cause. (Hysteria) -- Medical tests would not reveal anything wrong with patients with these disorders. SOMATOFORM DISORDERS Conversion Reaction Hypochondriasis
SOMATOFORM DISORDERS 1) Conversion Reaction- Emotional difficulties turn into the loss of a specific physical function. People with conversion disorder express emotional conflict or severe anxiety due to stress through physical symptoms that affect voluntary or sensory function. These may include problems with walking or moving an arm, or even blindness. This disorder generally occurs in people whose usual coping methods are overwhelmed.
SOMATOFORM DISORDERS Conversion Reaction (con’t) Major Point to Remember: This results in a real and prolonged handicap!!! Example: A person wakes up in the morning and can not move their legs, instead of “freaking out” about it, they accept it without worrying. Example: A person who has a fear of blurting things out in public, loses their speech. (solves the problem) *Can last for months, then effects can just disappear.
SOMATOFORM DISORDERS 2.) Hypochondriasis- Person in good health becomes preoccupied with imaginary ailments. -- spends time looking for signs of serious illness (they will often misinterpret minor aches, pains, or bruises as signs of fatal illnesses). -- despite tests, they still believe they are ill or that the tests malfunctioned Most “hypochondriacs” are: -- Young adults, female
Dissociative Disorders What is a dissociative disorder? It is defined as a “disturbance in the conscious experience”. Dissociative Disorders are characterized by either a loss of memory or a loss of identity.
Dissociative Disorders These are very rare disorders. Their causes are often unknown.
Dissociative Disorders PSYCHOGENIC AMNESIA The loss of memory/ identity (not due to a trauma to the head) Cause? Possibly to escape from problems by blotting them out completely. --- Amnesia patients know how to speak and have general knowledge, but do not remember who they are, where they live and work, or who their family is (not damage)
Dissociative Disorders PSYCHOGENIC FUGUE Amnesia paired with active flight to a different environment. Example: Person may suddenly disappear and wake up 200 miles from home, have a new identity, job, and family. They will repress knowledge of their previous life.
Dissociative Disorders PSYCHOGENIC FUGUE (con’t) Fugue- Traveling amnesia, no record of time when they wake up out of it. Purpose- To escape from unbearable conflict or anxiety . Ex: In the movie, “Fight Club”, the main character, played by Edward Norton, is extremely depressed and hates his job. As a result of these emotions, he assumes a new identity, played by Brad Pitt, and a new life of starting up “fight clubs” in different parts of the US. He is never aware of his different identity until the end of the movie when he realizes it is himself that is carrying out all of these different activities and not another person who he thought existed.
Dissociative Disorders What is it exactly? This occurs when a person has two or more distinct identities. The patient divides up their personality to escape from the part of themselves that they do not like. Ex: - going from being quiet, shy to being loud, obnoxious. - being reserved to being outgoing. MULTIPLE PERSONALITY
Dissociative Disorders How common is it? Only 250 documented cases in history up until 1990. Ex: “ Three Faces of Eve” Chris Costner Sizemore, a.k.a. “Eve”, sought psychiatric treatment in the early 1970’s for severe headaches and blackouts. During her sessions, it was discovered that she exhibited more than one personality. Each personality differed from her actual personality in some way. “Eve” was unaware of her different personalities (22 in total), but they all were aware of her. Eventually she was able to overcome her disorder through therapy. MULTIPLE PERSONALITY
MOOD Disorders 1) MAJOR DEPRESSIVE DISORDER- <ul><li>must occur over a 2 week period minimum </li></ul><ul><li>15-25% in women, 5 to 12% in men </li></ul>2 Types: <ul><li>Single Episode- strikes deeply and seriously in one dramatic episode (i.e. death of a loved one) </li></ul>2. Recurrent Depression- extended period of sadness, anxiety, fatigue (i.e. unhappy with job, life) EX: Shelley is depressed. She sits on the couch and watches television without enjoying the shows. She lacks the energy to clean the house or to care for the children. She cries frequently and for no apparent reason other than that she feels life is pointless.
MOOD Disorders What are some common characteristics of depression? Physical problems: Lack of energy Problems eating/ sleeping Large weight gains/ losses Mental issues: Dependency- sensed need for others help and support Negative view of themselves and their own worth Thoughts of worthlessness, guilt, suicide
MOOD Disorders Causes of depression: Environmental factors (day to day events) Life changing situations/ events (deaths, traumatic events) Chemical imbalances in the brain Is there a link between suicide and depression? Yes! There is a strong link between suicide and mood disorders, though not everyone that is depressed commits suicide. Yearly amount? 30,000 Americans per year (1 every 18 minutes) Most common among? Most common among elderly 2 nd - college students More women attempt it, more men succeed.
MOOD Disorders 2) BI-POLAR DISORDER- (Manic-Depressive) Individuals are excessively and inappropriately happy or unhappy. 2 Reactions: 1) Manic-type reaction- Person experiences elation, extreme confusion, distractibility, and racing thoughts. Ex : Lenny is a carpenter. While in a manic state, he decided to build a copy of the Empire State building in his backyard. He called the office, and quit his job, ordered supplies, and asked neighbors to help him. When the people down the street tried to tell him to check the city building codes, he became belligerent. He stormed out of their house accusing them of having no faith in the will and determination of his neighborhood. *A manic reaction is hard to detect because the person is very optimistic and full of energy.
MOOD Disorders A person with bi-polar disorder : Can function around others on a day to day basis. Can be treated with prescriptions drugs. Lithium is still the most used drug overall in mania, but mood stabilizers are also used. More than 2 million American adults, or about 1 percent of the population age 18 and older in any given year, have bipolar disorder. Both children and adolescents can develop Bi-polar Disorder. *Without effective treatment, bipolar illness leads to suicide in nearly 20% of cases. 2) Depressive-type reaction- Individuals are overcome by feelings of failure, worthlessness, and extreme sadness
MOOD Disorders 3) SEASONAL AFFECTIVE DISORDER- (SAD) Depression that sets in during the winter months. Cause? The less natural light during the winter causes the brain to produce more melatonin that can lead to SAD in individuals Treatment? Sitting under bright fluorescent lights during the evening or early morning hours. *Depression, like SAD, is twice as likely to affect women as men.
Schizophrenia Confused and disordered thoughts and perceptions. (Flawed thought processes) FACTS ABOUT: <ul><li>1 st appearance is during the teenage yrs. </li></ul><ul><li>It affects more males than females. </li></ul><ul><li>50% of all patients in mental hospitals have been diagnosed with it </li></ul>* This is a very serious and devastating disorder and also can be very dangerous. People with schizophrenia have an extremely hard time functioning safely and normally in society.
Schizophrenia Two things associated with schizophrenia: DELUSIONS - False beliefs maintained despite contrary evidence Ex : Someone is out to get them, though they have no facts that it is actually true. HALLUCINATIONS- Sights/ feelings/ sounds that are experienced without the appropriate stimulus. Ex: Seeing spiders crawling on your skin, when they aren’t there.
Schizophrenia Symptoms of: (can experience more than one) 1) Incoherence- Decline in the thought process, speeded language, or “word salad” Ex : A woman was delighted to receive a letter from her son abroad, but distraught when she read it: “Dear mother…I am writing on paper. The pen I am using is from a factory called Perry and Co. The factory is in England. The city of London is in England. I know this from my school days. Then I always liked geography. My last teacher in that subject was Professor August A. He was a man with black eyes. There are also blue and grey eyes and other sorts too. I have heard it said that snakes have green eyes. All people have eyes. There are some, too, who are blind.” -- from The Human Mind Examined, edited by Susan A. Greenfield, 1996.
Schizophrenia Symptoms (con’t) 2) Emotional Disturbances- They have inappropriate emotions for the circumstances. Ex: Giggling in the face of a disaster. Taking pride in hurting an animal. 3) Deterioration in normal movement- They have slower movement, no movement, or agitated behavior. 4) Diverted Attention- They are unable to focus.
Schizophrenia Types of Schizophrenia 1: Paranoid Type- (40% of all cases) involves having delusions a. Grandeur – “I am the savior of my people”, “I am God” b. Persecution – “Someone is watching me, or out to get me.” 2: Catatonic Type- (least frequent type) the patient will remain motionless for a long period of time (weeks, months, years), limbs will take time to return to their correct position when they awake. Will also exhibit speech impairment.
Schizophrenia Types (con’t) 3: Disorganized type- patient possesses incoherent language, inappropriate emotions (ex: laughing for no reason), hallucinations. 4: Undifferentiated type- (40% of cases) patient has hallucinations, delusions, scrambled thoughts, speech--- all characteristics or none.
Schizophrenia Treatment of Schizophrenia Treatment is long term and usually requires hospitalization. Often those with this disorder are institutionalized. (over 50% of total) Is it Permanent? -- Yes, but it can go into remission for a period of time with the proper treatment. No cure exists.
Schizophrenia Causes of Schizophrenia 1: Biological— - Genetics does play an important factor in developing the disorder. (13% get it from a parent) 2: Biochemistry and Physiology— - Chemical imbalances in the brain, like excess dopamine receptors that can cause flawed behavior and lead to the deterioration of brain tissue. 3: Family and Interactions— - Double bind theory- if childhood is filled with contradictory signals from parents…say love, but actions show hate., etc…(causes confusion in child’s head), child abuse, broken homes, etc.
Personality Disorders Why are people with certain personalities considered “abnormal”? - They are unable to establish meaningful relationships with other people. Types of Personality Disorders - Schizoid Personality Disorder Schizoid personalities are introverted, withdrawn, solitary, emotionally cold, and distant. They are often absorbed with their own thoughts and feelings and are fearful of closeness and intimacy with others. For example, a person suffering from schizoid personality is more of a daydreamer than a practical action taker.
Personality Disorders Schizotypal Personality Disorder A pattern of peculiarities best describes those with schizotypal personality disorder. People may have odd or eccentric manners of speaking or dressing. Strange, outlandish or paranoid beliefs and thoughts are common. People with schizotypal personality disorder have difficulties forming relationships and experience extreme anxiety in social situations. They may react inappropriately or not react at all during a conversation or they may talk to themselves. They also display signs of “magical thinking” by saying they can see into the future or read other people’s minds. <ul><ul><li>Borderline Personality Disorder People with borderline personality disorder are unstable in several areas, including interpersonal relationships, behavior, mood, and self-image. Abrupt and extreme mood changes, stormy interpersonal relationships, an unstable and fluctuating self-image, unpredictable and self-destructive actions characterize the person with borderline personality disorder. </li></ul></ul><ul><ul><li>These individuals generally have great difficulty with their own sense of identity. They often experience the world in extremes, viewing others as either “all good” or “all bad.” A person with borderline personality may form an intense personal attachment with someone only to quickly dissolve it over a perceived slight. </li></ul></ul>
Personality Disorders <ul><ul><li>Narcissistic Personality Disorder People with narcissistic personality have an exaggerated sense of self-importance, are absorbed by fantasies of unlimited success, and seek constant attention. The narcissistic personality is oversensitive to failure and often complains of multiple somatic symptoms. Prone to extreme mood swings between self-admiration and insecurity, these people tend to exploit interpersonal relationships. </li></ul></ul><ul><ul><li>Avoidant Personality Disorder Avoidant personalities are often hypersensitive to rejection and are unwilling to become involved with others unless they are sure of being liked. Excessive social discomfort, timidity, fear of criticism, avoidance of social or work activities that involve interpersonal contact are characteristic of the avoidant personality. They are fearful of saying something considered foolish by others; worry they will blush or cry in front of others; and are very hurt by any disapproval by others. </li></ul></ul>
Personality Disorders <ul><ul><li>Dependent Personality Disorder People with dependent personality disorder may exhibit a pattern of dependent and submissive behavior, relying on others to make decisions for them. They require excessive reassurance and advice, and are easily hurt by criticism or disapproval. They feel uncomfortable and helpless if they are alone, and can be devastated when a close relationship ends. They have a strong fear of rejection. Typically lacking in self-confidence, the dependent personality rarely initiates projects or does things independently. This disorder usually begins by early adulthood and is diagnosed more frequently in females than males. </li></ul></ul>
Personality Disorders <ul><ul><li>Antisocial Personality Disorder </li></ul></ul><ul><ul><li>People with antisocial personality disorder characteristically act out their conflicts and ignore normal rules of social behavior. </li></ul></ul><ul><ul><li>These individuals are impulsive, irresponsible, and callous. Typically, the antisocial personality has a history of legal difficulties, belligerent and irresponsible behavior, aggressive and even violent relationships. They show no respect for other people and feel no remorse about the effects of their behavior on others. These people ware at high risk for substance abuse, especially alcoholism, since it helps them to relieve tension, irritability and boredom. </li></ul></ul><ul><ul><li>They are often very intelligent and entertaining, can mimic emotions and feelings without actually having them. </li></ul></ul>Psychopaths/ Sociopaths
Personality Disorders Examples of Psychopaths: - serial killers EX: Jeffrey Dahmer : A young man from a good family deviated into necrophilia and cannibalism, then lured boys to his apartment to be murdered and maimed. John Wayne Gacy: One of the most notorious serial killers, "respectable" Chicago-area businessman hires young men to work in his contracting company, then rapes and murders scores of them, burying their bodies on his properties. In prison, he became the focus of researching the psychopathic mind
Personality Disorders Ted Bundy: The most frightening of serial killers: a handsome, educated psychopath who stalks and murders young college women. David Berkowitz: Calling himself the Son of Sam, this serial killer terrorized New York City in the late 1970s. Eddie Gein : Considered to be a mild-mannered bachelor whose emotional development had been stunted by his domineering mother, he shocked the world when police found his vest of human skin and a cache of body parts. Gein is the model for The Silence of the Lambs' Buffalo Bill and Psycho's Norman Bates.
DRUG Addiction Psychological Dependence- - compelled to use it because of the feeling it gives them. Addiction- - the physical dependence of a drug by the system (body). Tolerance- the body needs more of the drug to achieve the same effects or “high”, it becomes immune to the effects at a certain level. Withdrawal- the physical and psychological upset caused by the discontinued use of a drug.
DRUG Addiction Alcoholism - country’s most serious drug problem. Percentages- H.S. Seniors – 88% have tried it, 54% in the past month Adults– 10% of drinking adults consume 50% of the total alcohol in the United States. Crimes– 50% of all auto crashes can be blamed on alcohol. 50% of homocides involved alcohol.
DRUG Addiction Factors that affect Consumption Weight- the more weight a person has the more alcohol they can typically handle. Food- The presence of food in the body will cause the body to absorb the alcohol at a much slower rate. Metabolism - How quickly your liver can break the alcohol down will affect a person in different ways. (women metabolize slower than men)
DRUG Addiction Effects of: It was determined that most people begin to show measurable mental impairment at around 0.05% blood alcohol. At around 0.10% mental impairment will show obvious physical signs, such as an unsteady walk. Slurred speech shows up at around 0.15%. Unconsciousness results by 0.4%. Above 0.5%, the breathing center of the brain or the beating action of the heart can be anesthetized, resulting in death.
DRUG Addiction Stages of Alcoholism Stage 1: The individual realizes that alcohol reduces tension and gives them confidence. Reduces social pressure for them, so they are more likely to try it again. Stage 2: Alcohol becomes a drug an they begin to consume drinks heavily. They will often suffer blackouts from the heavy amounts consumed. Stage 3: The individual will drink compulsively, even in the morning. They will eat infrequently and often feel sick without the presence of alcohol in their body.