2. Mental Illness
• Abnormal psychology (“psychopathology”)
• Diagnosis
o Observing patient’s symptoms and inferring disorder
o Symptoms appear in clusters called syndromes
• Prognosis
o Refers to prediction about the course of identified disorder
over time
3. Mental Illness
• Neurotic disorders
o Primary symptoms include anxiety or defenses to ward off
anxiety (phobias, OCD, PTSD)
o Symptoms may cause distress or impair functioning but
generally allow for social functioning
• Psychotic disorders
o Includes more severe or “serious” mental disorders
o Thoughts and actions no longer meet the demands of
reality (schizophrenia, dissociative disorders)
4. Mental Illness
• Theoretical models of psychopathology
o Biomedical/biopsychosocial perspective
o Psychodynamic perspective
o Behavioral perspective
o Cognitive perspective
o Systems perspective
5. Biological Perspective
• Emphasizes the physical and biological bases of behavior
• Examines pathology within the brain
o Abnormality stems from disturbances in brain
activity, neurotransmitter problems, and/or chemical
imbalances
• Strongly influenced by neuroscience
o MRI and PET scans re: schizophrenia
6. Psychodynamic Perspective
• Abnormal behavior results from:
a) Unresolved psychological conflicts in early childhood
b) Conflict between selfish desires of Id and the demands of
society/personal conscience of Superego
• Emphasizes attacking defense mechanisms + provoking a
catharsis
7. Behavioral Perspective
• Behaviors learned through conditioning and society can
provide deviant/maladaptive models that children imitate
• Overcoming issues occurs by providing positive learning
experiences, healthy models, and rewarding positive
behavior
o Note: only some mental disorders neatly fit this model
(i.e., Little Albert)
8. Cognitive Perspective
• Abnormal behavior results from distorted/irrational
thinking that leads to maladaptive behavior
• Focuses on the role of patient interpretations and
expectations (thoughts) in generating/sustaining
emotion
• Offers useful understanding of depression
o “Automatic thought process” – depression result of
thinking negative/depressing thoughts about life’s
experiences
9. Systems Perspective
• Looks for the root of an individual’s problem behavior
within a broader social context (i.e., the family)
• Abnormality stems from dysfunctional group relations
within the family
• Focus of counseling treatment becomes the family system
(not the problem or symptomatic family member)
10. Mental Illness
• DSM-IV
o Classifies signs and symptoms into syndromes
• Signs = observable phenomena the patient exhibits
• Symptoms = what patients reports to health care professional
o Uses a multi-axial/multidimensional approach to
diagnose mental illness along 5 dimensions
o Diagnostic classification allows for description, future
course prediction, and treatment
11. DSM-IV
Axis I: Clinical Syndromes
- Signs and symptoms that cause distress (states)
II: Developmental Disorders
- Personality/developmental disorders (traits)
III: Physical Conditions
- Medical conditions (if any)
IV: Severity of Psychosocial Pressures
- Psychosocial/environmental problems
V: Highest Level of Functioning
- Global assessment of functioning
12. Mood Disorders
• Depression
o Psychoanalytic – Reaction to loss coupled with
suppressed/stifled anger
o Behaviorism – Lack of positive reinforcement
o Cognitive – Negative self-schemas that are global AND
stable; failures are magnified while successes
are minimized
o Biological – Neurotransmitter deficiencies/chemical
imbalances
13. Mood Disorders
• Treating depression
o Therapy
o Antidepressants/SSRIs (Paxil, Zoloft, Prozac)
o Electro-convulsive/electro-shock therapy
• Intentional induction of brain seizure
• Immediate improvement but can cause memory loss
• Researchers exploring less traumatic ways to alter electric
activity in brain (i.e., Transcranial Magnetic Stimulation?)
14. Mood Disorders
• Bipolar disorder
o “Manic depressive disorder”
o Alternating episodes of mania and depression
• Mania = Extreme euphoria, racing thoughts, hyperactivity,
little need for sleep
• Low incidence rate (0.5–1.6%) but high suicide rate (10–20%)
o Treatment
• Mood stabilizers (Lithium, Valproate)
15. Anxiety Disorders
• Characterized by intense feelings of distress, anxiety, or
apprehension
• Anxiety problematic when feelings become distressing
to the point it interferes with daily life
• Generalized Anxiety Disorder, phobias, Obsessive
Compulsive Disorder (OCD)
16. Anxiety Disorders
• Phobias
o Characterized by intense irrational fear
o Individual often aware the fear is groundless but will
continue to experience the phobia nonetheless
o Types of phobias
• Simple phobia (of a specific object like spiders)
• Social phobia (fear of public situations)
o Agoraphobia – fear of being in open places and unable
to escape (usually crowds)
17. Anxiety Disorders
• Obsessive compulsive disorder (OCD)
o Extremely persistent obsession (unwelcome thoughts)
and compulsions (unwelcome behavior)
• Several varieties of OCD
• Arrangers/Cleaners
• Counters
• Checkers
• Clutterers/Hoarders
18. Anxiety Disorders
• Treating anxiety
o “Systematic desensitization”
o Benzodiazepines/tranquilizers (Valium, Xanax)
• Problems/concerns:
o Dependency
o Doesn’t necessarily treat underlying anxiety issue(s)
o Many adverse side effects
o Strong cross-activity with other depressants (alcohol)
19. Schizophrenia
• Symptoms
o Disturbances of thought/attention
o Perceptual disturbances (louder noise, more intense color)
o Language disturbances (‘word salad’ – “why’s Wise wise?”)
o Loss of attentional focus
o Neologism – make up words that sound logical
(“She is prastigitious”)
o Associational chaining
20. Schizophrenia
• Symptoms (con’t)
o Affective disturbances (flat affect in inappropriate situations)
o Withdrawal from reality/complete catatonia
o Hallucinations (“see the spies coming”, hear things)
o Delusions or beliefs inconsistent with reality
…of thoughts/influence (others’ brainwaves can influence them)
…of persecution (convinced people are coming for them)
…of grandeur (false beliefs they are greater than they really are)
…of paranoia (high suspicion, constantly being watched)
21. Schizophrenia
• 2 types of onset
a) Acute
- Patient endures a stressor, followed by hallucinations
- Better chance for treatment (address the stressor)
b) Chronic
- Slow, gradual deterioration of the individual
- Actual cause unknown and therefore unclear what
treatment option is best
22. Schizophrenia
• Major types
o Paranoid
o Disorganized
o Catatonic
o Undifferentiated
o Residual
23. Schizophrenia
• Causes
o Biological considerations
• Appears to have a genetic link (i.e., runs in families)
• Identical twin = ~50% probability
o Social causes
• Genetics alone not sufficient cause for schizophrenia
• Low SES?
24. Schizophrenia
• Treatment(?)
o Anti-psychotic medications
• Thorazine – not a perfect drug!
o Causes dyskinesia
o Tolerance issues
o Is “zombification” a cure?
• Respiridone?
25. Dissociative Disorders
• Dissociative reactions
o Characterized by disruptions in consciousness, memory, or
sense of identity (“dissociated”)
o Psychogenic amnesia, “fugue”
• Dissociative Identity Disorder
o “Multiple Personality Disorder”
o At least two separate/distinct personalities exist within the
same individual
26. Personality Disorders
• Antisocial personality disorder
o “Without a conscience”, “sociopath”, “psychopath”
o Characterized as those who easily exploit or harm
others without guilt or remorse
o Slightly more common in men (3%) vs. women (1%)
o Violent and non-violent differentiation
27. Personality Disorders
• Narcissistic personality disorder
o Extreme preoccupation with the self and self-promotion
o Symptoms
• Disregard for the feelings of others
• Grandiosity
• Obsessive self-interest
• Pursuit of primarily selfish goals
• Often demand/expect constant attention and admiration
28. Therapy
• Psychotherapy/Psychoanalysis (Freud)
o Disorders stem from conflicts between Id, Superego,
and Ego
o Treatment involves communication between patient
and a therapist, either individually or in a group
o Make the unconscious conscious
29. Therapy
• Humanistic
o Client-centered therapy (Rogers)
• Assumes problems emerge when concept of self is
incongruent with actual experiences
• Therapist establishes unconditional positive regard and
acceptance
• “Empty chair technique”
30. Therapy
• Cognitive-behavioral
o Thoughts determine behavior, thus distorted thinking
leads to “maladaptive schemas”
o Cognitive restructuring and behavior modification
• Exposure techniques
o Systematic desensitization
o Aversive conditioning
o Flooding
o Modeling
