psychological disorders

1. Psychological disorders &
treatment
source: Bernstein psychology
by Sara Mehrez

2. What Is Abnormal?
The criteria for judging whether people’s thinking, emotions, or
behaviors are abnormal have been called the “three D’s”:
deviance, distress, and dysfunction.
• Deviance
If we define as normal the things most people think and do, an
obvious criterion for abnormality is statistical infrequency , what
is unusual or rare would be considered deviant , the violation of
social norms—the cultural rules that tell us how we should and should
not behave in various situations

3. • Distress
Another criterion for abnormality is distress, or personal suffering. In fact,
experiencing distress is the criterion that people often use to decide that their
psychological problems are severe enough to require treatment, but people can
display psychological disorders without experiencing distress if the disorders
have impaired their ability to recognize how maladaptive their behavior is.
Those who sexually abuse children, for example, create far more distress in
victims and their families than they suffer themselves.
• Dysfunction
A final criterion for abnormality is impaired functioning, which means having
difficulty in fulfilling appropriate and expected roles in family, social, and
work related situation
.

4. The Biopsychosocial Approach
in which mental disorders are regarded as resulting from the
combination and interaction of biological, psychological,and
sociocultural factors, each of which contributes in varying degrees
to particular problems in particular people.
Biological Factors
include physical illnesses, disruptions or imbalances in bodily
processes,and genetic influences
The medical model is now more properly called the
neurobiological model because it explains psychological disorders
in terms of particular disturbances in the anatomy
and chemistry of the brain and in other biological processes,.

5. Psychological factors
psychological factors, such as our wants, needs, and emotions;our learning
experiences; our attachment history; and our way of looking at the world.
• Freud’s psychodynamic approach.
He believed that those disorders are the result of unresolved,mostly unconscious
conflicts
• social-cognitive theorists : say disorders as resulting from the interaction of
past learning and current situations.
• The humanistic approach to personality suggests that behavior disorders
appear when a person’s natural tendency toward healthy growth is blocked,
usually by a failure to be aware of and to express true feelings. When this
happens, the person’s perceptions of reality become distorted. The greater
the distortion, the more serious the psychological disorder.

6. sociocultural factors
• Gender, age, and marital status; the physical, social, and economic situations
in which people live; and the cultural values, traditions, and expectations
• these factors shape the disorders and symptoms to which certain categories of
people are prone, and they even affect responses to treatment. For example,
among people diagnosed with schizophrenia, those living in a developing
country such as India are much more likely to improve than those living in a
more developed country, such as the United States .We don’t yet know for
certain what is responsible for this diff erence, but it may have something to
do with the ways in which schizophrenia is understood in different cultures.
In the West, schizophrenia is considered a chronic, debilitating illness. As a
result, many people find themselves left on the fringes of society. In some
non-Western societies, the disorder is seen as less severe and less resistant.

7. diathesis-stress model.
It assumes that biological, psychological, and sociocultural factors can predispose
us toward a disorder but that it takes a certain amount of stress to actually
trigger that disorder. People with a strong diathesis are more vulnerable, so even
relatively mild stress may be enough to create a problem.
People whose diathesis is weaker may not show signs of a disorder until stress
becomes extreme or prolonged.
Another way to think about the notion of diathesis-stress is in terms of risk: Th e
more risk factors for a disorder a person has—whether in the form of genetic
tendencies, personality traits, cultural traditions, or stressful life events—the
more likely it is that the person will display a form of psychological disorder
associated with those risk factors

8. diathesis-stress model.

9. Classifying Psychological Disorders
1. American diagnostic classification system, the
Diagnostic and Statistical Manual of Mental Disorders
(DSM)
2. International Classification of Diseases (ICD)

11. Evaluating the diagnostic system
First, as already mentioned, people’s problems often do not fit neatly into a single
category; mixed (or “comorbid”) disorders are common.
Second, the same symptom (such as sleeplessness) may appear as part of more
than one disorder.
Third, DSM specifies that to be given a particular diagnosis, a person must
display a certain number of symptoms at a certain level of severity for a certain
period of time. If these criteria are met, a person is said to “have” a certain
disorder. But in setting these criteria, the authors of DSM-IV-TR had to identify
some rather arbitrary boundaries between “having” a disorder and “not having”
it. These sharp boundaries fail to capture the varying levels of distress that diff
erent people experience

14. Behavior Therapy
Behavioral treatment can take many forms. By tradition,
those that rely mainly on classical conditioning principles are
usually referred to as behavior therapy.
Those that focus on operant conditioning methods are
usually called behavior modification.
And behavioral treatment that focuses on changing thoughts
as well as overt behaviors is called cognitive behavior
therapy.

15. Techniques for Modifying Behavior
1-systematic desensitization therapy, it is a method in which the client
visualizes a series of anxiety-provoking stimuli while remaining calm. Wolpe
believed that this process gradually weakens the learned association between
anxiety and the feared object until the fear disappears
2-Modeling Behavior therapists sometimes help clients develop more desirable
behaviors by demonstrating those behaviors. In modeling treatments, the client
watches the therapist or other people perform desired behaviors . Modeling is
also a major part of social skills training and assertiveness training,
3-Positive Reinforcement A therapy method that uses rewards to strengthen
desirable behaviors.
4-token economy programs, systems in which desirable behaviors are positively
reinforced with coin like tokens or points that can be exchanged later for snacks,
access to television, or other rewards
5-Extinction failing to reinforce undesirable behaviors can make them less likely
to occur, {The gradual disappearance of a conditioned response or operant
behavior through nonreinforcement

16. 6-flooding, an anxiety reduction treatment in which clients are kept in
a feared but harmless situation. The clients are flooded with fear at
first, but after a period of exposure to the feared stimulus without
pain, injury, or any other dreaded result, the association between
feared stimulus and fear response gradually weakens, and the
conditioned fear response is extinguished
7-exposure therapy Behavior therapy methods in which clients
remain in the presence of strong anxiety-provoking stimuli until the
intensity of their emotional reactions decrease.
8-aversion conditioning A method that uses classical conditioning to
create a negative response to a particular stimulus.
9-punishment A method that uses operant conditioning to weaken
undesirable behavior by following it with an unpleasant stimulus

17. Cognitive behavioral therapy of
understanding and treating OCD
Trigger
stimulus
Faulty appraisal
and believes
Neutralization of
compulsions
Decrease anxiety
/perceived sense of
control

18. 1- evaluation of the client
Each patient is different so tailaring unique plan for each patient is essential
2- psychoeducation about the following
• Illness, course of illness and plan of treatment
• Normacy of unwanted mental intrusions
• Role of appraisal of obecession
• Negative effect of neutralizing compulsion ( decrease anxiety on short
term but maintain sense of helplessness)
3- cognitive restructuring of appraisal of obcession
The trigger may be external or internal sensation or emotion
Patient may be unable to identify introsions if they highly focused on the
compulsion
Intrusions are normal experience but turn to obcession when patient give
them high significance and interpret them as a personal threat .

19. 6 types of appraisals of intrusions are identified
• Inflated resposibility
• Over importance of thoughts
• Over estimated threat
• Need for control over thought
• Intolerance of uncertainty
• Perfectionism
4- exposure and response prevention
• create exposure hiaracies from top to down
• Then we start with the least anxiety provoking situation up to the top
• Exposure is difficult so patient need validation for the trial
• For exposure to be effective , client need to stick around the stimulus until
their anxiety curve decrease
• Repeated exposure are usually necessary
• Client need to understand that therapy usually involves its ups and downs , the
curve of therapy is not always linear

20. 5- mindfullness of the thoughts and obcessions
• Patients learn to observe their introsions and obcessions and
observe their anxiety without performing the compulsion
• Mindfullness also help them to be in the moment rather than to
think about the future