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Historically individuals who

History

Historically, individuals who suffered from Psychological

Disorders were thought to be “crazy” or possessed by evil

spirits.

Abnormal Behavior

DeviantDistressful

Maladaptive

Deviant?

• A woman who washes her hands 4 or 5 times per hour and takes 7

Deviant?

per hour and takes 7 showers a day is abnormal because her behavior deviates from what we see as acceptable.

• A man believes that he can kill someone by breathing on them Thus

Maladaptive?

breathing on them. Thus, he does everything in his power to avoid being near people (it’s for their own good)…

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• We all get distressed from time to time But

Distressful?

from time to time. But if it’s long term and unrelenting, it becomes abnormal.

• Psychological disorders are classified via the Diagnostic and Statistical Manual 4th Edition –Text Revision

Classifying Disorders

Manual 4 Edition Text Revision (DSM-IV-TR).

• The DSM-IV-TR uses a multiaxialsystem of assessment. It provides information about a person’s overall functioning (not just a diagnosis).

• Multiaxial System• Axis I and II: Psychological Disorders

DSM-IV-TR Axes

• Axis III: General Medical Conditions• Axis IV: Psychosocial and

Environmental Problems• Axis V: Current Level of Functioning

• Advantages– Provides a common basis for communication– Helps clinicians make predictions

Classifying Disorders

– Naming the disorder can provide comfort• Disadvantages and Criticisms

– Classification based on the medical model– Manual may include too many behaviors– Focuses strictly on pathology and problems– Labels can have a stigmatizing effect

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• Psychological Disorders range from relatively mild disorders (such as adjustment disorders) to more severe and chronic disorders, such

hi h i d bi l di d

Range

as schizophrenia and bipolar disorder.

• Adjustment disorder: A maladaptive reaction to one or more identified stressors that occurs shortly following exposure to the stressor(s) and causes signs of distress beyond that which would be normally expected or impaired functioning.

.

Prevalence

Anxiety Disorders

Generalized Anxiety

Phobias

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Panic Disorder

Obsessive Compulsive Post-Traumatic Stress

• For individuals with PTSD, the traumatic event remains, sometimes for decades or a lifetime, a dominating psychological experience that retains its power to evoke panic, terror, dread, grief, or despair.

A

po e to e o e pa c, te o , d ead, g e , o despaThese emotions manifest in daytime fantasies, traumatic nightmares, and psychotic reenactments known as PTSD flashbacks. Furthermore, trauma-related stimuli that trigger recollections of the original event have the power to evoke mental images, emotional responses, and psychological reactions associated with the trauma.

• Avoidant/numbing consists of symptoms that reflect behavioral, cognitive, or

ti l t t i PTSD ti t

B

emotional strategies PTSD patients use in an attempt to reduce the likelihood that they will expose themselves to trauma-related stimuli.

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Women and PTSD

Notice the difference between noncriminal and criminal trauma…

• 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

Causal Factors

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 and Somatoform Disorders

• Dissociative Disorders: A class of psychological disorders involving changes in consciousness or self-identity.

Dissociative and Somatoform

y

• 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 assurances to the contrary.

Dissociative Disorders

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Dissociative Disorders

• There is much debate as to whether dissociative disorders even exist. Some feel that people who have been diagnosed with dissociative disorders are simply faking their symptoms.

• The great majority of people who have been diagnosed with

Causal Factors

• 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.

• Psychodynamic theorists believe the dissociative disorders are a result of massive repression while learning theorists believe that people with dissociative disorders have learned to redirect their thinking away from troubling memories in order to avoid feelings of shame, anxiety and guilt.

Somatoform Disorders

• Psychodynamic theory: Hysterical symptoms symbolize underlying psychological conflict.

Causal Factors

• 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 DisordersMood Disorders

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• Women are two times more likely to be diagnosed with depression than men.

• Women have greater stress

Mood Disorders

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.

• 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

Mood Disorders

or silliness, engage in risky behaviors, experience a flight of ideas and speak very rapidly.

• In the depression phase, people have a downcast mood, often sleep more than usual, and feel lethargic.

• In order to avoid the depressive phase, some people suffer from bipolar disorder may attempt suicide when the mood shifts from elation towards depression.

• Carolyn had been employed as a lawyer until she got into trouble for reckless and dangerous driving. She felt that she could avoid any danger even though she drove her sports car at 160 m/hr. When she got into

f th d h f lt i l bl d ld

BIPOLAR

one of these moods, she felt invulnerable and would even attempt driving stunts that were potentially very dangerous. Eventually, she was disbarred because of bankruptcy caused by uninhibited and unrestricted spending sprees. When she was asked for her resignation, she was not upset, telling her employers that she one day soon she would be the Chief Justice.

• Psychological Factors: From the psychodynamic perspective, depression is anger turned inward. Learning theorists suggest that depressed people lack sufficient reinforcement in their lives to maintain their mood and behavior. Finally, cognitive theorists believe

CAUSAL FACTORS

mood and behavior. Finally, cognitive theorists believe that the ways we interpret life events leads to emotional disorders such as depression.

• Biological Factors: Evidence suggests an important role for genetic factors in major depression and bipolar disorder. Research has identified irregularities in the use of serotonin in the brain (Prozac works to increase the level of serotonin in the brain).

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CAUSAL FACTORS

• 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

Schizophrenia

• About 2.5 million Americans are diagnosed with schizophrenia, with about 1 in 3 requiring hospitalization.

• 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.

• Paranoid Schizophrenia: A type of schizophrenia characterized primarily by delusions—commonly of persecution—and by vivid hallucinations.

Schizophrenia

• 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.

• When Betsy listened to her music she knew that there were messages in there that were only meant for her. They were messages from the devil telling her about plots to kill her and they could only be sent t h b f t d t i B t it

Paranoid Schizophrenia

to her by way of country and western music. But it wasn't only the music, it was people who listened to that sort of music like her close friends. They would have to be eliminated just to keep her safe. On one occasion she saw the devil's tentacles underneath Garth Brooks hat but no one else saw it. This syndrome had been slowly developing for about a year and for a long time she kept her secrets to herself.

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• 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.

Causal Factors

• 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.

• Pierce had always been a little odd at least to the few people who ever got to know him. When he was 18 he decided to forgo university and slowly over the next few years began a slow withdrawal from reality. Hi ff t b fl t it diffi lt t d i h

Catatonic Schizophrenia

His affect became so flat it was difficult to decipher whether he was happy or sad. He also began to complain of somatic delusions -- "ants running over my skin." When he was hospitalized two years later he was semi-stuporous. Soon thereafter he became motionless in a rigid unwavering position. Oddly if you moved one of his limbs it would remain motionless where it was placed.

Diathesis Stress