Psychological Disorders

What do you think?

Write a definition for a psychological disorder.

Do not give examples or define specific disorders- what does it mean to have a psychological disorder?

–distressing & harmful; disruptive

–behavior is uncontrollable

–Unjustified, Irrational

Psychological Disorder

Psychological Disorders

Must have personal distress and impaired functioning

Personal DistressThe behavior/symptoms

causes significant personal distress to the patient (may not realize)–Potential harm to self or others

Impairs FunctioningDaily life functioning

is impaired (one or both)–Work/School life–Home life–Varies throughout time/ culture

Ancient causes of Ancient causes of “madness”“madness”

–movements of sun or moon

lunacy- full moon (lunar)

–evil spirits

Ancient “cures”–Exorcism

–Caged like animals, beaten, burned, castrated, mutilated – blood

replaced with animal’s blood!

Diagnosis DSM-VDiagnostic and Statistical Manual

of Mental Disorders describes specific symptoms

and diagnostic guidelines for psychological disorders

– Provides a common language & comprehensive guidelines to help diagnose

DSM-V vs DSM-IV 5 axis diagnostic system now simplified – a

single diagnostic of all factors that could contribute to the patients well-being (physical, social, emotional, etc)

Reduction in the amount of time symptoms must be present to be diagnosed with a disorder. (for example, instead of 6 months with the symptoms now its only 3 months)

Insanity legal

definition only

unable to determine between right & wrong or understand consequences

Anxiety

An unpleasant emotional state characterized by general, vague feelings of tension, fear and apprehension

Generalized Anxiety Disorder (GAD)

Constant worry about many issues w/o cause, seriously interferes with functioning–Physical symptoms

headachesstomach achesmuscle tensionirritability

Panic Disorder Panic attacks—

sudden episode of helpless terror with high physiological arousal (increased blood pressure, heart beat, temp., sweating) Very frightening —sufferers live

in fear of having them

Agoraphobia often develops

NOT FEAR OF OUTDOORS Fear of being in situations in which escape might be difficult, they don’t feel safe- public places, crowds, wide open spaces–Mostly confined to homes- they are safe there

Specific Phobias

Intense, irrational fears that may focus on …….

Inappropriate response to ………..

Natural environment

type•the fear of heights (acrophobia) • the fear of lightning and thunderstorms (astraphobia).

Situational type–the fear of small confined spaces

(claustrophobia) – being "afraid of the dark," (nyctophobia).

–Monophobia—fear of being alone–Gephyrophobia - Fear of crossing bridges.

–Ligyrophobia — Fear of loud noises. –Xenophobia — Fear of strangers, foreigners, or aliens.

Blood/injection/injury type

– the fear of medical procedures including needles and injections (aichmophobia)

Algobphobia—fear of pain Pyrophobia—fear of fire Emetophobia — Fear of vomiting. Radiophobia— Fear of radiation or x-

rays Hemophopia (Haemophobia) — Fear

of blood

Animal type–the fear of spiders (arachnophobia)

–the fear of snakes (ophidiophobia).

Ailurophobia—fear of cats Myrmecophobia — Fear of ants. Cynophobia — Fear of dogs or of

rabies. Mottephobia — Aversion to moths

and butterflies.

Other– the fear of the number 13

(triskaidekaphobia)– the fear of clowns

(coulrophobia). Anthropophobia—fear of men Ephebiphobia — Fear/dislike of

teenagers. Zapatophobia - Fear of shoes,

socks, or sandals.

Common and uncommon fears

Afraid of it Bothers slightly Not at all afraid of it

Beingclosed in,

in a smallplace

Being alone

In a house

at night

Percentageof peoplesurveyed

100

90

80

70

60

50

40

30

20

10

0Snakes Being

in high,exposedplaces

Mice Flyingon an

airplane

Spidersand

insects

Thunderand

lightning

Dogs Drivinga car

Being In a

crowdof people

Cats

Follows events that produce intense horror or helplessness (traumatic episodes)

Actual or threatened death and/or injury–War, Rape, Accidents, Attacks, Abuse, Rescue workers

May be delayed after event- onset with trigger

Posttraumatic Stress Disorder (PTSD)

–Avoidance of situations that trigger recall of the event

–Increased physical arousal associated with stress

Core symptoms include:–Frequent recollection of traumatic event, often intrusive and interfering with normal thoughts

Obsessive-Compulsive Disorder

Obsessions—irrational, disturbing thoughts that intrude into consciousness (getting sick)

Compulsions—repetitive actions performed to alleviate obsessions (washing hands)

The compulsions (actions) help to keep away the obsessions (thoughts)

If the actions are not performed==anxiety

Observable or mental compulsions

Common Obsessions and Compulsions AmongPeople With Obsessive-Compulsive Disorder

Thought or Behavior Percentage*Reporting Symptom

Obsessions (repetitive thoughts)

Concern with dirt, germs, or toxins 40

Something terrible happening (fire, death, illness) 40

Symmetry order, or exactness 24

Excessive hand washing, bathing, tooth brushing, 85or grooming

Compulsions (repetitive behaviors)

Repeating rituals (in/out of a door, 51up/down from a chair)

Checking doors, locks, appliances, 46car brake, homework

Borderline Personality Disorder

Instability of self-image, relationships

Self-destructive behaviors, impulsive

Fear of abandonment

Dependent Personality Disorder

Unable to make decisions or do things on own

Narcissistic Personality Disorder

self importance, success fantasies, need for ^ attention, envy arrogance – others are inferior

Antisocial Personality

DisorderMight start as conduct disorder (children)

Manipulative, charming, “con man”

Cruel, destructiveLacking “conscience”, no guilt, no responsibility

What’s the difference between a psychopath and a sociopath?

Not much…both technically have Anti-Social Personality Disorder, but there are a few differences…– 1 – The cause The cause – many sociopaths get that way due to environmental

(or “social” circumstances (abuse, poverty, neglect, etc)

– 2 – The attachment The attachment – many sociopaths can emotionally attach to others and feel remorse when hurting those they are attached to, psychopaths do not.

– 3 – The presentation The presentation – The psychopath cons and manipulates others “pretending” to be “normal”. They are aware that what they are doing is wrong – they just don’t care. Conversely, the sociopath is less organized in his or her demeanor; he or she might be nervous, easily agitated, and quick to display anger. A sociopath is more likely to act out of impulse.

So which do you feel best describes the “Iceman”?

Psychopath or

Sociopath?

Dissociative Amnesia

Memory loss the only symptom…but no “organic” cause!

Often selective loss surrounding traumatic events–person still knows identity and most of their past

Dissociative Amnesia

Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers.

Margie was unable to recall Margie was unable to recall any details from the time of any details from the time of the accident until four days the accident until four days later.later.

Fugue State Considered by the DSM-V to be a “sub-category” of

Dissociative Amnesia

Amnesia with a journeyjourney involved – often with identity replacement

– leaves home– develops a new identity– apparently no recollection of former life

If fugue wears off– old identity recovers– new identity is totally forgotten

Dissociative Fugue

Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man.

Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married.

http://www.msnbc.msn.com/id/21134540/vp/15384724#15384724

Dissociative Identity Disorder (DID)

NormaNorma has frequent memory gaps and cannot account for her whereabouts

during certain periods of time. While being interviewed by

a clinical psychologist,

she began speaking in a

childlike voice. She claimed

that her name was Donna Donna and

that she was only six years

old.

Moments later, she seemed to revert to her

adult voice and had no no

recollection recollection of speaking in a childlike voice

or claiming that her name

was Donna.

Dissociative Identity Disorder

Most report recall of torture or sexual abuse as children and show symptoms of PTSD

Pattern typically starts prior to age 10 (childhood)

2 or more distinct personalities manifested by the same person at different times, VERY rare and controversial disorder

“Psychotic” loss of contact w/reality- irrational, distorted

Symptoms of Schizophrenia

–HallucinationsSeeing & hearing things that are not there

Command (something/ someone giving orders)

Symptoms of Schizophrenia

–DelusionsPersecution/Paranoid (they’re out to get me’)

Grandeur (“God” complex)

Being Controlled (CIA is controlling my brain with a radio waves)

Symptoms of Schizophrenia

Disorganized Speech (e.g., word salad)– jumping from idea to idea without the benefit of logical association

–Paralogic—on the surface, seems logical, but seriously flawede.g., Jesus was a man with a beard, I am a

man with a beard, therefore I am Jesus

Symptoms of SchizophreniaDisorganized behavior

–behavior is inappropriate for the situatione.g., wearing sweaters and overcoats on hot days

–Emotion is inappropriately expressedno emotion at all in face or speech, laughing at very serious things, crying at funny things

-Catatonia unresponsive

to surroundings

parrot-like speech

immobility for extended periods

Symptoms of Schizophrenia

Example of Schizophrenia (Heather)

Early Causes:

Genetic Predisposition

Prenatal Factors

Vulnerability:

•Cognitive impairments

•Social Anxiety

•Odd ideas

Reinforcement:

Social stress

Isolation

Drug/Alcohol abuse

PSYCHOSIS!

WHERE DOES IT COME FROM?

Nature AND Nurture!

Major Depression

extreme and persistent feelings of despondency, worthlessness and hopelessness that disturb everyday functioning

Symptoms of Major Depression

Emotional—sadness, hopelessness, guilt, turning away from others

Behavioral—tearfulness, dejected facial expression, loss of interest in normal activities, slowed movements and gestures, withdrawal from social activities

Cognitive—difficulty thinking and concentrating, global negativity, preoccupation with death/suicide

Physical—appetite and weight changes, excessive or diminished sleep, loss of energy, global anxiety, restlessness

treatment

Seasonal Affective Disorder

Episodes of depression occur in fall and winter then subside in spring and summer

(Seasonal regularity)

Considered by the DSM-V to be a “sub-category” of Major Depression

Dysthymic Disorder

Chronic, low-grade depressed feelings that are not severe enough to be major depression

May develop in response to trauma, but does not decrease with time

Usually does not severely impair functioning

Over two years

Bipolar Disorders

Mood levels swing from severe depression to extreme euphoria (mania), can have “normal” in between

No regular relationship to time of year (SAD)

Can vary in length of time for depression and mania

Must have at least one manic episode– Supreme

self-confidence

– Grandiose ideas and movements, little effort in carrying out plans

– Flight of ideas

Aggressive, hostile, wild, incomprehensible, violent

Depressed state Manic state Depressed state

PET scans show that brain energy consumption rises and falls with emotional swings

There are over 250 identifiable types of psychotherapy, though the most influential are:– Psychoanalytical Therapies– Humanistic Therapies– Cognitive Therapies– Behavior Therapies– Group and Family Therapies– Psychosurgery– Psychopharmacology

Any therapist who uses a combination of therapies is said to be using an “eclectic” approach to therapy

Therapeutic Perspectives

Psychoanalysis - assumes that many psychological problems are fueled by the childhood repression of impulses and conflicts

Humanistic - goal is to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.

Therapeutic Perspectives

Cognitive - attempt to teach people new, more adaptive ways of thinking and acting

Behaviorists - believe that problem behaviors are the problem, and the goal is to simply eliminate or unlearn the problem behavior

Types of Behavior Therapies

Systematic Desensitization attempt to gradually substitute a positive response for a negative response to a harmless stimulus.

Implosive Therapy floods patients with their worst fears first, in hopes that by confronting them, they’ll overcome them.

Aversive conditioning replace a positive response to a harmful stimulus with a negative response.

Benefits: others have same

disorder share therapy ideas receive feedback you are not alone

Group therapy is generally for people experiencing family conflicts or those whose behavior is distressing to others.

Therapeutic Perspectives

Methods:– Usually groups of six to ten individuals– Averaging up to 90 minutes per week

– Family Therapy promotes the idea that families are a unit that depends on each member to be positive and to communicate

Therapeutic Perspectives

Psychosurgery:– Surgery that removes or destroys brain tissue in

an effort to change behavior.– Once popular, but no more, a lobotomy cuts the

nerves that connect the frontal lobe to the emotion-controlling centers in the inner-brain.

Therapeutic Perspectives

Psychopharmacology:

– The study of the effects of drugs on the mind and behavior

– Introduced in the 1950’s– Greatly reduced those confined to a

hospital– currently applied to just about

anything

Therapeutic Perspectives

Types of DrugsAntianxiety Drugs:

– Are used for the purpose of alleviating the symptoms stemming from frightening situations and fear-inducing stimuli

– IE. Xanax, Valium

Types of Drugs Antipsychotic Drugs:

–Drugs used for the purpose of calming psychotic patients; those patients with fundamental mental derangement (such as schizophrenia)

–IE. Thorazine, Clozaril, Haldol

Types of Drugs

Antidepressant Drugs–The purpose is to lift people up from a state of depression

– IE. Prozac, Paxil, Zoloft–Lithium is an anti-depressant used mainly for manic-depressives (bipolar)

Some Criticisms of Drug Therapy:

–Doesn’t address the root causes of behavior disorders

–May cause addiction

–Increased risks for suicide with some drugs?

–May cause other symptoms, disorders or diseases

Alternative Therapies

A practitioner moves their hands a few inches from a patient’s body, purportedly “pushing energy fields into balance”

Therapeutic Touch:

Eye Movement Desensitization

Reprocessing (EMDR):– Usually for disorders associated with

trauma and anxiety.

– A patient is asked to close their eyes and to think about a traumatic scene from their life.

– A therapist waves their hand in front of their eyes as they are thinking, causing rapid eye movement

Does this Does this resemble the resemble the

stress-less stress-less REM of sleep?REM of sleep?

– Especially for seasonal affective disorder, or depression brought on seasonal changes from summer to winter (less light). The therapy includes timed doses of intense light in “light boxes”.

Light Exposure Therapy:

Electroconvulsive Therapy:

– Patients are given an anesthetic so that they are not conscious, and a muscle relaxant to prevent any injuries that may occur from convulsions.

–Patient’s brains are given momentary shock treatments, generally for about 30 seconds.

Electroconvulsive Therapy:–Used in cases of deep depression, but historically used for almost anything determined to be abnormal behavior.