u14 Disorders
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Transcript of u14 Disorders
Psychological Disorders
Unit 14
Preview
Introduction Psychological DisordersAnxiety DisordersMood DisordersPersonality DisordersDissociative DisordersSomotoform DisordersPsychotic Disorders
Introduction to Psychological Disorders
m47
• Psychological Disorder– A harmful dysfunction in which behavior is
judged to be• Atypical
• Disturbing
• Maladaptive
• and Unjustifiable
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Causes
Historical Perspective
• Perceived Causes– Movements of the sun or moon.
• Full moon == lunacy– Evil spirits
• Ancient Treatments– Exorcism, caged like animals, beaten, burned,
castrated, mutilated, blood replaced with animal’s blood.
Biological Perspective
• “The Medical Model”– Mental disorders as physical – Brain abnormalities– Chemical imbalances– Birth difficulties– High heritability
Psychodynamic perspective
• Sigmund Freud• Unconscious conflicts and drives• Early childhood trauma• Therapy helps person become aware of
underlying conflicts
• Cognitive Perspective
– Conscious thoughts
– Learned maladaptive thought patterns cause mental disorders
• Behavioral Perspective
– Learned maladaptive patterns of behavior cause mental disorder
Socio-Cultural Perspective
• Larger culture important to development of mental disorders
• Supporting evidence from “culture-bound syndromes”
– Anorexia and Bulimia in North America and Western Europe
• Bio-Psycho-Social Perspective– assumes that
biological, sociocultural, and psychological factors combine and interact to produce psychological disorders
Biological
SociologicalPsychological
Psychological disorder
Multiple-Causation• Predisposing causes
– In place before onset– Make person
susceptible– Inherited characteristics– Learned beliefs– Sociocultural beliefs
• Precipitating causes– Immediate events that
bring on the disorder– Loss– Perceived threat– When predisposition
high, precipitating event may be small
• Maintaining causes– Consequences of the disorder keep disorder going once it begins
• Sometimes positive consequences, like extra attention from friends, family & care professionals
• Sometimes negative consequences, like loss of friends, stigma, etc
Classifying Disorders
• DSM-IV– Neurotic disorders
• Disorders that are distressing, but still allow one to function in society
– Psychotic disorders• A person loses contact with reality, experiencing
irrational ideas and distorted perceptions
Rates of Psychological Disorders
• 2.1 million inpatient admissions to US hospitals and psychiatric units.
• Another 2.4 million have sought outpatient care.
• 15% of Americans are judged by health care professionals as needing some psychiatric help in the course of a year.
Rates of Psychological Disorders
• No known culture is free of schizophrenia and depression.
• WHO reports that 400 million worldwide suffer from a psychological disorder.
• Incidence of serious psychological disorders is doubly high among those below the poverty line.
Rates of Psychological Disorders
• 75% of people who will ever have a psychological disorder experience the first symptoms by age 24.– Antisocial personality disorder and phobias
appear by a median age of 8 and 10.
Anxiety Disorders
m48
• Generalized Anxiety Disorder– A person is continually tense, apprehensive,
and in a state of autonomic nervous system arousal
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anxiety
• Panic Disorder– Anxiety disorder marked by minutes-long
episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations
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• Phobias– A persistent, irrational fear and avoidance of a
specific object or situation.
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phobias
Afraid of it Bothers slightly Not at all afraid of it
Beingclosed in,
in a smallplace
Being alone In a
houseat night
Percentageof peoplesurveyed
100908070605040302010
0Snakes Being
in high,exposedplaces
Mice Flyingon an
airplane
Spidersand
insects
Thunderand
lightning
Dogs Drivinga car
Being In a
crowdof people
Cats
• Obsessive-Compulsive Disorder– Characterized by unwanted repetitive thoughts
(obsessions) and/or actions (compulsions)– Obsessions
• Concern with dirt, germs of toxins - 40%• Something terrible happening (fire, death, etc) – 24%• Symmetry, order, or exactness – 85%
– Compulsions• Excessive hand washing/ cleaning – 85%• Repeating rituals – 51%• Checking doors, locks, etc – 46%
Explaining Anxiety Disorders
• Learning Perspective
– Fear Conditioning
– Stimulus Generalizations
– Reinforcement
– Observational Learning
• Biological Perspective
– Evolution/ Natural Selection
– Genes/ temperament
– Physiology
–anterior cingulate cortex
–amygdala
Dissociative and Personality Disorders
m49
Personality Disorders
• Disorders characterized by inflexible and enduring behavior patterns that impair social functioning.– Histrionic Personality Disorder– Narcissistic Personality Disorder– Borderline Personality Disorder– Antisocial Personality Disorder
• Histrionic Personality Disorder– characterized by a pattern of excessive
emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood.
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• Narcissistic Personality Disorder– "a pervasive pattern of grandiosity, need for
admiration, and a lack of empathy."
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• Borderline Personality Disorder– "a pervasive pattern of instability of
interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts."
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• Antisocial Personality Disorder– "The essential feature for the diagnosis is a
pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."
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• Dissociative Amnesia– Loss of memory.– Selective memory loss often brought on by
extreme stress• Dissociative Fugue
– Flight from one’s home & identity accompanies amnesia
• Skeptics wonder if it’s strategic
Dissociative Disorders
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Dissociative Disorders
• Dissociative Identity Disorder– Person exhibits two or more distinct and
alternating personalities (dba. Multiple-Personality Disorder)
– Supporting evidence• Distinct brain & body states, handedness changes, different
vision– Contrary evidence
• Increasing diagnoses, increasing personalities
Somotoform Disorders
• Physical disorders which have psychological causes.
– Hypochondria
– Conversion Reactions
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hypochondria
Mood Disorders
m50
Suicide• More than 32,000 suicides a year;
425,000 self-inflicted injuries per year
• 40-50% of college students have thought about suicide.15% have attempted suicide.
• 1 out of 80 college students is the survivor of a loved one’s suicide.
• 78% of all suicides are by men– Firearms are most common for men; poison for women
• 17% of high school students have thought about suicide
• 2nd leading cause of death for 25-34 year-olds;3rd leading cause of death for 15-24 year-olds
Common Characteristics
1. Unendurable psychological pain
2. Frustrated psychological need
3. The search for a solution
4. Helplessness and Hopelessness
5. An attempt to end consciousness
6. Constrictions of options
7. Ambivalence
8. Communication of intent (80%)
9. Departure
10. Lifelong coping patterns
Warning Signs of Suicide• Talking about suicide• Statements about
hopelessness, helplessness, or worthlessness
• Preoccupation with death
• Suddenly happier, calmer
• Loss of interest in things one cares about
• Visiting or calling people that one cares about but hasn’t communicated with recently
• Making arrangements; setting one’s affairs in order
• Giving things away
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Mood Disorders
• Major Depressive Disorder
– A person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities
• Prevalence:10-25% chance for women; 5-12% for men.
• Median age of onset: 25
• Average Duration: 9 months
• 70% recurrence w/i 5 yrs;80% chance w/i 8 yrs
• 76% of patients respond to anti-depressants
Mood Disorders• Bipolar Disorder
– Major depression is sometimes followed by a manic episode: hyperactive, wildly optimistic state
– dba. Manic Depressive
Depressed state Manic state Depressed state
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Explaining Mood Disorders
• Biological Perspective– Genetic influences
• 50% chance twin will have similar mood disorder
– The Brain• High norepinephrine
during manic state; low norepinephrine during depression
• Low serotonin during depression
• Smaller frontal lobes in depressed people
• Social-Cognitive Perspective
– Negative thoughts feed negative moods
– Negative mood feeds negative thoughts
Schizophrenia
m51
Psychotic Disorders
• Schizophrenia– Symptoms
• Disorganized thinking• Disturbed perceptions• Inappropriate emotions and actions
– Types• Positive & Negative• Chronic & Acute
Compare to Infantile Autism
• Social isolation• Stereotyped behaviors• Resistance to any change• Abnormal responses to sensory stimuli• Insensitivity to pain• Inappropriate emotional expression• Disturbances of movement• Poor development of speech• Specific, limited intellectual problems
Psychotic DisordersSchizophrenia
Subtypes of Schizophrenia
Paranoid: Preoccupation with delusions or hallucinations
Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion
Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements
Undifferentiated Schizophrenia symptoms without fitting one of the or residual: above types
Understanding Schizophrenia
• Brain abnormalities– Dopamine overactivity
• More receptors; extra dopamine can induce (ie cocaine)
– Brain anatomy• Low frontal lobe activity• Spaces in brain filled with fluid• Smaller than average thalamus
Understanding Schizophrenia
• Genetic factors– 1 in 100 chance of developing schizophrenia.– 1 in 10 if parent or sibling developed.– 1 in 2 if identical twin develops it.