Unit 6 – Adjustment & Breakdown

Psychological Disorders

Psychological Disorders

Normal or Abnormal?What most people (majority) do is normal

Deviation is abnormalGetting along on the world is normal

Failure to adjust physically, emotionally or psychologically is abnormal

Striving for ideal psychological functioning (self-actualization) is normal

Abnormal Behavior

Is normal better than abnormal?Oppression, stonings, tax evasion,

speeding, smoking, drinking, late assignments, skipping class, …

Why study abnormal behavior?Harmful behaviors (crime, drug use,

violence) might be changed / stopped (i.e. BAU)

Abnormal Behavior

Depends on situation - where/ when ??

Abnormal Behavior

Depends on situation - where/ when ?? (comfort in environment, clothes for season

/ venue, urgency)

Cultural differences ?? (hand holding, men kissing, bowing, evil

spirits)

Occasional abnormal behavior does not mean a psychological disorder (TRY IT)

Failure to adjust

Does abnormal behavior cause difficulty getting along in the world? (can’t leave house…can’t work)

Everyone strives toward ideal functioning = self-actualization

Sanity

Legal definition – far too simple for psychologists

“most people labelled mentally ill are not ill at all” (Szasz)…simply have problems with daily living

Convenient to label people ill and hospitalize them

Classification

DSM (Diagnostic and Statistical Manual of Mental Disorders) – classify mental illnessDSM IV uses 5 major axes (dimensions):

I. Explicitly defined categories (mood, schizophrenia & other psychotic, eating…)

II. Developmental or long standing personality disordersIII. Physical disorders or medical conditionsIV. Measures stress levelV. Highest level of adaptive functioning

Mental Illness

Who is affected?•Mental illness indirectly affects all Canadians at some time through a family member, friend or colleague.•20% of Canadians will personally experience a mental illness in their lifetime.•Mental illness affects people of all ages, educational and income levels, and cultures.•Approximately 8% of adults will experience major depression at some time in their lives.•About 1% of Canadians will experience bipolar disorder (or “manic depression”).

Mental Illness

How common is it?•Schizophrenia affects 1% of the Canadian population.•Anxiety disorders affect 5% of the household population, causing mild to severe impairment.•Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds.•Suicide is one of the leading causes of death in both men and women from adolescence to middle age.•The mortality rate due to suicide among men is four times the rate among women.

http://www.cmha.ca/media/fast-facts-about-mental-illness/

The Issues

How many undiagnosed / misdiagnosed?Problem getting better or worse? Why?Are awareness campaigns successful?Why is there still such a stigma?

SECTION QUIZ 16-1

Types of Disorders

Mood

Schizophrenia

Somatoform

Dissociative

Personality

Drug Addiction

Anxiety

Mood DisordersTypes ?? Major depressive disorder – feelings of

worthlessness and diminished pleasure Case study: Kari

Bipolar disorder – cycle between alternating phases: manic (euphoria / frantic action) and depressive (deep despair)

Case study: Moira

Mood Disorders Seasonal Affective Disorder

(SAD) – melatonin high (sleep) + serotonin low (mood)

Post partum depression (PPD) – 3-4 weeks after birth, cause may be hormone shift, may lead to other depressive disorders

Mood Disorders

Causes ?? Self-esteem, social support, coping with stress Draw illogical conclusions about self (Beck) Learned helplessness (Seligman) No control – useless to try Reduced serotonin and/or noradrenaline Therefore, both biological & psychological

Risk of suicide (3rd leading cause of death for teens)

Schizophrenia

Chronic, severe, disabling brain disease

Confused and disconnected thoughts, emotions, & perceptions, decline in functioning, diverted attention

Incidence: 1% (10% if family history) Typical onset late teens / early 20s

Schizophrenia

Types:Paranoid (“positive” symptoms)

Delusions = false belief despite contrary evidence:

Grandeur (supreme power) Persecution (suspicions)

Hallucinations = perceptions with no direct external cause (all 5 senses)

Case study: Tara, John Nash

Schizophrenia

Disorganized (“negative” symptoms): Incoherent language (word salad)

Case study: Nathaniel Ayers Jr

Disturbed affect (inappropriate emotional expression)

Disorganized movementsDiverted attention

Catatonic = motionless / deteriorated movement

SchizophreniaCauses: Heredity Chemical imbalance (dopamine ++) Deteriorated brain tissue (CAT / MRI)

SchizophreniaCauses: Heredity Chemical imbalance (dopamine ++) Deteriorated brain tissue (CAT / MRI) Diasthesis hypothesis = inherit a predisposition +

exposure to stressors (i.e. pathogenic / unhealthful family)

Maternal infection Birth trauma

SchizophreniaPrognosis: No cure – recovery

(remission possible) Long term institutionalization

in mental hospital -> burnout (inability to function in society)

SECTION QUIZ 16-4

Somatoform Disorders

Somatoform disorder (Freud’s hysteria) = physical symptoms with no apparent cause:Conversion disorder: emotional difficulties -

> loss of physical function (paralysis / blindness…) calm acceptance (la belle indifference) suggests psychological

Hypochondriasis: imaginary symptoms (young adults, WebMD)

Dissociative Disorders

Experience alterations in memory, identity, consciousnessExamples ?? Dissociative Amnesia = lost memory

of personal events / info, no biological / physiological explanation, traumatic event

Dissociative Fugue = amnesia + active flight / travel away from home

Dissociative Disorders Dissociative Identity Disorder (DID):

2+ distinct personalities (patterns of thinking and behaving)

Usually suffered abuse as children Formerly multiple personality disorder Case study: Bill Green

SECTION QUIZ 16-3

Personality DisordersMaladaptive or inflexible ways of dealing with other people or situationsTypes ?? Antisocial (a.k.a. sociopath, psychopath) – shallow

emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers

Infamous Serial KillersName Date Country Name Date Country

Jack the Ripper 1888 England Alieen Wuornos 1989-1992 USA

Ed Gein (Buffalo Bill)

1954-1957 USA Gary Ridgway 1982-1998 USA

The Zodiac Killer

1968-1969 USA (California) Albert Fish 1919-1930

Charles Manson 1969 USA (California) Jeffrey Dahmer (Milwaukee Killer)

1978-1991 USA

Ted Bundy 1974-1978 USA (Florida) Robert Pickton 1980’s Canada (BC)

David Berkowitz (Son of Sam)

1976 USA (New York)

Coral Eugene Watts

1974-1982 USA

John Wayne Gracy

1972-1978 Albert DeSalvo (Boston Strangler)

1960’s USA

Personality DisordersMaladaptive or inflexible ways of dealing with other people or situationsTypes ?? Antisocial (a.k.a. sociopath, psychopath) – shallow

emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers

Dependent – submissiveness, excessive need for care Histrionic – excessive emotions, attention seeking Obsessive-compulsive – intense interest in order, perfection,

control (no anxiety – not OCD) Paranoid – suspicion of evil motives, distrust (no

hallucinations – not schizophrenia) Schizotypal – intense discomfort in close relationships

Drug Addiction

Addiction = ? Psychical dependence – overwhelming and

compulsive desire to obtain and use a drug Psychological dependence – feeling nervous and

anxious without the drug

Drug Addiction

Tolerance = ? Physical adaptation to a drug so that the person

needs an increased amount in order to produce the original effect

Drug Addiction

Withdrawal = ? Symptoms that occur after an addicted person

discontinues using the drug Nausea, the “shakes”, hallucinations, convulsions,

coma, death

Drug Addiction

Most serious drug problem ?? Alcoholism3 stages: Social – reduce tension, boost self confidence,

reduce social pressure Psychological dependence, tolerance + physical

addiction (heavy drink, hide habit, blackouts) Compulsive drink, eating less, sick when sober,

health deteriorates

Alcohol Addiction

Effect of alcohol entering the bloodstream depends on weight, quantity, speed of consumption

Treatment: Antabuse (Rx) + alcohol ->violent illness Psychotherapy

SECTION QUIZ 16-5

Anxiety Disorders

Excessive fear, generalized apprehension, reaction to vague or imagined dangersTypes?? Social Anxiety Disorder (SAD)

Case study: Marley

Anxiety Disorders

Excessive fear, generalized apprehension, reaction to vague or imagined dangersTypes?? Social Anxiety Disorder (SAD)

Case study: Marley Generalized Anxiety Disorder (GAD):

Environmental factors, role of learning, heredity

Physical symptoms – muscle tension, inability to relax, tense face

Case study: Alana

Anxiety Disorders Specific Phobia:

Extreme fear of a specific object, person, or event

Cope by avoiding the source: Agoraphobia – public / outdoors Claustrophobia – small / enclosed spaces Arachnophobia - spiders

Panic disorder: Sudden unexplainable attacks of intense

anxiety Breathing difficulty, faintness, dizziness,

nausea, chest pains

Anxiety Disorders

Post Traumatic Stress Disorder (PTSD):

Re-experience original trauma – nightmares or flashbacks

War veterans, survivors of natural disaster / human aggression

Case study: Tom, Chris

Anxiety Disorders Obsessive Compulsive

Disorder (OCD): Obsession – uncontrollable

thoughts, can’t stop even if unpleasant

Compulsion – repeated performance of an irrational action (coping behavior)

Case study: Jason, Tricia

SECTION QUIZ 16-2

Famous People

Isaac Newton Bipolar John Nash Schizophrenia

Beethoven Bipolar Carrie Fisher Cocaine addiction

Abe Lincoln Depression Ernest Hemingway Depression

Van Gogh Bipolar (suicide) Brooke Shields PPD

Winston Churchill Depression John Keats Depression

Virginia Woolf Bipolar Sylvia Plath Depression (suicide)

Linda Hamilton Bipolar Buzz Aldrin Depression

Shawn Colvin Depression Roseanne Barr Depression