Week 8PsychologicalDisorders

Psychological Disorders

Atypical Behavior - different than normal

Disturbing - determined by others

Maladaptive - distressing, disabling, risk

Unjustifiable - cannot be “rationally” justified

(Richardson, 1999)

Defining Abnormality

• Abnormality as deviation from the average• statistically-based approach

• Abnormality as deviation from the ideal• the standard toward which most people are striving

• Abnormality as a sense of subjective discomfort

• psychological consequences of the behavior for the individual

(Feldman, 1999)

Defining Abnormality

• Abnormality as the inability to function effectively

• inability to adjust to the demands of society

• Abnormality as a legal concept• the legal view of “insanity”

(Feldman, 1999)

Models of Abnormality

• Medical model– suggests that physiological causes are at the

root of abnormal behavior

• Psychoanalytic model– abnormal behavior stems from childhood

conflicts

(Feldman, 1999)

Models of Abnormality

• Behavioral model– abnormal behavior is a learned response

• Cognitive model– assumes cognitions (people’s thoughts and

beliefs) are central to abnormal behavior

(Feldman, 1999)

Models of Abnormality

• Humanistic model– emphasizes people’s control and responsibility

for their own behavior

• Sociocultural model– assumes behavior is shaped by family, society,

and culture

(Feldman, 1999)

Understanding Psych Disorders Medical PerspectiveMedical Perspective

• Mental disorders are a psychological response to stress & inhumane conditions

• Genetic components of many disorders

• Acceptance of phys cause & search for med treatment

The Medical ModelThe Medical Model• Mental illness• Diagnosis of symptoms • Cure via therapy

(Richardson, 1999)

Understanding Psych Disorders

ProblemProblemAren’t mental “illnesses” socially defined?

Bio-psycho-social Bio-psycho-social PerspectivePerspective

Major disorders, like depression & schizophreniaappear to be universal,

HOWEVERHOWEVEROther disorders appear to be tied to specific cultures

(anorexia nervosa & bulimia)

(Richardson, 1999)

Classifying Abnormal Behavior

• Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)– a system devised by the American Psychiatric

Association used by most professionals to diagnose and classify abnormal behavior

(Feldman, 1999)

Classifying Abnormal Behavior

• Five axes of the DSM-IV

• DSM is designed to be primarily descriptive and devoid of suggestions as to the underlying causes of an individual’s behavior and problems

(Feldman, 1999)

(Kohn & Kohn, 1998)

Classifying Disorders

Goals of Diagnostic ClassificationGoals of Diagnostic Classification Describe a disorder Predict its future course Imply appropriate treatment Stimulate research into its cause

Diagnostic & Statistical Manual of Mental Disorders

DSM-IVDSM-IV

Classification describes & orders clusters of symptoms

(Richardson, 1999)

Major Disorders

• Anxiety Disorder– the occurrence of anxiety without obvious

external cause, intruding on daily functioning

(Feldman, 1999)

Anxiety Disorders

• Phobic Disorder– intense, irrational fears of specific objects or

situations

• Panic Disorder– anxiety that manifests itself in the form of panic

attacks that last from a few seconds to as long as several hours

(Feldman, 1999)

Anxiety DisordersGeneralized Anxiety Disorder

Feeling unexplainably tense & uneasyUnavoidable because the cause can’t be identified

May develop into “Panic Attacks”

Phobic DisordersIrrational fear of a specific object or situation

People often accept & live with phobiasFear of snakes, high places, crowds, cats etc.

Obsessive-Compulsive DisorderRepetitive Thoughts or Repetitive Behaviors

They interfere with the way we live or cause distress(Richardson, 1999)

PsychoanalyticPerspective

Early childhoodfixation and/or

repression

Explaining Anxiety Disorders

LearningPerspective

Anxiety is based onpredictability of

stimulusBiologicalPerspectiveAnxiety as

evolutionarilyadaptive + twinstudies & PET

scans(Richardson, 1999)

Anxiety Disorders

• Obsessive-Compulsive Disorder

• Obsession– a thought or idea that keeps recurring in one’s

mind

• Compulsion– an urge to repeatedly carry out some act that

seems strange and unreasonable, evenif the sufferer realizes it is unreasonable

(Feldman, 1999)

(Feldman, 1999)

Somatoform Disorders

• Somatoform disorder– psychological difficulties that take on a

physical (somatic) form of one sort or another

(Feldman, 1999)

Somatoform Disorders

Conversion DisordersConversion Disorders - anxiety converted into a

physical symptom

HypochondriasisHypochondriasis - normal sensations interpreted

as symptoms of scary sicknesses

Disorders that involve physical symptoms

(Richardson, 1999)

Somatoform Disorders

• Hypochondriasis– constant fear of illness, and physical sensations

are misinterpreted as signs of disease

• Conversion disorder– involves an actual physical disturbance, such as

the inability to use a sensory organ or the complete or partial inability to move an arm or leg

(Feldman, 1999)

Dissociative Disorders

• Dissociative disorder– psychological dysfunctions characterized by the

splitting apart of critical personality facets that are normally integrated, allowing stress avoidance by escape

(Feldman, 1999)

Dissociative Disorders

• Dissociative identity disorder (multiple personality)– a disorder in which a person displays

characteristics of two or more distinct personalities

(Feldman, 1999)

Dissociative Disorders

• Dissociative amnesia– a failure or inability to remember past

experiences

• Dissociative fugue– an amnesiac condition in which people take

sudden, impulsive trips, sometimes assuming a new identity

(Feldman, 1999)

Dissociative DisordersDissociative DisordersSudden memory loss or change in identitySudden memory loss or change in identity

Dissociative Amnesia Selective forgeting Response to stress Temporary

Fugue Presumed forgetting Fleeing home & ID Temporary (Real?)

Multiple Personality Disorder Two or more distinct personalities Physio evidence for separate personalities popularity has lead to diagnosed cases More cultural than psychological?

(Richardson, 1999)

Mood Disorders

• Mood disorder– affective disturbances severe enough to

interfere with normal living

• Major depression– a severe form of depression that interferes with

concentration, decision making, and sociability

(Feldman, 1999)

Mood Disorders

• Mania– an extended state of intense euphoria and

elation

• Bipolar disorder– a disorder in which a person alternates between

euphoric feelings of mania and bouts of depression

(Feldman, 1999)

Mood Disorders

Major DepressiveMajor DepressiveDisordersDisorders

Bipolar DisordersBipolar Disorders

Experience prolongedhopelessness & lethargy,eventually rebounding to

normality

Alternate betweendepression and mania

(overexcited &hyperactive state)

(Manic-Depressive Disorder)

(Richardson, 1999)

Major Depressive DisorderMajor Depressive Disorder

Last > 2 weeks w/o notable cause?Last > 2 weeks w/o notable cause?

Seasonal Affective DisorderSeasonal Affective Disorder

Signs of Depression Poor Appetite Insomnia Lethargy Feelings of Worthlessness Loss of Interest in Family,

Friends & Activities

(Richardson, 1999)

Depression

(Kohn & Kohn, 1998)

(Kohn & Kohn, 1998)

(Kohn & Kohn, 1998)

(Kohn & Kohn, 1998)

Causes of Mood Disorders

• Learned helplessness– a state in which people conclude that

unpleasant or aversive stimuli cannot be controlled

– a view of the world that becomes so ingrained that they cease trying to remedy the aversive circumstances, even if they actually can exert some influence

(Feldman, 1999)

Schizophrenia

• Schizophrenia– a class of disorders in which severe distortion

of reality occurs• decline from a previous level of functioning

• disturbances of thought and language

• delusions

• perceptual disorders

• emotional disturbances

• withdrawal

(Feldman, 1999)

Schizophrenia

• Process schizophrenia– symptoms develop relatively early in life,

slowly and subtly

• Reactive schizophrenia– onset of symptoms is sudden and conspicuous

• Positive-symptom schizophrenia

• Negative-symptom schizophrenia(Feldman, 1999)

Schizophrenic DisordersSchizophrenic Disorders

Signs of Schizophrenia Disorganized Thinking Disturbed Perceptions Inappropriate Actions Inappropriate Emotions Affects ~ 1:100 people

(Richardson, 1999)

Disorganized ThinkingDelusions

Thinking is fragmented and distorted by false beliefs

Q: Why?A: Impaired Attention Breakdown in selective

attention leaves youeasily distracted.

“I’m a movie star, from the planet Gottu - when I finishmaking the movie, the president will give me an award. Is thisroom painted pink because you knew it was my favorite?”

“I’m a movie star, from the planet Gottu - when I finishmaking the movie, the president will give me an award. Is thisroom painted pink because you knew it was my favorite?”

(Richardson, 1999)

(Kohn & Kohn, 1998)

(Kohn & Kohn, 1998)

Inappropriate Emotions & Actions

Emotions & Actions seem split off from reality

Flat Affect - zombie-like state of apparent apathyCatatonia - period of remaining motionless followed

by state of agitation

Remember Robin Williamsin “Awakenings”?

(Richardson, 1999)

Types of Schizophrenia

Schizophrenia is a cluster of disordersSchizophrenia is a cluster of disorders

Positive Symptoms vs Negative Symptoms•disorganized/deluded vs toneless/expressionless•inappropriate emotions vs silence/catatonia

Positive Symptoms vs Negative Symptoms•disorganized/deluded vs toneless/expressionless•inappropriate emotions vs silence/catatonia

Chronic vs Acute Schizophrenia• slow development/history of social inadequacy• rapid development/reaction to particular life stress

Chronic vs Acute Schizophrenia• slow development/history of social inadequacy• rapid development/reaction to particular life stress

(Richardson, 1999)

Causes of Schizophrenia• Biological causes

– dopamine hypothesis• schizophrenia occurs when there is excess activity in

those areas of the brain that use dopamine as a neurotransmitter

• Environmental perspectives– expressed emotion

• an interaction style characterized by criticism, hostility, and emotional intrusiveness by family members

(Feldman, 1999)

The Prevalence of Psychological Disorders

(Feldman, 1999)

Bipolar DisorderBipolar Disorder

Signs of Bipolar Disorder Overtalkative Overactive Little Need for Sleep Elated Grandiose Optimism &

Self-Esteem

Mild B-D may result in creativityMild B-D may result in creativity

(Richardson, 1999)

(Kohn & Kohn, 1998)

(Kohn & Kohn, 1998)

Explaining Mood DisordersExplaining Mood Disorders

PsychoanalyticalCurrent feeling evokes

similar childhoodfeelings that turn inwardand produce depression

BiologicalDepression involves

genetic predispositionsand neurotransmitter

abnormalities

Social-CognitiveNegative thoughts influencebiochemical events creating

a cycle of depression

MoodMood

BrainBrainChemistryChemistry

CognitionCognition

(Richardson, 1999)

Cycle of Depression

22NegativeNegativeExplanatoryExplanatoryStyleStyle 33

DepressedDepressedMoodMood 44

Cognitive andCognitive andBehavioralBehavioralChangesChanges

11StressfulStressfulExperiencesExperiences

Causes of Mood Disorders

• Learned helplessness– a state in which people conclude that

unpleasant or aversive stimuli cannot be controlled

– a view of the world that becomes so ingrained that they cease trying to remedy the aversive circumstances, even if they actually can exert some influence

(Kohn & Kohn, 1998)

Disturbed Disturbed PerceptionsPerceptions

Patient experiences an altered worldPatient experiences an altered worldand perceives things that are not there.and perceives things that are not there.

Dreams breaking into waking consciousnessDreams breaking into waking consciousness(Richardson, 1999)

Understanding SchizophreniaBrain Abnormalities

Excessive dopamine (+ symptoms) Abnormal brain tissue Low activity in frontal lobes

Genetic Predisposition Odds are…

1:100 for general population1:10 if sibling or parent has it1:2 if identical twin has it

Psychological Factors(Richardson, 1999)

Personality Disorders

• Personality disorder– a mental disorder characterized by a set of

inflexible, maladaptive personality traits that keep a person from functioning properly in society

Personality Disorders

• Antisocial or sociopathic personality disorder

• a disorder in which individuals tend to display no regard for the moral and ethical rules of society or the rights of others

• Borderline personality disorder• a disorder in which individuals have difficulty in

developing a secure sense of who they are

Personality Disorders• Antisocial or sociopathic personality

disorder• no regard for the moral and ethical rules of society or

the rights of others

• Borderline personality disorder• difficulty in developing a secure sense of who they

are

• Narcissistic personality disorder• exaggerated sense of self-importance

References

• Feldman, M. (1999). McGraw Hill Company. Retrieved May 2002 from World Wide Web at: http://www.mcgrawhill.com.

• Kohn, A. J. & Kohn, W. (1998). The Integrator 2.0. CD-Rom. Brooks/Cole Thomson Learning.

• Richardson, K. (1999). Retrieved May 2002 from the World Wide Web at:

http://www.monmouth.edu.