Chapter 14 Psychological
Disorders: Part 1Music: “Rock’n Roll Suicide”
David Bowie
“Mad World” Adam Lambert
Today’s Agenda
• 1. What is Abnormal?– Criteria / Classification
• 2. Anxiety Disorders:– Generalized Anxiety/ Phobias/ Obsessive Compulsive
Disorders
• 3. Somatoform Disorders– Somatization Disorders/ Hypochondriasis
• 4. Dissociative Disorders– Multiple Personality Disorder
• 5. Mood Disorders– Depression/ Bipolar Disorders /Suicide
1. What IS Abnormal?? Criteria:
1) Distress is present: Person is suffering, unhappy, afraid
2) Behaviour is maladaptive• Impaired functioning • Inability to meet responsibilities
3) Socially Deviant Behaviour is unusual, “not normal”
Classification DSM-IV, p. 580 Why Classify?
• Simplify and create order• Research• Plan treatment
Criteria for Abnormality
Fig. 14.2 p. 578
Where is the dividing line between normal and abnormal behavior?
• Deviation from statistical average
• Deviation from cultural/societal average
1. Classification (cont’d)
Older Distinction: Neurotic vs. Psychotic
Neurotic: Distressing problem but person is still coherent and can
function socially (once acute phase of disorder is treated). E.g. most disorders discussed today
Psychotic: More bizarre, involving delusions or halucinations.
Individual has impaired thought processes and cannot function socially. Treatment is long term
E.g. schizophrenia (next week)
2. Anxiety Disorders
• Anxiety:– Fear in situations that pose no objective threat– 3 components:
• A) Cognitive:– Extreme/chronic worry; fear of harm
• B) Physiological:– Muscle tension, increased heart rate and blood pressure
• C) Behavioural:– Shaking, jumpiness, pacing, avoidance
• Generalized Anxiety Disorders (5%)– Symptoms of anxiety felt continuously for at least 6 months– Excessive worry, restlessness, sleep disturbance that are
difficult to control
2. Anxiety Disorders (cont’d)
• Panic Disorders: (2-3%)– Presence of recurrent, and unexpected panic attacks:
• Intense dread, shortness of breath, chest pain, choking, fear of going crazy or losing control or dying, shaking, sweating, nausea…
– May lead to Agoraphobia (fear of open spaces)
• Phobic Disorders: (10%)– Fear of a particular object, animal or context which is irrational– Is causing distress and impairment in functioning
• Social Phobia: (3-13%)– Fear of social or performance situations
• Public speaking; • Eating, drinking, writing in public
2. Anxiety Disorders (cont’d)
• Obsessive-Compulsive Disorders (2%)– Obsessions:
• Persistent, uncontrollable thoughts
– Compulsions:• Rituals, behaviours that reduce anxiety
• Interfere with functioning
– Thoughts and behaviours are not under voluntary control
– Case example: • Howie Mandel: Germaphobic & Hypochondriac
3. Somatoform Disorders
– Hypochondriasis:• 4-9% in medical practice• Inordinate preoccupation with health and illness• excessive anxiety about having a disease
– Somatization Disorder: • (1-2% women)• History of diverse physical complaints for which
there is NO organic basis• Long medical history of treatments for minor
physical ailments
4. Dissociative Disorders
• Multiple Personality Disorder (very rare)– Presence of at least 2 distinct personalities within
the same individual– Leads to sudden changes in identity and
consciousness– Each personality has its unique style and may
unaware of the existence of the other personalities
– Often related to severe abuse in early childhood
5. Mood Disorders• Depression
– Lifetime prevalence rates• 20% in women; 10% in men
– Why more common in women?• Cost of caring
– Greater burden due to nurturing roles– Also more affected by disruptions in relational ties
• Exposure to higher levels of stress– Victimization, abuse
• Ruminative cognitive style– as opposed to distraction or taking action– Perpetuates negative mood
• More likely to report symptoms
• Seasonal Affective Disorders (SAD)– Depressive symptoms related to physiological consequences of shorter
winter days– Treatable with light therapy
5. Theories of Depression• Biological predisposition
– Concordance rates in twins:• Identical: 65%• Fraternal: 15%
– G X E models (interaction of genetic and environmental contributors)• Cognitive Perspective
– Beck: Negative (dysfunctional) attitudes– Seligman: Attribution Theory
• How do you explain your circumstances?– Internal vs external– Stable vs unstable– Global vs specific
• Depression: internal, stable, global attributions for negative events– Diathesis-stress models
• Depression results from an interaction between personality and negative life events– Dependency and vulnerability to loss– Self-Criticism/Perfectionism and vulnerability to perceived failure
Cognitive Risk and Depression• Featured Study p. 596
– Those with dysfunctional attitudes and depressive attributional style were more likely to become depressed over 2 year period.
5. Mood Disorders (cont’d)
• Bipolar Disorders:– Periods of depression alternate with manic episodes– Mania:
• abnormally elevated mood, inflated self-esteem, pressure of speech, increased energy, decreased need for sleep, over-activity, lack of inhibition and impaired judgment
– Prevalence rates: • 1% in men and women• Strong genetic component
– Understood as a primarily biological disorder » Unlike unipolar depression which has cognitive, interpersonal and
environmental determinants
– Case Example: Vincent Van Gogh
Comparison of symptoms of depression and mania (p. 592)
5. Suicide• University students:
– 40-50% have had suicidal thoughts – 15% attempt suicide
• 3rd leading cause of death among 15-24 year-olds
• Major Risk Factors:– Feelings of Isolation– Having a serious mental or physical illness
• Including mood disorder (42%)/ depression and feelings of hopelessness– Experiencing a major loss or stressor
• Leading to feelings of shame, humiliation, failure or rejection• History of child abuse (leading to self-harm in women)
– Abuse of drugs or alcohol/ impulsivity (40%)– Having a plan– Risk increases in adolescence and young adulthood
5. Suicide (cont’d)
• How to help:– 1) Establish communication
• Talk about suicidal wishes
– 2) Identify needs that have been frustrated• Search for love, recognition, respect?
– 3) Broaden suicidal person’s perspective• Impermanence of feelings
– This too will pass
– Give yourself the chance to experience a better future
• Provide support for treatment
• Until next week:
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