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Psychological Disorders

The Science of Psychology: An Appreciative View, 2nd ed. 2011. Laura A. King, McGraw-Hill, New York
by

Ed Rauscher

on 1 December 2016

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Transcript of Psychological Disorders

Psychological Disorders
Chapter 12
This unit begins with the story of Bill Garrett, a freshman at Johns Hopkins University. Bill began hearing strange voices inside his head. The voices told him things such as he was stupid, fat, that the soap and shampoo were toxic, that his father poisened the family dog and that his grandmother was putting human body parts in his food.
Bill withdrew into this terrifying world, convinced that there were conspiracies out to get him.
Eventually, he was diagnosed with schizophrenia. A disorder characterised by disturbed thought.
Overview for this chapter;
1.
Survey psychological disorders, characteristics and classifications.
2.
Distinguish among anxiety disorders.
3.
Compare mood disorders and risk factors for depression and suicide.
4.
Describe the dissociative disorders.
5.
Characterize schizophrenia.
6.
Identify behavior patterns typical of personality disorders.
What is Abnormal Behavior
Abnormal behavior:
a bx that is Deviant, Dysfunctional, Distressful and or Dangerous.

Only
one
of these bxs needs to be present for the bx to be considered
abnormal
, but they may all be present.
Deviant behavior
is a behavior that deviates from what society sees as acceptable.
...a woman who washes her hands 3 or 4 times an hour and takes 7 showers a day is abnormal b/c it deviates from what we consider acceptable.
Dysfunctional:
bx interferes with a person’s ability to function effectively in society.
Distress:
Bx's, thoughts or emotions that cause significant personal distress.
...a woman who secretly makes herself vomit after every meal may cause her to feel intense shame, guilt and despair.
Theoretical Approaches to Psychological Disorders

primarily focuses on the brain, genetic factors and neurotransmitter functioning as sources of abnormality.
From the perspective of the biological, "medical model" abnormailties are called mental illnesses, those afflicted are called patients and are treated by doctors.

emphasizes the contributions of experiences, thoughts, emotions, and personality characteristics to explain psychological disorders.
Behavioral psychologists focus on the rewards and punishments in the environment.
Social cognitive psychologists focus on observational learning, cognitions, and beliefs as factors that foster abnormal behavior.

places more emphasis on larger social contexts in which a person lives.
...marital conflict or ineffective family functioning.
...The living conditions of those individuals living in poverty can create a stressful situation that can contribute to the development of a psychological disorder.
...these factors can operate alone but often act in combination with one another.
...according to this approach, biological, psychological and social factors are all significant in producing both normal and abnormal bx.
Classifying Abnormal Behavior
A classification system provides a common basis for communicating.
The
D
iagnostic
S
tatistical
M
anual of Mental Disorders was first developed in 1952 and is currently in its fourth edition. It has 374 disorders.
The DSM-5 includes a
multiaxial system
, individuals are classified on the basis of
five (5) dimensions.
Axis I
—all diagnostic categories except personality disorders and mental retardation
.
Axis II
—personality disorders and mental retardation
Axis III
—general medical conditions
Axis IV
—psychosocial and environmental problems
Axis V
—current level of functioning.
The DSM-5 classifies individuals based on their symptoms, using medical terminology in the psychiatric tradition of thinking about mental disorders in terms of disease.

Focuses strictly on pathology and probelms. There is no focus on a persons strengths.

labeling a problem can have serious negative implications by creating a
stigma
; a stigma is a mark of shame that may cause others to avoid or act negatively toward.
Critiques of the DSM
Anxiety Disorders
Generalized Anxiety Disorder:
sufferers are unable to specify the reasons for the anxiety and tend to worry a lot of the time about minor things.
Panic Disorder:
an individual has recurring sudden onsets of intense terror.
Panic attacks may occur without warning and produce severe palpitations, extreme shortness of breath, chest pains, trembling, sweating, dizziness, and a feeling of helplessness.
Women are twice as likely as men to have panic attacks
A phobic disorder:
occurs in an individual with an irrational, overwhelming, persistent fear of a particular object or situation.
A normal fear becomes a phobia when the individual will go to extreme lengths to avoid it.
Learning theorists say that phobias are learned fears. However, genes appear to play a role in social phobias as well.
Obsessive-compulsive disorder (OCD):
the individual has anxiety-provoking thoughts that will not go away and/or urges to perform repetitive behaviors to prevent or produce some future situation.
Most individuals do not enjoy the ritualistic behavior, but worry when they do not carry it out.
There is some genetic component because OCD runs in families
Post-traumatic stress disorder (PTSD):
develops through exposure to a traumatic event such as the Holocaust, severe abuse, rape, natural disasters, and unnatural disasters
symptoms of PTSD
may include flashbacks, constricted ability to feel emotions, excessive arousal, difficulties with concentration, feelings of apprehension, and impulsive outbursts.
Mood disorders
can include cognitive, behavioral, and somatic symptoms as well as interpersonal difficulties.
Mood Disorders
Depressive Disorders:
the individual suffers depression, especially an unrelenting lack of pleasure in life.
Some individuals develop
major depressive disorder
while others develop
dysthymic disorder,
which is a more chronic depression.
symptoms of major depressive disorder
are:
depressed mood most of the day,
reduced interest or pleasure in most activities,
significant weight loss or gain or decrease in appetite,
trouble sleeping or sleeping too much, fatigue,
feeling worthless or guilty in an excessive manner,
problems concentrating or making decisions,
recurrent thoughts of death and suicide.

Factors in development of depressive disorders
Biological factors
include: genetics, lower level of brain activity in a section of the prefrontal cortex
decrease in receptors for neurotransmitters serotonin and norepinephrine.
Psychological factors
include: (Behavioral)=learned helplessness, (Cognitive)=the types of thoughts and beliefs that contribute to the sense of learned helplessness
Sociocultural factors
include: low socioeconomic status (SES), living in poverty, and gender
Bipolar disorder:

characterized by extreme mood swings with at least one or more episodes of mania. The bipolar part of it means the individual experiences both depression and mania.
During a manic episode, the individual feels euphoric and on top of the world. The individual may be impulsive and find themselves in trouble in business and legal transactions.
Suicide is not a diagnosable disorder, rather a
tragic consequence of psychological disorders.
Suicide
Thinking about suicide is not necessarily abnormal, but attempting or completing the act is abnormal
Factors of Suicide
1.
Biological Factors
a. genetic factors in suicide.
b. low levels of serotonin are linked to suicide.
c. Poor physical health.
2.
Psychological Factors
a. mental disorders and traumas such as sexual abuse.
b. most common disorders that lead to suicide are depression
and anxiety.
c. stressful circumstance or substance abuse can lead to
suicide.
3.
Sociocultural Factors
a. The loss of a loved one can.
b. a long-standing history of family instability and unhappiness.
c. Chronic economic hardship.
d. Women are three times more likely than men to
attempt
suicide.
What is Abnormal Anyway?
Read each example and decide if the bx is abnormal.
Draw some conclusions about the difficulty and implications of such decisions.
What Type of Anxiety Disorder Is It?
Read through the examples and identify what type of anxiety disordered is being described.
Water
Spiders
Lightning
Thunder
Closed spaces
Dogs
Insanity
Electricity
Bridges
Reptiles
Water
Germs
Aquaphobia
Arachnophobia
Astrapobia
Brontophobia
Claustrophobia
Cynophobia
Dementophobia
Electrophobia
Gephyrophobia
Herpetophobia
Hydrophobia
Mikrophobia
Trigger
Phobia
Phobias: Irrational Fear of Objects or Situations
Heights
Flying
Entering Public Spaces
Cats
Vehicles, Driving
Flowers
Acrophobia
Aerophobia
Agoraphobia
Ailurophobia
Amaxophobia
Anthophobia
Trigger
Phobia
Specific Phobias:
specific triggers such as spiders, dogs, airplanes, elevators, or germs.

Social Phobias:
fear of situations where a person might be evaluated and possibly embarrassed.
In 1988 just, 500,000 cases were diagnosed.
Currently, 4 million children are diagnosed with ADHD each year!
Question
: When do you think its appropriate to label someone as having a psychological disorder?
Dissociative Disorders

Dissociation
refers to psychological states in which a person feels disconnected from their immediate experiences
Dissociative disorders involve the sudden loss of memory or change in identity.
Aspects of conscious awarenss becomes split from previous memories and thoughts.
Dissociative amnesia
is characterized by extreme memory loss that is caused by extensive psychological stress.
Dissociative fugue
occurs in individuals that have amnesia and travel away from home and assume a new identity.
Dissociative Identity Disorder:
the most dramatic, least common and most controversial dissociative disorder.
The majority of individuals with this disorder are women.
ex. 28 year old woman gave birth to her 6th child. Her family noticed she did not acknowledge her newborn as her own. She had no recollection of having given birth. Turns out she did not want another baby and it was a very draining and stressful pregnancy. With therapy she was able to recover her memory and experience of giving birth.
ex. August 28th 2008, Hannah, a middle school teacher in NYC, went for a jog and dissapeared. no wallet, no ID, no cellphone. Two weeks later, she was found floating face down in the New York harbor, sunburned and dehydrated but alive. She has no memory of those two weeks, or how she survived.
Dissociative identity disorder
; formerly called multiple personality disorder. Individuals with this disorder have two or more distinct personalities
Individuals with this disorder have two or more distinct identities and personalities. Each identity has its own memories, and bxs. One identitity dominates at one time. Sometimes the identities are separated by a wall of amnesia.
Some psychologists believe that a child can cope with intense trauma by dissociating from the experience and developing other alternate selves as protectors.
Three Faces of Eve.
One of the most famous real life cases of DID involves the "three faces of Eve".
Eve White was bland, quiet and serious. By contrast, Eve Black was carefree, mischievous and uninhibited. Eve Black would emerge at the most inappropriate times, leaving Eve White with hangovers, bill,s and a reputation.
During Tx, a third personality emerged, Jane. More mature than the other two.
Schizophrenia
Schizophrenia
is a severe disorder that is characterized by highly disordered thought processes.
The disorderd thoughts are referred to as
psychotic
b/c they are far removed from reality.
Ind with schizophrenia may see things that are not there, hear voices inside their heads, and live in strange world of twisted logic.
Often the experience of schizophrenia is one of extraordinary terror.
Typically diagnosed in early adulthood, the disorder can be debilitating. Remeber the case of William at the beginning of the chapter.
teens-30's
The suicide risk for ind with schizophrenia is 8 times that for the general population.
Symptoms of Schizophrenia
The
positive symptoms
are marked by a distortion or an excess of normal function and are called positive because something is being added and goes beyond normal behavior.
Hallucinations:
experiences in the absence of any stimuli.
Visual:
Seeing things that are not really present.
Auidtory:
hearing voices
(Most Common)
Hallucinations can also include smell and taste
Positive Symptoms Cont..
Delusions:
false, unusual and somtimes magical beliefs that are not part of an individuals culture.
Ex. a delusional person might think that he is Jesus Christ or Muhammad.
To the outsider, such delusions may seem completely illogical, but are experienced as all too real for ind with schizophrenia
Bill G. had a blister on his hand and he thought it was gangrene. He tried to cut off his hand with a knife, before his family stopped him.
more postitive symptoms....

Thought disorders
are unusual, sometimes bizarre thought processes that are characteristic of individuals with schizophrenia. They can be disorganized and confused. The individuals don’t make sense when they talk and write.
these incoherent, loose word associations are called, "word salads"
referential thinking:
ascribing personal meaning to random events.
ex. the traffic light turned red b/c you were in a hurry.
final positive symptom
Disorders of movement:
unusual mannerisms, body movements and facial expressions. In some cases the ind may become catatonic: A state of immobility and unresponsiveness for a long period of time.
Negative symptoms:
reflect social withdrawal, are behavioral deficits and a loss or decrease of normal functions.
Negative symptoms of Schizophrenia
Flat affect:

shows little or no emotion, speaks with emotional inflection, and maintains an immobile facial expression
They may experience a lack of positive emotion and show a deficient abiltiy to plan, initiate and engage in goal directed bx.
Causes of Schizophrenia
Biological Factors:
Research provides strong support, particularly for
genetic predisposition,
as well as
structural brain abnormalities
and
neurotransmitter regulation.

(dopamine production)
Psychological Factors:

The
diathesis-stress model
argues that a combination of biological predisposition and stress are the cause of schizophrenia.
diathesis means- physical vulnerability to a particular disorder.
Personality Disorders
Are there aspects of your personality that you would like to change? Imagine that your very personality---who you really are---is at the core of your life difficulties.
Personality disorders
are chronic, maladaptive cognitive-behavioral patterns that are integrated into the individual’s personality.
Personality disorders are relatively common, one study found
15%
of the population.
The DSM-IV lists 10 types of personality disorders.
We will examine 2 of the most studied,
antisocial and borderline personality disorders.
These disorders are associated with dire consequences, including criminal activity and violence (antisocial), and self-harm and suicide (borderline).
Antisocial Personality Disorder
:
characterised by guiltlessness, law-breaking, exploitation of others, irresponsibility, and deceit.
ASPD
is far more common in men and is related to criminal bx, vandalism and substance abuse.
DSM-IV-TR criteria for ASPD includes:
a
.Failure to conform to social norms or obey law
b
.Deceitfulness, lying, using aliases
c
.Impulsivity or failure to plan ahead
d
.Irritability and aggressiveness, fighting
e
.Reckless disregard for the safety of self or others
f
.Consistent irresponsibility, e.g. not paying bills
g
.Lack of remorse, showing indifference to the pain of others
Generally
ASPD
is associated with criminal behavior, but not all individuals with ASPD engage in crime and not all criminals suffer from ASPD.
There are antisocial physicans, clergy members, lawyers, and just about any other occupation.
Still such individuals tend to be exploitative of others and lack empathy. They break the rules.
ASPD subgroup known as Psychopaths
John Wayne Gacy
Ted Bundy
David Berkowitz
son of sam
Psychopaths are remorseless predators who engage in violence to get what they want.
Eitiology of ASPD
ASPD
has been linked to low levels of activation in the
prefrontal cortex
and has related these brain differences to poor decision making and problems in learning
Researchers have found that ind. with ASPD are less stressed by punishment and have the ability to keep their cool while engaging in deception.
Borderline Personality Disorder
Inds suffering from BPD are often emotionally unstable, impulsive, unpredictable, irritable, and anxious. These inds are insecure, impulsive, and emotional. They exhibit bxs such as cutting and are prone to suicide.
The
DSM-IV
specifies
BPD
is indicated by the presence of five or more of the following symptoms:

a
.Frantic efforts to avoid being abandoned
b
.Unstable and intense interpersonal relationships
c
.Marked and persistent unstable self-image or sense of self
d
.Impulsivity in at least two areas that are potentially self-damaging
e
.Recurrent suicidal behavior, gesture or threats or self-mutilating behavior
f
.Unstable and extreme emotional responses
g
.Chronic feelings of emptiness
h
.Inappropriate, intense anger or difficulty controlling anger
i
.Temporary stress-related paranoia
Those with BPD tend to see themselves and everyone else in absolute terms--as either perfect or worthless.
Possible Causes of BPD
Causes of BPD are likely complex and included biological factors as well as childhood experiences.
Many report childhood sexual abuse, as well as physical abuse and neglect.
childhood abuse experiences may combine with genetic factors in promoting BPD.
Characteristics of Schizophrenia Activity.
Each group is to create an example of an individual with schizophrenia. Groups will walk their individual through the various symptoms of schizophrenia. You may use the textbook to help you come up with speific symptoms for your individual.
When finished, discuss with the rest of the class the individual your group developed.
This activity will help you characterize Schizophrenia and its symptoms.

abnormal bx can be influenced by biological factors (genetics), psychological factors (childhood experiences), and sociocultural factors (gender)
Attention Deficit Hyperactivity Disorder ADHD:
feature motor tension, apprehensive expectations and thoughts. Involve
fears
that are
uncontrollable, disproportionate
to the actual danger, and
disruptive
of ordinary life.
Suicide is the
third
(3rd) leading cause of death today among U.S. adolescents 13-19 years of age.

Here is what you can do....
Psychologists believe that dissociation is an individual's way of dealing with extreme stress. By dissociating, the individual mentally protects his/her conscious self from the traumatic event.

i.e. enviornmental variables, with little or no genetic influence.
People with schizophrenia may say odd things, show inappropriate emotion, and move their bodies in peculiar ways. Often, they are socially withdrawn and isolated.
http://higheredbcs.wiley.com/legacy/college/psych/videos/bipolar/index.html
Bipolar Video
Depressive & Bipolar
Manic episodes may last a few days or even months; depressive episodes generally last three times longer

Low risk for bipolar disorder (0.5 to 1.6%), but among the most debilitating and lethal disorders with
10 to 20% suicide rate
1 in 100 people will develop in their lifetime
among the most commonly diagnosed and most functionally diabling of all mental disorders.
Originally, the term implied that the person was on the borderline between neurosis and schizophrenia.
people with BPD have a deep well of intens loneliness and chronic fear of abandonment.
Unfortunately, given their personality traits, friends, lovers and even therapists do "abandon" them.
(4D's)
...Drinking to the point that you cannot hold a job, stay in school or maintain relationships, would be considered abnormal bx.
Danger:
If someone's thoughts, emotions or bx's present a danger to self or others.
...engaging in road rage to the point of physical confrontation,
would be considered abnormal.
Use the main aspects,
deviant, distressful, dysfunctional & dangerous,
as a guide to justify your answers
.
Sexual abuse has occured in as many as 70% or more of DID cases. Although not all individuals that have been sexually or physically abused develop dissociative identity disorder.
Can you define, "normal" bx?
define, "abnormal" bx?
what point does
"normal" become "abnormal"?
Diagnosing Mental Disorders
For each of the following, play the role of the clinician and make the most accurate diagnosis possible from the information.
Dangerous & Painful Labels, pg.336
The Biological Approach:
The Psychological Approach:
Sociocultural Approach:
Biopsychosocial Approach:
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