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Psychological Disorders

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

Ed Rauscher

on 6 December 2018

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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 poisoned 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;
Survey psychological disorders, characteristics & classifications.
Distinguish among anxiety disorders.
Compare mood disorders
Characterize schizophrenia.
havior patterns typical of personality disorders.
What is Abnormal Behavior
Abnormal behavior:
a bx that is Deviant, Dysfunctional, Distressful and or Dangerous.

needs to be present for the bx to be considered
, but they may all be present.
Deviant behavior
is a bx 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.
bx interferes with ability to function effectively in society.
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.
Classifying Abnormal Behavior
A classification system provides a common basis for communicating.
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 Focuses strictly on pathology and problems. There is no focus on a persons strengths.

labeling a problem can have serious negative implications by creating a
; 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:
unable to specify the reasons for the anxiety and tend to worry a lot of the time about minor things.
Panic Disorder:
ind has recurring sudden onsets of intense terror.
attacks may occur without warning and produce severe palpitations, extreme shortness of breath, chest pains, trembling, sweating, dizziness, and a feeling of helplessness.
A phobic disorder:
an irrational, overwhelming, persistent fear of a particular object or situation. ex. spiders
A normal fear becomes a phobia when the ind will go to extreme lengths to avoid it.
Learning theorists say phobias are learned fears. However, genes appear to play a role in social phobias as well.
Obsessive-compulsive disorder (OCD):
the ind has anxiety-provoking thoughts that will not go away and/or urges to perform repetitive bxs to prevent or produce some future situation.
Most inds 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 combat, 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 inc cognitive, behavioral, and somatic symptoms as well as interpersonal difficulties.
Mood Disorders
Depressive Disorders:
the individual suffers depression, esp. an unrelenting lack of pleasure in life.
Some inds develop
major depressive disorder
while others develop
dysthymic disorder,
which is a more chronic depression.
symptoms of major depressive disorder
depressed mood most of the day,
reduced interest or pleasure in most activities,
sig. 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
Bio factors:
genetics, lower level of brain activity in a section of the prefrontal cortex
decrease in receptors for neurotransmitters serotonin and norepinephrine.
Psych factors:

=learned helplessness,
=the types of thoughts and beliefs that contribute to the sense of learned helplessness
Sociocultural factors:
low socioeconomic status (SES), living in poverty, and gender
Bipolar disorder:

charac by extreme mood swings w/ at least one or more episodes of mania. The bipolar part of it means the ind. experiences both depression and mania.
During a manic episode, the ind feels euphoric, has unrealistically high self esteem, inflated sense of self importance and poor judgement. May be hyperactive and not sleep for days
at a time. Thinking is faster than
normal, w/ rapid speech and
showing a "rapid flight of ideas".
Thinking about suicide is not necessarily abnormal, but attempting or completing the act is abnormal
Factors of Suicide
Biological Factors
a. genetic factors in suicide.
b. low levels of serotonin are linked to suicide.
c. Poor physical health.
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
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
What is Abnormal Anyway?
Read each example and decide if the bx is abnormal.
What Type of Anxiety Disorder Is It?
Read through the examples and identify what type of anxiety disordered is being described.
Closed spaces
Phobias: Irrational Fear of Objects or Situations
Entering Public Spaces
Vehicles, Driving
Specific Phobias:
specific triggers; 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, 6 million children are diagnosed with ADHD each year!
: If a teacher suggested that your child be tested for ADHD, what would you do?
Dissociative Disorders

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.
is a severe disorder that is characterized by highly disordered thought processes.
The disorderd thoughts are referred to as
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 exp of schizophrenia is one of extraordinary terror.
Typically diagnosed in early adulthood, the disorder can be debilitating. Remember the case of William at the beginning of the chapter.
The suicide risk for ind with schizophrenia is 8 times that for the general population.
Symptoms of Schizophrenia
positive symptoms
marked by a distortion or an excess of normal function and are called
pos b/c something is being added and goes beyond normal bx.
experiences in the absence of any stimuli.
Seeing things that are not really present.
hearing voices
(Most Common)
Hallucinations can also include smell and taste
Positive Symptoms Cont..
false, unusual and somtimes magical beliefs that are not part of an inds 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 inds with schizophrenia. They can be disorganized and confused. The inds 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.
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.
Neg symptoms:
reflect social withdrawal, are bx 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 exp 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
neurotransmitter regulation.

(dopamine production)
Psychological Factors:

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 cog-bx patterns that are integrated into the ind’s personality.
Personality disorders are relatively common, one study found
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.
is far more common in men and is related to criminal bx, vandalism and substance abuse.
DSM-IV-TR criteria for ASPD includes:
.Failure to conform to social norms or obey law
.Deceitfulness, lying, using aliases
.Impulsivity or failure to plan ahead
.Irritability and aggressiveness, fighting
.Reckless disregard for the safety of self or others
.Consistent irresponsibility, e.g. not paying bills
.Lack of remorse, showing indifference to the pain of others
is assoc with criminal bx, but not all inds 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 inds 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
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.

is indicated by the presence of five or more of the following symptoms:

.Frantic efforts to avoid being abandoned
.Unstable and intense interpersonal relationships
.Marked and persistent unstable self-image or sense of self
.Impulsivity in at least two areas that are potentially self-damaging
.Recurrent suicidal behavior, gesture or threats or self-mutilating behavior
.Unstable and extreme emotional responses
.Chronic feelings of emptiness
.Inappropriate, intense anger or difficulty controlling anger
.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.
Attention Deficit Hyperactivity Disorder ADHD:
motor tension, apprehensive expectations and thoughts. Involve
that are
uncontrollable, disproportionate
to the actual danger, and
of ordinary life.
Suicide is not a diagnosable disorder, rather a
tragic consequence of psych disorders.
Suicide is the
(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.
Depressive & Bipolar
Manic episodes may last a few days or even months; dep episodes gen 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 intense loneliness and chronic fear of abandonment.
Unfortunately, given their personality traits, friends, lovers and even therapists do "abandon" them.
...Drinking to the point that you cannot hold a job, stay in school or maintain relationships, would be considered abnormal bx.
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.
Does Everyone Have ADHD? pg.503
bx's that violate social norms
Anxiety Disorders are the most frequently occurring mental disorders
Twice as many women as men are diagnosed with anxiety disorders
Fortunately easiest to treat and offer best chances for recovery.
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