by Jim Foley Psychological Disorders 2013 Worth Publishers Module 39 Basic Concepts of Psychological Disorders and Mood Disorders Topics deserving our understanding and contemplation ID: 685761
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Slide1
PowerPoint®
Presentation
by Jim Foley
Psychological Disorders
© 2013 Worth Publishers Slide2
Module 39: Basic Concepts of Psychological Disorders, and Mood DisordersSlide3
Topics deserving our
understanding and contemplationDefining Psychological Disorders
Case study: ADHDBiopsychosocial and Medical models
Classifying DisordersThe effects of labelingResponsibility for one’s actionsRates of various DisordersMajor Depressive DisorderBipolar DisorderPrevalence and Course of mood disorders Biological Influences on DepressionSuicide and Self-InjurySocial- Cognitive Factors: Explanatory styleDepression’s vicious self-reinforcing cycleSlide4
Why Learn about Psychological Disorders?
Reasons for curiosity:
personal familiarity with psychological symptoms
knowing someone else with the disorderhearing about how prevalent and socially devastating some disorders have become in societywanting to learn more about mental health and human nature Slide5
Questions to Keep in Mind
Perspectives on Psychological Disorders
Defining psychological disorders
Thinking critically about ADHDUnderstanding psychological disordersClassifying psychological disordersLabeling psychological disordersInsanity and responsibility
How do we decide when a set of symptoms are severe enough to be called a disorder that needs treatment?
Can we define specific disorders clearly enough so that we can know that we’re all referring to the same behavior/mental state?
Can we use our diagnostic labels to guide treatment rather than to stigmatize people? Slide6
A Psychological disorder is:
A significant dysfunction in an individual’s cognitions, emotions, or behaviors.
Disorders are diagnosed when there is
dysfunction, behaviors which are considered maladaptive because they interfere with one’s daily life Disorders are diagnosed when the symptoms and behaviors are accompanied by Distress, suffering. New definition (DSM 5): “a disturbance in the psychological, biological, or developmental processes underlying mental functioning.”More Understandings about disorders: Slide7
Is Attention-Deficit/Hyperactivity Disorder (ADHD) a real disorder?
ADHD: Impulsivity mixed with Inattention and/or hyperactivity. Can include distractibility, disorganization, fidgeting, difficulty suppressing impulses, and impaired working memory. Is this a disorder?
Is it deviant?
Do some people have a level of inattentiveness, impulsiveness, or restlessness that goes beyond laziness or immaturity? Is it distressful? Is the person enjoying being energetic, or are they frustrated that they can’t sustain focus? Is there dysfunction? Are the symptoms harmless fun, or do they negatively impact work and relationships? Slide8
Understanding the Nature of Psychological Disorders
One reason to
diagnose a disorder is to make decisions about
treating the problem.Based on older understanding of psychological disorders, treatments have included: exorcising evil spirits, beatings, caging/restraint, andPinel’s New Approach
Philippe
Pinel
(1745-1826) proposed that mental disorders were not caused by demonic possession, but by stress and inhumane conditions.
Pinel’s
“moral treatment” involved gentleness, nature, and social interaction.
Pinel’s
interventions
improved lives but often did not effectively treat mental
illness.
But then…Slide9
The Medical Model
Psychological disorders can be seen as psychopathology, an illness
of the mind.Disorders can be
diagnosed, labeled as a collection of symptoms that tend to go together.People with disorders can be treated, attended to, given therapy, all with a goal of restoring mental health.The discovery that the disease of syphilis causes mental symptoms (by infecting the brain) suggested a medical model for mental illness. Slide10
The Biopsychosocial ApproachSlide11
Cultural Influences on Disorders
Examples: Bulimia Nervosa: binging/purging, in the United States
Running amok: violent outbursts, in MalaysiaHikikomori
: social withdrawal, in JapanCulture-bound syndromes are disorders which only seem to exist within certain cultures; they demonstrate how culture can play a role in both causing and defining a disorder.Slide12
Classifying Psychological Disorders
Why create classifications of mental illness? What is the value of talking about diagnoses instead of just talking about individuals?
Diagnoses create a verbal shorthand for referring to a
list of associated symptoms.Diagnoses allow us to statistically study many similar cases, learning to predict outcomes.Diagnoses can guide treatment choices.
The Diagnostic and Statistical ManualIt’s
easier to count cases of autism if we have a clear definition.
Versions: DSM-IV-TR,
DSM-V (May 2013)
The DSM is used to justify payment for treatment.
It’s consistent
with diagnoses
used by
medical doctors
worldwide.Slide13
The Five “Axes” of DiagnosisSlide14
Categories of DiagnosesSlide15
Categories of Diagnoses:
The 5 AxesSlide16
Critiques of Diagnosing with the DSM
1. The DSM calls too many
people “disordered.”
The border between diagnoses, or between disorder and normal, seems arbitrary.Decisions about what is a disorder seem to include value judgments; is depression necessarily deviant?Diagnostic labels direct how we view and interpret the world, telling us which behavior and mental states to see as disordered.Slide17
Stigma and Stereotypes
Many people
think a
diagnostic label means being seen as tainted, weak, and weird.However:these negative views/stigma come from popular cultural views of mental illness, and not from the DSM. the DSM may contain the information to correct inaccurate perceptions of mental illness. Slide18
Insanity and Responsibility
Jared Loughner shot many people, including a U.S. Representative, in 2011.
Loughner had schizophrenia and substance abuse problems, a combination associated with increased violence.
What is the appropriate consequence?To what degree, if any, should he be held responsible for his actions?Slide19
How common are psychological disorders?
Countries vary greatly in the percentage of people reporting mental health issues in the past year.Slide20
Vulnerable factors and ages for developing Mental Disorders
Poverty
increases the risk of many mental disorders including aggression and anxiety. Disorders decrease when poverty is lifted.“Immigrant paradox”: Despite the stress of immigrating, those who immigrate to the U.S.A. have a lower risk of disorders than their children born in the U.S.A. Many disorders begin to show symptoms by early adulthood. Developing on average around age 20: OCD, Schizophrenia, Bipolar, Alcohol Dependence.
Showing some signs earlier: Phobias (median age 10) and antisocial personality disorder (some symptoms by age 8)
Developing later than 20: Major Depressive Disorder.
Who is vulnerable to
mental disorders?
Age of vulnerability:Slide21
Rates of Psychological Disorders
This list takes a closer look at the past-year prevalence of various mental health diagnoses in the United States.Slide22
Mood Disorders: Not just feeling “down;” not just sad about something
Major Depressive Disorder: Stuck in dark withdrawal
Bipolar Disorder: sometimes fleeing depression into mania
Prevalence and Course of depression: Common, but for many it goes awayGenetic Influences on DepressionSuicide and Self-InjuryNegative Moods and Negative thoughts: Explanatory styleThe vicious cycle: Interaction of bad experiences depressive thoughts mood changes behavior changes more sad daysSlide23
Mood Disorders
Major depressive disorder [MDD] is:
more than just feeling “down.”
more than just feeling sad about something.Bipolar disorder is: more than “mood swings.” depression plus the problematic overly “up” mood called “mania.”Slide24
Criteria of Major Depressive Disorders
Depressed mood most of the day, and/or
Markedly diminished interest or pleasure in activities
Significant increase or decrease in appetite or weightInsomnia, sleeping too much, or disrupted sleep Lethargy, or physical agitation Fatigue or loss of energy nearly every day Worthlessness, or excessive/inappropriate guilt Daily problems in thinking, concentrating, and/or making decisions Recurring thoughts of death and suicide Major depressive disorder is not just one of these symptoms.It is one or both of the first two, PLUS three or more of the rest.Slide25
Depression is Everywhere
Depression shows up in people seeking treatment: Phobias are the most common (frequently experienced) disorder, but depression is the #1 reason people seek mental health services.
Depression appears
worldwide: Per year, depressive episodes happen to about 6 percent of men and about 9 percent of women. Over the course of a lifetime, 12 percent of Canadians and 17 percent of USA residents experience depression.Depression: The “Common Cold” of Disorders?Although both are “common” (occurring frequently and pervasively), comparing depression to a cold doesn’t work. Depression:
is more dangerous because of suicide risk.has fewer observable symptoms.
is more lasting than a cold, and is less likely to go away just with time.
is much less contagious.
And…depressive pain is beyond sniffles.Slide26
Seasonal Affective Disorder [SAD]
Seasonal affective disorder
is more than simply disliking winter.
Seasonal affective disorder involves a recurring seasonal pattern of depression, usually during winter’s short, dark, cold days.Survey: “Have you cried today”? Result: More people answer “yes” in winter.Percentage who cried
Men
Women
August
4
7
December
8
21Slide27
Bipolar Disorder
Bipolar disorder was once called “manic-depressive disorder.”Bipolar disorder’s two polar opposite moods are depression and mania.
Mania
refers to a period of hyper-elevated mood that is euphoric, giddy, easily irritated, hyperactive, impulsive, overly optimistic, and even grandiose.Contrasting SymptomsDepressed mood: stuck feeling “down,” with:Mania: euphoric, giddy, easily irritated, with:
exaggerated pessimismsocial withdrawal
lack of felt pleasureinactivity and no initiative
difficulty focusingfatigue and excessive desire to sleep
exaggerated optimism
hypersociality and sexualitydelight in everything
impulsivity and overactivity
racing thoughts; the mind won’t settle down
little desire for sleepSlide28
Many famous and successful people have lived with the ups and downs of bipolar disorder. Some speculate that the depressive periods gave them ideas, and the manic episodes gave them creative energy. Any evidence of mood swings here?
Bipolar Disorder and Creative Success Slide29
Bipolar Disorder in Children and Adolescents
Does bipolar disorder show up before adulthood, and even before puberty?
Many young people have cycles from depression to extended rage rather than mania.
The DSM-V may have a new diagnosis for some of these kids: disruptive mood dysregulation disorder.Slide30
Understanding Mood Disorders
Why are mood disorders so pervasive, especially among women?
Women, starting in adolescence, appear to ruminate more, have deeper sadness
then men, encounter more stressors, and report their depression more readily.Slide31
Understanding Mood DisordersCan we explain…
Why does depression often go away on its own?the course/development of reactive depression?
Often, time heals a mood disorder, especially when the mood issue is in reaction to a stressful event. However, a significant proportion of people with major depressive disorder do not automatically or easily get better with time.Slide32
Understanding Mood Disorders
Biological aspects and explanations
Social-cognitive aspects and explanations
EvolutionaryGenetic Brain /BodyNegative thoughts and negative mood Explanatory style The vicious cycleSlide33
An Evolutionary Perspective on the Biology of Depression
Depression, in its milder, non-disordered form, may have had survival value.
Under stress, depression is social-emotional hibernation. It allows humans to:
conserve energy. avoid conflicts and other risks. let go of unattainable goals. take time to contemplate.Slide34
Biology of Depression: Genetics
Evidence of genetic influence on depression:DNA linkage
analysis reveals depressed gene regions
twin/adoption heritability studies Slide35
Biology of Depression: The Brain
Brain activity is diminished in depression and increased in mania.
Brain
structure: smaller frontal lobes in depression and fewer axons in bipolar disorderBrain cell communication (neurotransmitters): more norepinephrine (arousing) in mania, less in depression reduced serotonin in depressionSlide36
Suicide and Self-Injury
Every
year,
1 million people commit suicide, giving up on the process of trying to cope and improve their emotional well-being. This can happen when people feel frustrated, trapped, isolated, ineffective, and see no end to these feelings.Non-suicidal self-injury has other functions such as sending a message, distracting from emotional pain, giving oneself permission to feel, or self-punishment. Slide37
Depressive Explanatory Style
Low Self-Esteem
Learned Helplessness
Rumination
Discounting positive information and assuming the worst
about self, situation, and the future
Self-defeating beliefs such as a
ssuming that one (self) is unable to cope, improve, achieve, or be happy
Depression is associated with:
Stuck focusing on what’s bad
Understanding Mood Disorders:
The Social-Cognitive Perspective Slide38
Depressive Explanatory Style
Mood/result that goes along with these views:
How we analyze bad news predicts mood.
Assumptions about the problemThe problem is:
The problem is:
The problem is:
Problematic event:Slide39
Depression’s Vicious Cycle
A depressed mood may develop when a person with a negative outlook experiences repeated stress.
The depressed mood changes a person’s style of thinking and interacting in a way that makes stressful experience more likely.