Historical Roots In the ancient world, psychopathology was thought to be caused by demons - PowerPoint Presentation

Historical Roots In the ancient world, psychopathology was thought to be caused by demons and spirits that had taken possession of the person’s mind and body.Part of daily life in ancient worlds was spent doing rituals aimed at outwitting or placating these supernatural beings.

Hippocrates In 400 B.C. the Greek physician Hippocrates took the first step toward a scientific view of mental illness when he said that abnormal behavior had physical causes. He taught his disciples to interpret the symptoms of psychopathology as an imbalance among our body fluids called “humors.” Humors Origins Temperament Blood Heart Sanguine (cheerful) Choler (yellow bile) Liver Choleric (angry) Melancholer (black bile) Spleen Melancholy (depressed) Phlegm Brain Phlegmatic (sluggish)

Early Theories Music or singing was often used to chase away spirits. In some cases trephening was used:Cutting a hole in the head of the afflicted to let out the evil spirit.

Salem Witch Trials As a result of erroneous thinking, thousands of mentally disturbed people were executed. In Salem Massachusetts, was one example of the problems with this type of thinking. A modern analysis of the Salem witch trials has concluded that the girls were probably suffering from poisoning by a fungus growing on rye grain-the same fungus that produces the hallucinogenic drug LSD.

Psychopathology What was formerly known as mental illness or mental disorder is now often referred to as psychopathology.Some feel “mental illness” puts the basis for the illness on biology, even though psychologists have shown that environment is often the cause of the disorder. Psychopathology is any pattern of emotions, behavior, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals.

Psychological Disorders/Abnormal Psych Psychological disorders are incurable People with psychological disorders are dangerous People with psychological disorders behave bizarrely & are very different from “normal” people Stereotypes & Stigma What effect do these have on the likelihood of someone truly suffering seeking help?

Psychological Disorders At various moments, all of us feel, think or act the way disturbed people do much of the time. We, too, get anxious, depressed, withdrawn, suspicious, or deluded, just less intensely and more briefly.Some 450 million people world wide suffer psychological disorders.No culture known to man is without some form of psychological disorders.

Prevalence of Psychopathology In America, mental illness is far more common than most people realize. Over 15% of the population currently suffers from diagnosable mental health problems. Another study found that during any given year, the behaviors of over 56 million Americans meet the criteria for a diagnosable psychological disorder (Carson et al. 1996).Over the lifespan, as many as 32% of Americans suffer from some psychological disorder (Regier et al., 1988).

What is Psychological Disorder? How do we discern what is normal and abnormal? What about a soldier who risks his life in war? A grief stricken mother who cannot return to her normal routines three months after losing her son? Psychological disorders are persistently harmful thoughts, feelings and actions.When behavior is deviant, distressful and dysfunctional , psychologists label it a disorder.

3 Classical Symptoms of Severe Mental IllnessThe more extreme a disorder is, the more easily it is detected. When trying to diagnose a patient, doctors look for three classic symptoms of sever psychopathology: Hallucinations-false sensory experiences.Delusions-extreme disorders that involve persistent false beliefs. Affect (emotion)-characteristically depressed, anxious, manic, or no emotional response.

Psychological Disorders as a Continuum No Disorder Mild Disorder Moderate Disorder Severe Disorder Absence of signs of psychological disorder Few signs of distress or other indicators of psychological disorder Indicators of disorders are more pronounced and occur more frequently Clear signs of psychological disorder, which dominate the person’s life Absence of behavioral problems Few behavior problems; responses usually appropriate to the situation More distinct behavior is often inappropriate to the situation Severe and frequent behavior problems; behavior is usually inappropriate to the situation No problems with interpersonal relationships Few difficulties with relationships More frequent difficulties with relationships Many poor relationships or lack of relationships Disorders are exaggerations of normal behavior and responses.

The Medical Model In the late 18th century, the “disease view” reemerged. The result was the medical model, a view that mental disorders are diseases of the mind that, like ordinary physical diseases, have objective causes and require specific treatment. **

Problems with the Medical Model Despite its success, modern psychologists find fault with relying solely on the medical model. They suggest that treating the disorder as a “disease” leads to a doctor-knows-best approach in which the therapist takes all the responsibility for diagnosing and correcting the problem. In this model, the patient becomes a passive recipient of medication and advice.

Perspectives and Disorders Psychological School/Perspective Cause of the DisorderPsychoanalytic/PsychodynamicInternal, unconscious drives Humanistic Failure to strive to one’s potential or being out of touch with one’s feelings. Behavioral Reinforcement history, the environment. Cognitive Irrational, dysfunctional thoughts or ways of thinking. Sociocultural Dysfunctional Society Biomedical/Neuroscience Organic problems, biochemical imbalances, genetic predispositions.

Social-Cognitive-Behavioral Approach As psychology has evolved, theories which were originally at odds, have now been combined to offer more thorough explanations, for example, cognitive psychology and behaviorism. Cognitive psychology looks inward, emphasizing mental processes. Behaviorism looks outward and emphasizes the influences of the environment. Psychologist from these perspectives see these two as complementary, and add that cognitions and behavior usually happen in social context, requiring social perspective .

Combining Perspectives The behavioral perspective tells us that abnormal behaviors can be acquired in the same fashion as healthy behaviors-- through behavioral learning.The cognitive perspective suggests that we must consider how people think about themselves and their relations with other people. Social-cognitive-behavioral approach , then, is an alternative to the medical model combining all three of psychology’s major perspectives.

The Bio-psycho-social Model of Mental Disorder Modern bio-psychology assumes that some mental disturbances involve the brain or nervous system in some way. Subtle changes in the brain’s tissue or its chemical messengers- the neurotransmitters- can profoundly alter thoughts and behaviors. Genetic factors, brain injury, infection, and learning are some of the factors that can tip the balance towards psychopathology.

Bio-psycho-social Model In short, biological, socio-cultural and psychological factors contribute to psychological disorders Biological (Evolution, individual genes, brain structures and chemistry) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Sociocultural (Roles, expectations, definition of normality and disorder)

A Short History of the DSM The DSM-1 (1952), 106 disorders across several major categories, reflecting a psychodynamic perspective on etiologyDSM II (1968), 182 disorders, similar framework as DSM-1; like DSM-1, it lacked specification of specific symptoms of many disorders; distinguished among disorders at broader levels of neurosis, psychosis, and personality disturbance DSM-III (1980) and DSM-III-R (1987), which focused on standardization of diagnostic categories by linking them to specific criteria or symptom clusters, expressed in colloquial language; included 265 diagnoses in DSM-III and 292 in DSM-III-R, which changed some of the diagnostic criteria DSM-IV (1994) and DSM-IV-TR (2000), 297 disorders, relatively minor changes

Major Changes Change CommentElimination of multi-axial system a Clinicians wanted simplified, diagnosis-based system; distinctions between Axis I and Axis II disorders were never clearly justified; clinicians can still specify external stressors; new assessment measures will be introduced Establishes 20 diagnostic classes or categories of mental disorders Categories based on groupings of disorders sharing similar characteristics; some categories represent spectrums of related disorders Introduction of new diagnostic category of Neurodevelopmental Disorders to include Autism Spectrum Disorder and ADHD and other disorders reflecting abnormal brain development Increasing emphases on neurobiological bases of mental disorders and the developing understanding that abnormal brain development underlies many types of disorders

Major Changes ChangeComment Introduces more dimensionality (severity ratings) but does not restructure personality disorders as some had proposedMajor changes in personality disorders held over until next revision, the DSM 5.1 (or maybe 5.2) Roman numerals dropped: DSM-5, not DSM-V Allows for easier nomenclature for midcourse revisions, 5.1, 5.2, etc. Removes obsessive-compulsive disorder from category of Anxiety Disorders and places it in new category of Obsessive-Compulsive and Related Disorders Recognizes a spectrum of obsessive-compulsive type disorders, including body dysmorphic disorder; however, anxiety remains the core feature of OCD, so questions remain about separating it from anxiety disorders

Major Changes ChangeComment Provides a means of rating severity of symptoms, such as for ASDEncourages clinicians to recognize the dimensionality of disorders Greater emphasis on comorbidity; e.g., u se of anxiety ratings in diagnosing depressive and bipolar disorders Provides more explicit recognition of comorbidity in having clinicians rate level of anxiety in mood disorders

Major Changes Change CommentElimination of term “somatoform disorders” (now Somatic Symptom and Related Disorders)Eliminates a term few people understood (somatoform disorders) and now emphasizes the psychological reactions to physical symptoms, not whether they are medically based Reorganization of mood disorders into two separate diagnostic categories of Depressive Disorders and Bipolar and Related Disorders No major changes anticipated, but no clear basis for eliminating umbrella construct of mood disorders

Major Changes Change CommentHypochondriasis dropped as distinct disorder Eliminates the pejorative term “ hypochondriasis ”; people formerly diagnosed with hypochondriasis may now be diagnosed with Somatic Symptom Disorder if their physical symptoms are significant or with Illness Anxiety Disorder if their symptoms are minor or mild Factitious Disorder moved to Somatic Symptom and Related Disorders Associated with other somatic symptom disorders, but is distinguished by intentional fabrication of symptoms for no apparent gain other than assuming medical patient role

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorders Neurodevelopmental Disorders Autism Spectrum Disorder Specific Learning Disorder Communication Disorders ADHD, Motor Disorders, etc. Schizophrenia Spectrum and Other Psychotic Disorders Schizophrenia Schizophreniform Disorder Schizoaffective Disorder Delusional Disorder Schizotypal Personality Disorder Bipolar and Related Disorders Bipolar I Disorder, Bipolar II Disorder Cyclothymic Disorder Depressive Disorders Disruptive Mood Dysregulation Disorder Major Depressive DisorderPersistent Depressive DisorderPremenstrual Dysphoric Disorder

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorders Anxiety DisordersSpecific Phobia Social Anxiety Disorder (Social Phobia) Panic Disorder Agoraphobia Generalized Anxiety Disorder Separation Anxiety Disorder Selective Mutism Obsessive-Compulsive and Related Disorders Obsessive-Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Hair-Pulling Disorder ( Trichotillomania )Excoriation (Skin-Picking) DisorderTrauma and Stressor Related DisordersAdjustment DisordersAcute Stress DisorderPosttraumatic Stress DisorderReactive Attachment Disorder Disinhibited Social Engagement Disorder

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorders Dissociative Disorders Dissociative Identity Disorder Dissociative Amnesia Depersonalization/Derealization Disorder Somatic Symptom and Related Disorders Somatic Symptom Disorder Illness Anxiety Disorder Conversion Disorder (Functional Neurological Symptom Disorder) Factitious Disorder Feeding and Eating Disorders Anorexia Nervosa Bulimia Nervosa Binge Eating Disorder Pica, Rumination Disorder Avoidant/Restrictive Food Intake DisorderElimination DisordersEnuresisEncopresis

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorders Sleep-Wake DisordersInsomnia DisorderHypersomnolence DisorderNarcolepsyBreathing-Related Sleep DisordersCircadian Rhythm Sleep-Wake Disorders Parasomnias: Sleepwalking, Sleep Terrors, Nightmare Disorder, Rapid Eye Movement Sleep Behavior Disorder Restless Legs Syndrome Sexual Dysfunctions Delayed Ejaculation Erectile Disorder Female Orgasmic Disorder Female Sexual Interest/Arousal Disorder Genito -Pelvic Pain/Penetration Disorder Male Hypoactive Sexual Desire Disorder Premature (Early) Ejaculation

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorder Gender DysphoriaGender Dysphoria Disruptive, Impulse-Control, and Conduct Disorders Oppositional Defiant Disorder Intermittent Explosive Disorder Conduct Disorder Antisocial Personality Disorder Pyromania Kleptomania Substance-Related and Addictive Disorders Substance Use Disorders Substance-Induced Disorders Gambling Disorder Neurocognitive Disorders Delirium Major & Mild Neurocognitive Disorders

Diagnostic Categories Diagnostic CategoryExamples of Specific Disorders Personality DisordersParanoid Personality DisorderSchizoid Personality DisorderSchizotypal Personality DisorderAntisocial Personality DisorderBorderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder

Indicators of Abnormality While psychologists look for the three classical symptoms, not all disorders have such sever symptoms. A few others are:Distress: Does the individual show unusual or prolonged levels of anxiety?Maladaptiveness: Does the person act in ways that make others fearful? Irrationality: Does the person act or talk in ways that are irrational or incomprehensible to others? Unpredictability: Does the individual behave erratically and inconsistently at different times? Unconventional/undesirable behavior: Does the person act in ways that are statistically rare and violate social norms?

Anxiety Disorders Anxiety Disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxietyWe all experience anxiety at one point and time in our lives, however it is not intense and not persistentAnxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18% of U.S. population).

Anxiety Disorders Symptoms: Often jitteryAgitatedSleep deprivedDifficulty concentratingDepressed MoodApprehension may leak out throughFurrowed browsTwitching eyelids TremblingPerspirationFidgeting

Anxiety Disorders Generalized Anxiety DisorderAn anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousalGAD affects 6.8 million adults, or 3.1% of the U.S. population.Women are twice as likely to be affected as men.

Psychological Disorders/Abnormal Psych Anxiety Disorders : Generalized Anxiety Disorder : High level of “free-floating” anxiety not tied to specific threat; pervasive & persistent stimulation of ANS Must last at least 6 months for diagnosis Brood over relatively minor issues However, as time passes emotions tend to mellow and by age 50, generalized anxiety disorder becomes rare More common in females

Anxiety Disorders Specific phobias focus on one thingPeople tend to avoid that situation or particular thingSocial Phobias is basically shyness taken to the extremeIntense fear of being scrutinized by others, avoid potentially embarrassing social situations, or will sweat, tremble, or have diarrhea when doing so15 million, 6.8% Equally common among men and women, typically beginning around age 13.AgoraphobiaFear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes

Anxiety Disorders PhobiasAnxiety disorder marked by a persistent, irrational fear and avoidance of a specific object or situation19 million, 8.7%Women are twice as likely to be affected as men.Typically begins in childhood; the median age of onset is 7.

Psychological Disorders/Abnormal Psych Anxiety Disorders Phobic Disorder : Anxiety now has a specific focus: persistent, irrational fear of something presenting no real danger Beyond simple phobias – maladaptive, disruptive to everyday life (e.g ., various social phobias, often w/ physical symptoms Remember conditioning!

Causes of Phobias GeneticsMartin Seligman used photos of flowers and snakes to test this theorySpecific eventsSpecific events can trigger a phobiaPhobias are likely linked to the amygdala, the part of the brain that controls aggression and fear

Anxiety Disorders Common and uncommon fears

Anxiety Disorders Panic DisorderAn anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, chocking, or other frightening sensations

Psychological Disorders/Abnormal Psych Anxiety Disorders Panic Disorder 6 million, 2.7% Women are twice as likely to be affected as men.  Very high comorbidity rate with major depression.  Recurring attacks of overwhelming anxiety, sudden & relatively brief May be mistaken for heart attack Often linked to agoraphobia ; may “fear the fear itself ” Onset late adolescence, early adulthood; may be rooted in limbic system

Anxiety Disorders Understanding Anxiety DisordersLearning perspectiveFear conditioning: researchers have demonstrated ability to condition fear in ratsTwo specific learning processes contribute to anxietyStimulus generalizationReinforcementObservational Learning

Anxiety Disorders Biological PerspectiveNatural Selection: fear threats face by ancestorsGenetics: researchers are examining neurotransmitters that influence an anxiety geneThe Brain: Anxiety disorders are manifested biologically as an overarousal of brain areas involved in impulse control and habitual behaviors

Obsessive-Compulsive and Related Disorders Obsessive-Compulsive DisorderAn anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)Crosses the line from normality to disorder when they persistently interfere with everyday living and cause the person distress2-3% cross the line during their teens or early twenties

Obsessive-Compulsive and Related Disorders Obsessive thoughts and compulsive behavior become so ritualistic that effective functioning become impossible

Anxiety Disorders

Acute Stress Disorder The person experienced or witnessed trauma with an event where there was the threat of or actual death or serious injury. The event may also have involved a threat to the person's or another person's physical well-being.The person responded to the event with strong feelings of fear, helplessness, or horror.

Acute Stress Disorder The person experiences at least three of the following dissociative symptoms during or after the traumatic event:Feeling numb or detached or having difficulties experiencing emotions.Feeling dazed or not entirely being aware of surroundings.Derealization, or feeling as though people, places, and things are not real.Depersonalization, or feeling separated and detached from oneself. Dissociative amnesia, or being unable to recall important parts of the traumatic event.

Acute Stress Disorder Studies of motor vehicle accident (MVA) survivors have found rates of ASD ranging from approximately 13% to 21%A study of survivors of a typhoon revealed an ASD rate of 7% While a study of survivors of an industrial accident revealed a rate of 6% A rate of 19% was found in survivors of violent assault While a rate of 13% was found in a mixed group consisting of survivors of assaults, burns, and industrial accidents. A study of victims of robbery and assault found that 25% met criteria for ASD. While a study of victims of a mass shooting found that 33% met criteria.

Acute Stress Disorder ASD and PTSD differ in two fundamental ways:The first difference is that the diagnosis of ASD can be given only within the first month following a traumatic event. If posttraumatic symptoms were to persist beyond a month, the clinician would assess for the presence of PTSD. The ASD diagnosis would no longer apply.ASD also differs from PTSD in that it includes a greater emphasis on dissociative symptoms.  

Psychological Disorders/Abnormal Psych Trauma & Stressor Disorder Post-Traumatic Stress Disorder (PTSD) : Delayed (“post”) stress (“stress”) reaction to uncontrollable danger (“traumatic”) Haunting memories that constantly intrude on thoughts; nightmares; social withdrawal; depression Symptoms may last years Often seen in war veterans, victims of violent crime, etc.

7.7 million, 3.5% Women are more likely to be affected than men. Rape is the most likely trigger of PTSD: 65% of men and 45.9% of women who are raped will develop the disorder.  Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD. Post-Traumatic Stress Disorder ( PTSD

Post-Traumatic Stress Disorder PTSDCause: experiencing / witnessing a traumatic event (fear, helplessness, horror)Nightmares, flashbacks, social withdrawal, insomniaCombat veterans, disaster or accident survivors, sexual assault victims, 2/3 of prostitutes Basic trust erodes, sense of hopelessness15% of Vietnam vets (45% for heavy combat)1 in 6 Iraqi combat infantry veterans

Shell Shock Precursor to PTSD?

Psychological Disorders/Abnormal Psych Trauma & Stressor Disorder Etiology of Anxiety Disorders : Biological Concordance rates show some genetic basis Hypersensitivity to internal signs of anxiety GABA synapses affected by anti-anxiety meds (Valium, Xanax, Prozac) that suppress the CNS Conditioning/Learning Phobias & preparedness Observational learning Cognitive factors: misinterpretation, inappropriate focus etc. Stress-related factors: duh

Reactive Attachment Disorder Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn't establish healthy attachments with parents or caregivers. Reactive attachment disorder may develop if the child's basic needs for comfort, affection and nurturing aren't met and loving, caring, stable attachments with others are not established.

Withdrawal, fear, sadness or irritability that is not readily explained Sad and listless appearanceNot seeking comfort or showing no response when comfort is givenFailure to smileWatching others closely but not engaging in social interaction Failing to ask for support or assistanceFailure to reach out when picked upNo interest in playing peekaboo or other interactive games

Major Depression Major depression is a form of depression that does not alternate with mania (happiness).It is normal to become depressed after a sad or unfortunate event but if a person remains depressed weeks or months after that event, it may be classified as major depression. Major depression does not give way to manic episodes.

Major Depression By many accounts, depression is under diagnosed and under treated. Globally speaking, studies indicate that depression is the single most prevalent disability.While some differences may be a result of reporting, other factors seem to be at work too:Taiwan/Korea = low divorce rate Lebanon = war in Middle East Taiwan 1.5% Korea 2.9% Puerto Rico 4.3% U.S. 5.2% Germany 9.2% Canada 9.6% New Zealand 11.6% France 16.4% Lebanon 19% Lifetime Risk of a Depressive Episode lasting a Year or More

Depression

Mood Disorders-Depression Canadian depression rates

Causes of Depression Some causes of major depression involve genetic predisposition. Severe bouts of depression often run in families-this indicates a biological basis.Further indication of a biological basis for depression are that drugs that affect the brains levels of certain neurotransmitters can be very effective. However, biology alone cannot account for everything.

Cognitive Explanations Probably because of low self-esteem, depression-prone people are more likely to perpetuate the depression cycle by attributing negative events to their own personal flaws or external conditions they feel helpless to change. Martin Seligman calls this learned helplessness.Locus of control-internal vs. external

Cognitive-Behavioral Cycle of Depression Low Self-Esteem and Negative Interpretations Social Rejection and Loneliness Negative Event Depression Negative Behaviors Fred decides to be more sociable, but when he asks Teresa for a date she already has plans. Fred concludes that he is not very interesting or attractive and that people don’t like him. Fred feels completely alone and unhappy Fred avoids people, skips school and neglects personal hygiene Because of Fred’s negative behaviors, people avoid him-reinforcing his symptoms.

The Cognitive Approach The cognitive approach to depression points out that negative thinking styles are learned and modifiable. *Think classical and operant conditioning.

Beck’s Basics Aaron Beck suggests that depression is a result of negative thinking which he called ‘cognitive errors’ (errors in logic) Beck identified three negative thoughts that seemed to be really automatic and occurred without delay in depressed patients. The “Cognitive Triad:” Self External WorldFuture Beck believes that faulty thinking leads to depression. The question remains though, which came first, the depression or the faulty thoughts.

WHO BECOMES DEPRESSED? Studies show that depression rates are higher in women. The difference may be in the way men and women handle emotional situations. Women tend to be introspective: Think about their feelings and what may be causing them. Men, on the other hand, try to distract themselves from the depressed feelings. This suggests the more ruminative response of women increases their vulnerability to depression. Depression breeds depression

Increasing Rates of Depression Rates of depression have increased 10-20 times what they were 50 years ago. The average age of people experiencing depression has gone down. Martin Seligman identifies 3 causes of this trend:Out-of-control individualism/self-centeredness-focuses on individual successes and failures rather than group accomplishments.

Increasing Rates of Depression The self-esteem movement- teaching a generation of children they should feel good about themselves, irrespective of their efforts and achievements. A culture of victimology- reflexively pointing the finger of blame at someone or something else.

Types of Dissociative Disorders Four Major Types: Dissociative amnesia Dissociative identity disorder Dissociative fugue Depersonalization Disorder

Types of Dissociative Disorders Psychogenic Amnesia: Amnesia with no physiological basis biologically induced amnesia = organic amnesia) Fugue = Psychogenic Amnesia + unfamiliar environment (fugue = flight / loss of identity and flee)

Signs and Symptoms Memory loss (amnesia) of certain time periods, events and people Mental health problems, including depression and anxiety A sense of being detached from yourself (depersonalization) A perception of the people and things around you as distorted and unreal (derealization) A blurred sense of identity

Causes AbusePhysical SexualEmotionalFrightening home lifeIt is rare for adults to develop a dissociative disorder

Types of Dissociative Disorders Dissociative Identity Disorder (DID)AKA Multiple Personality DisorderUsually from traumatic event / overwhelming stress (high % report child abuse) often at young age (3-5 years)Self-protection / coping mechanismDistinctive identities for different events (toddler to adult) Norm- 3-6 identities (2 to qualify) Almost entirely confined to N. America Very controversial as medical diagnosis

Dissociative Disorders Psychological Disorders/Abnormal Psych Depersonalization Disorder: Feeling that you aren’t “real” Sense of detachment from your own body, feeling as if you’re losing grip on reality, living in a dream Only a disorder if recurring (est. 70% experience at some point)

Somatoform Disorders “soma” = bodyPsychological problem manifested in a physiological symptom (IOW: physical problem without a physical cause)Common among those claiming disabilityTwo major disorders: hypochondriasis: imagined or exaggerated illnesses (no medical cause) Conversion disorder : involves motor or sensory problems with no biological explanation / cause Conversion blindness, conversion paralysis

Explaining Somatoform PsychoanalyticOutward manifestations of unconscious conflict BehavioristsReinforcement for behavior (can’t work or sympathy / attention)

Clinical Distinction… Somatoform patient: unconscious of psychological causes (does not seek to maintain role of patient)Factitious patient: Consciously creating the symptoms, …prolonging role of patient

Psychological Disorders/Abnormal Psych Somatoform Disorders Body Dysmorphic Disorder: Characterized by excessive concern with bodily appearance Concern their nose is too big, hair too thin, over/underweight to the point of maladaptive behavior & personal distress Some become “plastic surgery addicts”

Psychological Disorders/Abnormal Psych Somatoform Disorders Etiology of Somatoform Disorders: Personality Histrionic personality – attention? Neuroticism Cognitive factors Misinterpret minor issues Faulty stds of “good health” “Sick Role” Like a defense mechanism – don’t have to deal w/ other problems

Bipolar & Related Manic Episode a mood disorder marked by a hyperactive, wildly optimistic stateBipolar Disordera mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania formerly called manic-depressive disorder

Schizophrenia Disordered / distorted thinkingBreakdown in selective attention (Can’t filter out information)Disturbed perceptionsDelusions: beliefs that have no basis in reality Delusions of persecution = paranoiaDelusions of grandeur = greatness Hallucinations: Perceptions in the absence of sensory stimulationInappropriate actions / emotions

Things to consider… Most severe of psych disordersUsually starts in late teens / early twenties1 out of every 100 people have Schizophrenia

Types of Schizophrenia Disorganized SchizophreniaParanoid SchizophreniaCatatonic SchizophreniaUndifferentiated Schizophrenia Acute vs. Chronic SchizophreniaWhat’s the difference?Acute: Abrupt display of symptoms- can be short duration and never return or become longterm issue Chronic: Long-term struggle with Schizophrenia

Disorganized Schizophrenia Odd use of language (Word Salad = fragmented speechNeologisms: made up wordsClang associations: string together nonsense words that rhyme Inappropriate effect: Laugh in sorrowful settingFlat effect: no emotional response at all

Paranoid Schizophrenia Delusions of persecution“out to get me”

Catatonic Schizophrenia Engage in odd movementsRemain motionless for hours (odd positions / poses / Waxy flexibility parrot-like repeating of speech, movement

Undifferentiated Schizophrenia Disordered thinking, but no symptoms of other types of Schizophrenia

Explaining Schizophrenia BiologicalDopamine hypothesisExcessive levels = Schizophrenia (average 6x normal levels)Enlarged brain ventriclesGenetic predispositions Abnormality of 5th chromosomeSocial-CognitiveDouble binds: contradictory messages = distorted ways of thinking

Schizophrenic DisordeRs Psychological Disorders/Abnormal Psych Is a change in order for the DSM-V? : Eliminate subcategories in favor of: Positive: behavioral excesses (hallucinations, delusions, bizarre behavior) Negative: behavioral deficits (poverty of speech, withdrawal, flat affect, apathy)

Schizophrenic DisordeRs Psychological Disorders/Abnormal Psych Etiology of Schizophrenic Disorders : Typically emerges in late adolescence; more significant in males Biological factors: Genetics Excess dopamine Structural abnormalities in brain Problems during prenatal neural development (viral infections?) Stress may be an important trigger

Schizophrenic DisordeRs Psychological Disorders/Abnormal Psych

Schizophrenia

Personality Disorders Enduring, maladaptive behavior that negatively affects one’s ability to function.Usually less serious than other disorders.Nurture based

Personality Disorder Antisocial disorder (most serious)No regard for others’ feelings / world as hostile / look out for oneself / absence of conscience No fear, no shameserial criminals, serial killers (worst case)Electric shock: no increased anxiety in anticipation Causes: Both Biological and Psychological Nurture influential: hero or villain …

More Personality Disorders Borderline PersonalityDisorder of emotions (intense instability) self-mutilationSevere anxiety, depression Dependant personality disorderOverly dependant on attention, help from othersParanoid Personality DisorderFeel persecuted, very distrustfulNarcissistic Disorder Self-love, grandiose self-importance, entitlement, failed relationships, “”narcissistic paradox” Histrionic Disorder : (center of attention) Overly dramatic behavior Obsessive-Compulsive Disorder Overly concerned with thoughts and behaviors