Psychological Disorders

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Psychological Disorders
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What do you think?

• Write a definition for a psychological disorder.
• Do not give examples or define specific
  disorders- what does it mean to have a
  psychological disorder?

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Psychological Disorder

• distressing harmful disruptive
• behavior is uncontrollable
• Unjustified, Irrational

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Psychological Disorders

• Must have personal distress and impaired
  functioning

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Personal Distress

• The behavior/symptoms causes significant personal
  distress to the patient (may not realize)
• Potential harm to self or others

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Impairs Functioning

• Daily life functioning is impaired (one or both)
• Work/School life
• Home life

• Varies throughout time/ culture

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How have disorders been classified

• How would you classify someone with a mental
  problem?

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Ancient causes of madness

• movements of sun or moon
• lunacy- full moon (lunar)
• evil spirits

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Ancient cures

• Exorcism
• Caged like animals, beaten, burned, castrated,
  mutilated

• blood replaced with animals blood!

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Today

• This is what we use today to classify people with
  disorders- DSM-IV-TR
• Why do we need a way to classify disorders?

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Diagnosis DSM-IV-TR

• Diagnostic and Statistical Manual of Mental
  Disorders

• describes specific symptoms and diagnostic
  guidelines for psychological disorders
• Provides a common language comprehensive
  guidelines to help diagnose

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Insanity

• legal definition only
• unable to determine between right wrong or
  understand consequences

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What do you think

• How easy do you think it would be to classify
  someone as insane?

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Psychological Disorders here we come!!
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Anxiety Disorders

• An unpleasant emotional state characterized by
  general, vague feelings of tension, fear and
  apprehension

Anxiety
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• Anxiety Disorders differ from general feelings of
  anxiety in that

• Distressing, persistent
• And/or
• The behaviors that reduce anxiety

begin to control and dominate life!
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Anxiety Disorders are

• Irrational (exaggerated or non existent threats,
  response is out of proportion)
• Uncontrollable (can not be turned off, even if
  the person wants to)
• Disruptive (interferes with life)

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Types of Anxiety Disorders

• GAD
• Panic
• Agoraphobia
• Phobias
• PTSD
• OCD

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Generalized Anxiety Disorder (GAD)

• Constant worry about many issues w/o cause,
  seriously interferes with functioning
• Physical symptoms
• headaches
• stomach aches
• muscle tension
• irritability

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Panic Disorder

• Panic attackssudden episode of helpless terror
  with high physiological arousal (increased blood
  pressure, heart beat, temp., sweating)

• Very frightening sufferers live in fear of
  having them

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• Agoraphobia often develops
• FEAR OF OUTDOORS

• Fear of being in situations in which escape might
  be difficult, they dont feel safe- public
  places, crowds, wide open spaces
• Mostly confined to homes- they are safe there

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Specific Phobias

• Intense, irrational fears that may focus on .
• Inappropriate response to ..

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Natural environment type

• the fear of heights (acrophobia)
• the fear of lightning and thunderstorms
  (astraphobia).

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Situational type

• the fear of small confined spaces
  (claustrophobia)
• being "afraid of the dark," (nyctophobia).
• Monophobiafear of being alone
• Gephyrophobia - Fear of crossing bridges.
• Ligyrophobia Fear of loud noises.
• Xenophobia Fear of strangers, foreigners, or
  aliens.

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Blood/injection/injury type

• the fear of medical procedures including needles
  and injections (aichmophobia)
• Algobphobiafear of pain
• Pyrophobiafear of fire
• Emetophobia Fear of vomiting.
• Radiophobia Fear of radiation or x-rays
• Hemophopia (Haemophobia) Fear of blood

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Animal type

• the fear of spiders (arachnophobia)
• the fear of snakes (ophidiophobia).
• Ailurophobiafear of cats
• Myrmecophobia Fear of ants.
• Cynophobia Fear of dogs or of rabies.
• Mottephobia Aversion to moths and butterflies.

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Other

• the fear of the number 13 (triskaidekaphobia)
• the fear of clowns (coulrophobia).
• Anthropophobiafear of men
• Ephebiphobia Fear/dislike of teenagers.
• Zapatophobia - Fear of shoes, socks, or sandals.

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Common and uncommon fears
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Posttraumatic Stress Disorder (PTSD)

• Follows events that produce intense horror or
  helplessness (traumatic episodes)
• Actual or threatened death and/or injury
• War, Rape, Accidents, Attacks, Abuse, Rescue
  workers
• May be delayed after event- onset with trigger

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• Core symptoms include
• Frequent recollection of traumatic event, often
  intrusive and interfering with normal thoughts

• Avoidance of situations that trigger recall of
  the event
• Increased physical arousal associated with stress

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Obsessive-Compulsive Disorder (OCD)

• Obsessionsirrational, disturbing thoughts that
  intrude into consciousness
• Compulsionsrepetitive actions performed to
  alleviate obsessions

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• The compulsions (actions) help to keep away the
  obsessions (thoughts)
• If the actions are not performedanxiety
• Observable or mental compulsions

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OCD Examples

• Obsessions about getting hurt, hurting someone,
  getting sick, contamination, symmetry
• Compulsions cleaning, checking, hoarding,
  touching, counting, arranging, ordering,
  repeating phrases

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Review

• What are the characteristics of a disorder?
• When does anxiety regular anxiety turn into a
  disorder?
• Make your charts
• Disorder in the middle
• 1st square - Define it, 2nd square -define all
  the types of disorders, 3rd square examples of
  each type, 4th non-examples of each type

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Next set of disorders Personality disorders
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Personality Disorders

• Inflexible, maladaptive pattern of thoughts,
  emotions, behaviors
• stable over time and across situations
• deviate from the expectations of the individuals
  culture
• Antisocial, Borderline, Dependent, Narcissistic,
  Paranoid

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Antisocial Personality Disorder

• Might start as conduct disorder (children)
• Manipulative, charming, con man
• Cruel, destructive

• Lacking conscience, no guilt, no responsibility

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Borderline Personality Disorder

• Instability of mood, self-image, relationships
• Self-destructive behaviors, impulsive
• Fear of abandonment

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Dependent Personality Disorder

• Excessive need to be taken care of
• Unable to make decisions or do things on own
• Leads to submissive
• Clinging behavior fear of separation
• Inability to assume responsibility

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Narcissistic Personality Disorder

• Grandiose sense of self importance,
• success fantasies,
• need for increased attention,
• Excessive need for admiration
• arrogance others are inferior
• Boastful and pretentious

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Paranoid Personality Disorder

• Pervasive but unwanted distrust and
  suspiciousness
• Assumes that other people intend to deceive,
  harm, exploit them

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Review Personality disorders

• Make your charts
• Disorder in the middle
• 1st square - Define it, 2nd square -define all
  the types of disorders, 3rd square examples of
  each type, 4th non-examples of each type

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Next set of disorders dissociative disorders
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Dissociative Disorders

• literally a dis-association of memory
• person suddenly becomes unaware of some aspect of
  their identity or history

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Dissociative Disorders

• unable to recall except under special
  circumstances (e.g., hypnosis)
• dissociative amnesia, dissociative fugue,
  dissociative identity disorder

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Dissociative Amnesia

• Margie and her brother were recently victims of a
  robbery. Margie was not injured, but her brother
  was killed when he resisted the robbers.
• Margie was unable to recall any details from the
  time of the accident until four days later.

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Dissociative Amnesia

• Memory loss the only symptom
• Too extensive to be explained by ordinary
  forgetfulness
• Often selective loss surrounding traumatic events
• person still knows identity and most of their past

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Dissociative Fugue

• Amnesia with a journey involved often with
  identity replacement
• leaves home
• develops a new identity
• apparently no recollection of former life
• If fugue wears off
• old identity recovers
• new identity is totally forgotten

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Dissociative Fugue

• Jay, a high school physics teacher in New York
  City, disappeared three days after his wife
  unexpectedly left him for another man.
• Six months later, he was discovered tending bar
  in Miami Beach. Calling himself Martin, he
  claimed to have no recollection of his past life
  and insisted that he had never been married.

http//www.msnbc.msn.com/id/21134540/vp/153847241
5384724
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Dissociative Identity Disorder (DID)

• Norma has frequent memory gaps and cannot account
  for her whereabouts during certain periods of
  time.
• While being interviewed by a clinical
  psychologist, she began speaking in a childlike
  voice. She claimed that her name was Donna and
  that she was only six years old.
• Moments later, she seemed to revert to her adult
  voice and had no recollection of speaking in a
  childlike voice or claiming that her name was
  Donna.

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Dissociative Identity Disorder

• 2 or more distinct personalities manifested by
  the same person at different times, VERY rare and
  controversial disorder

• Most report recall of torture or sexual abuse as
  children and show symptoms of PTSD
• Pattern typically starts prior to age 10
  (childhood)

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Review

• What are the different types of dissociative
  disorders?
• Make your charts
• Disorder in the middle
• 1st square - Define it, 2nd square -define all
  the types of disorders, 3rd square examples of
  each type, 4th non-examples of each type

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Mood disorderswhat are they?
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Mood Disorders

• Significant and persistent disruption in mood,
  causing impaired cognitive, behavioral, and
  physical functioning
• Major depression
• Dysthymic disorder
• SAD
• Bipolar disorder

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Major Depression

• extreme and persistent feelings of despondency,
  worthlessness and hopelessness that disturb
  everyday functioning

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Symptoms of Major Depression

• Emotionalsadness, hopelessness, guilt, turning
  away from others
• Behavioraltearfulness, dejected facial
  expression, loss of interest in normal
  activities, slowed movements and gestures,
  withdrawal from social activities

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• Cognitivedifficulty thinking and concentrating,
  global negativity, preoccupation with
  death/suicide
• Physicalappetite and weight changes, excessive
  or diminished sleep, loss of energy, global
  anxiety, restlessness

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treatment
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• Difficult to sleep, to eat, to think, to
  concentrate
• May have suicidal thoughts, may not be able to
  carry out plan

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Dysthymic Disorder

• Chronic, low-grade depressed feelings that are
  not severe enough to be major depression
• May develop in response to trauma, but does not
  decrease with time
• Usually does not severely impair functioning
• Over two years

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Seasonal Affective Disorder

• Episodes of depression occur in fall and winter
  then subside in spring and summer (Seasonal
  regularity)

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Bipolar Disorders

• Mood levels swing from severe depression to
  extreme euphoria (mania), can have normal in
  between
• No regular relationship to time of year (SAD)
• Can vary in length of time for depression and
  mania

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• Must have at least one manic episode
• Supreme self-confidence
• Grandiose ideas and movements, little effort in
  carrying out plans
• Flight of ideas
• Aggressive, hostile, wild, incomprehensible,
  violent

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PET scans show that brain energy consumption
rises and falls with emotional swings
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Review of Mood Disorders

• Make your charts
• Disorder in the middle
• 1st square - Define it, 2nd square -define all
  the types of disorders, 3rd square examples of
  each type, 4th non-examples of each type

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The disorder - Schizophrenia
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Psychotic

• loss of contact w/reality- irrational, distorted

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Schizophrenia

• Disordered thoughts/ communications/
• inappropriate emotions, bizarre behavior

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Symptoms of Schizophrenia

• Hallucinations
• Seeing hearing things that are not there
• Command (something/ someone giving orders)

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Symptoms of Schizophrenia

• Delusions
• Persecution (theyre out to get me paranoia)
• Grandeur (God complex, megalomania)
• being controlled (the CIA is controlling my brain
  with a radio signal)

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Symptoms of Schizophrenia

• disorganized speech (e.g., word salad)
• jumping from idea to idea without the benefit of
  logical association
• Paralogicon the surface, seems logical, but
  seriously flawed
• e.g., Jesus was a man with a beard, I am a man
  with a beard, therefore I am Jesus

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Symptoms of Schizophrenia

• Disorganized behavior
• behavior is inappropriate for the situation
• e.g., wearing sweaters and overcoats on hot days
• Emotion is inappropriately expressed
• no emotion at all in face or speech, laughing at
  very serious things, crying at funny things

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Types of Schizophrenia

• Paranoid type

• delusions of persecution, believes others are
  spying and plotting
• delusions of grandeur, believes others are
  jealous, inferior, subservient

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Catatonic type

• unresponsive to surroundings, purposeless
  movement, parrot-like speech
• usually marked by immobility for extended
  periods

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Disorganized type

• disorganized speech and behavior
• Childlike
• Inappropriate emotions
• delusions and hallucinations with little meaning

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Review of Schizophrenia

• Make your charts
• Disorder in the middle
• 1st square - Define it, 2nd square -define all
  the types of disorders, 3rd square examples of
  each type, 4th non-examples of each type

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• Somatoform Disorders

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• Somatoform Disorders are characterized by the
  presence of physical symptoms that cannot be
  explained by a medical condition or another
  mental illness

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• Somatoform disorder is characterized by physical
  symptoms that mimic disease or injury for which
  there is no identifiable physical cause for
  physical symptoms such as pain, nausea,
  depression, and dizziness.
• Somatoform disorder is a condition in which the
  physical pain and symptoms a person feels are
  related to psychological factors. These symptoms
  can not be traced to a specific physical cause.

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• Their symptoms are similar to the symptoms of
  other illnesses and may last for several years.
  People who have somatoform disorder are not
  faking their symptoms. The pain that they feel is
  real.

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• Hypochondriasis refers to an excessive
  preoccupation or worry about having a serious
  illness.
• Often, hypochondria persists even after a
  physician has evaluated a person and reassured
  them that their concerns about symptoms do not
  have an underlying medical basis or, if there is
  a medical illness, the concerns are far in excess
  of what is appropriate for the level of disease.

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• Hypochondria is often characterized by fears that
  minor bodily symptoms may indicate a serious
  illness, constant self-examination and
  self-diagnosis, and a preoccupation with one's
  body.

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• With Conversion Disorder, patients present with
  neurological symptoms or deficits that affect
  voluntary motor or sensory function such as
  numbness, paralysis, blindness, etc.. It is
  thought that these problems arise in response to
  difficulties in the patient's life.
• The diagnosis of conversion disorder involves
  three elements - the exclusion of neurological
  disease, the exclusion of feigning, and the
  determination of a psychological mechanism

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• Body Dysmorphic Disorder is a preoccupation with
  an imagined or minor defect in appearance which
  causes clinically significant distress or
  impairment in social, occupational, or other
  important areas of functioning.
• The disorder generally is diagnosed in those who
  are extremely critical of their physique or
  self-image even though there may be no noticeable
  disfigurement or defect, or a minor defect which
  is not recognized by most people. Too Ugly To
  Live - Part 1

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• Substance-Related Disorders
• Substance Abuse Disorders

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• Substance-related disorders result from the abuse
  of drugs, side effects of medications, or
  exposure to toxic substances

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• Adjustment Disorders

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• Adjustment disorders are defined as a inability
  or maladaptive reaction to an identifiable
  stressful life event/ stressor. ( e.g.,
  divorce,  family crises). Symptoms must occur
  within three months of the event/stressor and
  persisted for no longer than six months. Usually
  includes depression, withdrawal, or a rebellion
  against society, family, or the law.

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• Cognitive Disorders

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• Cognitive disorders, such as delirium and
  dementia, involve a significant loss of mental
  functioning

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• Dementia, for example, is characterized by
  impaired memory and difficulties in such
  functions as speaking, abstract thinking, and the
  ability to identify familiar objects. The
  conditions in this category usually result from a
  medical condition, substance abuse, or adverse
  reactions to medication or poisonous substances

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• Disorders usually first diagnosed in Infancy,
  Childhood, or Adolescence

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• Childhood Disorders are those disorders that are
  generally diagnosed in children through the age
  of 18

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• Autism is most commonly characterized by
  non-normal social attachments, withdrawal,
  echolalia (repeat word patterns), strange motor
  behaviors, and those affected are often mentally
  retarded

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• Factitious Disorders

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• People with factitious disorders intentionally
  produce or fake physical or psychological
  symptoms in order to receive medical attention
  and care. For example, an individual might
  falsely report shortness of breath to gain
  admittance to a hospital, report thoughts of
  suicide to solicit attention, or fabricate blood
  in the urine or the symptoms of rash so as to
  appear ill

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• Mental Disorders Due to a General Medical
  Condition

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• The general mental disorders are diagnosed when
  there is evidence they are caused by the
  specified medical conditions
• IE. A coma caused by a bad food reaction, a
  change in personality or mood due to a hormonal
  change in the body

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• Other Conditions

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• Others are not mental disorders, but one of
  the individuals involved may have a mental
  disorder that is not itself the focus of, and may
  or may not be related to the clinical attention

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