Psychological Disorders

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Psychological Disorders

• Psychological behaviors run a continuum from very
  mild to extreme. Everyone has these behaviors to
  one degree or another.
• It is not until a behavior or feeling interferes
  with your quality of life that they become a
  disorder.

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Psychological Order

• Self-acceptance understanding yourself and
  accepting the good and bad parts of yourself.
• Positive relationships with others ability to
  form good trusting interpersonal relationships.
• Autonomy self-controlled and able to resist peer
  pressure.

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Psychological Order

• Environmental masters internal locus of control
  master of your domain.
• Purpose in life goals and sense of direction
  not diffused.
• Personal Growth see yourself growing and
  expanding self knowledge self actualization.

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Psychological Disorders are

• Atypical, disturbing, maladaptive, and
  unjustifiable behavior.

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Psychological Disorders Causes

• Are not usually caused by a single factor. The
  medical model is probably not correct where you
  can take a pill to rid yourself of a disorder.
• The bio-psycho-social school most disorders are
  caused by a biological predisposition,
  physiological state, psychological dynamics, and
  social circumstances.

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Defining Disorders

• DSM IV-Diagnostic and Statistical Manual vol. 4.
  attempts to describe psychological disorders,
  without explaining the causes, predicts the
  future course, and suggests treatments.
• Categorizes 230 disorders, in 17 categories.

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Dangers of Labeling

• Labeling someone with a disorder can create
  self-fulfilling prophesies, where the label
  creates the behavior.
• Also, if a professional hears a person has a
  disorder, they may look back at that persons
  history and see things that caused those
  behaviors, which might not be accurate.

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Anxiety Disorders

• Generalized Anxiety Disorder (GAD) Persistent
  symptoms of an excited sympathetic, nervous
  system sweating, heart racing, dizziness,
  shakiness, accompanied by persistent negative
  feelings and fearnot triggered by specific
  events.

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Anxiety Disorders

• Panic Disorder unpredictable, minutes long
  intense anxiety attack, as if you're going to be
  killed any second, but no specific, real threat
  is apparent.
• Phobias persistent, irrational fear of a
  specific object of situation. Very common.
  Spiders, snakes, heights, water, enclosed spaces
  are all very common phobias.

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Anxiety Disorders

• Obsessive-Compulsive disorder (OCD)
• Obsessions intrusive thoughts or fears.
• Compulsions repetitive behaviors that soothe the
  fears

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Anxiety DisordersDifferent perspectives would
ascribe different causes

• Psychoanalytic repressed feelings during
  childhood symbolized by trigger.
• Behavioral learned fear, which has been
  reinforced, or social learning, imitating others
  who have fear, like parents. May be generalized
  from other learned experiences one dog to all
  dogs.
• Biological predisposed genetically to be afraid
  of things that can cause death snakes, spiders,
  height, enclosed places, disease.

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Post Traumatic Stress Disorder

• PTSD--Caused by prolonged or intensely stressful
  situations, like war or rape.
• Symptoms difficulty sleeping, nightmares
  anxiety attacks or GAD intrusive memories Guilt
  associated with event
• Some psychologists dismiss this disorder pointing
  to those who do not get it after experiencing
  similar trauma
• That probably has more to do with biological
  predisposition than to lack of evidence that PTSD
  exists

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Multiaxial Classification in DSM-IV
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders 16 syndromes) present?
Axis I
Is a Personality Disorder or Mental Retardation
present?
Axis II
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis III
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis IV
What is the Global Assessment of the persons
functioning?
Axis V
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Mood Disorders

• Some types Major, Clinical Depression Dysthymic
  Depression Bipolar disorder
• Mood disorders are the most common psychological
  disorders called the common cold of disorders
• Depression among the young is on the rise more
  diagnosis or more cases?

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Major Depressive Disorder

• Major Depressive Disorder
• 2 or more weeks of depressed mood, intense
  feelings of worthlessness and hopelessness and
  diminished interest in things that were once
  considered pleasurable.
• People feel like they are in a deep black hole
  with no way to get out. The hopeless feeling
  often prevents them from seeing any reason to try
  to get out. Very dangerous illness.

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Symptoms for Major Depressive Disorder

• Symptoms include
• discouraging feelings about the future
• life dissatisfaction
• isolation from others
• difficulty sleeping OR sleeping a lot
• inability to concentrate
• lethargy feelings of worthlessness
• loss of interest in friends or family activities

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Dysthymic Depression Symptoms

• Dysthymic Depression
• Down-in-the-dumps mood that lasts from months to
  years the feelings aren't as intense, but they
  last longer
• Difficult to detect because of the lack of
  intensity but takes a large toll on body and
  psychology systems

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Treatments for Depression

• Cognitive Therapy is effective, coupled with
  antidepressants trying to change internal
  sentences. Because depressed people see the world
  through dark glasses, their thoughts intensify
  the feelings leading to a downward spiral.
• Medical now treated with classes of Selective
  Serotonin Reuptake Inhibitors. SSRIs. They keep
  serotonin in the synapse longer, elevating mood.
  (some well-known brands--Prozac, Zoloft, Paxil,
  Lexapro)

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Treatment for Dysthymic Depression

• College students with dysthymic or moderate
  depression responded far better to aerobics than
  other treatments.

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Depression Facts

• Facts Major Depression usually lasts less than
  three months may or may not return often
  triggered by stressful events, although not
  necessarily caused by it (biological
  predisposition)
• Dysthymic depression lasts two years or longer.
• Women are twice as likely to have it as men
• Depression is a whole body disorder with
  biochemical and psychological roots, therefore
  generally requires both therapy and
  antidepressant treatment.

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Depression facts

• Those who are depressed often become socially
  isolated as they withdraw from friends and
  friends withdraw from them as their old self
  changes.
• The depressed person is likely to blame
  themselves with negative self speak which
  exacerbates the depression
• Reciprocal Determinism

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Bipolar Disorder (formerly manic-depression)

• Bipolar Disorder
• alternates between hopelessness and lethargy of
  depression and over-excited manic state.

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Bipolar Disorder (manic-depression) Some
Symptoms

• Manic state typically over-talkative
  overactive little or no sleep highly impulsive,
  loud, flighty, hard to interrupt, sexually less
  inhibited. Grandiose optimism and self-esteem.
  May be very irritable.
• People then fall back to either a normal state,
  or into a major depressed state

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Treatment for Bipolar Disorder

• TreatmentIn depressed state high levels of
  neurotransmitter Norepinephrine.
• Treatment usually with Lithiummood
  stabilizer--for the manic state and
  antidepressants for the depression.
• Treatment is very effective if patients continue
  using medication.

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Somatoform Disorders

• Characterized by physical symptomspain,
  paralysis, blindness, or deafness W/OUT any
  demonstrated physical cause
• Differs from psychosomatic (tension headaches,
  ulcers, heart problems brought on by stress)
• as no physical damage is done

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Somatoform Disorders5 types

• 1.)Somatization disorder characterized by many
  somatic symptoms that cannot be explained
  adequately based on physical and laboratory
  examinations. Specific characteristics include
  the following
• Onset of unexplained medical symptoms in persons
  younger than 30 years
• Multiple and chronic complaints of unexplained
  physical symptoms

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Somatoform Disorders Somatization Symptoms contd

• Multiple pain symptoms involving multiple sites,
  such as the head, neck, back, stomach, and limbs
• At least 2 or more unexplained gastrointestinal
  symptoms, such as nausea and indigestion
• At least 1 sexual complaint and/or menstrual
  complaint
• At least 1 pseudoneurological symptom, such as
  blindness or inability to walk, speak, or move

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2 more Somatoform Disorders

• 2.) Conversion Disorderused to be known as
  hysterialoss of function (becoming blind, deaf,
  or paralyzed) w/out physical damage to the
  affected organs nor their neural connections
• 3.) Hypochondriasisperson unrealistically
  interprets physical signspains, lumps, or
  irritationsas evidence of serious disease

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Somatoform Disorders

• 4. Pain disorder somatoform disorder
  characterized by a focused pain complaint that
  cannot be entirely attributed to a specific
  medical disorder. Specific symptoms of pain
  disorder include the following
• Pain in 1 or more anatomical sites producing a
  predominant clinical focus
• Psychological factors (felt to play an important
  role in the onset, severity, or course of pain)
• Pain symptom that is not feigned or intentionally
  produced

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Somatoform Disorders

• 5.) Body Dysmorphic Disorder somatoform disorder
  characterized by a focus on a physical defect
  that is not evident to others. Specific
  characteristics of body dysmorphic disorder
  include the following
• Preoccupation with an imagined defect in
  appearance
• May be associated with multiple, frantic, and
  unsuccessful attempts to correct imagined defect
  by cosmetic surgery

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Somatoform Disorders--Causes

• No definitive causes for most of the somatoform
  disorders have been established.
• Genetic and environmental influences appear to
  contribute to somatization.
• Children raised in homes with a high degree of
  parental somatization may model somatization.
• Sexual abuse may be associated with an increased
  risk of somatization later in life.
• Poor ability to express emotions (alexithymia)
  may result in somatization.

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Somatoform Disorders--Treatment for specific
somatoform disorders

• Somatization disorder Patients may resist
  suggestions for individual or group psychotherapy
  because they view their illness as a medical
  problem.
• Patients who accept psychotherapy may be able to
  reduce health care utilization.
• Psychosocial interventions that focus on
  maintaining social and occupational function
  despite chronic medical symptoms may be helpful.

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Somatoform Disorders--Treatment

• Conversion disorder Limited studies about
  specific psychotherapy exist for conversion
  disorder.
• Behavior therapy or hypnosis may be effective.
  Symptoms often resolve spontaneously.

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Somatoform DisordersTreatment contd

• Hypochondriasis Physicians should attempt to
  answer questions and reduce the patient's fear of
  a specific illness.
• Group psychotherapy may provide social support
  and reduce anxiety.
• Cognitive therapy strategies may help by focusing
  on distorted disease-related cognitions.
• Individual insight-oriented psychotherapy has not
  been proven effective.

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Somatoform DisordersTreatment contd

• Pain disorder Behavior therapy, including
  biofeedback, can be helpful.
• Hypnosis also may be considered for chronic pain
  syndromes.
• Some outcome data supports the effectiveness of
  individual psychotherapy.
• Exploration of interpersonal effects of chronic
  pain may reduce social complications of pain.

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Schizophrenia and Symptoms

• A group of severe psychotic disorders
  characterized by disorganized thought and
  delusional thinking disturbed perceptions and
  inappropriate emotions and actions. Onset often
  occurs in late adolescence.
• Delusion-irrational, unjustifiable, grandiose,
  usually paranoid, belief of persecution by an
  unseen entity.
• Hallucinations the perception of non-existent,
  external stimuli, usually auditory.

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4 Types of Schizophrenia

• Paranoid preoccupations with delusions and
  hallucinationspositive symptoms
• Catatonic immobility or excessive purposeless
  movements.---negative symptoms flat affect
• Disorganized disorganized speech or behavior,
  inappropriate emotions. Word Salads scrambled or
  nonsensical speech.
• Undifferentiated symptoms, but doesn't fit above
  models.

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2 Levels of Schizophrenia

• 1.) Chronic slowly develops over time,
  prognosisbad.
• 2.) Acute reaction to life stresses, quick
  onset, good prognosis.
• Schizophrenic thinking may be seen as an
  uncontrolled rapid change of selective attention,
  where the mind rapidly shifts from one thought to
  another.

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Causesof Schizophrenia

• Psychology triggering experiences, genes
  predisposed but some react to traumatic triggers
  (stressors) by developing schizophrenia. They
  vary.
• Biochemical 6 times the normal amount of
  Dopamine receptors that increase brain activity
  to manic levels. Thus dopamine blockers reduce
  symptoms.

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Causes of Schizophrenia

• It is also thought to perhaps be triggered or
  caused by the introduction of a prenatal virus
  that affects brain development, possibly in the
  thalamus.
• People conceived in Winter months are more apt to
  develop schizophrenia in Northern hemisphere,
  while the reverse is true in the Southern.

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Rule of Thirds

• About 1/3 of people who develop schizophrenia
  only have one episode, 1/3 have reoccurring
  episodes, and 1/3 are chronic with unremitting
  symptoms.

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Causes of Schizophrenia contd.

• Amphetamines and cocaine sometimes intensify
  symptoms.
• Dopamine is also associated with physical
  movement, disruption of is associated with
  schizophrenia(excess dopamine receptors)
• Brain anatomy they have abnormal brain tissue,
  low frontal lobe activity.
• Thalamusstructure is smaller than normal and is
  reactive--that may cause brain over -stimulation.
  
• People exposed to certain flu viruses during
  prenatal development have higher incidences.

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Genetic factors of Schizophrenia

• Definite genetic link the closer you are
  genetically to someone with Schizophrenia, the
  more likely you are to get it.
• 1 in 100 people get it.
• 1 in 10 of siblings
• 1 in 2 identical twins, even if raised apart

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Treatment for Schizophrenia

• Psychopharmaceuticals
• Antipsychotic Medication OR Neuroleptics
• Haldol, Clozaril, Thorazinedecreases
  hallucinations, lessen agitated behavior
• Negative side effects because the drugs are
  Dopamine blockers
• Tardive Dyskinesiaproblems walking, drooling,
  involuntary muscle movements

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Dissociative Disorders

• Dissociation is the feeling that you are outside
  of yourself, looking at yourself. That your mind
  is separate from body.
• Person has separated parts of their personality
  or memory for consciousness.

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Dissociative Identity Disorder Multiple
Personality Disorder

• This is a disorder in which your mind partitions
  itself into two or more distinct personalities
  that may or may not know about each other. One
  personality emerges to handle stressful
  situations that the whole psyche or other parts
  cannot handle.
• Caused by traumatic event or events where the
  mind represses parts of itself that cant handle
  the pain. Repressed from a psychoanalytical
  point of view.

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Dissociative Identity Disorder

• Skeptics believe that people are either lying,
  are fantasy-prone, or have had this disorder
  suggested to them by therapists.
• It only seems to occur in places, like here,
  where people know about it through books like the
  Sybil and the Three Faces of Eve.

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Dissociative Amnesia

• Selective memory loss of a specific traumatic
  event. The amnesia vanishes as abruptly as it
  begins and rarely reoccurs.

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Dissociative Fugue

• In this type of dissociation, the person just
  leaves their home and starts on new life, with no
  memory of their past life. The memory may
  reoccur and the person may return home, only to
  leave again.

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Personality Disorders

• Personality consists of enduring traits or
  characteristicsso personality disorderspersisten
  t traits or characteristics that are atypical,
  disturbing, maladaptive and unjustified.
• Prognosis for treatment (intensive psychotherapy)
  for many is not very good.

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Personality Disorders-6 Types

• 1.) Antisocial most common, person has no
  conscience. Lacks a sense of wrongdoing, even
  toward friends or family members.
• Usually a man thing.
• Usually emerges before 15
• Person may be aggressive and/or ruthless.
  Deceiving or conning others or be aggressive
  sexuallyany all with no remorse. Psychopaths,
  serial killers, sociopaths.

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Personality Disorders

• 2.) Histrionic displays shallow,
  attention-getting behaviors, feeling
  uncomfortable when not the center of attention.
• Acting in an aggressive, sexual way that makes
  others uncomfortable.
• Rapid shifting of emotions. Dressing
  provocatively to gain attention, speaks in
  dramatic tones.

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Personality Disorders

• 3.) Narcissistic Preoccupied with themselves and
  an exaggerated sense of their own importance.

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Personality Disorders

• 4.) Schizoid
• either desires nor enjoys close relationships,
  including being part of a family
• Almost always chooses solitary activities
• Has little, if any, interest in having sexual
  experiences with another person
• Takes pleasure in few, if any, activities
• Lacks close friends or confidants other than
  first-degree relatives
• Appears indifferent to the praise or criticism of
  others
• Shows emotional coldness, detachment, or
  flattened affectivity
• (Source MayoClinic.com)

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Personality Disorders contd.

• 5.) Avoidant
• Avoids occupational activities that involve
  significant interpersonal contact, b/c of fears
  of criticism or rejection.
• Is unwilling to get involved w/people unless
  certain of being liked.
• Shows restraint w/in intimate relationships b/c
  of the fear of being shamed or ridiculed.
• Is preoccupied with being criticized or rejected
  in social situations.
• Is inhibited in new interpersonal situations
  because of feelings of inadequacy.
• Views self as socially inept, personally
  unappealing, or inferior to others.
• Is unusually reluctant to take personal risks or
  to engage in any new activities because they may
  prove embarrassing. (DSM-IV)

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Personality Disorders

• 6.) Borderline
• unstable sense of self
• rapidly changing affect will be clingy one
  minute and then hostile the next
• try to pull people close and then do things to
  drive them away
• very manipulative to gain attention unstable
  relationships
• Very poor prognosis for recovery, so some
  therapists wont treat them