Research suggests that the stigma and stress associated ......Somatoform, Dissociative, and...

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Research suggests that the stigma and

stress associated with being gay increase

the

risk of mental health problems.

2

In some cultures, depression and

schizophrenia are nonexistent.

3

Research indicates that in the United States there are

more prison inmates with

severe mental disorders than there are psychiatric

inpatients in all the country’s hospitals.

4

About 30 percent of psychologically

disordered people are dangerous; that is,

they are more likely than other people to

commit a crime.

5

Identical twins who have been raised

separately sometimes develop the same

phobias.

6

Dissociative identity disorder is a

type of schizophrenia.

7

In North America, today’s young adults are three

times as likely as their

grandparents to report having experienced

depression.

8

White Americans commit suicide nearly twice as

often as black Americans do.

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There is strong evidence for a genetic

predisposition to schizophrenia.

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An estimated one in seven Americans suffers

a clinically significant mental disorder.

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Module 66 & 67 (Abnormal Quiz + Module 65) Anxiety, Obsessive-Compulsive, Post-Traumatic

Stress Disorders, & Mood Disorders Module 69 (NOT ON QUIZ)

Somatoform, Dissociative, and Personality Disorders

symptoms highlighted in red are

“key” symptoms to know

Anxiety Disorders

• a group of conditions where the primary symptoms are anxiety or defenses against anxiety.

• They are in a state of intense apprehension, uneasiness, uncertainty, or fear.

Generalized Anxiety Disorder GAD

• Pathological worry continually.

• Jittery, agitated, trembling, sleep-deprived, fidgeting

• Free-floating anxiety • Depression may

accompany this disorder • May not be able to

identify and therefore deal with or avoid the causes.

• Physical problems – high blood pressure

Panic Disorder

• An anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences

• terror • accompanying chest pain • Choking sensation other • frightening sensations. • Anxiety tornado • Panic attack – can be

minutes long

Specific Phobias • A person experiences sudden episodes of

intense dread.

• Must be an irrational fear. Avoiding object, activity, or situation.

• Social Anxiety Disorder (Social Phobia) – shyness to the extreme, intense fear of being scrutinized by others, avoid potentially embarrassing social situations

• Agoraphobia – fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes. (panic attack)

• Phobia List

Obsessive-compulsive disorder • Persistent unwanted

thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action, which persistently interferes with daily living and causes distress.

• Obsession – thoughts • Compulsion -

behaviors • Obsession about dirt

and germs may lead to compulsive hand washing.

Classified as its own category – not classified under anxiety disorders

Post-traumatic Stress Disorder a.k.a. PTSD

• Recurring haunting memories, nightmares

• Flashbacks

• Social withdrawal

• Jumpy anxiety

• Insomnia

• Memories of the event cause anxiety.

Important to highlight in Explanations of Anxiety Disorders

seciton Psychoanalytic Repressed impulses Behavioral Fear conditioning Reinforcement Observational learning Biological Highlight all Evolutionary Inherit fears from our ancestors

Module 69: Somatic Symptom and related

disorders (Somatoform disorders)

Utilize Barron’s Book this information is not in your text.

Somatoform Disorders

• Occur when a person manifests a psychological problem through a physiological symptom.

Conversion Disorder (aka Functional neurological symptom disorder)

• A person experiences very specific physical symptoms for which no physical basis can be found.

• blindness

• paralysis

• Inability to swallow

Illness Anxiety Disorder (Hypochondriasis)

• Interpret normal sensations (headache, stomach cramps, etc) as symptoms of a dreaded disease.

• Minor illness is a major one

Theories about possible causes of Somatic Symptom Disorder

1. Psychoanalytical – outward manifestations of unresolved unconscious conflicts.

2. Behaviorist – somatic symptoms are being reinforced for their behavior

Module 69: Dissociative Disorders

Utilize Barron’s Book and pages 644-645 in text

Dissociative Disorders

• Disruption in conscious processes.

• Often in response to an overwhelmingly stressful situation.

• Three types….

Psychogenic Amnesia (Dissociative Amnesia)

• A person cannot remember things with no physiological basis for the disruption in memory.

• NOT organic amnesia. • Dissociative fugue -A

state of mind wherein one’s entire personal identity is abandoned and no other reasonable explanation

Dissociative Identity Disorder • Used to be known as

Multiple Personality Disorder.

• A person has several rather than one integrated personality.

• People with DID commonly have a history of childhood abuse or trauma.

Dissociative Disorders

Understanding Dissociative Identity

Disorder

• Genuine disorder or not?

• DID rates

• Differences are too

great

• DID and other

disorders

Module 67: Mood Disorders

• Experience extreme or inappropriate emotion.

Major Depression Disorder

• Unhappy for more than 2 weeks in the absence of a clear reason.

• Common cold of all psychological disorders.

• Displays 5 symptoms on slide 5

Persistent Depressive Disorder (also called Dysthymia)

• Mildly depressed mood more often than not for at least two years

• Display two of the symptoms from slide 5

(SSRI’s)serotonin reuptake inhibitors – blocks the reuptake or breakdown of serotonin supply. (Prozac, Zoloft, Paxil, Luvox)

Bipolar Disorder

• Formally manic depression. • Involves periods of

depression and manic episodes.

• Manic episodes involve feelings of high energy (but they tend to differ a lot…some get confident and some get irritable).

• Engage in risky behavior during the manic episode.

• (add to major biological causes in bipolar section) Increase of norepinephrine during mania and decrease of serotonin during depressed state

(lithium Carbonate) Treats bipolar disorder

Causes of Depression Biological Bases

• Neurotransmitter theories

– dopamine

– norepinephrine

– Serotonin

• Treat with SSRI’s (Prozac, Zoloft, Paxil)

• Physical exercise

• Genetic component

– more closely related people show similar histories of depression

Cognitive Bases • A.T. Beck: depressed people hold

pessimistic views of – themselves – the world – the future

• Depressed people distort their experiences in negative ways

– exaggerate bad experiences – minimize good experiences

• Hopelessness theory – depression results from a pattern of

thinking – person loses hope that life will get

better – negative experiences are due to stable,

global reasons • e.g., “I didn’t get the job because I’m

stupid and inept” vs. “I didn’t get the job because the interview didn’t go well”

Understanding Depressive and Bipolar Disorders

The Social-Cognitive Perspective:

Depression’s Vicious Cycle

Some helpful Resources Abnormal Psych Resources

• Crash course videos – Abnormal Psychology #29 -33

• Myers Module Videos 65 -67 DSM, Anxiety, and Schizophrenia

Personality Disorders

Pages in textbook 653-657

Barron’s book pages 249-250

Personality Disorders • Well-established,

maladaptive ways of behaving that negatively affect people’s ability to function.

• Significant impairments in self and interpersonal functioning.

• Dominates their personality.

Personality Disorders Clusters

Cluster A (odd or eccentric behavior)

• Paranoid

• Schizoid

• Schizotypal

Cluster B (dramatic or impulsive behavior; attention-getting)

• Antisocial

• Borderline

• Histrionic

• Narcissistic

Cluster C (anxiety-related)

• Avoidant

• Dependent

• Obsessive-compulsive

Narcissistic Personality Disorder

• Pervasive pattern of grandiosity

• Need for admiration

• Exaggerated sense of self-importance

Histrionic Personality Disorder

• Pervasive and excessive emotionality and attention-seeking behavior

• Feels uncomfortable and unappreciated if he/she is not center of attention.

• Melodramatic and flirtatious manner

Borderline Personality Disorder • Pervasive pattern of instability in interpersonal

relationships and self-image • Impulsive • Intensely concerned with abandonment

People with this disorder are prone to constant mood swings and bouts of

anger.

Antisocial Personality Disorder

• Disregard for, and violation of, the rights of others

• Deceit, manipulation, and exploitation

• Lack of empathy. • Weak decision making

Causes: • Genetic • Little autonomic nervous system

arousal • Lower levels of stress hormone at

young age • Reduced activity in the frontal

lobes • 11 % less frontal lobe tissue than

normal • Brain responds less to facial

displays of others in distress

Schizophrenia

Pages in textbook 646-652

Barron’s Book pages247-249

Schizophrenia • Most severe and

debilitating of the psychological disorders.

• Strikes at young adulthood

• Psychotic disorder – marked by irrationality and lost contact with reality.

Symptom 1: Disorganized Thinking

• The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs.

• Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information.

Symptom 2: Delusions (beliefs that have no basis in reality)

• Delusions of Persecution – belief that people are out to get you.

• Delusions of Grandeur – belief that you enjoy greater power and influence than you do.

Symptom 3: Disturbed Perceptions

• hallucinations- sensory experiences without sensory stimulation.

• Auditory most common

Symptom 4: Inappropriate

Emotions and Actions

• Laugh at

inappropriate times.

• Flat Effect

• Senseless,

compulsive acts.

• Catatonia-

motionless Waxy

Flexibility

Symptom 5: Odd use of Language

• Make up their own words (neologisms)

• Clang associations • Word salad – jumping

from one idea to another in totally nonsensical pattern

• Echolalia parrot like repeating of another’s speech and Echopraxia -movements

Clang Association Example: "Imagine the worst Systematic, sympathetic Quite pathetic, apologetic, paramedic Your heart is prosthetic“

Additional Symptoms

• Neglect of personal hygiene

• Socially withdrawn

• Loss of motivation

• Inappropriate clothing – layers of clothing in hot weather

Classifying Symptoms

Positive Symptoms

• Presence of inappropriate symptoms

Examples:

Negative Symptoms

• Absence of appropriate ones.

Examples:

Overall Causes of Schizophrenia Brain Anatomy

- Dopamine hypothesis – excess dopamine (hallucinations & paranoia)

- Gray matter in brains less dense

- Temporal lobe activation (hallucinations)

- Low activity in frontal lobes

- Fluid filled areas and corresponding shrinkage of cerebral tissue

- Smaller-than-normal cortex & thalamus

Prenatal Development • Low birth weights • Oxygen deprivation during

delivery • Famine • Maternal viral infection • Experience the flu Environmental • Double binds – person is

given contradictory messages which may cause distorted way of thinking

• Diathesis-stress model – environmental stressors can provide circumstances under which a biological predisposition for illness can express itself.

Overall Causes Cont.

Genetic Factor

• higher rates of schizophrenia for people with sibling or parent with disease

• Twins who shared placenta are more likely than twins who didn’t to both get disease

Case Study of Schizophrenia

Identify symptoms of schizophrenia

Somatic Therapies Psychopharmacology • Antipsychotics – most work as dopamine

antagonists (thorazine & Clorzaril) • Anti-anxiety (valium, barbiturates,

Librium, & Xanax) central nervous system depressants

Antidepressants - Mood Disorders • MAOI’s – inhibit MAO enzyme from

breaking down norepinephrine and seratonin at the synapse (Nardil and Parnate)

• (SSRI’s)serotonin reuptake inhibitors – blocks the reuptake of only seratonin (Prozac, Zoloft, Paxil, Luvox)

• (lithium Carbonate) Treats bipolar disorder

• (TCA’s) Tricyclics – blocks the reuptake of norepinephrine & seratonin (Trofanil, Elavil, & Norprmin)

Tardive dyskinesia – involuntary

movements of facial muscles

AKA -

Neuroleptics

Group vs. Individual Therapy

• Group therapy can help more people and cost less per person than individual therapy.

• Knowledge of others similar problems.

Family Therapy – therapy that treats the family as a system.

Advantages of Family therapy • Opens up communication

within a family • Learn new ways of preventing

or resolving conflict.