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WHAT IS PSYCHOLOGICAL DISORDER?
• Psychopathology: Any pattern of emotions, behaviors, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals
• Synonymous terms include:• Mental illness• Mental disorder• Psychological disorder• Abnormal psychology
Atypical Maladaptiveness
Disturbing Unjustifiable
INDICATORS OF ABNORMALITY
• Three classic signs suggest a severe psychological disorder • Hallucinations• Delusions• Severe affective (mood) disturbances
• Other signs of a disorder are more subtle, and a diagnosis depends heavily on clinical judgment
CHANGING CONCEPTS OFPSYCHOLOGICAL DISORDER
• Medical Model: Diseases of the mind; objective causes & require specific treatments• Disadvantages: Encourages patient to be passive,
psychologists not as important as psychiatrists, overmedicating
• Psychological Models• Behavioral perspective: Abnormal behaviors can be
acquired through behavioral learning• conditioning (class/operant) - fears, anxiety
• Cognitive perspective: Abnormal behaviors are influenced by mental processes• how people perceive themselves and relations with others• locus of control, coping mechanisms
• Both have a social component as well!• Social-Cognitive-Behavioral Approach
THE BIOPSYCHOLOGY OF MENTAL DISORDER
• Although there is reservation about the medical model, psychologists do not deny the influence of biology on thought and behavior• Biopsychology – influence of biology on
thought and behavior• Biopsychosocial Model: combination!!!
• Diathesis-stress hypothesis: Genetic factors place the individual at risk, but environmental stress factors transform this potential into an actual disorder
OVERVIEW OF DSM-IV CLASSIFICATION SYSTEM
• DSM-5: Diagnostic and Statistical Manual of Mental Disorders• Most accepted classification system in US• Closely tied to medical model• Avoids endorsing theories of cause or
treatment• Statistics data
SOMATIC SYMPTOM AND RELATED DISORDERS
• Somatic Symptom Disorders: Prominence of somatic symptoms associated with distress and impairment.• Somatic Symptom Disorder: distressing
somatic symptoms plus abnormal thoughts, feelings and behaviors in response to them• Illness Anxiety Disorder: Preoccupation with
having or acquiring a serious illness without somatic symptoms.• Conversion disorder: Altered voluntary motor
or sensory functions without physical cause (paralysis, weakness, or loss of sensation) – video
PERSONALITY DISORDERS• Personality disorders: Enduring pervasive and
inflexible pattern of inner experience and behavior that deviates from one’s culture and is stable over time• Personality traits to an excessive degree and
in rigid ways that undermine their adjustment• Handout – focus on middle column (Cluster B)• Antisocial, Borderline, Histrionic, Narcissistic
FEEDING AND EATING DISORDERS
• Persistent disturbance of eating or related behavior resulting in altered consumption or absorption of food that impairs health or functioning• The following involve undue influence of weight
or shape on self-evaluation• Anorexia Nervosa: restriction of energy
intake that leads to significantly low weight with a fear of gaining weight• Bulimia Nervosa: recurrent episodes of
binge eating and behaviors to prevent weight gain
• Pica, Rumination, Avoidant, Binge Eating
ANXIETY DISORDERS• Share features of excessive fear, anxiety and
related behavioral disturbances(survey)• Fear: emotional response to real/perceived threat• Anxiety: anticipation of future of threat
• Specific Phobia: Marked fear of a specific object or situation• Significantly interferes with daily routine, occupation,
or social life.• Animal, Enviro, Situational, Injury/blood/inject• Preparedness hypothesis: innate tendency to respond
quickly and automatically to stimuli that posed a survival threat to our ancestors
ANXIETY DISORDERS (CONT’D)• Social Anxiety Disorder: A persistent fear of
1+ social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. • Fears that he or she will act in a way that will be
embarrassing and humiliating.
• Generalized anxiety disorder: Excessive anxiety and worry about a number of things without any real external cause• Panic disorder: Recurrent, unexpected panic
attacks followed by worry of another• http://www.youtube.com/watch?v=WWngA_ZMCD4
ANXIETY DISORDERS• Agoraphobia: Fear of being in places where it
may be difficult or embarrassing to get out quickly or where you may have a panic attack and can't get help
• Avoid places where you think you may have a panic attack or panic-like symptoms.
• Often leads to not wanting to leave your home (video)
• Causes of Anxiety Disorders:• Genetics• Abnormal neurotransmitters• Environment• Learning
TRAUMA AND STRESSOR RELATED DISORDERS
• Post-Traumatic Stress Disorder: Recurrent, involuntary, and intrusive distressing memories of traumatic events• Actual or threatened death, serious injury,
sexual violence• Direct experience, witness, learning about,
extreme exposure• Avoid associated stimuli, negative cognitions/
moods, alterations in arousal/reactivity
OBSESSIVE-COMPULSIVE AND RELATED DISORDERS
• Obsessive-compulsive disorder: Presence of obsessions and /or compulsions• Obsession: Intrusive, persistent thought, image,
or urge• Compulsion: Repetitive behavior or mental act
one feels driven to do in response to an obsession• Take up more than 1 hour of the day• Handout, video clips, survey• http://www.youtube.com/watch?v=44DCWslbsNM (AGAIG)• http://www.youtube.com/watch?v=Rn1OYlYzgm8 (Spokesperson)
OBSESSIVE-COMPULSIVE AND RELATED DISORDERS
• Body Dysmorphic Disorder: Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others•Hoarding: Persistent difficulty discarding or parting with possessions regardless of their value• Trichotillomania, Excoriation
DISSOCIATIVE DISORDERS• Dissociative disorders: Disruption in the
integration of consciousness, memory, identity, emotion, perception, and behavior• Intrusion into awareness or inability to access
information/control mental functions• Extreme stress – consciousness becomes
dissociated (split) from previous thoughts and memories• Trouble integrating dimensions of
consciousness• They remain split and operate independently
of each other
DISSOCIATIVE DISORDERS
• Dissociative Amnesia: A psychologically induced inability to recall biographical information, usually of traumatic or stressful nature• May be localized, selective or generalized• May involve fugue – purposeful traveling or
bewildered wandering• Dissociative Identity Disorder: Disruption of identity
characterized by 2+ distinct personality states• Marked discontinuity in sense of self• Recurrent gaps in everyday events, personal info• 90%+ have history of childhood abuse and neglect• http://www.youtube.com/watch?v=YXuG2zI39yA&feature= related
DEPRESSIVE DISORDERS• Sad, empty, or irritable mood, accompanied by somatic
& cognitive changes that significantly affect functioning• Major depression: Form of depression that has clear
cut changed in affect, cognition, and behavior with inter-episode remissions• A change in previous functioning for a 2 week period• Must have a depressed mood or loss of interest or pleasure
along with 4+ other symptoms• Symptoms slide…• With Seasonal Pattern: Onset and remission of MD episodes
at characteristic times of year
• Persistent Depressive Disorder (Dysthymia): Depressed mood for most of the day, more days than not, for at least two years; symptoms not as severe as MDD
• Causes of DDs: Genetics, chemical (serotonin) environment, cognitions
BIPOLAR DISORDER AND RELATED DISORDERS
• Bipolar disorder: Periods of elevated mood (mania) and periods of depression• Manic Episodes:
• Excessively “high,” overly good, euphoric, maybe angry• Increased energy, activity, irritability, restlessness • Racing thoughts, talking very fast, can’t concentrate well • Little sleep needed, poor judgment, spending sprees • Unrealistic beliefs in one’s abilities• Increased sexual drive, abuse of drugs, denial of problem
• Bipolar I: Typically severe mania and depression• Bipolar II: Typically hypomania and severe
depression• Cyclothymic: Typically hypomania with less
severe depression
SCHIZOPHRENIC DISORDERS
• Schizophrenia: Abnormalities in 1+ of the following: delusions, hallucinations, disorganized thinking, abnormal motor behavior, and negative symptoms; reality falls apart• Delusion: false belief that a person maintains
in the face of contrary evidence• Reference – everything related to you• Persecution – everybody plotting against/harm• Grandeur – more important, powerful, wealthy
• Hallucination: sensory perception w/ no external cause usually auditory; related to delusions
SYMPTOMS OF SCHIZOPHRENIA
Positive
•Any form in which the person displays active symptoms
•Excess or distortion of normal functions
•Delusions, hallucinations, word salads
•Responds to anti-psychotic meds
Negative
•Any form distinguished by deficits
•Loss of normal functioning
•Alogia, avolition, decreased emotional expression (flat affect)
•Does not usually respond to anti-psychotic meds
•Catatonia