Psychological Disorders

Chapter 8

Anxiety Disorders

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Mood Disorders

Dissociative and Dissociative and Somatoform Somatoform DisordersDisorders

SchizophreniaSchizophrenia

Personality Disorders

What are What are Psychological Psychological Disorders?Disorders?

What Are Psychological Disorders?What Are Psychological Disorders?

• Behaviors or mental processes that are connected with various kinds of

distress or impaired functioning. However they are not expectable

responses to specific events.

What Are Psychological Disorders?What Are Psychological Disorders?

• Psychological Disorders range from relatively mild disorders (such as adjustment disorders) to more severe and chronic disorders, such as schizophrenia and bipolar disorder.

• Adjustment disorder: A maladaptive reaction to one or more identified stressors that occurs shortly following exposure to the stressor(s) and causes signs of distress beyond that which would be normally expected or impaired functioning.

Criteria for Determining Abnormal Criteria for Determining Abnormal BehaviorBehavior

• 1. Unusualness

• 2. Faulty perception or interpretation of reality

• 3. Significant personal distress

• 4. Self-defeating behavior

• 5. Dangerousness

• 6. Social unacceptability in a given culture

Classifying Psychological DisordersClassifying Psychological Disorders

• Psychological disorders are classified via the Diagnostic and Statistical Manual 4th Edition –Text Revision (DSM-IV-TR).

• The DSM-IV-TR uses a multiaxial system of assessment. It provides information about a person’s overall functioning (not just a diagnosis).

PHOBIASPHOBIAS

• Specific Phobia: an excessive, irrational fear of a specific object or situation, such as snakes or heights. Examples include claustrophobia (fear of tight or enclosed spaces) and acrophobia (fear of heights).

• Social Phobia: Also called Social Anxiety Disorder, a social phobia is a persistent fear of social interactions in which one might be scrutinized or judged negatively by others.

• Agoraphobia: Fear of open or crowded places.

Panic DisorderPanic Disorder

• Panic Disorder: The recurrent experiencing of attacks of extreme anxiety in the absence of external stimuli that usually elicit anxiety.

• These attacks seem to come “out of the blue” but may become associated with certain cues over time.

• Panic disorders are characterized by strong physical symptoms such as shortness of breath, heavy sweating, tremors, and pounding of the heart.

• Investigators estimate that 1% to 4% of the U.S. adult population is affected by panic disorder at some point in their lives.

Generalized Anxiety DisorderGeneralized Anxiety Disorder

• Generalized Anxiety Disorder: A psychological disorder involving persistent feelings of worry accompanied by states of bodily tension and heightened arousal.

• The central feature of generalized anxiety disorder is a general state of anxiety that becomes expressed in the form of persistent worrying.

• The anxiety is not focused on a specific object, situation or activity.

• Symptoms may include motor tension, autonomic overarousal, feelings of dread and foreboding and excessive worrying and vigilance.

Obsessive-Compulsive DisorderObsessive-Compulsive Disorder

• Obsessive-Compulsive Disorder: A disorder characterized by the presence of obsessions, compulsions or both.

• Obsession: A recurring thought or image that seems beyond one’s ability to control.

• Compulsion: An apparently irresistible urge to repeat an act or engage in ritualistic behavior such as hand washing.

Posttraumatic Stress Disorder and Posttraumatic Stress Disorder and Acute Stress DisorderAcute Stress Disorder

• Posttraumatic Stress Disorder (PTSD): A prolonged maladaptive reaction to a traumatic event that is characterized by intense fear, avoidance of stimuli associated with the event, and re-living of the event.

• Exposure to trauma in the form of physical attacks, combat, medical emergencies, accidents, terrorist attacks or witnessing a death can lead to PTSD.

• PTSD may not begin for many months or years after the trauma, but it may last for years or even decades afterward.

• Acute Stress Disorder: Characterized by feelings of intense anxiety and feelings of helplessness during the first month following exposure to a traumatic event.

Causal Factors in Anxiety Disorders.Causal Factors in Anxiety Disorders.

• Psychological Views: Learning theorists would point out that some phobias may be learned on the basis of classical conditioning and by observational learning. Psychodynamic theorists believe that phobias symbolize unconscious conflicts originating in childhood. Cognitive theorists suggest that anxiety is maintained by exaggerating the consequences of threatening events.

• Biological Views: There is much evidence to support the role that biological factors play in anxiety disorders. For example, Genetic factors may account for faulty regulation of levels of serotonin and norepinephrine in the brain, leading to unusually high levels of anxiety in response to particular threats.

• Ultimately though, while genetics may cause a tendency towards certain disorders, whether the person actually develops the disorder depends on many other factors (such as a warm and loving family, level of stressful events, coping ability, etc.).

Dissociative and SomatoformDissociative and Somatoform

• Dissociative Disorders: A class of psychological disorders involving changes in consciousness or self-identity.

• Somatoform Disorders: A class of psychological disorders in which people have physical complaints that cannot be explained medically or attribute their physical problems to grave causes despite assurances to the contrary.

Dissociative DisordersDissociative Disorders

• Dissociative Amnesia: A dissociative disorder marked by loss of personal memories or self-identity; skills and general knowledge are usually retained. The loss of memory is not due to an organic problem (such as a blow to the head). Examples include a soldier who, following a stressful combat experience, cannot remember what happened for several hours.

• Dissociative Fugue: Dissociative disorder in which

one experiences amnesia, then flees to a new location. The new personality is often more outgoing than the “real” identity. Following recovery, the events are not recalled.

Dissociative DisordersDissociative Disorders

• Dissociative Identity Disorder (DID): Disorder in which a person appears to have two or more distinct identities which may alternate in controlling them. Some psychologists feel that people with DID have constructed these alternate personalities as roles they play to act out confusing emotions.

• Depersonalization Disorder: A dissociative disorder in which one experiences persistent or recurrent feelings that one is not real or is detached from one’s own experiences or body.

Causal Factors in Dissociative Causal Factors in Dissociative DisordersDisorders

• There is much debate as to whether dissociative disorders even exist. Some feel that people who have been diagnosed with dissociative disorders are simply faking their symptoms.

• The great majority of people who have been diagnosed with dissociative disorders have suffered terrible sexual or physical abuse in childhood, usually before the age of 5.

• Psychodynamic theorists believe the dissociative disorders are a result of massive repression while learning theorists believe that people with dissociative disorders have learned to redirect their thinking away from troubling memories in order to avoid feelings of shame, anxiety and guilt.

Somatoform DisordersSomatoform Disorders

• Conversion Disorder: A disorder in which anxiety or unconscious conflicts are “converted” into physical symptoms that often have the effect of helping the person cope with anxiety or conflict.

• Hypochondriasis: A disorder characterized by the persistent belief that one has a serious medical disorder despite lack of medical finding.

Causal Factors in Somatoform Causal Factors in Somatoform DisordersDisorders

• Psychodynamic theory: Hysterical symptoms symbolize underlying psychological conflict.

• Learning theory: Conversion symptoms represent learned responses that are reinforced by avoidance of painful or anxiety-evoking situations.

• Cognitive factors: Evidence is emerging that points to cognitive factors such as distorted thinking patterns.

Mood DisordersMood Disorders

• Major Depression: A mood disorder in which the person may have a dampened mood, changes in appetite and sleep patterns, and lack of interest or pleasure. In extreme cases, people suffering from major depression may experience psychotic behaviors.

• Psychotic: Relating to a break with reality, as manifested by delusional thinking or hallucinations.

Mood DisordersMood Disorders

• Women are two times more likely to be diagnosed with depression than men.

• Women have greater stress than men (multiple demands of childbearing, childrearing and financial support of the family).

• Hormonal differences can also contribute to the differences between men and women.

Mood DisordersMood Disorders

• Bipolar Disorder: A mood disorder in which mood alternates between two extreme poles (elation or manic and depression).

• In the manic phase, the person may show excessive excitement or silliness, engage in risky behaviors, experience a flight of ideas and speak very rapidly.

• In the depression phase, people have a downcast mood, often sleep more than usual, and feel lethargic.

• In order to avoid the depressive phase, some people suffer from bipolar disorder may attempt suicide when the mood shifts from elation towards depression.

Causal Factors in Mood DisordersCausal Factors in Mood Disorders

• Psychological Factors: From the psychodynamic perspective, depression is anger turned inward. Learning theorists suggest that depressed people lack sufficient reinforcement in their lives to maintain their mood and behavior. Finally, cognitive theorists believe that the ways we interpret life events leads to emotional disorders such as depression.

• Biological Factors: Evidence suggests an important role for genetic factors in major depression and bipolar disorder. Research has identified irregularities in the use of serotonin in the brain (Prozac works to increase the level of serotonin in the brain).

SchizophreniaSchizophrenia

• Schizophrenia: A severe and persistent psychological disorder characterized by a break with reality, disturbances in thinking, and a disturbed behavior and emotional responses.

• About 2.5 million Americans are diagnosed with schizophrenia, with about 1 in 3 requiring hospitalization.

• People with schizophrenia have problems with memory, attention and communication. Their thinking becomes unraveled and their speech jumbled.

• Many people with schizophrenia have delusions. Others may enter a stuporous state or become wildly agitated.

SchizophreniaSchizophrenia

• Paranoid Schizophrenia: A type of schizophrenia characterized primarily by delusions—commonly of persecution—and by vivid hallucinations.

• Disorganized Schizophrenia: A type of schizophrenia characterized by incoherent speech, disorganized or fragmentary delusions, and vivid hallucinations.

• Catatonic Schizophrenia: A type of schizophrenia characterized by striking impairment of motor activity. These individuals may show waxy flexibility and/or mutism.

Causal Factors in SchizophreniaCausal Factors in Schizophrenia

• Genetic Factors: Heredity plays a key role in schizophrenia. The more closely related two people are by blood, the more likely they are to share the disorder.

• Other Biological Factors: Complications during childbirth, being born during the winter (predictive of viral infection) and poor maternal nutrition are also linked to schizophrenia.

• Dopamine Theory: According to the dopamine theory, people with schizophrenia overutilize the neurotransmitter dopamine.

Personality DisordersPersonality Disorders

• Personality Disorders: Enduring patterns of maladaptive behaviors that are sources of distress to the individual or others.

• Personality disorders cause difficulties in social, personal or occupational functioning.

• The DSM-IV-TR lists 10 specific types of personality disorders that are organized in three clusters: Odd or eccentric behavior, Behavior that is overly dramatic, emotional or erratic and behavior that is anxious or fearful.

Personality DisordersPersonality Disorders

• Paranoid personality disorder: A personality disorder characterized by persistent suspiciousness, but not involving the disorganization of paranoid schizophrenia.

• Schizoid personality disorder: A personality disorder characterized by social detachment or isolation.

• Schizotypal personality disorder: A personality disorder characterized by oddities of thought and behavior, but not involving bizarre behaviors associated with schizophrenia.

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Personality DisordersPersonality Disorders

• Borderline Personality Disorder: A personality disorder characterized by failure to develop a stable self-image, by a pattern of tumultuous moods and stormy relationships with others, and by difficulties controlling impulsive behaviors.

• Histrionic Personality Disorder: A personality disorder characterized by overly dramatic and emotional behavior; by excessive needs to bet he center of attention; and by constant demands for reassurance, praise, and approval.

• Narcissistic Personality Disorder: A personality disorder characterized by an inflated or grandiose self-image and extreme needs for admiration.

• Antisocial Personality Disorder: A personality disorder characterized by a pattern of antisocial and irresponsible behavior, a flagrant disregard for the interests and feelings of others, and lack of remorse for wrongdoing.

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Personality DisordersPersonality Disorders

• Avoidant personality disorder: A personality disorder in which the person is generally unwilling to enter relationships without assurance of acceptance because of extreme fears of rejection and criticism.

• Dependent personality disorder: A personality disorder characterized by excessive dependence on others and difficulties making independent decisions.

• Obsessive-compulsive personality disorder: A personality disorder described by excessive needs for attention to detail and demands for orderliness, as well as perfectionism and highly rigid ways of relating to others.

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Causal Factors in Personality Causal Factors in Personality DisordersDisorders

• Most of the theoretical explanations come from the psychodynamic model. Traditional Freudian theory focuses upon faulty resolution of the Oedipal complex.

• Learning theorists suggest the childhood experiences can contribute to maladaptive ways of relating to others in adulthood.

• Cognitive theorists find that antisocial adolescents interpret social information in ways the bolster their misdeeds.

• Genetic factors are implicated in some personality disorders such as schizoid personality disorder.

Preventing SuicidePreventing Suicide

• Suicide is the 8th leading cause of death in the United States.

• Most suicides are linked to mood disorders, especially depression and bipolar disorder. Other factors include feelings of hopelessness, serious medical illness and schizophrenia.

• High risk groups include teenagers and young adults, college students, women, European Americans (versus African Americans), Native-American teenagers and older people who are separated or divorced.

Tips if a person refuses to seek help:Tips if a person refuses to seek help:

• Keep the person talking.• Be a good listener.• Suggest that something other than suicide might

solve the problem, even if it is not evident at the time.• Emphasize as concretely as possible how the

person’s suicide would be devastating to you and to other people who care.

• Ask how the person intends to commit suicide.• Do not tell people threatening suicide that they’re

acting stupid or crazy.• Suggest that the person go with you to obtain

professional help now.