Psychological Disorders

Definition

A harmful dysfunction that occurs when behavior is atypical, disturbing, maladaptive, and unjustifiable

Breaking it down Atypical- outside the average scope of human

behavior Ex. A person who disregards social norms like

wearing a costume every day

Disturbing- bothersome to you or others Ex. A person who sees or hears things that does not

exist and then tries to respond to those stimuli

Maladaptive- gets in the way of living one’s life Ex. A person won’t go to work because it makes him

anxious

Unjustifiable- no external explanation for the behavior Ex. When a person is sad even though their life is

going well.

Perspectives

Medical- disorders are sicknesses that can be diagnosed with symptoms and treated with therapy

Bio-Psycho-Social- disorders are a product of biology, psychology, and sociocultural factors

DSM-V

Diagnostic Statistical Manual for Mental Disorders

Classifies disorders according to symptoms, treatments, and expected duration

Types of Disorders

Anxiety Disorders

Characterized by fear or anxiety.

Types of Anxiety Disorders

generalized anxiety disorder (person is continually tense, apprehensive, and in a state of autonomic nervous system arousal)

panic disorder (episodes of intense dread accompanied by physiological reactions)

phobias (persistent, irrational fear marked by avoidance)

obsessive-compulsive disorder (unwanted repetitive thoughts and actions)

post-traumatic stress (people in a state of anxiety or fear after a traumatic event)

Causes

Learning Perspective

Anxiety is a result of classically conditioned fear.

Fear is generalized

Behavior that reduces fear is reinforced (because it takes the fear away)

We learn anxiety by observing the fears of others

Biological Perspective

Natural selection makes some fears more likely

Some people are genetically predisposed to have more fear

Physiology- brain areas involved in emotion and fear are overactive

Dissociative and Personality Disorders

Break from normal personality

Abnormal personality

Types of Dissociative and Personality Disorders dissociative-identity disorder (multiple personalities)-

very sketchy in terms of research

avoidant personality disorder (fear of rejection and therefore withdrawal from others)

schizoid personality disorder (eccentric behaviors such as social disengagement)

histrionic personality disorder (shallow, attention-getting emotions, goes to great lengths to get praise and reassurance)

narcissistic personality disorder (exaggerate their own importance, aided by fantasies)

antisocial personality disorder (sociopath, one who lacks conscience)

Debate over Dissociative Disorders

Those who say yes:

There are distinct brain and body states associated with different personalities

Handedness can switch

Visual acuity and eye-muscle balance changes

Subtle memories don’t transfer

Those who say no: Those with dissociative

disorders are also highly hypnotizable

Only 2 cases per decade from 1930-1960

20,000 cases in 1980s

Almost solely diagnosed in North America

Causes

A way of dealing with childhood trauma?Then why do the children who survived

the Holocaust not exhibit an increased rate of personality disorders?

Mood Disorders

Characterized by unstable moods

Types of Mood Disorders

major depressive disorder (two or more weeks of depressed moods with no apparent cause)

bipolar disorder (alternating between manic and depressive episodes)

Explanations of Mood Disorders

Behavior and cognition- depressed people have negative thoughts about their behavior

Depression is common- it’s causes must likewise be common

Women are twice as likely to have major depression

Most major depressive episodes self-terminate

Stressful events often precede major depression

PerspectivesBiological

Mood disorders linked to genetics

Genes change neurotransmitters: Norepinephrine is

overabundant in mania and scarce in depression

Serotonin is scarce during depression

Social-Cognitive

Negative thoughts lead to negative moods

Negative moods lead to negative actions

Negative actions lead to a negative response from others

Negative response leads to negative thoughts

Schizophrenia

Characterized by disorganized thinking, disturbed perceptions, and inappropriate emotions and actions

Types of Schizophrenia

paranoid (preoccupation with delusions or hallucinations)

disorganized (disorganized speech or behavior or flat or inappropriate emotion)

catatonic (immobility or repetitive movements, extreme negativism or parroting others)

undifferentiatied (many or varied symptoms)

residual (withdrawal after hallucinations and delusions have disappeared)

Potential Causes

Brain abnormalities Dopamine overactivity

Low activity in frontal lobe

High activity in thalamus during hallucination

Large fluid-filled areas that shrink cerebral tissue

Maternal virus during pregnancy

Genetic factors Identical twins are much more likely to both have

the disorder than are fraternal twins

Psychological factors

Psych Therapies

Psychotherapy

An emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties

Eclectic approach- uses techniques from various therapies to help a client

Psychoanalysis

Traditional Psychoanalysis

Started by Freud in the late 1800’s

Assumption is that disorders are caused by repressed traumas (usually from childhood)

Freud used free association, where the patient would start discussing any memory focusing on thoughts and feelings

When the patient hit a block, called resistance, the psychoanalyst would interpret the underlying wishes, feelings, and conflicts.

Traditional Psychoanalysis

Another method is dream interpretation

Freud believed that the content of dreams could tell an analyst about a clients repressed feelings and drives

Psychodynamic Therapy

Psychodynamic therapy is an update to psychoanalysis

Focuses on interpretation of past memories

Comparing Therapies

Psychoanalysis

Therapist is out of the line of vision

Client comes several times a week

Client comes for several years

Psychodynamic

Therapist may talk to client face-to-face

Client comes once a week

Client comes from a few weeks

Interpersonal Therapy

A brief alternative to psychodynamic therapy

Especially used for depressed clientsFocus is on improving current

relationships and interpersonal skills

Humanistic Therapies

Basic Principles

Focus on the present and the futureFocus on conscious thoughts and

feelingsTaking immediate responsibility for

one’s feelings and actionsPromotes growth instead of cures

illness

Methods

Client-centered therapy- developed by Carl Rogers, a technique where the therapist creates an accepting, genuine and empathetic environment

Active listening- a type of listening in which the listeners echoes, restates, and clarifies what the speaker has said

Behavior TherapiesFocus on Classical and Operant Conditioning Techniques

Classical Conditioning Techniques

Counterconditioning- conditioning new responses to stimuli that trigger unwanted behaviors

Two types:Systematic Desensitization- associating a

relaxed state with something that would normally cause anxietyExposure therapies- treat anxiety by exposing

people to the things they fear or avoid

Aversive Conditioning- associating an unpleasant state with an unwanted behavior

Operant Conditioning Techniques

Using rewards or punishments to change behavior

Token economy- a way to reward desired behavior Patient exchanges a token

earned for exhibiting the desired behavior for privileges or treats

Cognitive Therapies

Basic Ideas

Teaches people more adaptive ways of thinking and acting

Based on the assumption that our thoughts intervene between our events and our emotional reactions

Example

EventYou lose your job

EventYou lose your job

Thought“I’m worthless. It’s hopeless.”

ResultDepression

Thought“I deserve something better.” Result

No Depression

Biomedical Therapies

Drug Therapies Antipsychotic drugs- block dopamine

receptor sites Patients must be carefully monitored

Can produce symptoms akin to Parkinson’s disease

Antianxiety drugs- depress central nervous system activity Treat symptoms but not causes

Antidepressant drugs- increase the availability of certain neurotransmitters (serotonin and norepinephrine)

Electroconvulsive Therapy

A therapy for severely depressed patients where a brief electrical current is sent through the brain of an anesthetized patient

We don’t know for sure why it works

Only for severe depression

After 3 sessions a week for two to four weeks, 80% of patients show improvement

Psychosurgery

Surgery that removes or destroys brain tissue

Only used as a last resort because the operations are irreversible

Can reduce uncontrollable seizures by deactivating specific nerve clusters

Can also cut the circuits involved in severe obsessive compulsive disorder

Lobotomies

A psychosurgery procedure used during the 1930s-1950s

Used to control uncontrollably violent or emotional patients

Procedure severs the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain

This procedure is rarely used today

Group and Family Therapies

Basic Principles

Using psych therapy techniques in small groups

Saves the patient time and money and is generally just as effective

Provides social support for patients

Family therapy uses group therapy principles to better family relationships

Alternative Therapies

Types

Therapeutic Touch- a practitioner hovers her hands over a patient to move “energy fields”

Eye Movement Desensitization and Reprocessing (EMDR)- rapidly moving one’s eyes in order to relieve anxiety or stress

Light exposure therapy- exposing seasonally depressed people to a bright light

Evaluating Psychotherapies

Is It Worth It? Clients often enter therapy in a crisis, so

their positive expectations can enhance healing

Unusual events tend to regress toward the mean

Clients generally like their therapists and speak kindly of them

80% of people have poorer outcomes than the average treated person

The type of therapy depends on the problem

Commonalities

Therapy offers hopeTherapy offers an explanation for

behavior and a way to change that behavior

Clients and therapists have an empathic, trusting, and caring relationship