Perspectives on the Causes of Mental Disorders

• Psychodynamic– Results from intrapsychic conflict and ineffective defense mechanisms

• Medical– Caused by abnormalities of brain & nervous system

• Cognitive-Behavioral– Due to learning and/or faulty beliefs

• Humanistic– Being overly sensitive to the expectations & criticisms of others

• Sociocultural– Mismatch between behavior & expectations of culture

• Diathesis-Stress Model– Genetic predispositions triggered by stress that exceeds coping ability

Classification of Mental Disorders• The DSM-IV• How are diagnoses done?– The clinical approach: Based upon experience of

therapist– The actuarial approach: Applying statistical rules

based on research– Research shows actuarial approach to be superior

Types of Psychological Disorders• Psychoses– Severely Disordered Thinking– Delusional– Person may be unaware that anything is wrong

• Neuroses– People are anxious, fearful, unhappy, depressed– Behavioral/Perceptual Strategies no longer work well– Person knows that something is wrong

• Mood Disorders• Miscellaneous Disorders

Psychoses (Schizophrenia)• Positive Symptoms of Schizophrenia

– Thought Disorders• Loose associations; word salads; clang associations• Excessively concrete thinking

– Hallucinations (Usually auditory)– Delusions

• Persecution• Grandeur• Somatic• Control• Reference

• Negative Symptoms of Schizophrenia– Flattened, blunted emotions; apathetic– Poverty of speech– Social Withdrawal– Lack of Initiative– Inability to experience pleasure

Classification of Schizophrenia• Catatonic– Catatonic postures; Waxy Flexibility– Alternates with repetitive activity

• Paranoid– Delusions of persecution & grandeur

• Disorganized– Progressive, irreversible disturbances of thought

• Undifferentiated– Pattern of symptoms change; a little bit of

everything

Causes of Schizophrenia• There have been a variety of different theoretical

explanations over time, but it has a clear biological basis

• A Biological predisposition activated by stress– Positive symptoms seem to be the result of the

overproduction of Dopamine (Can be treated by Chlorpromazine [brand name = Thorazine])

– Negative symptoms appear to be due to an actual loss of brain tissue

• Evidence indicates a genetic link• Neurodevelopmental hypothesis:– Nervous system impairments that develop around the

time of birth (not necessarily genetic)• (e.g., People in North born in winter are at greater risk)

Neuroses• Anxiety Disorders– Generalized Anxiety Disorder– Panic Disorder

• Attacks of terror (may last seconds or hours)• Often afraid that they are dying or going crazy• Hyperventilation• More common in women

– Phobic Disorders• Agoraphobia• Social Phobias• Specific Phobias

• Obsessive-Compulsive Disorders• Somatoform Disorders• Dissociative Disorders

Neuroses• Obsessive-Compulsive Disorders

– Obsession (thought) leads to compulsion (behavior)– Obsessions center on doubts/uncertainty or fear of doing something

prohibited– Common categories: counting, checking, cleaning, avoidance

• Somatoform Disorders– Physical symptoms without apparent cause– Somatization Disorder: Pain, heart symptoms, gastrointestinal

symptoms– Conversion Disorder: Blindness, deafness, loss of felling, paralysis.– Often occurs in response to an event

• Dissociative Disorders– Dissociative Amnesia– Dissociative Fugue State (Fugue State)– Dissociative Identity Disorder (DID) (Multiple personality Disorder)

Mood Disorders• Seasonal Affective Disorder (SAD)– Overeating, oversleeping, lethargy

• Bipolar Disorder– Alternating Mania & Depression

• Severe Depression– Sad, apathetic mood– Feelings of worthlessness/hopelessness– Social Withdrawal– Sleeplessness, loss of appetite & sexual desire– Change in activity level– In extreme cases there may be delusions– CAUSES: Faulty cognitions; internal attributions for negative things;

genetic predisposition– TREATMENT: ECS; Lithium Carbonate (Bipolar); Anti-depressants;

Cognitive Therapy

Miscellaneous Disorders• Substance Abuse Disorders (More common in men)• Impulse Control Disorders– Intense drive; behaviors reduce tension– Gambling, Pyromania, Kleptomania

• Psychosexual Disorders– Gender Identity Issues (Transexualism, Transvestism)– Paraphilias– Sexual Dysfunction

• Personality Disorders– Narcissism– Anti-Social Personality (Psychopath, Sociopath)

Types of Psychotherapy• Insight Therapies

– Psychoanalysis– Person-Centered Therapy (Humanistic)– Existential Therapy

• Gestalt Therapy• Behavior Therapies

– Systematic Desensitization– Aversion Therapy– Implosive Therapy/Flooding– Behavior Modification

• Cognitive-Behavior Therapies– Rational-Emotive Therapy (RET)– Beck’s Cognitive Therapy for Depression– Cognitive-Behavior Therapy

Types of Psychotherapy• Somatic/Biological Therapy– Psychosurgery– Electroconvulsive Therapy– Psychopharmacology

• Group Therapy

Does Psychotherapy Work?

Professionals Involved in Therapy

A History of Treating Mental Disorders