PSYC2301INTRO TO PSYC

Chapter 14—Psychological Disorders

Introduction

• Psychopathology-the scientific study of the origins, symptoms, and development of psychological disorders

• Psychological disorder-a pattern of behavioral and psychological symptoms that causes significant personal distress, impairs the ability to function in one more more important areas of daily life, or both

DSM IV

• Currently DSM IV (TR) Text Revision

• Provides mental health professionals with:– A common language to label mental disorders– Comprehensive guidelines to diagnose mental

disorders

Prevalence of Psychological Disorders

• 1994, findings provided by the National Comorbidity Survey (NCS)– The prevalence of psychological disorders was

much higher than expected (48%)– The great majority (80%) of those with the

symptoms of psychological disorder had not sought any type of treatment

Anxiety Disorders

• Anxiety-an unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension, and worry

• Pathological anxiety– irrational– uncontrollable– disruptive

Anxiety Disorders

• Generalized anxiety disorder is characterized by chronic, excessive, global, and persistent symptoms of anxiety; also called free-floating anxiety

• Panic disorder is an anxiety disorder in which the person experiences frequent and unexpected panic attacks

Phobia

• Phobia-an irrational fear triggered by a specific object or situation– Specific phobia– Agoraphobia– Social phobia

Explaining Phobias

• Learning theories– Classical conditioning– Operant conditioning– Observational learning

• Evolution

PTSD• PTSD-an anxiety disorder in which chronic

and persistent symptoms of anxiety develop in response to an extreme physical or psychological trauma– frequent recall of the event– avoidance of stimuli or situations that tend to

trigger memories of the experience and a general numbing of emotional responsiveness

– increased physical arousal associated with anxiety

Obsessive-compulsive disorder

• An anxiety disorder in which the symptoms of anxiety are triggered by intrusive, repetitive thoughts (obsessions) and urges to perform certain actions or behaviors (compulsions)

• Compulsions– Overt physical behaviors– Covert mental behaviors

Obsessive-compulsive disorder

• Biological factors– A deficiency in the neurotransmitter serotonin– Dysfunction in specific brain areas, such as the

frontal lobes and the caudate nucleus, which is involved in regulating movements

Mood Disorders

• A category of mental disorders in which significant and chronic disruption in mood is the predominant symptom, causing impaired cognitive, behavioral, and physical functioning.

Major Depression

• Symptoms (2 weeks or longer)– Emotionally, the person feels an overwhelming

sadness– Behaviorally, the depressed person’s feelings

are reflected in dejected and spiritless facial expressions; crying spells may occur for no reason

Major Depression

• Symptoms (2 weeks or longer)– Cognitively, memory is often impaired; thought

processes feel dull and sluggish; person may have problems concentrating

– Physically, there is a general loss of mental and physical energy, along with vague physical aches and pains

Dysthmic disorder

• A mood disorder involving chronic, low grade feelings of depression that produce subjective discomfort but do not seriously impair the ability to function

Prevalence and Course of Major Depression

• “The common cold” of psychological disorder

• Women are twice as likely to be diagnosed

• Most at risk: 15-24 and 35-44

• Left untreated, depression may recur and become progressively more severe

Bipolar Disorder

• A mood disorder involving periods of incapacitating depression alternating with periods of extreme euphoria and excitement

• Formerly called manic depression

Characteristics

• Self-esteem is wildly inflated; grandiose ideas, which may represent delusional beliefs

• Frenzied, goal-directed behavior abounds

• Attention is easily distracted by virtually anything, triggering a flight of ideas

Cyclothymic Disorder

• A chronic mood disorder characterized by moderate but frequent mood swings that are not severe enough to qualify as bipolar disorder

Prevalence and Course of Bipolar Disorder

• Onset typically occurs in early 20s

• Affects about 2 million Americans annually

• No gender differences in the rate of occurrence. Lifetime risk is about 1 percent

• It is a recurring mental disorder

• often recurs when a person stops taking lithium

Explaining Mood Disorders

• Multiple factors appear to be involved in the development of the mood disorders. Three key factors have been implicated– Genetics– Neurotransmitters– Stress

Personality Disorders

• Someone with a personality disorder exhibits inflexible and maladaptive patterns of thoughts, emotions, behavior, and interpersonal functioning that are stable over time and across situations, and deviate from the expectations on the individuals’ culture

Personality Disorders• DSM-IV--10 personality disorders, grouped

in 3 basic clusters– The odd, eccentric includes paranoid, schizoid,

and schizotypal personality disorders– The dramatic, emotional, or erratic cluster

consists of antisocial, borderline, histrionic, and narcissistic personality disorders

– The anxious, fearful cluster includes people who display an avoidant, dependent, or obsessive-compulsive personality disorder

Personality Disorders• Paranoid-characterized by a pervasive

distrust and suspiciousness of the motives of others without sufficient basis

• Antisocial-characterized by a pervasive pattern of disregarding and violating the rights of others

• Borderline-characterized by instability of interpersonal relationships, self-image, and emotions, and marked impulsivity

The Dissociative Disorders

• Dissociative experience-a break or disruption in consciousness during which awareness, memory, and personal identity become separated or divided.– Dissociative amnesia– Dissociative fugue

Dissociative Identity Disorder

• Formerly known as multiple personality disorder, DID involves extensive memory disruptions for personal information along with the presence of two or more distinct identities or “personalities.”

DID

• Symptoms of amnesia memory problems are present in virtually all cases

• “loses time” and is unable to recall her behavior or whereabouts during specific time periods

• Typically have numerous psychiatric and physical symptoms and chaotic personal history

Explaining DID

• DID represents an extreme form of dissociative coping brought on by trauma, often extreme physical or sexual abuse in childhood

Skepticism

• DID patients are consciously or unconsciously “faking” the symptoms, responding to a therapist’s suggestions, or mimicking the symptoms of sensational DID case portrayed in the media

Schizophrenia

• A psychological disorder in which the ability to function is impaired by severely distorted beliefs, perceptions, and thought processes

• Schizophrenia is diagnosed when two or more symptoms are present for a month or longer

Symptoms of Schizophrenia

• Positive symptoms– reflect excesses or distortions of normal

functioning and include delusions, hallucinations, and severely disorganized thought processes, speech, and behavior

• Negative symptoms– reflect a restriction or reduction of normal

functions, such as greatly reduced motivation, emotional expressiveness, or speech

Delusions: False Beliefs

• A falsely held belief that persists in spite of contradictory evidence or appeals to reason– Delusions of reference– Delusions of grandeur– Delusions of persecution

Hallucinations: False Perceptions

• False or distorted perceptions that seem vividly real

• Can involve any of the senses

• Most common auditory, followed by visual

Negative Symptoms

• Deficits in behavior, emotion, and motivation– Flat affect, or affective flattening– Alogia– Avolition

Types of Schizophrenia

• Paranoid-characterized by the presence of delusions, hallucinations, or both

• Catatonic-marked by highly disturbed movements or actions; symptoms may include waxy flexibility

Types of Schizophrenia

• Disorganized-exhibits extremely disorganized behavior, disorganized speech, and flat affect.

• Undifferentiated-displays some combination of positive and negative symptoms that does not clearly fit the criteria for the paranoid, catatonic, or disorganized types

Prevalence and Course of Schizophrenia

• Onset typically occurs during young adulthood

• Approximately 1 million Americans are treated annually

• About 1/4 of those who experience an episode recover completely; another 1/4 experience recurrent episodes, but often with only minimal impairment of functioning

Prevalence and Course of Schizophrenia

• One half, schizophrenia becomes a chronic mental illness, and the ability to function normally in society may be severely impaired

Explaining Schizophrenia• Genetic

– Schizophrenia tends to cluster in certain families

– The more closely related a person is to someone who has schizophrenia, the greater the risk that she will be diagnosed with schizophrenia at some point in her lifetime

– If either biological parent of an adopted individual has schizophrenia, the adopted individual is at greater risk to develop schizophrenia

Explaining Schizophrenia• Abnormal brain chemistry: the dopamine

hypothesis

• Abnormal brain structure and functioning: enlargement of the fluid-filled cavities called ventricles, located deep within the brain

• Environmental factors: the viral infection theory

• Psychological factors: unhealthy families