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Psychologi
15
cal
Disorders
PowerPoint
Presentation
by Jim Foley
2013 Worth Publishers
Perspectives on Psychological
Disorders
Defining
psychological
disorders
Thinking critically
about ADHD
Understanding
psychological
disorders
Classifying
psychological
disorders
Labeling
psychological
disorders
Insanity and
responsibility
Psychological disorders
are:
patterns of thoughts, feelings, or
actions that are deviant,
distressful, and dysfunctional.
Deviant?
To deviate, in general,
means to vary from
what typically would
happen.
In psychology, a
behavior or mental
state is considered
deviant by a culture
when it is different from
what would be expected
in that culture.
A disorder may also be
a deviation from a
typical developmental
pathway.
Defining Deviance:
The Role of Context
and Culture
Context: whether a
behavior varies from
expectation depends on the
situation in which the
behavior occurs Yelling for
hours is not deviant when it
happens at a football game.
Culture: these painted
faces might seem deviant
when viewed from a
different culture
Is Attention-Deficit/
Hyperactivity Disorder
(ADHD)
a disorder?
Is it deviant? Do some people have a level of
inattentiveness, impulsiveness, or restlessness
that goes beyond laziness or immaturity?
Is it distressful? Is the person enjoying being
energetic, or are they frustrated that they cant
sustain focus?
Is there dysfunction? Are the symptoms
harmless fun, or do they negatively impact
work and relationships?
Pinels New
Approach
The
Medical
Model
The Biopsychosocial
Approach
Cultural Influences on
Disorders
Culture-bound syndromes
are disorders which only
seem to exist within certain
cultures; they demonstrate
how culture can play a role
in both causing and
defining a disorder.
Examples:
Bulimia Nervosa: binging/purging, in the United
States
Running amok: violent outbursts, in Malaysia
Hikikomori: social withdrawal, in Japan
Classifying Psychological
Disorders
Why create classifications of mental
illness? What is the value of talking about
diagnoses instead of just talking about
individuals?
1.Diagnoses create a verbal shorthand for
referring to a list of associated symptoms.
2.Diagnoses allow us to statistically study
many similar cases, learning to predict
outcomes.
3.Diagnoses can guide treatment choices.
The Diagnostic
and Statistical
Manual
Its easier to count
cases of autism if
we have a clear
definition.
Versions: DSM-IVTR, DSM-V (May
2013)
The DSM is used
to justify payment
for treatment.
Its consistent with
diagnoses used by
medical doctors
worldwide.
Categories
of
Diagnoses
Critiques of Diagnosing
with the DSM
1. The DSM calls too many people
disordered.
2. The border between diagnoses, or
between disorder and normal,
seems arbitrary.
3. Decisions about what is a disorder
seem to include value judgments;
is depression necessarily deviant?
4. Diagnostic labels direct how we
view and interpret the world,
telling us which behavior and mental
states to see as disordered.
To what degree, if
any, should he be
held responsible for
his actions?
What is the
appropriate
consequence?
Anxiety Disorders
GAD:
Generalized
Anxiety
Emotional-cognitive
Disorder
symptoms include
Panic
Disorder:
Im
Dying
A panic attack is not just an
Specific
Phobia
A specific phobia is more
Obsessive-Compulsive
[OCD]
ObsessionsDisorder
are intense,
unwanted worries, ideas, and
images that repeatedly pop up in
the mind.
A compulsion is a repeatedly
strong feeling of needing to
carry out an action, even though
it doesnt feel like it makes
sense.
When is it a disorder?
Distress: when you are deeply
frustrated with not being able
to control the behaviors
or
Dysfunction: when the time
and mental energy spent on
these thoughts and behaviors
interfere with everyday life
Post-Traumatic
Stress
Disorder
[PTSD]
About 10 to 35 percent
of people who
experience trauma not
only have burned-in
memories, but also four
weeks
to aintrusive
lifetime of:
repeated
recall of those
memories.
nightmares and other
re-experiencing.
social withdrawal or
phobic avoidance.
jumpy anxiety or
hypervigilance.
situation
Those traumatized more
frequently
Those with brain differences
Those who have less resiliency
Those who get re-traumatized
Resilience and
Post-Traumatic
Growth
Resilience/recove
ry after trauma
may include:
some lingering,
but not
overwhelming,
stress.
finding strengths
in yourself.
finding
connection with
others.
finding hope.
seeing the
trauma as a
challenge that
can be overcome.
Understanding Anxiety
Disorders: Explanations from
Different Perspectives
Psychodyna
mic/
Freudian:
repressed
impulses
Classical
conditioning
:
overgeneralizi
ng a
conditioned
response
Operant
conditioning
: rewarding
avoidance
Observation
al learning:
worrying like
mom
Cognitive
appraisals:
uncertainty is
danger
Evolutionary
: surviving by
avoiding
danger
Understanding Anxiety
Disorders:
Freudian/Psychodynamic
Perspective
Sigmund Freud
felt
Classical
Conditioning
Anxiety
Inand
the experiment
by John
Operant
Conditioning
and
Anxiety
We
may feel
anxious in a
Observation
al Learning
and Anxiety
Experiments with
humans and monkeys
show that anxiety can
be acquired through
observational
learning. If you see
someone else avoiding
or fearing some object
or creature, you might
pick up that fear and
adopt it even after the
original scared person is
not around.
In this way, fears get
passed down in families.
Cognition
and Anxiety
Examples of Cognitions
that can Worsen Anxiety:
Cognitive errors, such as believing
that we can predict that bad events
will happen
Irrational beliefs, such as bad
things dont happen to good people,
so if I was hurt, I must be bad
Mistaken appraisals, such as
seeing aches as diseases, noises as
dangers, and strangers as threats
Misinterpretations of facial
expressions and actions of others,
such as thinking theyre talking
about me
Neurotransmitters
Mood Disorders
Major depressive disorder
[MDD] is:
more than just feeling
down.
more than just feeling
sad about something.
Bipolar disorder is:
more than mood swings.
depression plus the
problematic overly up
mood called mania.
Major Depression:
Not Just a Depressive
Reaction
Some people make an
unfair criticism of
themselves or others
with major depression:
There is nothing to be
depressed about.
If someone with asthma
has an attack, do we say,
what do you have to be
gasping about?
It is bad enough to have
MDD that persists even
under good
circumstances. Dont add
criticism by implying the
depression is an
exaggerated response.
Depression is Everywhere
Depression shows up in
people seeking treatment:
Phobias are the most
common (frequently
experienced) disorder, but
depression is the #1 reason
people seek mental health
services.
Depression appears
worldwide:
Per year, depressive
episodes happen to about 6
percent of men and about 9
percent of women.
Over the course of a lifetime,
12 percent of Canadians and
17 percent of Americans
experience depression.
Women
August
December
21
Bipolar Disorder
Bipolar disorder was once called
manic-depressive disorder.
Bipolar disorders two polar
opposite moods are depression
and mania.
Mania refers to a
period of hyperelevated mood that is
euphoric, giddy, easily
irritated, hyperactive,
impulsive, overly
optimistic, and even
Contrasting Symptoms
grandiose.
Depressed mood: stuck
Mania: euphoric, giddy,
Understanding Mood
Disorders
Why are mood disorders so
pervasive, and more common
among the young, and
especially among women?
Understanding Mood
Disorders
Can we explain
Understanding Mood
Disorders
Biological
aspects and
explanations
Social-cognitive
aspects and
explanations
Evolutionary
Genetic
Brain /Body
Negative thoughts
and negative mood
Explanatory style
The vicious cycle
An Evolutionary
Perspective on the Biology
Depression, in its milder,
ofnon-disordered
Depression
form, may
have had survival value.
Under stress, depression is
social-emotional
hibernation. It allows
humans to:
conserve energy.
avoid conflicts and other
risks.
let go of unattainable
goals.
take time to contemplate.
Biology of Depression:
Genetics
Preventing or Reducing
Depression:
Understanding Mood
Disorders: The SocialCognitive
Perspective
Discounting positive
Low SelfEsteem
information and
assuming the worst
about self, situation,
and the future
Depression is
associated
with:
Ruminatio
n
Learned
Helpless
ness
Depressi
ve
Explanat
ory Style
Stuck focusing on
whats bad
Self-defeating
beliefs such as
assuming that
one (self) is
unable to
cope,
improve,
achieve, or be
happy
Depressive Explanatory
Style
How we analyze bad
news predicts mood.
Problematic
event:
Assumptions
about the
problem
The problem
is:
The problem
is:
The problem
is:
Mood/result
that goes along
with these
Depressions Vicious
Cycle
A depressed mood
may develop when a
Hallucinations
(illusory
perceptions),
especially auditory
Delusions (illusory
beliefs), especially
persecutory
Disorganized
thought and
nonsensical speech
absence
of
healthy
behaviors
Schizophrenia Symptoms:
?!?!
Schizophrenia Symptoms:
Disturbed Perceptions
People with schizophrenia often experience
hallucinations, that is, perceptual
experiences not shared by others.
The most common form of hallucination is
hearing voices that no one else hears,
often with upsetting (e.g. shaming) content.
Hallucinations can also be visual,
olfactory/smells, tactile/touch, or
gustatory/taste.
Am I
evil?
Youre
evil!
Schizophrenia Symptoms:
Inappropriate Emotions
Odd and socially
inappropriate responses
such as looking bored or
amused while hearing of a
death
Flat affect: facial/body
expression is flat with no
visible emotional content
Impaired perception of
emotions, including not
reading others
intentions and feelings
Schizophrenia Symptoms:
Inappropriate
Odd and socially inappropriate
Actions/Behavior
behavior can be caused by
Onset and
Development
of
Schizophreni
a
Course of
Schizophrenia
Acute/Reactive
Schizophrenia In
reaction to stress, some
people develop positive
symptoms such as
hallucinations.
Recovery is likely.
Chronic/Process
Schizophrenia develops
slowly, with more
negative symptoms such
as flat affect and social
withdrawal.
With treatment and
support, there may
be periods of a
normal life, but not a
cure.
Subtypes of Schizophrenia
Understanding
Schizophrenia
Whats going on
in the brain in
schizophrenia?
Abnormal brain
structure and
activity
Too many dopamine/D4
receptors help to explain
paranoia and hallucinations;
its like taking amphetamine
overdoses all the time.
Poor coordination of neural
firing in the frontal lobes
impairs judgment and selfcontrol.
The thalamus fires during
hallucinations as if real
sensations were being
received.
Understanding
Schizophrenia
Are there biological risk
factors affecting early
development?
Schizophrenia is
more likely to
develop in babies
born:
during and after
flu epidemics.
in densely
populated areas.
a few months
after flu season.
after mothers had
the flu during the
second trimester,
or had antibodies
showing viral
infection.
Theget
lesson
is to:
flu shots
with early fall
pregnancies.
Understanding
Schizophrenia
Genetic Factors
If one twin has
schizophrenia, the
chance of the other
one also having it are
much greater if the
twins are identical.
Having adoptive
siblings (or parents)
with schizophrenia
does not increase the
likelihood of
developing
schizophrenia.
Understanding
Schizophrenia
Even if maternal
flu during the
Even in identical twins, genetics do
second trimester
not fully predict schizophrenia.
doubles the risk
This could be because of
of schizophrenia,
this means only 2
environmental differences.
percent of these
First difference: twins in separate
babies develop
placentas.
the disorder.
Genetics may
differentiate
these 2 percent.
Research shows
many genes
linked to
schizophrenia,
but it may take
environmental
Only one of two twins has the enlarged
factors to turn on
ventricles seen in schizophrenia.
these genes.
Understanding
Schizophrenia
Are there
psychological
causes?
SocialPsychological
Factors
Research does not support
the idea that social or
psychological factors (such as
parenting) alone can cause
schizophrenia.
However, there may be
factors such as stress that
affect the onset of
schizophrenia.
Until we find a mechanism of
causation, all we may have is
a list of factors which
correlate with increased risk.
Predicting
Schizophrenia:
Early Warning Signs
Social/psychological
factors which tend to
appear before the
onset of
schizophrenia:
early separation from
parents
short attention span
disruptive OR withdrawn
behavior
emotional unpredictability
poor peer relations and/or
solitary play
Biological factors
which tend to appear
before the onset of
schizophrenia:
having a mother with
severe chronic
schizophrenia
birth complications,
including oxygen
deprivation and low
birth weight
poor muscle
coordination
Other
Disorders
Eating
Disorders
Dissociati
ve
Disorders
Personali
ty
Disorders
Dissociation refers to a
Dissociati
separation of conscious
awareness from thoughts,
ve
memory, bodily sensations,
Disorders
feelings, or even from identity.
Dissociation can serve as a
psychological escape from an
overwhelmingly stressful
situation.
A dissociative disorder refers to
dysfunction and distress caused
Examples:
by chronic and severe
dissociation.
Loss
of
memory
with no known physical
Dissociative
Amnesia:
Dissociative
Fugue
Dissociative
Identity
Disorder
(D.I.D.)
Dissociative Identity
Disorder (D.I.D.) formerly
Multiple PersonalityAlternative
Disorder
Explanations for
D.I.D.
Dissociative
identities might just
be an extreme form of
playing a role.
D.I.D. in North America
might be a recent
cultural construction,
similar to the idea of
being possessed by evil
spirits.
Cases of D.I.D. might
be created or worsened
by therapists
encouraging people to
Explaining
fragmentation of
personality from
different
perspectives
Psychoanalytic
perspective:
diverting id
Cognitive
perspective:
coping with abuse
Learning perspective:
dissociation pays
Social influence:
Eating
Disorders
Anorexia nervosa
Bulimia nervosa
Binge-eating disorder
Anorexia
Nervosa
Bulimia
Nervosa
Definition
Prevalence
Compulsion to lose weight, 0.6 percent
coupled with certainty
meet criteria
about being fat despite
at some time
being 15 percent or more
during
underweight
lifetime
Compulsion to binge,
eating large amounts fast,
then purge by losing the
1.0 percent
food through vomiting,
laxatives, and extreme
exercise
Personali
ty
Disorders
Personality
disorders are
enduring patterns
of social and other
behavior that
impair social
functioning.
Deceitfulness
Disregard for safety of
self or others
Aggressiveness
Failure to conform to
social norms
Lack of remorse
Impulsivity and failure to
plan ahead
Irritability
Irresponsibility regarding
jobs, family, and money
Antisocial or unemotional
biological relatives increases
risk.
Some associated genes
have been identified.
Risk factors include bodybased fearlessness, lower
levels of stress hormones, and
low physiological arousal in
stressful situations such as
awaiting receiving a shock.
Fear conditioning is impaired.
Reduced prefrontal cortex
tissue leads to impulsivity.
Substance dependence is
Antisocial PD
Criminality
Antisocial Crime
Biosocial roots of
crime: birth
complications and
poverty combine to
increase risk.
Rates of
Psychologica
l Disorders
This list takes a closer look at
the past-year prevalence of
various mental health
diagnoses in the United
States.