History of Psychological Disorders Psychological disorders were once understood as religious experiences, demonic possession, God’s punishment Patients.

Psychological Disorders

When Things Go Wrong

History of Psychological Disorders

Psychological disorders were once understood as religious experiences, demonic possession, God’s punishment

Patients were treated as “mad,” imprisoned or executed for abnormalities

Medical model: the conceptualization of psychological abnormalities as diseases that, like biological diseases, have symptoms and causes and possible cures

Totally Legitimate Medical Terminology

How to Classify Disorders?

Diagnosis: determining the nature of the disorder

Symptoms: signs of an underlying problem or “syndrome”

DSM-IV-TR: a classification system that describes the features used to diagnose each recognized mental disorder and indicate how the disorder can be distinguished from other, similar problems

What is a “Disorder”?

DSM-IV-TR defines a disorder as Manifested in symptoms that involve

disturbances in behavior, thoughts, or emotions

Symptoms are associated with significant personal distress or impairment

Symptoms stem from an internal dysfunction (biological, psychological, or both)

NOT just deviation from what is “normal” Lots of behaviors—including positive ones

—aren’t perfectly normal, but not all signify psych disorders

What is a “Disorder” (Part 2)?

Different names for disorders Neurosis: a condition that involves anxiety or the

inability to properly sublimate psychical energy Psychosis: a condition in which a person

experiences serious distortions of perception and thought that weaken his/her grasp on reality

Anxiety Disorders: like neuroses; each subgroup is classified based on observable features

Controversy Many diagnoses continue to depend on

professional interpretation rather than factual, quantifiable observations

Many still rely on self-reports, which can be misleading!

Problems with Diagnosis

Disorders can arise from purely psychological, environmental, or genetic/biological factors—or some of each

Comorbidity: the co-occurrence of two or more disorders in a single individual A person might be depressed

because their social phobia makes interaction impossible, or a person could be phobic about showing their depression in public—or the disorders could be unrelated but co-occurring

Problems with Diagnosis (Part 2)

Diathesis-Stress Model A person may be predisposed for a mental

disorder that remains unexpressed until triggered by stress

Predispositions & environment can work in tandem Maria is predisposed to introversion, avoids

people for fear of rejection, gains a reputation as a loner, and is therefore rejected by others more often

Fundamental Attribution Error The tendency to ascribe behavior to

INTERNAL, essential causes rather than external, contingent ones Sitao comes to class with a bucket on his

head. Why?

Anxiety Disorders

Anxiety Disorder The class of mental disorder in which anxiety is

the predominant feature Generalized anxiety disorder, phobic disorder,

panic disorder, obsessive-compulsive disorder

Generalized Anxiety Disorder

GAD Unrelenting worries that are not focused on any

particular threat Chronic excessive worry is accompanied by three or

more of the following symptoms Restlessness Fatigue Concentration problems Irritability Muscle tension Sleep disturbances

Phobic Disorders

Marked, persistent, excessive fear and avoidance of specific objects, activities, or situations

Individuals recognize that phobias are irrational but can’t help but feel them

Specific phobia: an irrational fear of a particular objet or situation that markedly interferes with an individual’s ability to study Common phobias: animals; natural environments;

situations; blood, injections, and injury; social phobias Preparedness theory!

Panic Disorder

Different interpretations of physiological sins of anxiety Sodium lactate tests

Agoraphobia Extreme fear of venturing into public places Many are simply afraid of having panic

attacks in public

Sudden occurrence of multiple psychological and physiological symptoms that contribute to a feeling of stark terror Shortness of breath, heart palpitations,

sweating, dizziness, depersonalization ( feeling of being detached from one’s body) or derealization (feeling that the world is unreal)

Obsessive-Compulsive Disorder

Primary symptoms are unwanted, recurrent thoughts and actions; ritualistic behaviors (compulsions) designed to fend off those thoughts

Individuals are aware that symptoms are irrational

Obsessions typically derive from concerns that could pose a real threat (such as contamination, aggression, disease)

Psychotherapy is often as effective as medication

Dissociative Disorders

A condition in which normal cognitive processes are severely disjointed and fragmented, creating significant disruptions in memory, awareness, or personality that can vary in length from a matter of minutes to many years

Dissociative identity disorder: the presence within an individuals of two or more distinct identities that at different times take control of the individual’s behavior “Host” personality often does not know

about “alters,” but alters know about host and other alters

Dissociative Disorders (Part 2)

Dissociative amnesia: the sudden loss of memory of significant personal information

Dissociative fugue: the sudden loss of memory for one’s personal history, accompanied by an abrupt departure from home and the assumption of a new identity

Mood Disorders

Mood Disorders: mental disorders that have mood disturbance as their predominant feature

Major Depression Severely depressed mood that lasts 2 or more weeks and

is accompanied by feelings of worthlessness and lack of pleasure, lethargy, and sleep and appetite disturbances

Not necessarily SADNESS!

Facts Median lifetime risk for depression is about 16% and

seems to be increasing in younger generations Women are twice as likely to develop depression

(hormonal?)

Mood Disorders (2)

Bipolar Disorder An unstable emotional condition characterized

by cycles of abnormal, persistent high mood (mania) and low mood (depression)

Manic phase must last at least a week to qualify as mania Elevated mood, irritability, grandiosity,

decreased need for sleep, talkativeness, racing thoughts, distractibility, reckless behavior

Sometimes features hallucinations and delusions

Polygenic Arising from the action of many genes in an

additive or interactive fashion

Schizophrenia

Schizophrenia Profound disruption of basic psychological processes; a

distorted perception of reality; altered or blunted emotion; and disturbances in thought, motivation, and behavior

Symptoms emerge during continuous period of at least one month with signs of disorder persisting for at least six months Delusion Hallucination Disorganized speech Grossly disorganized behavior Catatonic Behavior Negative symptoms

Delusions

Patently false belief system, often bizarre and grandiose, that is maintained in spite of its irrationality

Adopted identities in schizophrenia do not alternate, exhibit amnesia for one another, or otherwise “split”

Delusions of persecution, paranoia

Hallucination

A false perceptual experience that has a compelling sense of being real despite the absence of external stimulation

Hearing seeing or smelling things that are not there or having tactile sensations in the absence of relevant sensory stimulation

65% report hearing voices repeatedly

Disorganized Speech

Severe disruption of verbal communication in which ideas shift rapidly and incoherently from one to another unrelated topic

“I have not been a drinker for 16 years. I am taking a mental rest after a ‘carter’ assignment of ‘quill.’ You know, a ‘penwrap.’ I had contracts with Warner Brothers Studios and Eugene broke phonograph records but Mike protested. I have been with the police department 35 years. I am made of flesh and blood—see Doctor?”

Grossly Disorganized Behavior

Behavior that is inappropriate for the situation or ineffective in attaining goals, often with specific motor disturbances

Improper sexual behavior, childlike behavior, disheveled appearance, loud shouting or swearing

Catatonic behavior A marked decrease in all movement

or an increase in muscular rigidity and over activity

Negative Symptoms

Emotional and social withdrawal; apathy; poverty of speech; and other indications of the absence or insufficiency of normal behavior, motivation, and emotion

Negative = things MISSING in people

Causes of Schizophrenia

Strong heritability coefficient

Monozygotic twins are highly likely to develop schizophrenia

Prenatal Factors Monozygotic twins generally share

same amniotic fluid Viral infections, toxins in mother’s

blood could contribute Higher chance of being

schizophrenic if born in winter months

Personality Disorders

Antisocial Personality Disorder Pervasive pattern of disregard for and violation of

the rights of others that begins in childhood or early adolescence and continues into adulthood

Signs before age of 15 include: aggression; destruction of property; rule violations; deceitfulness, lying, or stealing; repeatedly setting fires

APD individuals are often called “sociopaths” May be biologically predisposed to being insensitive

to fear