🧜🏼‍♀️Intro Psyc Ch 8 Behavioral Disorders🧜🏼‍♀️

Dissociative disorders

Separation of anxiety-producing thoughts from conscious awareness 🔺Disruption of memory, identity, or consciousness due to REPRESSION

How does Freud’s psychoanalytic theory explain Dissociative Disorders?

▪️Overwhelming anxiety or trauma occurs

▪️Excessive Repression Blocks anxiety/trama

▪️Defense mechanisms to cope

▪️Leads to dissociation (disconnection from memory, identity, or reality)

Behavioral explanation for dissociative reactions

Behavior reduces anxiety

Gets reinforced (avoidance learning)

Memory loss after trauma or stress that removes a specific time period, but remembers skills like speaking or playing piano

Dissociative amnesia

After a traumatic accident, someone cannot remember anything about the event or the surrounding time period

Dissociative amnesia

Depersonalization-derealization disorder

Feeling detached from your own body or like you’re watching yourself, along with a out-of-body, dreamlike sense of surroundings

Primary personality unaware of others but others may know primary

Dissociative identity disorder.

🔹Switching between a primary personality and one or more (multiple) secondary personalities not caused by disease or brain injury

🔹Subordinate personalities are usually aware of the primary personality, but the primary is not aware of them

🔺9x more women affected than men

Dissociative identity disorder

🔹An interesting case of dissociative identity disorder that  appeared in early childhood, around age 2

🔹Followed a long history of sexual  abuse, which original personality was “asleep” while other personalities emerged

🔺Displayed 92 separate personalities, called ____

🔺____ Case

🔺Troops

🔺Truddi Chase

Truddi Chase Personality that acted as the perfect woman

Miss Wonderful

Truddi Chase Personality character who played a vulgar woman

Sewer Mouth

Truddi Chase Personality Mean Joe

11-foot protector of the troops

Truddi Chase Personality Carefree & irresponsible

Elvira

Truddi Chase Personality that communicated only through howls of pain

Rabbit

Truddi Chase Personality responsible for tracking other personalities (Troops)

The Front Runner

Truddi Chase Personality Sensitive & artistic child

Twelve

How does Freud’s Psychoanalytic theory explain dissociative disorders?

excessive use of defense mechanisms to cope with anxiety & internal conflict.

Psychoanalytic perspective on Dissociative Disorders

Excessive repression

Defense mechanisms BLOCK (sexual) impulses from awareness

According to Behavioral theory, Dissociative behaviors (operant avoidance responses) continue because ____

🔹They are Reinforced because they Reduce Anxiety (avoidance learning)

Jamie withdraws from friends, gains weight, feels constant sadness, and thinks about suicide

Major depressive disorder — persistent sadness, loss, worthlessness, possible suicidal thoughts.

What increases risk of relapse in Major Depression Disorder?

🔺Early onset (before age twenty) major depression

🔺Marital distress

🔺Critical/Hostile family environment

Bipolar disorder

Extreme mood swings from Immobilizing Depression to Euphoria & Frantic activity

🔹high energy & mood

🔹increased psychomotor agitation/activity (pacing, constant irritation, high anxiety, verbal outbursts

🔹fast speech / pressure of speech

🔹risky behavior

🔹reduced need for sleep

🔹grand flight of ideas

🔹spending sprees, big unrealistic plans

🔹Inflated self-esteem

🔹distractibility

Mania

Psychomotor agitation in Mania

Increased activity level and restless movement

🔹A patient shows high energy, little sleep, & distractibility.

🔺What additional symptom would BEST confirm mania

🔹Which DSM-5 Manic symptom involves increased activity & restlessness

Psychomotor agitation

Bipolar I Disorder

At least 1 Manic episode occurs w/ Major depression

Bipolar II disorder

at least 1 episode of Hypomania (mildly manic, hypomanic) & Major Depressive episodes

🔹A mood characterized by persistent and pervasive elevated mood

🔹Less severe form of mania with elevated mood but still functioning

Hypomania

A patient reports periods of depression along with elevated mood that is noticeable but not severe enough to be considered mania

Bipolar II disorder

A rigid/strong, exaggerated belief with no basis in reality

Delusion

Perceiving things that are not there

(hearing voices)

Hallucination

Which DSM-5 Manic symptom may become delusional

Inflated self-esteem / Grandiosity

When do delusions, hallucinations & disorganized thinking occur?

🔹Advanced stages of Mania

🔹Severe Mania

Who offered the first detailed interpretation of depression

Karl Abraham (1877–1925)

a German psychoanalyst and student of Freud

How does Abraham’s psychoanalytic theory explain the origin of mood disorders?

🔹originate from an oral fixation

🔹Where Frustration during the oral stage leads to ambivalent (love/hate) feelings toward the mother

🔹Which are later transferred to loved ones → then to the self

According to Abraham, how do mood disorders develop?

🔹 When Ambivalent (love/hate) feelings are Turned inward =

🔹Mania ➜ excessive self-love

🔹Depression ➜ exaggerated self-hatred

How does Freud’s psychoanalytic theory explain the origin of depression?

1️⃣Overdependence 2️⃣Ambivalent relationships, You love them… but also feel anger toward them

3️⃣Loss or threat of loss of a loved one

4️⃣Anger turned Inward = Depression

Why does overdependence increase risk of depression?(psychoanalytic Freud)?

It creates unresolved unconscious anger

A man unconsciously directs anger toward himself after losing a loved one. This is ____

Freud Psychoanalytic explanation of depression development - Leads to- despair, Depression, Suicidal thoughts

Why is bipolar disorder especially dangerous?

High risk of Suicide

After losing her spouse, Maria withdraws because her main source of reinforcement is gone. This supports ____

Behavioral view of depression- loss of positive reinforcement in a person’s life

🔺Death

🔺job loss

🔺Moving

🔺illness.

What did Swann (1992) find about depressed people & feedback?

Prefer unfavorable/negative feedback, even when it makes them feel unhappy

Another Behavioral perspective on depression is Seligman’s theory of ____

Learned Helplessness become depressed you have no control over the 

reinforcers & punishers in their lives

What is Seligman's theory of learned helplessness?

Depression can result when people believe they have no control over the reinforcers & punishers in their lives

How was learned helplessness demonstrated in animal studies?

🔹Dogs exposed to unavoidable shocks developed passive resignation

🔹Dogs that could escape shocks learned to avoid them by using their nose to press a button

🔹A person repeatedly experiences situations where their actions do not change outcomes. Later, even when change is possible, they fail to act. This pattern best reflects ____

Learned Helplessness become depressed you have no control over the

 reinforcers & punishers in their lives

Learned helplessness is best defined as ____

Reduced ability to learn avoidance responses after uncontrollable events

Monoamine theory: depression is caused by low activity of ___ & ___

🔺Serotonin

🔺Norepinephrin

In the 1950s, researchers learned that two classes of drugs — ____ & ____ often Alleviated the symptoms of Depression, by increasing the brain levels of  neurotransmitters, norepinephrine & serotonin

🔹Monoamine oxidase inhibitors (MAOIs)

🔹Tricyclics

Monoamine theory

🔹Depression linked to Reduced activity of the Monoamine neurotransmitters, norepinephrine and/or serotonin

🔹The 1st formal biochemical theory of mood disorders

How is Seasonal Affective Disorder (SAD) linked to brain biochemistry?

🔹Too much melatonin or prolonged melatonin secretion

🔹Affecting mood & energy

What did studies in the 1950s reveal about drugs and depression?

MAOIs & Tricyclics alleviated depression by increasing norepinephrine & serotonin levels in the brain

Schizophrenia

Severe and disabling mental disorder characterized by extreme disruptions of perceptions, thoughts, emotions, & behavior, and Hallucinations

🔹One of the most serious & debilitating psychological disorders

How is schizophrenia different from multiple personality disorder?

🔹Involves a disorganized split between thoughts & feelings

🔹Leading to bizarre & dysfunctional behavior

How prevalent is schizophrenia?

🔹About 1% of people worldwide

🔹Up to 3 out of 100 may experience it at some time in their lives

🔹In the U.S., 600,000 people receive treatment annually

Schizophrenia was previously called ____

Dementia praecox

The term Schizophrenia was later coined by ____(1950) to describe what he saw as the primary symptom of this disorder: a dissociation of

thoughts from appropriate emotions caused by a splitting off of parts of the mind 

Eugene Bleuler

Extreme disturbances in thinking that lead to maladaptive behavior (aggression, self-Injurious, property Destruction)

Schizophrenia

What is a delusion of persecution?

Belief that one is being hunted, harmed, or interfered with by certain individuals or organized groups

What is a delusion of bodily changes?

Belief that the body is changing in strange ways (blood turning into snakes, flesh to concrete)

What is delusion of nihilism

🔹The belief that nothing exists, that all things are shadows

🔹idea that one has been dead for many years & is observing the world from afar 

What is a delusion of reference?

Belief that others are talking about you or that you are being included in media

What is a delusion of influence?

🔹Belief that others control your actions through TV or wires

🔹making you do things against your will

What is a delusion of grandeur?

Belief that one is a great historical or famous figure; Napoleon, Queen Victoria, president of the United States

What is the most common type of hallucination in schizophrenia?

Auditory hallucinations (hearing voices)

Echolalia in schizophrenia

🔹Repeating what others say verbatim

🔹Repeat virtually every statement they hear uttered

Echolalia

meaningless repetition of another person's spoken words as a symptom of psychiatric disorder.

Positive symptoms of schizophrenia

🔺Excess distorted behaviors

🔺Hallucinations, delusions, disorganized speech,

excessive verbal behavior

Negative symptoms of schizophrenia

🔹Diminished/Absent normal behaviors

🔹flat affect

🔹diminished social behavior

🔹apathy (lack of interest)

🔹anhedonia (Inability to experience pleasure)

🔹catatonic motor behavior

Anhedonia

Inability to experience pleasure

Dopamine hypothesis of schizophrenia

Suggests that schizophrenia is caused either by 

abnormally high levels of dopamine or by above-normal activity due to an increased number of 

receptors for dopamine

How do phenothiazines help schizophrenia?

Alleviate symptoms by reducing the activity of dopamine by blocking postsynaptic dopamine receptors

Brain structure abnormalities in schizophrenia

🔺Enlarged ventricles

🔺reduced volume of temporal lobe gray matter

🔺reduced volume/smaller hippocampus

🔺unusually small corpus callosum 

A person regresses to childlike thinking after being overwhelmed by internal conflict. This reflects _____

(Freud’s psychoanalytic development of schizophrenia)

1️⃣ Ego overwhelmed by Id demands/guilt

2️⃣ Ego retreats

3️⃣ Regression → oral stage

4️⃣ Primary process (childlike/illogical)

According to Freud, how do symptoms of schizophrenia develop?

1️⃣ Loss of contact with reality

2️⃣ Restitutional symptoms appear (hallucinations, delusions, bizarre speech)

3️⃣ These symptoms are attempts to regain reality 4️⃣May include delusions of self-importance

A theorist argues schizophrenia develops because appropriate social behaviors were never reinforced. This is _____

Behavioral cause of schizophrenia

🔺A patient begins hearing voices and acting strangely.

🔺 Others respond with attention, which increases these behaviors.

This BEST supports:

(schizophrenia)

Behavioral maintenance

Abnormal behavior

🔹Behavior that is atypical

🔹Maladaptive

🔹Socially unacceptable

🔹Produces emotional discomfort

4 criteria of abnormal behavior

🔹Atypical → unusual

🔹Dysfunction → can’t function normally

🔹Distress → emotional pain

🔹Danger → risk to self/others

🔹Behavior that is rare or statistically uncommon, but rarity alone is not enough

Means?

Atypical

Dysfunction

Impairment in ability to function in everyday social or occupational roles

Distress

Emotional pain such as anxiety, depression, or agitation

Dangerousness

Behavior that may harm self or others

Important note about abnormal criteria

Not all 4 criteria must be present in every disorder

Defining abnormality is difficult, there are shades of gray on the ________ from normal to abnormal

continuum

What is used for classifying and diagnosing behavioral disorders?

🔹Diagnostic and Statistical Manual of Mental Disorders (DSM)

🔹1952

In 2013, the American Psychiatric Association released DSM-5, which reclassified several of the major psychological disorders and refined diagnostic criteria for many of them. 

The behavioral disorders include:

🔻anxiety disorders

🔻bipolar disorder

🔻post-traumatic stress disorder (PTSD)

🔻depressive disorders

🔻obsessive compulsive disorder (OCD)

🔻dissociative disorders

🔻schizophrenia

🔻personality disorders

Key to diagnosis

Persistent cluster of symptoms, not temporary ones

Attention-deficit/hyperactivity disorder (ADHD)

Pattern of inattention and hyperactivity that interferes with educational, social, or occupational functioning

ADHD symptoms

🔹Inattention

🔹impulse control

🔹interrupting

🔹Fidgeting

ADHD prevalence trend, Increased from ____ to ____

🔹~7.5% in 2000

🔹over 8% in 2019 (13.6 million children)

ADHD in adulthood ____

Decreases to about 2.5%

Anxiety

General feeling of dread or apprehension

with physical symptoms:

🔻increased heart rate

🔻rapid shallow breathing

🔻sweating

🔻muscle tension

🔻dry mouth

What BEST distinguishes anxiety from fear?

🔹Fear has a clear cause, linked to specific events

🔹Anxiety is vague and persistent

Anxiety disorder definition

Produce pervasive (widespread) feelings of anxiety

Panic attack

Sudden, overwhelming, debilitating fear that is not caused by a specific event, comes on quickly and dissipates quickly

Panic disorder criteria

🔹Anxiety disorder in which an individual experiences numerous panic attacks (4 or more in a 1 month)

🔹Feelings of overwhelming terror & often feelings of unreality or depersonalization

🔹“I’m going crazy”

“I’m dying” (heart attack)

🔹A person suddenly feels intense fear, cannot breathe, and thinks they are dying, but returns to normal after a few minutes.

What did they experience?

Panic attack

Panic Disorder Symptoms

🔹erratic or pounding heartbeats

🔹labored breathing, dizziness

🔹chest pain

🔹sweating &trembling

🔹feelings of choking & suffocating.

Derealization during a panic attack

Feeling that the world is not real