Unit 10 - Psychological Disorders, Therapy, and Treatment

Psychological Disorder

a condition characterized by abnormal thoughts, feelings, and behaviors

Abnormal Behavior

patterns of emotions, thoughts, and actions considered pathological for one or more of the following reasons:

infrequent occurrence

personal distress

dysfunction

unexpectedness

violation of norms

Infrequent Occurence

use the normal curve to determine the frequency of the suspected abnormal behavior with the frequency of that behavior in the population

problem: either extreme of behavior is abnormal

Personal Distress

use individual’s judgement of their current level of functioning

problem: people often deny they have a problem and others may not care

Dysfunction

individual’s behavior is abnormal if their behavior is interfering with their ability to function in their own life and society

problem: not all people with psychological disorders have behaviors that interfere with social functioning

Unexpectedness

behavior is unusual given the circumstances

problem: just because a behavior is unexpected doesn’t necessarily make it abnormal

Violation of Norms

behavior is considered abnormal if it goes against society’s rules, norms, or standards

problems: what is considered abnormal at one point in time may not be abnormal at another point; cultures differ

Diathesis-Stress Model

there is an underlying predisposition for a disorder, and stressful life events activate it

Neurosis

a condition involving excessive anxiety

Psychosis

a condition involving a loss of contact with reality

Diagnostic and Statistical Manual of Mental Disorders (DSM-V)

the current classification system, developed by the American Psychological Association (APA)

DSM-V Requirements

a mental disorder must…

be a clinically significant detriment

derive from an internal source

have an involuntary manifestation

Medical Student’s Disease

the tendency to diagnose yourself with the disorders about which you learn

Classifications of Disorders

anxiety disorders

obsessive-compulsive disorder

posttraumatic stress disorder

major depressive disorder

bipolar disorder

schizophrenia

dissociative disorders

antisocial personality disorder

childhood disorders

Anxiety Disorders

characterized by persistent, unrealistic, irrational fear and anxiety; all have a genetic influence

Types of Anxiety Disorders

phobias (agoraphobia, social anxiety disorder, specific phobia)

panic disorder

generalized anxiety disorder

Phobias

characterized by intense, irrational fear and avoidance of objects or situations

Agoraphobia

fear of open spaces or unfamiliar spaces; often follows the onset of panic disorder

Social Anxiety Disorder

severe anxiety in social situations in which a person could be negatively evaluated

Specific Phobia

an irrational fear of a specific object or situation

Panic Disorder

characterized by sudden and inexplicable attacks of intense fear (panic attacks); studies have linked a tendency towards catastrophizing

Panic Attacks

symptoms include difficulty breathing, heart palpitations, dizziness, trembling, terror, and feelings of impending doom

Generalized Anxiety Disorder

characterized by chronic, uncontrollable, and excessive worry not focused on any particular object or situation

Obsessive-Compulsive Disorder (OCD)

characterized by intrusive thoughts (obsessions) and urges to perform repetitive, ritualistic behaviors (compulsions)

OCD Treatment

has been linked to over-activity in the caudate nucleus and hypoactivity in the orbitofrontal cortex

often treated with drugs that increase serotonin levels, which reduced activity in the caudate nucleus

OCD Related Disorders

body dysmorphia

hoarding

Body Dysmorphia

preoccupation with a perceived flaw in one’s physical appearance

Hoarding

an inability to part with possessions

Posttraumatic Stress Disorder (PTSD)

characterized by uncontrollable “re-living” of a traumatic event or events; as well as sleeplessness, guilt, and irritability

90% of individuals experience PTSD after severe trauma, so many believe this is not abnormal behavior

Theoretical Causes of Anxiety/OCD/PTSD

behavioral and social learning theory

biological

sociocultural

Behavioral and Social Learning Theory

both cognition and learning have been implicated in anxiety disorders; many individuals appear to be hypervigilant; fears can be learned through classical/operant conditioning

Biological

genetically inherited overactive autonomic nervous system (amygdala and prefrontal cortex)

Sociocultural

western society have become very fast-paced and stressful, causing the activation of the autonomic nervous system

Mood Disorders

depressive disorder

bipolar disorders

Depressive Disorders

characterized by persistent depressive states; strong genetic component

Depressive Disorder Types

major depressive disorder

seasonal affective disorder

Major Depressive Disorder

characterized by a long-lasting depressed mood that interferes with the ability to function, feel pleasure, or maintain interest in life; feelings are without apparent cause and are excessive

Major Depressive Disorder Treatment

anti-depressive drugs which boost serotonin and norepinephrine

Seasonal Affective Disorder (SAD)

characterized by experiencing depression in relation to the amount of available sunlight (winter depression)

SAD Treament

sitting in front of a bank of full-spectrum lights for a couple hours a day

Causes of Depressive Disorders

biological

psychosocial

Biological

changes in the functioning of the brain and the levels of available neurotransmitters; the right frontal lobe is more active and serotonin/norepinephrine are imbalanced

Psychosocial

psychoanalytic: anger turned on self

humanistic: blocked personal growth

behaviorism/cognitive: learned helplessness

Bipolar Disorders

characterized by episodes of mania (excessive and unreasonable elation and hyperactivity) followed by even longer episodes of depression; strong genetic component

Bipolar Disorder Types

bipolar i

bipolar ii

Bipolar I

experience mania, which may be followed by major depressive episodes and/or hypomania

Bipolar II

experience hypomania (mood elevation not as extreme as mania) and major depressive disorders

Schizophrenia

major disturbances in perception, language, thought, emotion, and behavior; individuals in the midst of an episode are not sharing the same reality as others

Perceptual Disturbances

hallucinations (sensory perceptions that occur without an external stimulus; mainly auditory, may be visual and haptic (touch)

Language Disturbances

words lose their usual meanings and associations

world salad (words strung together in a jumbled manner)

neologisms (artificial words created by combining other words)

Thought Disturbances

delusions (mistaken beliefs maintained in spite of strong evidence to the contrary; mainly delusions of persecution, grandeur, and of being controlled

Emotional Disturbances

flatted affect (almost no response of any kind)

inappropriate emotions where the individual responds abnormally under the circumstance

Behavioral Disturbances

catatonic (nearly immobile position)

waxy flexibility (tendency to maintain whatever position is imposed)

hebephrenic (excessive, undirected movement; plain odd mannerisms)

Schizophrenia Types

positive symptoms

negative symptoms

Positive Schizophrenia

distorted or excessive activity (delusions, hallucinations, inappropriate emotions, word salad, excessive or bizarre movements)

Negative Schizophrenia

behavioral deficits or loss of activity (flattened affect, social withdrawal, poverty of speech, catatonic posture)

Schizophrenia Causes

biological

psychosocial

Biological

dopamine hypothesis

brain function

genetics

prenatal and perinatal conditions

marijuana exposure

Dopamine Hypothesis

symptoms of schizophrenia are caused by overactivity of dopamine neurons (positive symptoms)

Brain Function

enlarged ventricles (excessively large fluid-filled cavities in the brain)

reduced activity of the frontal and temporal lobes

(negative symptoms)

Genetics

there is a genetic predisposition for schizophrenia

Prenatal and Perinatal Conditions

viral infections during the 5th month of pregnancy and difficulties during birth are correlated with an increased risk of schizophrenia

Marijuana Exposure

casual factor; however, this is not an accepted finding

Psychosocial

stress (extreme stressors appear to trigger acute schizophrenia)

family communication

Dissociative Disorders

characterized by a splitting apart of conscious experience to escape the memory of a painful experience

Dissociative Disorder Types

dissociative amnesia

dissociative fugue

depersonalization-derealization disorder

dissociative identity disorder (DID)

Dissociative Amnesia

characterized by an inability to recall personal past due to psychological distress

Dissociative Fugue

characterized by leaving past life and assuming a new identity

Depersonalization-Derealization Disorder

the individual experiences a persistent detachment from thoughts, feelings, or body sensations

DID

characterized by the presence of 2+ distinct personalities within the same person

DID Causes

childhood-trauma theory

culturally-conditioned iatrogenic theory

Childhood-Trauma Theory

severe abuse in childhood usually before age 10

Culturally-Conditioned Iatrogenic Theory

DID became more common after books and movies were created about it; most DID is “discovered” in therapy usually involving hypnosis

Personality Disorders

individuals with inflexible, maladaptive personality traits; are extremely difficult to treat because individuals do not find anything “wrong” with their personalities

Personality Disorder Types

antisocial personality

Antisocial Personality

characterized by egocentrism, lack of conscience, impulsive behavior, and charisma (sociopath/psychopath)

Antisocial Personality Cause

biological

abusive parenting

Biological

most have a reduction in the response of their sympathetic nervous system; there is considerably less emotional responsiveness to threatened pain

Abusive Parenting

inappropriate modeling of behavior; emotion deprivation is common

Neurodevelopmental Disorders

disorders diagnosed in childhood

Neurodevelopmental Disorder Types

attention-deficit/hyperactivity disorder

autism spectrum disorder

Attention-Deficit/Hyperactivity Disorder (ADHD)

patterns of inattention and/or hyperactive and impulsive behaviors that interferes with normal functioning

Autism Spectrum Disorders

deficits in social interactions; deficits in communication; repetitive, stereotypical behavior

Therapy

various methods of treatment that aim to improve psychological functioning and promote adjustment to life; address thoughts, emotions, behaviors, interpersonal relationships, and biomedical disturbances

Therapy Divisions

biomedical therapies

psychotherapies

Psychotherapy

based on the major perspectives in psychology that serve to improve psychological functioning and promote adjustment to life

Psychotherapy Divisions

insight

behavioral

Insight Therapy

“talk therapy” designed to increase self-knowledge and understanding into the bases of the individual’s difficulties

Insight Therapy Types

psychoanalytic

cognitive

humanistic

group/family/marital counseling

Psychoanalysis

emphasizes conflicts between unconscious thoughts and emotions; treatment consists of attempting to make the unconscious conscious

Psychoanalysis Methods

the couch

free association

dream analysis

resistance

transference

interpretation

The Couch

a reclining position increases the number of intimate disclosures by the patient; serves to relax the patient and allow the unconscious to slip out

Free Association

reporting whatever comes to mind; one idea leads to another and allows the unconscious to slip out

Dream Analysis

therapist seeks the true hidden meaning in the manifest content of dreams

Resistance

the patient avoids attempts to make the unconscious conscious; indicates that the therapist is getting close to the unconscious conflict

Transference

the patient displaces feelings from earlier stages in life onto the therapist (falling in love or hating therapist, etc.)

Interpretation

the therapist points out to the patient defensive behaviors and helps them recognize their unconscious conflicts

Psychoanalysis Limitations

limited applicability (best for less severe disorders in well-off individuals)

lack of scientific credibility

Cognitive Therapy

emphasizes faulty thinking and belief patterns; works by changing destructive thought patterns and self-talk

Self-Talk

internal dialogue in which people interpret events in their environment; not always realistic