Psychological Disorders

• How do we differentiate abnormal from normal behavior?

• Abnormal- requires mental health intervention

Early Explanations of Mental Illness

• Trepanning- holes drilled in head to release evil spirits; ancient times

• Hippocrates- mental illness due to imbalance in body’s humors; ancient greek physician

• Middle ages- mentally ill possessed by witches; treatment was torture

Definitions of Abnormality

• Psychopathology- study of abnormal behavior

• Psychological disorder- any kind of behavioral pattern that:

1. Causes significant stress

2. Causes harm to others

3. Harms their ability to function in daily life

• Criteria for Abnormality:

• Statistically rare

• Deviant from social norms

• Subjective discomfort- emotional distress or emotional pain

• Maladaptive- causes dysfunction or impairment in major life areas

Causes of Psychopathology

• Biological model- chemical, structural,  or genetic systems of the body

• Psychoanalytic- unconscious conflicts;  attachment problems

• Behaviorists- principles of learning

• Cognitive theorists- irrational beliefs and illogical patterns of thought

14.2 model

• About 26.2% of American adults over the age of 18 have a mental disorder in any given year

• 61.5 million people in the U.S.

14.3 Diagnosing and Classifying Disorders

ICD: International Classification of Diseases

DSM-5: Diagnostic and Statistical Manual of Mental Disorders (describes about 250 different psychological disorders)

Now DSM-5-TR

Useful in providing clinicians with descriptions and criteria for diagnosing mental disorders and insurance billing through each disorder’s number

• 1 in 5 American adults in a given year

• Only about 4.5% suffer from a severe mental disorder (psychotic)

• More than one disorder at a time is common (comorbid)

• Diagnostic labels:

• Anxiety disorders- excessive or unrealistic apprehension and fearfulness

• Free-floating anxiety- unrelated to any realistic, known source

• Phobia- irrational, persistent fear of an object, situation, or social activity

• Social anxiety disorder (social phobia)- fear of negative evaluation in social situations

• Specific phobias- fear of particular objects, situations, or events

• Agoraphobia- fear of place/situation from which escape is difficult or impossible

Generalized Anxiety Disorder

• Chronic apprehension or worry

• Chronic muscle tension and soreness

• Difficulty sleeping

• Irritability

• Difficulty concentrating

• Minimum duration 6 months

Other Disorders Related to Anxiety 14.5

Obsessive-Compulsive Disorder

-Now falls in the category of “Obsessive-Compulsive and related disorders”

• With DSM-5, this disorder is no longer classifies as an anxiety disorder

• Obsessive, reoccurring thought create anxiety

• Compulsive, ritualistic behavior or mental acts reduce that anxiety

Acute Stress and Posttraumatic Stress Disorders

PTSD

-Symptoms include persistent ASD lasting longer than a month or can emerge as late as six months after trauma

• Neither are no longer classified as anxiety disorders

Causes of Anxiety, Trauma, and Stress Disorders 14.6

Somatic Symptom Disorders

• Somatic Symptom Disorders- take the form of bodily symptoms with no real physical disorders

Somatic Symptom Disorders: Types

• Illness anxiety disorder- preoccupied with bodily sensations (formerly known as hypochondriac disorder)

-Worries constantly about severe illness

-Consults physicians repeatedly

• Somatic symptom disorder- dramatic complaints of specific symptoms (no real physical cause)

• Conversion disorder (functional neurological symptom disorder)- specific symptom in the somatic nervous system’s functioning (ex. paralysis, numbness (glove anesthesia), or blindness)

-No physical cause

Causes of Somatic Symptom Disorders

• Psychoanalytic- anxiety converted into a physical symptom

• Behavioral- negative reinforcement when the “ill” person escapes unpleasant situations (ex. work, combat)

• Cognitive- people magnify physical symptoms out of irrational fear

Dissociative Disorders

• Dissociative Disorders- disorders in which there is a break in conscious awareness, memory, the sense of identity, or some combination

• Dissociative amnesia- loss of memory for personal information, either partial or complete (traumatic experiences, not caused by physical trauma) memory can come back

• Dissociative fugue- traveling away from familiar surroundings with amnesia for the trip and for personal information (traumatic experiences, not caused by physical trauma) memory can come back

• Dissociative identity disorder (formerly known as multiple identity disorder)- person seems to have two or more distinct personalities within one body (no awareness of disorder, loss of some memory, has alters)

Development of Dissociative Disorders

• Psychoanalytic- dissociation as a repression of traumatic memories; defense mechanism against anxiety (often cause is torture, develops in adulthood as self-protection) Treatment: psychotherapy

• Cognitive-behavioral- type of avoidance learning through negative reinforcement (treatment: years of psychotherapy for personality unification)

Major Depressive Disorder and Bipolar Disorders 14.9

• Affect: An emotional reaction (emotions of the moment)

• Disorders of mood: Disturbances in emotion ranging from mild to moderate, or can be extreme (mood has to last at least two weeks unless hospitalized)

Extreme sadness Mild sadness Normal emotions Mild elation Extreme Elation

Mood Disorders

• Major depression- severe sad mood, comes on suddenly, seems to have no external cause

• Manic episode- excessive excitement, energy, and elation or irritability

• Bipolar disorder- alternates between major depressive episodes and manic episodes; severe mood swings or mood cycling

• Bipolar 1 Disorder: mood spans from normal to manic, without episodes of depression (most severe)

• Bipolar 2 Disorder: normal mood with episodes of major depression and episodes of hypomania (greater rate of psychosis)

Bipolar Disorder and ADHD

• Possible connection

• Hyperactivity can be present in both disorders

Causes of Mood Disorders

• Psychoanalytic- depression as anger turned inward; mania as defense against depression

• Learning- depression as learned helplessness

• Cognitive- depression caused by pessimistic, irrational thinking

• Biological- imbalances in serotonin, norepinephrine (similar to dopamine; neurotransmitter), and dopamine brain systems

Schizophrenia

• Schizophrenia- fragmented and delusional (disordered) thinking, bizarre behavior, hallucinations

• Psychotic- impaired reality testing (auditory is common)

• Positive symptoms- behavioral excesses or additions to normal behavior (hallucinations, delusions)

• Delusions- false beliefs that defy reality

1. Persecution- person convinced others are attempting to harm them

2. Grandeur- person convinced they are all powerful or important

• Hallucinations- false sensory perceptions that do not exist

1. Auditory

2. Visual- seeing things or people

• Negative symptoms- behavioral deficits or absences of  normal behavior

1. Poor attention

2. A

3. Poverty of speech

Causes of Schizophrenia

• Positive symptoms

• Genetics

• Brain structural defects

• Biological roots

• Stress-vulnerability model

Personality disorders- persistent, rigid, maladaptive patterns of behavior that cause dysfunction

• Odd & Eccentric: paranoid, schizoid, and schizotypal

• Dramatic, Emotional, & Erratic: antisocial personality, borderline, histrionic, narcissistic

• Anxiety or Fearfulness: avoidant, dependent, obsessive-compulsive