assistance needed with psychology

Psychological Disorders

INTRODUCTION

• Insanity - legal definition, means not knowing the difference between right and wrong

What is Abnormal Behavior?

• Unusualness – unusual behavior or experienced by only a few may be abnormal – but not in all cases.

• Social Deviance – societies have social norms that define socially acceptable behavior. Deviation from norms may be considered abnormal.

• Ex. shouting vulgarities at strangers in the street – abnormal, shouting vulgarities at referees – semi-normal.

What is Abnormal Behavior? • Emotional Distress – considered abnormal

when inappropriate, excessive, or prolonged for the situation.

• Maladaptive behavior – self-defeating, causing distress, associated with significant health, social or occupational problems.

• Dangerousness – violent or dangerous behaviors

• Faulty perception or interpretations of reality – hallucinations or delusions.

Culture • A behavior may be considered abnormal in

one culture & normal in another.

• Ex. in some Native American cultures it is considered normal to hear voices of recently deceased relatives.

• Americans experience anxiety through excessive worries of health, finances, jobs etc… In some Native African & Australian Aboriginal cultures anxiety is expressed in the form of witchcraft or sorcery.

Early Beliefs – Ancient Times through Middle Ages

• Abnormal behavior explained by supernatural forces or demonic possession.

• Exorcism used to pull devil or demons from people – if unsuccessful other tactics were used such as a torture rack.

18th & 19th Centuries: Medical Model

• Shift from religious dogma to scientific or naturalistic explanations of human behavior.

• Medical model – belief that abnormal behavior patterns are mental illnesses or brain diseases that have a biological basis & can be classified by characteristics & symptoms.

Psychological Models

• 1st major psychological model of abnormal behavior was the psychodynamic approach developed by Sigmund Freud.

• Belief that issues arise from unconscious conflicts that remain unresolved from childhood.

• Psychological issues were outward expression of inner turmoil.

• Contemporary psychodynamic theorists evolved from Freud but retain the central belief that unconscious conflicts are the root of abnormal behavior patterns.

Psychological Models

• Behavioral Model – maladaptive behaviors could be learned or acquired through experience – classical & operant conditioning. Pavlov Watson Bandura

• Behavior Model is based on the belief that abnormal behaviors are learned the same way normal behaviors are learned.

Psychological Models • Humanistic Model – humans possess intrinsic ability to make

conscious choices & to strive toward self-actualization.

• Abnormal behavior develops when people encounter roadblocks on the path toward personal growth.

• To satisfy demands of others to think, feel, and act in certain ways, people may become detached from their true selves and develop a distorted self-image that can lead to emotional problems.

• To resolve issues people need to become aware of their true feelings and come to accept themselves as they truly are.

Sociocultural Model

Abnormal behavior by have more to do with social ills or failures of society more than problems within the individual.

• Examine range of social and cultural influences on behavior – social class, poverty, ethnic & cultural background – racial & gender discrimination.

• Ex. stress of coping with poverty can take a toll on mental health.

• Evidence shows of number of psychological disorders occur proportionately more often among poor & socially disadvantaged groups.

Biopsychosocial Model • View that abnormal behavior is best explained by complex interactions

of biological, psychological, environmental, & sociocultural factors.

• Diathesis-Stress Model – certain people have a vulnerability/predisposition – diathesis, which increases risk of developing a particular disorder.

• Diathesis is usually genetic in nature, but can involve psychological factors such as maladaptive personality traits or dysfunctional thinking patterns.

• If diathesis is present, the likelihood of the disorder emerging depends on the level of stress they encounter – if low stress & high coping skills, a person w a diathesis may never develop the disorder.

Psychological Disorders, Mental Illnesses, Mental Disorders

• Distinctive patterns of abnormal behavior

• Disturbances of mood, behavior, thought processes or perception that result in significant personal distress or impaired functioning.

• About 46% of adult Americans develop diagnosable psychological disorders at some point in their lifetimes.

Diagnostic & Statistical Manual of Mental Disorders – DSM-V

• Manual contains descriptions & diagnostic criteria fro every recognized psychological disorder.

• Developed by American Psychiatric Association APA

Anxiety-Related Disorders

Module 13.2

Anxiety

• Emotional state of uneasiness or distress associated with worry or apprehension about the future.

• Can be an adaptive response is some situations – motivates us for action

• When excessive can interfere with ability to function.

• Fear – anxiety experienced in specific situations – final exam, boarding a plane.

Anxiety-Related Disorders

• Among most common psychological disorders affecting about 1 in 5 American adults.

• Excessive/inappropriate anxiety reactions

• Phobias, panic disorder, generalized anxiety disorder, posttraumatic stress disorder.

• OCD used to be classified as an anxiety disorder but moved to compulsive behavior problems in DSM-V

Phobias

• Irrational or excessive fears of particular objects or situations.

• Go to great lengths to avoid feared object.

• Social anxiety disorder (social phobia) – intense fear of social interactions – meeting others, dating, giving a speech, etc..

• Specific Phobia – excessive fear of specific situations or objects – animals, insects, heights, enclosed spaces.

• Agoraphobia – general fears of venturing into open places or going out in public.

Panic Disorder

• Panic attacks – sudden episodes of sheer terror.

• Intense physical symptoms – profuse sweating, nausea, numbness, tingling, flushes, chills, trembling, chest pain, shortness of breath, pounding heart.

• Many feel as if they are having a heart attack or losing control.

• An attack can last from a few minutes to over an hour.

• Sometimes people who experience panic attacks develop agoraphobia.

Generalized Anxiety Disorder (GAD)

• Persistent anxiety that is not tied to any particular object or situation.

• Chronic worry, shakiness, inability to relax, fidgeting, feelings of dread.

Obsessive-compulsive disorder

• obsessions, persistent, recurring irrational thoughts, impulses, or images, that a person is unable to control and that interfere with normal functioning

• compulsions, irresistible impulses to perform over and over some senseless behavior or ritual

OCD

➢Although it was once thought that this might be the result of

learning, researchers have found that when OCD occurs in the

next generation, it often takes a different form.

➢For example, a parent may be a “checker,” while the son or

daughter is a compulsive washer.

➢Many researchers now believe that there is a biological basis for

OCD.

➢What is transmitted is the predisposition to develop OCD

symptoms under certain conditions, but not a specific obsession

or compulsion.

Posttraumatic stress disorder

PTSD

• disabling condition that results from personally experiencing an

event that involves actual or threatened death or serious injury

• from witnessing or hearing of such an event happening to a

family member or close friend

PTSD Symptoms

• psychological symptoms include recurring and disturbing

memories, terrible nightmares, and intense fear and anxiety

• Flashbacks

• Intense prolonged psychological stress

• Avoidance efforts – things associated w/ event, memories

• Dissociative amnesia

• Negative self beliefs

• Self blame

• Persistent negative emotional state – fear, horror, guilt

• Loss of interest in activities

PTSD Symptoms

• Feeling detached from others

• Inability to experience positive emotions

• Irritability/anger outbursts

• Self-destructive behaviors

• Hypervigilance

• Exaggerated startle response

• Concentration difficulties

• Sleep disturbance

Causes of Anxiety-Related Disorders

Biological Factors • Genetic factors may affect brain circuitry involved in

body’s response to threatening stimuli.

• Amygdala may be over-reactive.

• In panic disorder, disturbances in neurotransmitter

functioning in brain may trigger internal alarm system that

induces feelings of panic.

• OCD, brain may be continually sending messages that

something in wrong & needs attention. Compulsions

linked to abnormalities in brain circuits that ordinarily put

brakes on repetitive, ritualistic behaviors.

Causes of Anxiety-Related Disorder

Psychological Factors

• Some phobias may have been learned via classical

conditioning.

• Operant conditioning may account for avoidance &

compulsive behaviors.

• Panic disorder may be due to misinterpretation of

relatively minor changes in bodily sensations as signs of

imminent catastrophe – the anxiety then feeds more

anxiety.

Dissociative &

Somatic

Symptom &

Related

Disorders

Module 13.3

Dissociative Disorders

• Rare

• Problems with memory or changes in consciousness or

self-identity that fracture the continuity or wholeness of

the individual’s personality.

• Affect the ability to maintain a cohesive sense of self or

unity of consciousness resulting in unusual or bizarre

behavior.

DISSOCIATIVE DISORDER (CONT’D)

• Dissociative identity disorder

• Formerly called multiple personality disorder

• Presence of two or more distinct identities or personality states, each with its

own pattern of perceiving, thinking about, and relating to the world

• Different personalities take control of an individual’s thoughts at different

times

• Relatively rare, with more diagnoses in 1970-80’s

• Females more at risk

• Caused by trauma, or possibly cultural factors

Is DID real?No • Short history – 1930-1960 – 2

cases reported per decade

• 1980s (when in DSM) 20,000 cases.

• Increased cases after DID movies

• Not common outside of North America

• Extension of the way we vary our “selves”

• Therapists suggestibility to fantasy-prone, suggestible, imaginative patients

Yes • Activity in brain regions

linked to traumatic events

• Defense mechanism against anxiety

• Many suffer severe physical, emotional, or sexual abuse as children

• Mannerisms, nonverbal behavior, handedness, eye-muscle balance change w/ personalities

Dissociative Amnesia

• Experience a loss of memory for

information about themselves or their

life experiences.

• Info. lost to memory is usually

traumatic or stressful experience.

Causes of Dissociative Disorders

• Disconnect from trauma

• Protect & separate self

from anxiety

• Severe, repetitive physical

or sexual abuse in

childhood, usually

beginning before age 5

appears in most case

histories of people with DID

Somatic Symptom & Related Disorders

(formerly known as somatoform disorders)

• Abnormal behavior

patterns associated with

physical symptoms.

• Soma – body (Greek)

• Physical symptoms that

cannot be medically

explained.

Somatic Symptom & Related Disorders

Conversion Disorder AKA functional neurological symptom

disorder

• Loss of, or significant change in a physical function, such

as the inability to lift an arm (hysterical paralysis), loss of

vision (hysterical blindness) or loss of feeling in hand or

arm (anesthesia) without any physical cause.

• Some people appear strangely unconcerned about

symptoms.

Somatic Symptom & Related Disorders

Somatic Symptom Disorder

• Formerly known as hypochondriasis

• Belief that something is terribly wrong with health despite

medical reassurances to the contrary.

• Excessive concerns about symptoms significantly affect

thoughts, feelings, & behaviors of daily life.

• Anxiety contributes to physical complaints leading to

sweating, dizziness, rapid heartbeat, etc…

Causes of Somatic Symptom & Related Disorders

• Unconscious struggles/anxiety

• Avoid painful or anxiety-evoking situations -

psychoanalytic

• Reinforced by sympathy & support from others relieving

them from responsibilities - learning

• Misinterpretation of bodily sensations similar to panic

disorder - cognitive

Feeding & Eating Disorders

• “…persistent disturbance of eating or eating-related

behavior that results in the altered consumption or

absorption of food and that significantly impairs

physical health or psychosocial functioning” (DSM-

V, 329, APA).

Anorexia Nervosa

• Restriction in energy in-take leading to

significantly low body weight.

• Intense fear of gaining weight or

becoming fat

• Impaired judgement towards body’s

weight & shape

• Lack of recognition of severity of low

body weight.

Bulimia Nervosa

• Binge eating

combined with

inappropriate

compensatory

behaviors to prevent

weight gain – purging,

laxatives, diuretics,

meds, fasting,

excessive exercise.

Binge-Eating Disorder

• Recurrent episodes on binge eating

• Sense of lack of control over eating

• Eating large amounts of food within short periods of time

• Eat more rapidly than normal

• Eat until uncomfortably full

• Eat large amounts when not physically hungry

• Eat alone b/c of embarrassment over the amount eaten

• Feeling disgust, depression, guilt.

• Binge at least once per week over 3 months

• Not associated with recurrent use of inappropriate compensatory

behavior.

The National Association of Anorexia Nervosa and Associated

Disorders, (ANAD)

MOOD DISORDERS

Module 13.4

Mood Disorders

• Class of psychological disorders involving disturbances in mood

states.

• Major Depression – AKA Major Depressive Disorder

• Feelings of worthlessness

• Changes in sleep & appetite

• Lethargy,

• Loss of interest in pleasurable activities

• Irritability

• Poor decisiveness

• Poor concentration

• Suicidal thoughts

Major Depression

• About 1 in 5 U.S. adults suffer from major depression at

some point

• Women 2x as likely as men

• Women – more stress – abuse, poverty, single

parenthood, sexism, aging parents, household & childcare

chores.

• Women tend to ruminate over emotional concerns –

which can amplify emotional distress.

• Men tend to distract themselves from distress

Bipolar Disorder

• Formerly known as Manic Depression.

• Experience mood swings that shift between periods of

mania and periods of depression with intervening periods

of normal moods.

• Affects about 1% of the population

Bipolar Disorder

Mania

Depression • Hopelessness

• Despair

• Some become suicidal wanting to avoid the depth of depression.

Causes of Mood Disorders

• Life stressor can contribute to mood disorders

• Living alone

• Loss of a loved one

• Prolonged unemployment

• Serious physical illness

• Marital problems

• Separation, divorce

• Financial hardship

• Work pressures

Causes of Mood Disorders

• Biological Factors

• Antidepressants increase levels of serotonin & norepinephrine in the brain.

• Growing evidence of brain differences found in the prefrontal cortex & hippocampus

• Genetic component

Suicide…

• 2nd leading cause of death of 15-24 year olds.

• Suicide rates have increased 24% from 1999 – 2014

• Most prevalent among Native American youth/young adults & older Caucasian men

• Closely linked to major depression & bipolar disorder.

• Irregularities in serotonin may cause disinhibition effect – removal of inhibitions that might otherwise constrain impulsive behavior, including impulse to commit suicide.

• Viewing no other way to solve physical or psychological pain.

• Linked to loss of supportive people – death, separation, divorce

• Widely publicized teen suicides often lead to copycat attempts

Suicide… • Even professionals have difficulty predicting whether someone is likely to

commit suicide.

• TREAT ANY TALK OF SUICIDE AS A CLEAR WARNING SIGN

• TAKE IMPLIED THREATS SERIOUSLY

• Engage the person in conversation, try to understand them.

• Focus on alternative ways to solve problems.

• Assess the immediate danger – specific plan? Weapons/drugs in the home? Do not leave them home alone.

• Enlist person’s agreement to seek help. Accompany them to ER, health professional, hotline 1-800-SUICIDE

• Accompany person to seek help. DO NOT LEAVE PERSON ALONE! If they refuse services call a mental health professional, suicide hotline or police.

Schizophrenia Module 13.5

Schizophrenia

• Greek “Split Mind”

• 1% of adult population worldwide

• Schizophrenia – a severe & chronic psychological disorder characterized by disturbances in thinking, perception, emotions, & behavior.

• Psychotic disorder – break with reality. Reality is confused with fantasy.

• Typically develops in late adolescence or early adulthood.

Symptoms of Schizophrenia

➢Positive symptoms: the presence of inappropriate behaviors (hallucinations, disorganized or delusional talking)

➢Negative symptoms: the absence of appropriate behaviors (expressionless faces, toneless voices, mute, rigid bodies)

➢Positive symptoms may fade after acute episodes, but

negative symptoms are typically more enduring.

Schizophrenia: Disturbed Perceptions

➢A schizophrenic person may perceive things that are not there.

➢Hallucinations – false perceptions

➢Frequently such hallucinations are auditory and lesser visual, somatosensory (skin), olfactory (smell), or gustatory (taste).

Schizophrenia: Disorganized Thinking

• Delusions – false beliefs, often of persecution

(maltreatment) or grandeur (greatness)

• Word Salad – jumbled ideas that make no sense even

within sentences (Ex. Calling photos makes peace and

jelly).

Schizophrenia

• Catatonic Behavior – remaining in a

motionless state or stupor in which they

appear unresponsive to the environments

• May maintain a fixed or rigid posture for

hours then abruptly shift into a highly

agitated state.

• Waxy Flexibility – body position can be

molded by others into unusually, even

uncomfortable positions that they hold for

hours at a time.

Causes of Schizophrenia

• Belief that multiple genes are involved in creating a genetic

predisposition

• 13% of those with a parent will develop it.

• 45-50% if identical twin has it.

• Biochemical Imbalances – antipsychotic drugs reduce dopamine

activity by blocking dopamine receptors in the brain, preventing

molecules from docking at the receptor sites.

• Dopamine receptors may be overly sensitive to dopamine. (it

appears that too much dopamine is NOT being produced – it’s the

sensitivity of the receptor site)

Causes of Schizophrenia

• Brain Abnormalities

• Enlarged ventricles

• Differences in prefrontal cortex

(organizing thoughts, behavior,

carrying out goals), limbic

system (forming new memories

& processing emotions), &

thinning of neurons connecting

them.

Causes of Schizophrenia

• Psychosocial Influences

• Diathesis (predisposition) + Stress (abuse, head

trauma, loss, etc) = development of schizophrenia

Personality Disorders Module 13.6

Personality Disorders • Class of psychological

disorder characterized by rigid personality traits that impair people’s ability to adjust to the demand they face in the environment and that interfere with their relationships with others.

PERSONALITY DISORDERS

• Obsessive-

Compulsive

Personality Disorder

– intense interest in

being orderly,

achieving perfection,

and having control

Borderline Personality Disorder

• pattern of instability in personal relationships, self-image, and

emotions, as well as impulsive behavior

• Intense, unpredictable emotional outbursts, lack impulse control,

express inappropriate anger, engage in dangerous behaviors.

• Insecurity in relationships

• Splitting

• 75% engage in physical self-harming behaviors, ex, cutting,

burning

• 10% commit suicide.

Borderline personality disorder

• Possible causes

• overactive amygdala with underactive areas responsible

for emotional regulation

• History of abuse

• Childhood trauma – abuse, prohibited from expressing

negative emotions

• Psychoanalytic theorists – unable to develop a cohesive

concept of self & others in early childhood.

• Genetic factors

Antisocial personality disorder

• APD - refers to a pattern of disregarding or violating the

rights of others without feeling guilt or remorse

• May be highly intelligent & have superficial charm

• Low anxiety

• Most are law-abiding but…

• 50% - 80% of prisoners meet the criteria for a diagnosis of

antisocial personality disorder.

• 3-6% men, 1% women

Antisocial Personality Disorder• Possible causes

• Psychosocial factors such as childhood aggression

or abuse

• Lack of parental warmth

• Biological factors such as genetic inheritance or

early damage to prefrontal cortex

• MRI scans indicated 11% fewer brain cells in

prefrontal cortex.

• Treatment

• Psychotherapy largely ineffective

• Some success with serotonin-increasing drug

treatments, but limited