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Module 22

Assessment & Anxiety Disorders

Psychology 1: General Psychology

J. Marie Hicks, Ph.D. Adjunct Psychology Instructor [email protected]

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INTRODUCTION

Insanity

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

Mental Disorders

defined as a prolonged or recurring problem that seriously interferes with an individual’s ability to live a satisfying personal life and function adequately in society

Phobia

An anxiety disorder characterized by an intense, excessive and irrational fear that is out of all proportion to the danger elicited by the object or situation

Insanity

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

Mental Disorders

defined as a prolonged or recurring problem that seriously interferes with an individual’s ability to live a satisfying personal life and function adequately in society

Phobia

An anxiety disorder characterized by an intense, excessive and irrational fear that is out of all proportion to the danger elicited by the object or situation

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FACTORS IN MENTAL DISORDERS

Causes of abnormal behavior

Biological & Environmental Factors

Genetic factors

Neurological factors

Causes of abnormal behavior

Biological & Environmental Factors

Genetic factors

contribute to the development of mental disorders

unlearned or inherited tendencies that influence how a person thinks, behaves, and feels

Neurological factors

such as having an overactive brain structure that contributes to the development of a mental disorder by causing a person to see the world in a biased or distorted way and to see threats when none really exist

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FACTORS IN MENTAL DISORDERS

Causes of abnormal behavior

Biological & Environmental Factors

Cognitive-emotional-behavioral & environmental factors

As always – Genetics and Environment affect each other – the environment affects how genes are expressed, and the expression of the genetic code affects the environment.

Causes of abnormal behavior

Biological & Environmental Factors

Cognitive-emotional-behavioral & environmental factors

contribute to the development of mental disorders including deficits in cognitive processes, such as having unusual thoughts and beliefs

deficits in processing emotional stimuli, such as under-or-overreacting to emotional situations

environmental challenges, such as dealing with stressful situations

As always – Genetics and Environment affect each other – the environment affects how genes are expressed, and the expression of the genetic code affects the environment.

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Definition of abnormal behavior

Statistical frequency approach

Comparison to the behaviors of the general population

deviation from social norms

Social norms approach

Comparison to accepted social standards, values, or norms

Maladaptive behavior approach ** MOST COMMON

a behavior as psychologically damaging or abnormal if it interferes with the individual’s ability to function in one’s personal life or in society

FACTORS IN MENTAL DISORDERS

Definition of abnormal behavior

Statistical frequency approach

says that a behavior may be considered abnormal if it occurs rarely or infrequently in relation to the behaviors of the general population

deviation from social norms

Social norms approach

behavior is considered abnormal if it deviates greatly from accepted social standards, values, or norms

Maladaptive behavior approach ** MOST COMMON

a behavior as psychologically damaging or abnormal if it interferes with the individual’s ability to function in one’s personal life or in society

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ASSESSING MENTAL DISORDERS

Definition of assessment

Clinical assessment

involves a systematic evaluation

Three methods of assessment

Neurological tests

Definition of assessment

Clinical assessment

involves a systematic evaluation of an individual’s various psychological, biological, and social factors, as well as identifying past and present problems, stressors, and other cognitive or behavioral symptoms

Three methods of assessment

Neurological tests

check for possible brain damage or malfunction

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ASSESSING MENTAL DISORDERS

Three methods of assessment

Clinical interview

Psychological tests

Include two different kinds of tests:

Objective tests (self-report questionnaires), such as the MMPI

Projective tests, such as the Rorschach inkblot test (VERY SUBJECTIVE)

Three methods of assessment

Clinical interview

method of gathering information about a person’s past and current behaviors, beliefs, attitudes, emotions, and problems

some clinical interviews are unstructured (no set questions)

others are structured (follow a standard format of asking a similar set of questions

Psychological tests

Include two different kinds of tests:

Objective tests (self-report questionnaires), such as the MMPI

Projective tests, such as the Rorschach inkblot test (VERY SUBJECTIVE)

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DIAGNOSING MENTAL DISORDERS

Real-life assessment

clinical assessments answer a number of questions

DSM-IV-TR

Clinical diagnosis

DSM-IV-TR

Real-life assessment

clinical assessments answer a number of questions

current symptoms

past events

Situations

DSM-IV-TR

Clinical diagnosis

process of matching an individual’s specific symptoms to those that define a particular mental disorder

DSM-IV-TR

Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision or DSM-IV-TR

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DIAGNOSING MENTAL DISORDERS

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DIAGNOSING MENTAL DISORDERS

Axis I: Nine Major Disorders / Problems

contains lists of symptoms and criteria about the onset, severity, and duration of symptoms

disorders usually first diagnosed in infancy, childhood, or adolescence

organic mental disorders

substance-related disorders

schizophrenia and other psychotic disorders

mood disorders

anxiety disorders

somatoform disorders

dissociative disorders

sexual and gender identity disorders

Axis I: Nine Major Disorders / Problems

contains lists of symptoms and criteria about the onset, severity, and duration of symptoms

disorders usually first diagnosed in infancy, childhood, or adolescence

organic mental disorders

substance-related disorders

schizophrenia and other psychotic disorders

mood disorders

anxiety disorders

somatoform disorders

dissociative disorders

sexual and gender identity disorders

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DIAGNOSING MENTAL DISORDERS

Other problems and disorders: Axes II, III, IV, V

Axis II: personality disorders

involve patterns of personality traits that are long-standing, maladaptive, and inflexible, and involve impaired functioning or subjective distress

Axis III: general medical conditions

Axis IV: psychosocial and environmental problems

Axis V: global assessment of functioning scale

Other problems and disorders: Axes II, III, IV, V

Axis II: personality disorders

involve patterns of personality traits that are long-standing, maladaptive, and inflexible, and involve impaired functioning or subjective distress

Axis III: general medical conditions

refers to physical disorders or conditions, such as diabetes, arthritis, and hemophilia

Axis IV: psychosocial and environmental problems

refers to psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders in Axes I and II

Axis V: global assessment of functioning scale

used to rate the overall psychological, social, and occupational functioning of the individual on a scale from 1 (severe danger of hurting self) to 100 (superior functioning in all activities)

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DIAGNOSING MENTAL DISORDERS

Potential problems with using DSM-IV-TR

Labeling mental disorders

Social and political implications

Potential problems with using DSM-IV-TR

Labeling mental disorders

refers to identifying and naming differences among individuals

places individuals in specific categories

may have either positive or negative associations

Social and political implications

labels, such as anxious, compulsive, or mentally ill, can change how an individual is perceived

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DIAGNOSING MENTAL DISORDERS

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ANXIETY DISORDERS

Generalized anxiety disorder (GAD)

characterized by excessive or unrealistic worry about almost everything or feeling that something bad is about to happen

Symptoms

Treatment

Generalized anxiety disorder (GAD)

characterized by excessive or unrealistic worry about almost everything or feeling that something bad is about to happen

Symptoms

psychological and physical symptoms

psychological: being irritable, having difficulty concentrating, and being unable to control one’s worry, which is out of proportion to the actual event

Treatment

Tranquilizers, such as alprazolam and benzodiazepines

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ANXIETY DISORDERS

Panic Disorder

characterized by recurrent and unexpected panic attacks

Panic Attack

period of intense fear or discomfort in which four or more of the following symptoms are present:

treatment

benzodiazepines, antidepressants, and or psychotherapy

Panic Disorder

characterized by recurrent and unexpected panic attacks

person becomes so worried about having another panic attack that this intense worrying interferes with normal psychological functioning

Panic Attack

period of intense fear or discomfort in which four or more of the following symptoms are present:

pounding heart, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, feeling dizzy, and fear of losing control or dying

treatment

benzodiazepines, antidepressants, and or psychotherapy

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ANXIETY DISORDERS

Phobias

anxiety disorder characterized by an intense and irrational fear that is out of all proportion to the possible danger of the object or situation

Social phobias

Specific phobias

Agoraphobia

Phobias

anxiety disorder characterized by an intense and irrational fear that is out of all proportion to the possible danger of the object or situation

Intense fear, accompanied by increased physiological arousal, person goes to great lengths to avoid the feared event, if event cannot be avoided, person feels intense anxiety

Social phobias

characterized by irrational, marked, and continuous fear of performing in social situations

Specific phobias

formerly called simple phobias

characterized by marked and persistent fears that are unreasonable and triggered by anticipation of, or exposure to, a specific object or situation

Agoraphobia

characterized by anxiety about being in places or situations from which escape might be difficult or embarrassing

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DIAGNOSING MENTAL DISORDERS

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ANXIETY DISORDERS

Obsessive-compulsive disorders

Obsessions

Compulsions

Treatment

exposure therapy

Obsessive-compulsive disorders

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

Treatment

exposure therapy

involves gradually exposing the person to the actual anxiety-producing situations or objects that he or she is attempting to avoid and continuing the exposure treatments until the anxiety decreases

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ANXIETY DISORDERS

Posttraumatic stress disorder - PTSD

disabling condition that results from personally experiencing an event that involves actual or threatened death or serious injury

or from witnessing or hearing of such an event happening to a family member or close friend

PTSD suffers experience a number of psychological symptoms, including:

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 suffers experience a number of psychological symptoms, including:

recurring and disturbing memories

terrible nightmares

intense fear and anxiety

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SOMATOFORM DISORDERS

Definition and examples

Somatoform disorders

marked by a pattern of recurring, multiple, and significant bodily (somatic) symptoms that extend over several years

Somatization disorder

Definition and examples

Somatoform disorders

marked by a pattern of recurring, multiple, and significant bodily (somatic) symptoms that extend over several years

symptoms (pain, vomiting, paralysis, blindness) are not under voluntary control

no known physical causes

caused by psychological factors

Somatization disorder

begins before age 30, lasts several years, and is characterized by multiple symptoms

pain, gastrointestinal, sexual, and neurological

have no physical causes

triggered by psychological problems or distress

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SOMATOFORM DISORDERS

Conversion disorder

Mass hysteria

Conversion disorder

refers to changing anxiety or emotional distress into real physical, motor, sensory, or neurological symptoms for which no physical or organic cause can be identified

Mass hysteria

condition experienced by a group of people who, through suggestion, observation, or other psychological processes, develop similar fears, delusions, abnormal behaviors, or physical symptoms

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RESEARCH FOCUS

Conduct disorder

repetitive and persistent pattern of behaving that has been going on for a least a year and that violates the established social rules or the rights of others

Problems/Symptoms:

aggressive behaviors such as threatening to harm people

abusing or killing animals

destroying property

being deceitful

stealing

Conduct disorder

repetitive and persistent pattern of behaving that has been going on for a least a year and that violates the established social rules or the rights of others

Problems

aggressive behaviors such as threatening to harm people

abusing or killing animals

destroying property

being deceitful

stealing

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