1

Psychological Disorders

According to the Law

The definition of mental disorders rests on whether:

1- the person is aware of of the consequences of his actions

2- can control his behavior

If not the person may be declared insane.

2

Definitions of Mental DisorderA Harmful Dysfunction

1- Mental disorders as a violation of cultural standards or atypical

2- Mental disorder as maladaptive or harmful behavior

3- Mental disorder as a disturbing emotional distress.

4- Mental disorder as unjustifiable

3

Psychologists’ Definition

• Any behavior or emotional state that

1- causes the individual great suffering or worry

2- is self-destructive,

3- is maladaptive and disrupts either the person’s relationships or the larger community.

4

Understanding Psychological Disorders

The Medical Perspective

Psychological disorders are sicknesses and can be diagnosed, treated, and even cured.

The Bio-Psycho-Social Perspective

How biological, psychological, and social factors interact to produce specific psychological disorders.

5

Diagnostic & Statistical Manual of Mental Disorders

• DSM-IV (1994) contains more than 300 mental disorders.

• Provides diagnostic categories

• Does not provide information on causes

• Does not provide information on treatment

• It is organized in 5 axes

6

Axis IClinical Syndromes

Anxiety disorders

Mood disorders

Dissociative disorders

Substance abuse disorders

Schizophrenia

7

Axis IIDevelopmental and Personality Disorders

Ingrained aspects of the client’s personality that are likely to affect the person’s ability to be treated, such as self-involvement or dependency.

8

Axis IIIPhysical Disorders and Conditions

• Medical conditions that are relevant to the disorder, such as respiratory or digestive problems.

9

Axis IVSeverity of Psychosocial Stressors

• Social and environmental stressors that can make the disorder worse, such as job and housing troubles or having recently left a network of close friends.

10

Axis VGlobal Assessment of Functioning

• The client’s overall level of functioning at work, relationships, and leisure time including whether the problem was of a recent origin or of long duration, and how incapacitating it is.

11

Diagnostic Criteria for Attention-Deficit Hyperactivity Disorder

• Symptoms must persist for at least six months

• Symptoms must have begun before age seven

• Symptoms present in at least two situations• Disorder impairs functioning• Symptoms not explained by another

disorder such as:

12

Diagnostic Criteria for Attention-Deficit Hyperactivity Disorder

• Anxiety

• Schizophrenia

• Mania

• Dissociative Disorder

• Personality Disorder

• Developmental Disorder

13

Anxiety Disorders

• 1- Generalized Anxiety Disorder

• 2- Posttraumatic Stress Disorder

• 3- Panic Disorder

• 4- Fears and Phobias

• 5- Obsession Compulsions

14

Posttraumatic Stress Disorder

• When people are in danger, they produce high levels of natural opiates, which can temporarily mask pain. They also produce stress hormones.

• People with PTSD tend to continue producing these hormones.

• Norepinephrine is higher than normal. It activates the hippocampus, which is involved with memory and long term memory.

• At high levels, stress hormones can become toxic and can damage the brain.

15

Phobias

• Acrophobia: fear of heights• Brontophobia: fear of thunder• Claustrophobia: fear of closed places• Porphyrophobia: fear of the color purple• Mysophobia: fear of dirt and germs• Agoraphobia: fear of being away from a safe

place. • Triskaidekaphobia: fear of number 13

16

Obsession Compulsions

• ObsessionsRecurrent, persistent, unwished-for thoughts or

images.Example: repetitive thoughts about killing a child or

becoming contaminated by shaking hands. • CompulsionsRepetitive, ritualized behavior that the person feels

must be carried out to avoid disaster.Example: hand washing, counting, & checking

17

Obsession Compulsions

• The orbital cortex sends messages of impending danger to the caudate nucleus (prepares the body to respond to external danger).

• In people with OCD, the orbital cortex keeps on sending false alarms of danger.

• But the caudate nucleus fails to turn them off.

18

Explaining Anxiety Disorders

The Learning Perspective

Fear Conditioning

Stimulus Generalization

Reinforcement

Observational Learning

The Biological Perspective

Evolution

Genes

Physiology

19

Mood Disorders

• 1- Depression

• 2- Mania

• 3- Bipolar

20

Symptoms of Depression

• Feeling of despair and hopelessness• Exaggerating minor failings and ignoring positive

events• Interpreting losses as signs of personal failures

and concluding that happiness is not possible.

Physical Changes• Overeating, insomnia, lack of appetite trouble

concentrating, feeling tired all the time

21

Mania

• An abnormally high state of exhilaration

• Excessive energy

• Irrational decisions

• Feeling of excessive hopefulness

• Speaking rapidly and dramatically

• Excessive feeling of ambition

• Inflated self esteem

22

Stages of Mania

• 1-HypomaniaPatients are energetic, extroverted, and

assertive• 2-ManiaLoss of judgment• 3-Delusion with Paranoid ThemesSpeech is generally rapid and hyperactive

behavior may lead to violence.

23

Causes of Mania

• Excessive production of one or two neurotransmitters:

• 1-Norepinephrine

• 2-Serotonin

24

Bipolar DisorderManic-Depressive

• When people alternate between episodes of depression and one or more episodes of mania.

• Occurs equally in both sexes.• The onset is between 20-30 with a second peak at

40• Those who have rapid cycling may experience

more episodes of mania and depression that succeed each other without a period of remission.

25

People Who Had Bipolar

• Abraham Lincoln Edgar Allan Poe

• Van Gough Virginia Wolf

• Vivian Lee Walt Whitman

• Charles Dickens Ernest Hemingway

• Newton

• Mark Twain

26

Theories of Depression

• 1- Biological explanations emphasize genetic and brain chemistry.

• 2- Social explanations emphasize the stressful circumstances of people’s lives.

• 3- Attachment explanations emphasize problems with close relationships.

• 4- Cognitive explanations emphasize particular habits of thinking and interpreting events

• 5- “Vulnerability-stress” explanations draw on all four explanations.

27

Biological Explanation

• Genes may exert their influence by creating biochemical imbalances

• The low production of the neurotransmitters norepinephrine and serotonin may be the cause of depression.

• The brains of depressed people seem less active. • The frontal lobes are 7% smaller in severely

depressed patients.

28

Cognitive Explanations

• Internality

The reason for misery is internal

• Stability

The situation is permanent

• Lack of Control

There is no control over the situation

29

Learned Helplessness

• Pessimistic Explanatory Style

• Brooding and Ruminating about Unhappiness

30

Vulnerability-Stress Model of Depression

• Upsetting Events

Loss of loved ones

Loss of job

Failure

Trauma

Violence

Temporary unhappiness

• Individual Vulnerability

Biological predisposition

Low self-esteem

Insecure attachment

Learned helplessness

Negative thinking

Pessimism

Brooding

31

Personality Disorders

• 1- Paranoid Personality Disorder

• 2- Narcissistic Personality Disorder

• 3- Antisocial Personality Disorder

32

Paranoid Personality Disorder

• Unfounded suspiciousness

• Mistrust of other people

• Irrational jealousy

• Secretiveness

• Doubt about the loyalty of others

• Delusions of being persecuted by others.

33

Narcissistic Personality Disorder

• Exaggerated sense of self-importance

• Self-absorption

• Fantasies of unlimited success & power

• Demand of constant attention & admiration

• Feeling of entitlement of special favors

• Narcissistic people cant find a good match because they expect perfection.

34

Symptoms of Antisocial Personality Disorder

• 1- They repeatedly break the law.• 2- They are deceitful, using lies to con others.• 3- They are impulsive and unable to plan ahead.• 4- They repeatedly get into fights or assaults.• 5- They show reckless disregard to their own

safety or that of others.• 6- They are constantly irresponsible, failing to

meet their obligations.• 7- They lack remorse for actions that harm others.

35

Causes for APD

• 1- Abnormalities in the brain and central nervous system

• 2- Problems with impulse control

• 3- Brain damage

• 4- Vulnerability-stress explanations

36

Emotion

• You perceive the sensory stimulus.• The adrenal gland sends two hormones:

epinephrine and norepinephrine.• They activate the sympathetic nervous system. • That produces a state of arousal or alertness that

provides the body with the energy to act (the pupils dilate, the heart beats faster, and breathing speeds up).

37

Vulnerability – Stress Explanation

• Biological vulnerability

Brain damage

Genetic predisposition

Birth complications

Central nervous system abnormalities

• Stressful Experiences

Physical abuse

Maternal rejection

Lack of contact comfort

38

Dissociative Disorders

• 1- Amnesia

• 2- Fugue

• 3- Dissociative Identity Disorder

(Multiple Personality Disorder)

39

Causes of Addiction

• 1- The Disease Model

• 2- The Learning Model

40

The Disease Modal“The Disease Concept of Alcoholism”

by E. M. Jellinek• Alcoholism is a disease over which an individual

has no control and from which he or she never recovers

• Addiction is due to a person’s biochemistry, metabolism, and genetic predisposition.

• Genetic Predisposition:– Contribute to traits that predispose the person to

become alcoholic.– May affect biochemical processes in the brain that

make some people more susceptible than others.

41

The Learning Model of Addiction

1- Addiction patterns vary according to cultural practices and the social environment.

2- Policies of total abstinence tend to increase rates of addiction rather than reduce them.

3- Not all addicts have withdrawal symptoms when they stop taking a drug.

4- Addiction does not depend on properties of the drug alone, but also on the reason for taking it.

42

Active Symptoms of Schizophrenia

• 1- Bizarre delusions (Paranoid/Identity)

• 2- Hallucinations and heightened sensory awareness (auditory, visual, or tactile)

• 3- Disorganized, incoherent speech

• 4- Grossly disorganized and inappropriate behavior

43

Negative Symptoms of Schizophrenia

• Loss of motivation

• Poverty of speech

• Making only brief and empty replies

• Diminished thought and emotionality

• Emotional flatness

• Unresponsive facial expressions

• Poor eye contact

44

Explanation of Schizophrenia

• 1- Genetic predisposition• 2- Structural brain abnormalities• 3- Neurotransmitter abnormalities• 4- Prenatal abnormalities• 5- The Vulnerability-stress

approach

45

Genetic PredispositionRisk of Developing Schizophrenia

• Identical twins……less than 50%

• Child of 2 schizophrenic parents... 34-46%

• Fraternal twins ….less than 20%

• Children with 1 schizophrenic parent 12%

• Siblings ….. Less than 10%

46

Brain Abnormalities

• Signs of cerebral damage

• Decreased brain weight

• Reduced numbers of neurons in the prefrontal cortex

• Decrease in volume of the limbic regions

• Abnormalities in the thalamus

• Enlarged ventricles or spaces in the brain

47

Neurotransmitter Abnormalities

• Serotonin

• Glutamate

• Dopamine

48

Prenatal Abnormalities

• Malnutrition

• Infectious virus during prenatal development

• Mother’s exposure to influenza virus during the second trimester of pregnancy

49

Vulnerability – Stress Explanation

• Biological Vulnerability

Genetic predisposition

Birth complications that damage the brain

Prenatal damage due to viral infection

• Stressful Experiences

Unstable family life

Extreme stress in late adolescence and early adulthood.