chapman chapters 14 and 15 part i psychological disorders 3 slide blackboard version

8/13/2019 Chapman Chapters 14 and 15 Part I Psychological Disorders 3 Slide Blackboard Version

1/13

11/25/13

1

Psychological

DisordersDr. L. Kevin Chapman

Psychology 201

Chapter 14

Psychological Disorders

Definition and Prevalence Anxiety Disorders: Description & Causes

Treatments for Anxiety Disorders Biological Behavioral

Mood Disorders: Description & Causes Treatments for Mood Disorders

Biological Behavioral

Examples throughout


How are psychological disordersdefined?

Specific criteria DSM-V (May 2013)


2/13

11/25/13

2

Figure 14.1 Sample DSM-IV-TR Diagnostic CriteriaHockenbury: Psychology, Fourth EditionCopyright 2005 by Worth Publishers


How are psychological disordersdefined?

Personal distress Impairment in functioning


The National Comorbidity Study (Kessleret al., 1994)

NCS Revised (2005) Prevalence of Psychological Disorders insample of people representative of the

general U.S. population: Lifetime and Past

Year

Rates of Treatment Seeking


3/13

11/25/13

3

National Comorbidity SurveyReplication Results

Approximately 46% of adults experienced apsychological disorder at least once in their

lives

About 26% of people experienced apsychological disorder in the past year

Approximately 59% who experiencedsymptoms in the last year did NOT seek

treatment

NCS-R -Age of Onset andLifetimePrevalence ofMental Disorders

National Comorbidity SurveyReplication (NCS-R): One out of fourrespondents (26 percent) reportedexperiencing symptoms of apsychological disorder duringprevious year

NCS-R found one out of two adults(46 percent) experienced symptomsof a psychological disorder at somepoint in lives

Different categories of mentaldisorders vary significantly in themedian age of onset

NCS-R found that most people withthe symptoms of a mental disorder(59 percent) received no treatmentduring the past year

Approximately 80 percent whoexperienced symptoms in the lastyear did not seek treatment

Most people seem to deal withsymptoms without completedebilitation

Clicker Q next

Anxiety: What is it? How Does It Differ

From Fear?

FEARAn emotion alarmresponding to a present dangerTruealarmSpecific, or focalAdaptiveExample: Angry DogANXIETYFalsealarm responding topossible dangerVague feeling of anticipatoryapprehensionPrimes the pump for fearCan be maladaptiveExample: Angry Dog


4/13

11/25/13

4

Anxiety

Cognitive: thoughts of what if, catastrophic thoughts Subjective (e.g., feelings of fear and apprehension) Physiological Behavioral: Maladaptive behaviors to reduce anxiety Everyone experiences it; becomes a problem/disorder

when it is irrational, uncontrollable, and disruptive

Worry is in response to anxiety An attempt to cope (often futile)

Putting anxiety in to words: I dont know if this event willhappen again, but I have to be prepared just in case!

Types of Anxiety Disorders

Most common diagnosed disorders throughoutthe US (18% of the population)

Types of Anxiety Disorders Generalized Anxiety Disorder Panic Disorder (with or without Agoraphobia) Phobias Posttraumatic Stress Disorder (PTSD) Obsessive-Compulsive Disorder (OCD)

***Please note that anxiety runs in families***

Children of anxious parents are 4-7 times more likelythan children of non-anxious parents to develop an

anxiety disorder

Generalized Anxiety DisorderWorrying About Anything and Everything

Explaining Generalized AnxietyDisorder (GAD)

Environmental,psychological, andgenetic factors, as wellas other biologicalfactors, are probablyinvolved in GAD

Problematic anxietycan be evident from avery early age

Early stressfulexperiences maycontribute

Anxiety disordercharacterized byexcessive, global, andpersistent symptoms of

anxiety; also calledfree-floating anxiety In generalized anxiety

disorder, when onesource of worry isremoved, anothermoves in to take itsplace


5/13

11/25/13

5

Panic Attacks andPanic DisordersSudden Episodes of Extreme Anxiety

Pounding heart

Rapid breathing

Breathlessness

Choking sensationSweating, trembling, and

experiencing light-headedness

Chills or hot flashes

Escalating surge of physicalarousal

Feelings of terror and belief that

one is about to die, go crazy, orlose control

Panic attackSudden episode of

extreme anxiety thatrapidly escalates in

intensity

Symptoms:

Typically peaks within 10minutes of onset and then

gradually subsides

Panic Disorder

An anxiety disorder in whichthe person experiences

frequent and unexpectedpanic attacks

Frequency of panic attacks is highly variable and quite unpredictable Very frighteningsufferers live in fear of having them Agoraphobia often develops as a result gradually subsides

Panic Disorder

Panic attacks - helpless terror,high physiological arousal

Very frightening - sufferers live infear of having them

Agoraphobiaoften develops as aresult

Agoraphobia

Anxiety about placeswhere panic may occur

and escape is difficult

Afraid that help wontbe available if one

panics Crowds, malls,

supermarkets,elevators, etc

Client examples Case example


6/13

11/25/13

6

Explaining PanicDisorder

Barlow: Triple vulnerabilities model of panic based on combination of

Biological predisposition toward anxietyLow sense of control over potentially life-threatening eventsOversensitivity to physical sensations

Catastrophic cognitions theory

People with panic disorder are not only oversensitive

to physical sensations they also tend tocatastrophize meaning of their experience

The PhobiasFear and Loathing

Encountering feared situation or object can provoke a full-fledgedpanic attack

About 13 percent of the general population experiences a specificphobia

More than twice as many women as men suffer from specificphobia

Phobia

Persistent and irrational fear of a specific object, situation, or activity

Specific Phobia

Excessive, intense, and irrational fear of a specific object, situation, or

activity that is actively avoided or endured with marked anxiety

Four PrimaryCategories of Specific

Phobias

Fear of particular situations

Fear of features of the natural

environment

Fear of injury or blood

Fear of animals and insects

Most Common Phobias:

1) Animals2) Heights3) Flying4) Blood/Injection


7/13

11/25/13

7

Explaining PhobiasLearning Theories: Di#erent pathways

Classical Conditioningas seen in the Watson

and Raynerdemonstration with Little

Albert

Operant Conditioningwe are rewarded by

reducing ourconditioned fear by

avoidance of theconditioned stimulus,

an example of negativereinforcement

Observational Learningwe model and imitatethe fears we see in

others

Biological Preparation certain fears, such as tospiders or heights, have an evolutionary history;

may represent a fear of contamination: spoiledfoods, infection, parasites

Specific Phobia: Pathways

Phobia Clip

http://vimeo.com/38121852

(Begin at 14:00)


8/13

11/25/13

8

Behavioral Treatments: Exposure

Gold standard treatment for phobias Exposure important for treatment of ALL anxiety disorders Systematic desensitization=type of Exposure

train client in muscle relaxation then combine imagery of feared object with relaxation use increasingly frightening scenes Principle=counterconditioning: learn a new CR that

inhibits old CR (i.e., anxiety)

Systematic Desensitization is NOT the most effectivetreatment for phobias today.

Exposure and Cognitive work (explain in treatment section)

Comparing AnxietyDisorders --

Agoraphobia: Fear of panic attacks in placeswhere help or escape options seemunavailable

Social Anxiety Disorder (formerly socialphobia): Fear of Social Situations

Panic Disorder: fear of fear

About one out of eight adults inthe United States have experienced

social phobia at some point in theirlives.

SAD is far more debilitating thaneveryday shyness.

People with SAD are intenselyfearful of being watched or judgedby others.

Even ordinary activities, such aseating with friends in a shoppingmall food court, can cause

unbearable anxiety. Most common fear throughout the

United States is (drumroll) PublicSpeaking

Social Anxiety Disorder


9/13

11/25/13

9

Anxiety Disorders: Social Anxiety

Disorder Persistent fear of one or more

social or performancesituations

Severe anxiety upon exposureto social situations whereridicule may occur Similar to panic attack

Social situation avoided orendured with significantanxiety i.e., formal speaking, group

meetings, class participation

Case example

Posttraumatic Stress Disorder

(PTSD)

Follows traumaticevent or events suchas war, rape, orassault

Symptoms include: INTRUSIONS (e.g,

nightmares, flashbacks)

AVOIDANCE HYPERAROUSAL

(e.g., sleeplessness,easily startled,irritability)

Causes

The symptoms of posttraumaticstress disorder can apparently

last a lifetime. More than 60 years after the

close of World War IIthousands of veterans, now in

their eighties, still suffer from

nightmares, anxiety, and otherPTSD symptom

Some experts estimate that asmany as 200,000 World War II

veterans may continue to sufferfrom the symptoms of PTSD

PTSD


10/13

11/25/13

10

CompulsionsRepetitive behaviors or

mental acts that areperformed to prevent or

reduce anxietyMay be overt or covert

ObsessionsRepeated, intrusive, anduncontrollable irrational

thoughts or mental images thatcause extreme anxiety and

distress

Common fear of dirt, germs;pathological doubt abouthaving completed a task

ObsessiveCompulsive DisorderChecking It Again and Again

Often accompanied by an irrational belief that failure to performritual action will lead to catastrophe

Usually both obsessions and compulsions are present and thesufferer cant resist them even though they know they are absurd

Content mirrors cultural beliefs United States fear of germs India concerns about religious purity

An anxietydisorder in

which

symptoms ofanxiety aretriggered by

intrusive,repetitive

thoughts andurges to

perform certainactions.

OCD: Anxiety Disorder but notits own category

OCD now its own category Obsessive Compulsive and Related Disorders

along with:

Hoarding Disorder Body Dysmorphic Disorder Excoriation Disorder (skin picking) Trichotillomania (hair pulling disorder)


11/13

11/25/13

11

Dysfunction in specific brainareas

Areas involved in the fight-or-flight response

Frontal lobes, which play a key

role in our ability to think andplan ahead

Heightened neural activity incaudate nucleus involved in

regulating movements

Deficiency in serotonin,

norepinephrine implicated

Drugs that increase the

availability of theseneurotransmitters decrease

symptoms

Explaining ObsessiveCompulsive Disorder

Excessive responsibility, guilt, and rigid codes of conduct may predisposesomeone to OCD Generalized and specific psychological vulnerabilities May create thought-action fusionwhich is related to OCD symptoms Intrusions produce distress when they have idiosyncratic meaning So, certain intrusive thoughts are learned as unacceptablebecause they

signal danger for which the person feels personally responsible

OCD Clip

http://vimeo.com/53904764

(Stop at about 8 minutes)

Mood Disorders (Affective Disorders)

Major Depression Dysthymic Disorder


12/13

11/25/13

12

Depression

Major Depression More severe depression lasts without remission for at least 2 weeks

Dysthymia less severe, but long-lasting depression lasts for at least 2 years

Can have both at the same time Women diagnosed 2x as often as men

The Prevalence of Major Depression

6 percent to 7 percent of Americans areaffected by major depression

Lifetime prevalence, about 15 percent ofAmericans at some point in their lives

Women are about twice as likely as men tobe affected by major depressionWomen more vulnerable becauseExperience greater degree of chronicstress in daily life

Have lesser sense of personal controlMore prone to dwell on their problems

Course of Major Depression

Left untreated,symptoms of

major depressioncan easily lastsix months or

longer

Left untreated,depression may

recur andbecome

progressivelymore severe

More than half of allpeople who havebeen through oneepisode of majordepression can

expect a relapse,usually within two

years

Symptoms tendto increase inseverity and

time between

episodesdecreases

Situational Bases forDepression

Positive correlationbetween stressful lifeevents and onset ofdepression.

Does life stress causedepression?

Most life events that causedepression are losses (ofa spouse or companion,long-term job, health, orincome)

The Symptoms of Major Depression The experience of major depression canpermeate every aspect of life. This figure shows some of the most common

emotional, behavioral, cognitive, and physical symptoms of that disorder.


13/13

11/25/13

13

Biological Bases for Depression

Genetic vulnerability Neurotransmitter theories

Low levels norepinephrine Low levels serotonin

Can Depression be Treated?

Most cases of depression can be effectivelytreated

Antidepressants Cognitive-Behavioral Therapy Both

chapman chapters 14 and 15 part i psychological disorders 3 slide blackboard version

Documents