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Chapter 15Psychological Disorders

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Defining/Explaining Abnormal Behavior Anxiety Disorders Mood Disorders Dissociative Disorders Schizophrenia Personality Disorders Psychological Disorders and Health and

Wellness

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Abnormal Behavior

Behavior that is…

deviant (atypical) maladaptive (dysfunctional) personally distressing (despair)

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Theoretical Approaches

Biological Approach: Medical Model disorders with biological origins

Psychological Approach experiences, thoughts, emotions, personality

Sociocultural Approach social context

Biopsychosocial Model interaction of biological, psychological and

sociocultural factors

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DSM-IV Classification System

Advantages provides a common basis for communication helps clinicians make predictions naming the disorder can provide comfort

Disadvantages stigma (shame, negative reputation) medical terminology implies internal cause focus on weaknesses ignores strengths

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DSM-IV-TR Axes

Multiaxial System

Axis I and II: Psychological Disorders Axis III: General Medical Conditions Axis IV: Psychosocial/Environmental Problems Axis V: Current Level of Functioning

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DSM-IV-TR Axes

Multiaxial System

Axis I: 312.9 Disruptive Behavior Disorder

305.20 Cannabis Abuse Axis II: V71.09 No Diagnosis Axis III: Asthma, Diabetes Axis IV: Ecomonic, Education, Single mx Axis V: 51

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Global Assessment of Functioning

100-91 No symptoms

90-81 Absent or minimal symptoms (e.g., mild anxiety)

80-71 Expectable symptoms, slight impairment

70-61 Some mild symptoms/mild difficulty functioning

60-51 Moderate symptoms/moderate difficulty functioning

50-41 Serious impairment in functioning

40-31 Some impairment in reality testing/major impairment in many areas

30-21 Inability to function in most areas, hallucinations, delusions

20-11 Some danger of hurting self, impairment in communication

10-1 Persistent danger of hurting self, inability to function

0 Inadequate information

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Anxiety Disorders

…uncontrollable fears that are

disproportionate and disruptive

generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder

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Generalized Anxiety Disorder

Diagnosis and Symptoms persistent anxiety for at least 6 months inability to specify reasons for the anxiety

Etiology biological factors

- genetic predisposition, GABA deficiency, respiration

psychological and sociocultural factors- harsh self-standards, critical parents, negative

thoughts, trauma

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Panic Disorder

Diagnosis and Symptoms recurrent, sudden onsets of intense terror that

often occur without warning

Etiology biological factors: genetic predisposition psychological factors: misinterpret arousal sociocultural factors: gender differences

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Phobic Disorder

Diagnosis and Symptoms an irrational, overwhelming, persistent

fear of a particular object or situation (e.g., social phobia)

Etiology biological factors: genetic disposition psychological factors: learned

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Examples of Phobic Disorders

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Social Phobias in the U.S.

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Obsessive-Compulsive Disorder

Diagnosis and Symptoms persistent anxiety-provoking thoughts and/or

urges to perform repetitive, ritualistic behaviors to prevent or produce a situation

Etiology biological factors: genetic predisposition psychological factors: life stress

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Post-Traumatic Stress Disorder

Diagnosis and Symptoms

Symptoms develop as a result of exposure to a

traumatic event, oppressive situation, natural or

unnatural disasters

- flashbacks

- constricted ability to feel emotions

- excessive arousal

- difficulties with memory and concentration

- feelings of apprehension

- impulsive outbursts

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Post-Traumatic Stress Disorder

Etiology trauma

- combat and war-related

- sexual abuse and assault

- natural and unnatural disasters vulnerability

- previous history of trauma

- genetic predispositions

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Mood Disorders

…disturbance of mood that affects entire emotional state

Symptoms may include cognitive, behavioral, or physical symptoms interpersonal difficulties

Types major depressive disorder, dysthymic disorder bipolar disorder

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Major Depressive Disorder (MDD)

Diagnosis and Symptoms

significant depressive episode that lasts for at least two weeks

defined by presence of at least 5 out of 9 symptoms

daily functioning is impaired

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Dysthymic Disorder (DD)

Diagnosis and Symptoms

chronic depression- unbroken depressed mood lasting at least two

years (adult) or one year (child)

fewer symptoms than MDD- defined by presence of 2 out of 6 symptoms

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Major Depressive Disorder (MDD)

Etiology biological factors: genetic disposition

- underactive prefrontal cortex

- regulation of neurotransmitters psychological factors:

- learned helplessness

- ruminating on negative, self-defeating thoughts

- pessimistic attribution sociocultural factors

- poverty

- gender differences

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Bipolar Disorder

Characterized by extreme mood swings Bipolar I and Bipolar II

Frequency and separation of episodes usually separated by 6 months to a year

Etiology strong genetic component swings in metabolic activity in cerebral

cortex levels of neurotransmitters

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Suicide

Prevalence

over 32,000 in year 2004

one completion for every 8 to 25 attempts

3rd leading cause of death in early adolescence

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Suicide

Biological factors low levels of serotonin poor health

Psychological Factors mental disorders trauma (recent/immediate and highly stressful) substance abuse

Sociocultural Factors chronic economic hardship cultural and religious norms gender differences

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When Someone is Threatening Suicide

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Dissociative Disorders

…sudden loss of memory or change in identity

Dissociation protection from extreme stress or shock problems integrating emotional memories

Types dissociative amnesia dissociative fugue dissociative identity disorder (DID)

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Dissociative Disorders

Dissociative Amnesia individuals experience extreme memory

loss caused by extensive psychological stress

Dissociative Fugue individuals experience amnesia,

unexpectedly travel away, and sometimes assume a new identity

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Dissociative Identity Disorder

Diagnosis and Symptoms the same individual possesses two or more distinct personalities each personality has unique memories, behaviors, and

relationships only one personality is dominant at a time personality shifts occur under distress

Etiology extraordinarily severe abuse in early childhood social contagion mostly women runs in families

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Schizophrenia

highly disordered thought

split from reality (psychotic)

typically diagnosed in early adulthood

high suicide risk

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Symptoms of Schizophrenia

Positive Symptoms hallucinations and delusions thought disorders and disorders of movement

Negative Symptoms flat affect

Cognitive Symptoms attention difficulties and memory problems impaired ability to interpret information and

make decisions

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Etiology of Schizophrenia

Biological Factors genetic predisposition structural brain abnormalities regulation of neurotransmitters

Psychological Factors diathesis-stress model

Sociocultural Factors influence how disorder progresses

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Personality Disorders

Cluster A Paranoid, Schizoid, and Schizotypal

odd and eccentric Cluster B

Antisocial, Borderline, Histrionic, and Narcissistic dramatic, emotional, or erratic

Cluster C Avoidant, Dependent, and Obsessive-Compulsive

anxious or fearful

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Personality Disorders

…chronic maladaptive cognitive-behavioral patterns

Antisocial Personality Disorder

Diagnosis and Symptoms

- guiltless lawbreaking, violence, deceit

- impulsive, irritable, reckless, irresponsible

Etiology

- biological factors (genetic, brain, and ANS differences)

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Personality Disorders

Borderline Personality Disorder

Diagnosis and Symptoms instability in interpersonal relationships & self-image impulsive, insecure, unstable & extreme emotions

Etiology genetic childhood abuse irrational belief one is powerless, unacceptable, and that

others are hostile

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Psychological Disorders andHealth and Wellness

Stereotypes and Stigma

Rosenhan’s study - fake psychiatric patients

negative attitudes toward mentally ill

physical health risk

successfully functioning individuals with mental illness reluctant to “come out”

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Chapter Summary

Discuss the characteristics, explanations, and classifications of abnormal behavior.

Distinguish among the various anxiety disorders. Compare the mood disorders and specify risk

factors for depression and suicide. Describe the dissociative disorders. Characterize schizophrenia. Identify behavior patterns typical of personality

disorders. Explain the impact of the stigma associated with

mental illness.

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Chapter Summary

Abnormal Behavior deviant, maladaptive, or personally distressing

Theoretical Approaches biological, psychological, and sociocultural biopsychosocial

Classifying Abnormal Behavior DSM-IV-TR Axes advantages and disadvantages

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Chapter Summary

Anxiety Disorders

generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder

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Chapter Summary

Mood Disorders major depressive disorder dysthymic disorder bipolar disorder suicide

Dissociative Disorders dissociative amnesia dissociative fugue dissociative identity disorder

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Chapter Summary

Schizophrenia positive, negative and cognitive symptoms etiology (biological, psychological, sociocultural)

Personality Disorders antisocial personality disorder borderline personality disorder

Psychological Disorders and Health & Wellness stigmas and stereotypes