Chapters 12 and13Chapters 12 and13Psychological Psychological DisordersDisorders

Defining Psychological Defining Psychological DisordersDisorders

Mental processes and/or behavior Mental processes and/or behavior patterns that cause patterns that cause emotional emotional distress distress and/or and/or substantial substantial impairmentimpairment in functioning in functioning

InsanityInsanity

A person is not legally A person is not legally responsible for his or her acts responsible for his or her acts due to their mental condition. due to their mental condition.

Classifying Psychological Disorders The The Diagnostic and Statistical Diagnostic and Statistical

Manual of Mental Disorders (DSM-Manual of Mental Disorders (DSM-5)5) provides a system for diagnosing and provides a system for diagnosing and classifying psychological disordersclassifying psychological disorders

It describes about 300 specific disorders It describes about 300 specific disorders and organizes them into categoriesand organizes them into categories

NEVER SHOWS CAUSE!!!NEVER SHOWS CAUSE!!!

Anxiety Disorders

Characterized by frequent Characterized by frequent fearfulfearful thoughts about what thoughts about what mightmight happen happen in the futurein the future

Most common category of Most common category of psychological disorderspsychological disorders

Anxiety Disorders

Generalized anxiety disorderGeneralized anxiety disorder– Disorder involving overwhelming, chronic, Disorder involving overwhelming, chronic,

excessive worry for six months or more. excessive worry for six months or more. Continuous state of sympathetic nervous Continuous state of sympathetic nervous system activity. system activity.

Anxiety DisordersPanic attackPanic attack

An episode of overwhelming anxiety, fear, or An episode of overwhelming anxiety, fear, or terrorterror

Brains of panic-attack sufferers respond to Brains of panic-attack sufferers respond to normal changes in the body as if they were normal changes in the body as if they were life threateninglife threatening

Panic disorderPanic disorder Disorder in which a person experiences Disorder in which a person experiences

recurring, unpredictable episodes of recurring, unpredictable episodes of overwhelming anxiety, fear, or terroroverwhelming anxiety, fear, or terror

PhobiasPhobias

Phobia: a persistent, a persistent, irrationalirrational fear of fear of some object, situation, or activity that some object, situation, or activity that poses little or no real dangerposes little or no real danger

3 subtypes3 subtypesAgoraphobiaAgoraphobia Intense fear of being in a situation from Intense fear of being in a situation from

which escape is not possible if one which escape is not possible if one experiences overwhelming anxiety or a panic experiences overwhelming anxiety or a panic attackattack

Often begins with repeated panic attacksOften begins with repeated panic attacks People sometimes plan their entire lives People sometimes plan their entire lives

around avoiding feared situationsaround avoiding feared situations

Phobias

Social anxiety disorder: Social anxiety disorder: fear and and avoidance of any social or avoidance of any social or performance situation in which one performance situation in which one might embarrass or humiliate oneself might embarrass or humiliate oneself in front of othersin front of others

Common Anxiety Disorders cont…

Specific phobia Specific phobia is a fear of a specific is a fear of a specific object or situation, a general label for object or situation, a general label for any phobia other than any phobia other than agoraphobiaagoraphobia or or social phobia social phobia (catchall category)(catchall category)

Treatment: Behavior Treatment: Behavior Modification Techniques Based Modification Techniques Based on Learning Theorieson Learning Theories

Systematic desensitizationSystematic desensitization -- based -- based on classical conditioning; used to treat on classical conditioning; used to treat fearsfears

Trained to relax while being confronted Trained to relax while being confronted with a with a hierarchy of fearshierarchy of fears. .

Eventually, client can stay relaxed while Eventually, client can stay relaxed while confronting even the most feared confronting even the most feared situationsituation

Behavior Modification Behavior Modification Techniques Based on Learning Techniques Based on Learning Theories cont…Theories cont…

Flooding Flooding also based on classical also based on classical conditioningconditioning

Client is exposed to the feared object or event for an extended period

Until their anxiety decreases

Biological TreatmentsBiological Treatments

Antianxiety drugsAntianxiety drugs– BenzodiazepinesBenzodiazepines are effective for treating are effective for treating

generalized anxiety disorder and panic disordergeneralized anxiety disorder and panic disorder

– Valium, XanaxValium, Xanax Block reuptake of Block reuptake of GABAGABA

– Addictive, drug tolerance and withdrawal, sedatingAddictive, drug tolerance and withdrawal, sedating

Antidepressants (work on Serotonin)Antidepressants (work on Serotonin)– Paxil, ZoloftPaxil, Zoloft

Obsessive-Compulsive Disorders

Disorder in which a person suffers Disorder in which a person suffers from recurrent obsessions and/or from recurrent obsessions and/or compulsionscompulsions

ObsessionObsession– persistent, involuntary thought, image, or persistent, involuntary thought, image, or

impulse that causes great distressimpulse that causes great distress CompulsionCompulsion

– persistent, irresistible, and irrational urge persistent, irresistible, and irrational urge to perform an act or ritual repeatedlyto perform an act or ritual repeatedly

– often involve cleaning and washing, often involve cleaning and washing, counting, checking, touching objects, counting, checking, touching objects, hoarding, or excessive organizinghoarding, or excessive organizing

Mood Disorders

Disorders characterized by Disorders characterized by extreme extreme and and unwarrantedunwarranted disturbances in disturbances in emotion or moodemotion or mood

DepressionDepression mania mania

Major Depressive DisorderMajor Depressive Disorder marked by feelings of great sadness, marked by feelings of great sadness,

despair, and hopelessness as well as despair, and hopelessness as well as loss of the ability to feel pleasure loss of the ability to feel pleasure (anhedonia)(anhedonia)

Symptoms also include:Symptoms also include:– Changes in appetite, weight, and Changes in appetite, weight, and

sleep patterns sleep patterns – Difficulty thinking or concentratingDifficulty thinking or concentrating

Cognitive TherapiesCognitive Therapies

Therapies that assume Therapies that assume maladaptive behavior can result maladaptive behavior can result from from irrational, automaticirrational, automatic thoughts, beliefs, and ideasthoughts, beliefs, and ideas

Helps clients stop their negative Helps clients stop their negative thoughts as they occur and replace thoughts as they occur and replace them with more objective thoughtsthem with more objective thoughts

Aaron Beck and Albert EllisAaron Beck and Albert Ellis

Rational Emotive Rational Emotive TherapyTherapy

A-activating eventA-activating event B-beliefB-belief

C-consequencesC-consequences

What needs to change?What needs to change?

Figure 13.1 The ABCs of Rational Emotive Therapy

Drug Therapy

Antidepressant drugsAntidepressant drugs Act as mood elevators for people who are Act as mood elevators for people who are

severely depressedseverely depressed Selective serotonin reuptake Selective serotonin reuptake

inhibitors (SSRIs) Prozac, Paxil, inhibitors (SSRIs) Prozac, Paxil, ZoloftZoloft

Block the reuptake of Block the reuptake of serotoninserotonin, increasing , increasing its availability at the synapses of the brainits availability at the synapses of the brain

Selective serotonin norepinephrine Selective serotonin norepinephrine reuptake inhibitors (SSNRIs) (Effexor, reuptake inhibitors (SSNRIs) (Effexor, Pristiq, Cymbalta)Pristiq, Cymbalta)

Electroconvulsive therapy (ECT)

Electric current is administered to the Electric current is administered to the right cerebral hemisphereright cerebral hemisphere– Patient is under anesthesiaPatient is under anesthesia– Usually reserved for Usually reserved for severely depressed severely depressed

patients who are suicidalpatients who are suicidal ECTECT was misused and overused in the was misused and overused in the

1940s and 1950s, leading to a bad 1940s and 1950s, leading to a bad reputationreputation

Can be a highly effective treatment for Can be a highly effective treatment for major depressionmajor depression

Bipolar Disorder A mood disorder in which A mood disorder in which manic manic

episodesepisodes alternate with periods of alternate with periods of depression, usually with relatively normal depression, usually with relatively normal periods in betweenperiods in between

Manic episodesManic episodes are periods of excessive are periods of excessive euphoria, inflated self-esteem euphoria, inflated self-esteem (grandiosity), wild optimism, pressured (grandiosity), wild optimism, pressured speech, flight of ideas and hyperactivity, speech, flight of ideas and hyperactivity, often accompanied by hostility if activity often accompanied by hostility if activity is blockedis blocked

Biological TreatmentsBiological Treatments

LithiumLithium– Reduces both manic and depressive Reduces both manic and depressive

episodesepisodes– Treatment dose and toxic dose similarTreatment dose and toxic dose similar

Anticonvulsant MedicationsAnticonvulsant Medications– DepakotDepakot– TegratolTegratol

Mechanism unknownMechanism unknown

Risk Factors for Mood Risk Factors for Mood DisordersDisorders A small area in the A small area in the prefrontal cortexprefrontal cortex, ,

that plays a role in controlling that plays a role in controlling emotions, is smaller than normal in emotions, is smaller than normal in people with major depressionpeople with major depression

Abnormal levels of Abnormal levels of serotoninserotonin and and norepinephrinenorepinephrine are strongly linked to are strongly linked to depressiondepression

What are some risk factors for What are some risk factors for mood disorders?mood disorders?

Prevalence rates differ between men Prevalence rates differ between men and womenand women

In most countries, rate of depression In most countries, rate of depression in females is about twice that for in females is about twice that for malesmales

Suicide rates differ: ♀ 3x more likely to Suicide rates differ: ♀ 3x more likely to attempt; ♂ 4x more likely to completeattempt; ♂ 4x more likely to complete

Schizophrenia

A severe psychological disorder A severe psychological disorder characterized by loss of contact with characterized by loss of contact with reality, hallucinations, delusions, reality, hallucinations, delusions, inappropriate or flat affect, some inappropriate or flat affect, some disturbance in thinking, social disturbance in thinking, social withdrawal, and/or other bizarre withdrawal, and/or other bizarre behaviorbehavior

Symptoms of SchizophreniaSymptoms of Schizophrenia

Positive symptomsPositive symptoms are abnormal are abnormal behaviors that are present in people behaviors that are present in people with schizophreniawith schizophrenia

HallucinationsHallucinations Delusions (of grandeur or of Delusions (of grandeur or of

persecution)persecution) Disorganized behaviorDisorganized behavior Inappropriate affectInappropriate affect

Symptoms of Schizophrenia Symptoms of Schizophrenia cont… cont…

Negative symptoms Negative symptoms areare a loss or a loss or deficiency in thought or behavior that deficiency in thought or behavior that is characteristic of normal functioningis characteristic of normal functioning

Social withdrawalSocial withdrawal ApathyApathy Loss of motivationLoss of motivation Flat affectFlat affect

– Limited speech and slow movementsLimited speech and slow movements– Poor hygiene and grooming Poor hygiene and grooming

Explaining Schizophrenia

There is probably no single cause of There is probably no single cause of schizophreniaschizophrenia

Instead, several factors interact to Instead, several factors interact to produce schizophrenia, including:produce schizophrenia, including:– Constitutional vulnerability– Stress– Neuromaturational processes

Explaining Schizophrenia Explaining Schizophrenia cont…cont…

Constitutional vulnerability Constitutional vulnerability refers to refers to the aspects of an individual’s congenital the aspects of an individual’s congenital risk of developing schizophrenia that are risk of developing schizophrenia that are attributable to two factors:attributable to two factors:

GenderGender – Males are more likely than – Males are more likely than females to develop schizophrenia females to develop schizophrenia

Heredity Heredity –– Chances of developing Chances of developing schizophrenia are higher if one has a schizophrenia are higher if one has a close genetic relative with schizophreniaclose genetic relative with schizophrenia

Explaining Schizophrenia Explaining Schizophrenia cont…cont…

StressStress– Stressful events may trigger development Stressful events may trigger development

of schizophrenia in individuals with of schizophrenia in individuals with constitutional vulnerabilityconstitutional vulnerability

Neuromaturational processesNeuromaturational processes– Environmental factors may disrupt normal Environmental factors may disrupt normal

brain developmentbrain development– Causing decreased frontal lobe Causing decreased frontal lobe

functioning, destruction of gray matter, functioning, destruction of gray matter, and abnormal dopamine activityand abnormal dopamine activity

Figure 12.6 Destruction of Gray Matter in the Brains of Adolescents Diagnosed with Schizophrenia

Drug Therapy

Antipsychotic drugsAntipsychotic drugs– Prescribed primarily for Prescribed primarily for schizophreniaschizophrenia – Used to treat symptoms such as Used to treat symptoms such as

hallucinations, delusions, and disorganized hallucinations, delusions, and disorganized behaviorbehavior

– Work by inhibiting Work by inhibiting dopaminedopamine activity activity