Ch.16.ppt _ F07

Ch.16.ppt _ F07 - Chapter 16 Psychological Disorders...

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Unformatted text preview: Chapter 16: Psychological Disorders Psychological Disorder a "harmful dysfunction" in which behavior is judged to be: atypical disturbing maladaptive unjustifiable Psychological Disorders Medical Model concept that diseases have physical causes that can be diagnosed, treated, and cured assumes that these "mental" illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital (or w/ drugs) Psychological Disorders Bio-psycho-social Perspective assumes that biological, sociocultural, and psychological factors interact to produce psychological disorders Psychological Disorders DSM-IV DSM-TR APA's Diagnostic and Statistical Manual of Mental Disorders (4/e - TR) used for classifying psychological disorders Multiaxial Classification Is a Clinical Syndrome (cognitive, anxiety, mood Axis I disorders [16 syndromes]) present? Axis II Is a Personality Disorder or Mental Retardation present? Is a General Medical Condition (diabetes, Axis III hypertension or arthritis etc) also present? Are Psychosocial or Environmental Problems Axis IV (school or housing issues) also present? What is the Global Assessment of the person's Axis V functioning? Psychological Disorders Neurotic problems (term seldom used now) usually distressing but that allows one to think rationally and function socially Psychotic disorder person loses contact with reality experiences irrational ideas and distorted perceptions Example: Schizophrenia Psychological Disorders Anxiety Disorders Generalized Anxiety, Phobias, Panic Disorder, & Obsessive-Compulsive, & PTSD Mood Disorders Depression & Bipolar Disorder Major Schizophrenia Personality Antisocial Disorders Personality Dissociative Disorders Identity Disorder Dissociative Anxiety Disorders Anxiety Disorders distressing, persistent anxiety or maladaptive behaviors that reduce anxiety person is tense, apprehensive, and in a state of autonomic nervous system arousal persistent, irrational fear of a specific object or situation Generalized Anxiety Disorder Phobia Kinds of Phobias Agoraphobia Acrophobia Claustrophobia Hemophobia Phobia of open places. Phobia of heights. Phobia of closed spaces. Phobia of blood. Anxiety Disorders Panic Disorder marked by an episode of intense dread in which a person experiences terror and often chest pains, choking, or other frightening sensation by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Obsessive-Compulsive Disorder characterized Anxiety Disorders Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder Thought or Behavior Obsessions (repetitive thoughts) Concern with dirt, germs, or toxins Something terrible happening (fire, death, illness) Symmetry order, or exactness Compulsions (repetitive behaviors) Excessive hand washing, bathing, tooth brushing, or grooming Repeating rituals (in/out of a door, up/down from a chair) Checking doors, locks, appliances, car brake, homework 85 51 46 40 40 24 Percentage* Reporting Symptom PostTraumatic Stress Disorder Four or more weeks of the following symptoms constitute posttraumatic stress disorder (PTSD): Haunting memories 2. Nightmares 3. Social withdrawal 1. 4. Jumpy anxiety 5. Sleep problems Bettmann/ Corbis Resilience to PTSD Only about 10% of women and 20% of men react to traumatic situations and develop PTSD. Holocaust survivors show remarkable resilience against traumatic situations. All major religions of the world suggest that surviving a trauma leads to the growth of an individual. Anxiety Disorders- Treatment G.A.D. & Panic: Cognitive-Behavior Anti-depressants Therapy O.C.D. & Phobia: Cognitive-Behavioral Therapy Exposure Therapy (Systematic Desensitization) Anti-depressants Mood Disorders Mood Disorders characterized by emotional extremes Major Depressive Disorder a mood disorder ; for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. Signs include: 1. 2. 3. 4. Lethargy and fatigue Feelings of worthlessness Loss of interest in family & friends Loss of interest in activities Dysthymic Disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Blue Mood Dysthymic Disorder Major Depressive Disorder Bipolar Disorder Formerly called manicdepressive disorder. An alternation between depression and mania signals bipolar disorder. Depressive Symptoms Gloomy Withdrawn Inability to make decisions Tired Slowness of thought Manic Symptoms Elation Euphoria Desire for action Hyperactive Multiple ideas Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. George C. Beresford/ Hulton Getty Pictures Library Earl Theissen/ Hulton Getty Pictures Library The Granger Collection Bettmann/ Corbis Whitman Wolfe Clemens Hemingway Mood Disorders-Bipolar PET scans show that brain energy consumption rises and falls with emotional swings Depressed state Manic state Depressed state Mood Disorders-Treatment Major Depression Drugs (Prozac - 70% show improvement) Behavioral-Cognitive Therapy ElectroConvulsive Therapy (ECT) 70-130 volts Last resort treatment (30% of depression cases) Effective 60-80% Bipolar Drugs (Lithium) Personality Disorders Personality Disorders disorders characterized by inflexible and enduring behavior patterns that impair social functioning usually without anxiety, depression, or delusions Dramatic / impulsive personality disorders Histrionic personality disorder Shallow, attn-getting behavior; exhibitionistic beh.; egocentric Dennis Rodman Exaggerate own importance Theatrical performers are vulnerable Unstable relationships, identity, emotions; threats of self-destructive behavior Narcissistic personality disorder Borderline personality disorder Personality Disorders Three clusters: 1) Anxiety behaviors (withdrawal) Avoidant personality disorder Schizoid personality disorder 2) Eccentric behaviors 3) Dramatic or impulsive behaviors Personality Disorders Antisocial Personality Disorder disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members may be aggressive and ruthless or a clever con artist Personality Disorders PET scans illustrate reduced activation in a murderer's frontal cortex Normal Murderer Schizophrenia Schizophrenia Psychotic Split disorder from reality a group of severe disorders characterized by: disorganized and delusional thinking disturbed perceptions inappropriate emotions and actions Subtypes of Schizophrenia Paranoid: Disorganized: Preoccupation with delusions or hallucinations Disorganized speech or behavior, or flat or inappropriate emotion Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another's speech or movements Schizophrenia symptoms without fitting one of the above types Catatonic: Undifferentiated or residual: Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Brain Abnormalities Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluidfilled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development. Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991). 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries. Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983). The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. Courtesy of Genain Family Genain Sisters Warning Signs Early warning signs of schizophrenia include: 1. A mother's long lasting schizophrenia. 2. Birth complications, oxygen deprivation and low birth weight. 3. Short attention span and poor muscle coordination. 4. Disruptive and withdrawn behavior. 5. Emotional unpredictability. 6. Poor peer relations and solo play. Schizophrenia - Treatment Antipsychotic drugs To reduce positive symptoms Drugs to reduce levels of dopamine Thorazine or haloperidol For negative symptoms Drugs that reduce dopamine in addition to other neurotransmitters such as serotonin (clozapine) Dissociative Disorders Dissociative Disorders conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings Dissociative Identity Disorder rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities formerly called multiple personality disorder Rates of Psychological Disorders Percentage of Americans Who Have Ever Experienced Psychological Disorders Ethnicity Disorder Alcohol abuse or dependence Generalized anxiety Phobia Obsessive-compulsive disorder Mood disorder Schizophrenic disorder Antisocial personality disorder Gender Men 23.8% 2.4 10.4 2.0 5.2 1.2 White 13.6% 3.4 9.7 2.6 8.0 1.4 Black 13.8% 6.1 23.4 2.3 6.3 2.1 Hispanic 16.7% 3.7 12.2 1.8 7.8 0.8 Women 4.6% 5.0 17.7 3.0 10.2 1.7 Totals 13.8% 3.8 14.3 2.6 7.8 1.5 2.6 2.3 3.4 4.5 0.8 2.6 Risk and Protective Factors Risk and protective factors for mental disorders (WHO, 2004). Risk and Protective Factors ...
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