14 Psychological Disorder

14 Psychological Disorder - Psychological Psychological...

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Unformatted text preview: Psychological Psychological Disorders Causes of Abnormal Behavior Causes of Abnormal Behavior Genetic errors (Huntington’s Disease) Progressive Cell Death­(Alzheimer’s/ Parkinsons) Rapid Cell death­ traumatic brain injury Loss of neural connections­ MS Still lots of work to be done in this field Research Methods Research Methods Patients Brain imaging studies Behavioral studies Case studies Monkeys Rats/Mice/KO Mice Laboratory Animals Molecular Biology Genetic Studies Challenges of Diagnosis Challenges of Diagnosis Can only judge based on pt behavior Self and/or families People are subjective Interpretation by different professionals Psychiatrist, General Practitioner, Psychologist Social work, neurologist, etc. Differences in diagnostic criteria Both causes and treatments Challenges of Research Challenges of Research Nonspecificity of NT’s Diffuse throughout the brain, serving dif fxns No specific receptor for specific problem Ex: Aspirin headache Ex: Schizophrenia/antipsychotics block D2 receptor), helpful but not causational Animal model provide oversimplified view Brain lesions do not produce behavioral symptoms How do we classify mental illness? How do we classify mental illness? DSM­IV­TR Diagnostic & Statistical Manual of Mental Disorder, 4th ed. (DSM­IV­TR) System devised by APA used by professionals to diagnose & classify abnormal behavior 17 major categories 5 Axes to assess a patient DSM categories DSM categories D/o diagnosed in infancy, childhood, & adolescence Delirium, dementa, amnesia, other cognitive d/o’s Mental d/o’s due to gen. med. cond Substance­related d/o Schizophrenia & other psychotic d/o Mood d/o Anxiety d/o Somatoform d/o Fictitious d/o Dissociative d/o Eating d/o Sexual d/o, sexual ident d/o Sleep d/o Impulse­control d/o Adjustment d/o Other cond. May be of focus of clinical attention Anxiety disorder Anxiety disorder Anxiety­ feeling of apprehension/tension in reaction to stressful situations Anxiety d/o is occurrence of anxiety w/o an obvious external cause, affects daily functioning 1. Phobic D/o 2. Panic D/o 3. Generalized anxiety D/o 4. Obsessive­Compulsive D/o Anxiety D/o’s Anxiety D/o’s Trigger by life experiences, psychological traits stress, inadequate coping mechanisms Family history and genetics Some studies found imbalance in brain NT’s that regulate anxiety (NE, 5­HT, GABA), may contribute to the symptoms Brain Areas in anxiety Brain Areas in anxiety Forebrain is greatly affected in people w/anxiety Limbic system­ memories/emotions, plays a central role in processing anxiety­related info. Locus coeruleus and the dorsal raphe project projects to other areas that mediate anxiety. Hippocampus, amygdala, hypothalamus also play a role NOT LIMITED TO JUST THESE AREAS Obsessive­Compulsive Disorder Obsessive­Compulsive Disorder Characterized by obsessions and/or compulsions ~3.3 mil, 2.3%, US pop OCD Initial symptoms often childhood adolescence. Equal in males/females. Comorbid w/depression, eating disorders, substance abuse, other anxiety disorders Obsessions vs Compulsions Obsessions vs Compulsions Obsession­ persistent, unwanted thought, idea keeps recurring Ex: “Plane crash” Compulsion­ irresistible urge strange/ unreasonable act Ex: “Tap plane 15x wont crash” “Magical” superstitious thinking Common Obsessions Common Obsessions Common Compulsions Contamination fears of germs, dirt, Washing etc. Imagining having harmed self or Repeating others Imagining losing control or aggressive Checking urges Intrusive sexual thoughts or urges Touching Excessive religious or moral doubt Counting Forbidden thoughts Ordering/Arranging A need to have things "just so“ Hoarding A need to tell, ask, confess Praying OCD and Brain Imaging OCD and Brain Imaging http://www.sciencedaily.com/releases/2008/07/080717140456.htm Treatments for anxiety Treatments for anxiety Cognitive­Behavioral Therapy (CBT) Systematic desensitization­ expose anxiety obj repeatedly to patient, w/relaxation techniques. phobia loses anxiety­provoking power Medication restore chemical imbalances lead to symptoms Relaxation Techniques­ Breathing, exercise, etc. Treatment 90 % successful for anxiety d/o patients. Best type is combo of techniques Possible Medication for anxiety Possible Medication for anxiety Drug Class Antidepressants SSRIs, TCAs, MAOIs Anxiolytics Benzodiazepines AntiConvulsants Examples Prozac, Zoloft, Paxil, Cymbalta, Nardil Xanax, Klonopin Target D/o’s PD, OCD, SAD, GAD, PTSD GAD, SAD, PD Potential Mechanism of Axn Affects conc. and activity of 5­HT (and/or NE) Enhance GABA; exact mechanism not known Depakote, Lamictal Augmentation Enhance GABA, Therapy­ increase mechanism still effects of other meds partially unknown Performance Anxiety, PD Augmentation therapy; OCD; anxiety Noadrenergic Agents BetaBlockers, Atypical Antipsychotics Inderal Blocks receptors assoc. w/physiologic symptoms of anxiety May be given in combo w/other meds; affects 5­HT conc. Abilify, Zyprexa, Seroquel, Risperdal Schizophrenia Schizophrenia Class of disorders severe distortion of reality occurs ~1 % US pop. develops schizophrenia ~2 mil = men & women Symptoms: hearing voices, believing others read their minds, controlling their thoughts, or plotting to harm. Characteristic symptoms Characteristic symptoms 2 or more present during a 1­mo period Positive Symptoms Delusions Hallucinations Disorganized speech Grossly disorganized beh Negative Symptoms Negative Symptoms Absence/lack of abilities. Lack of emotion Blank, blunted facial expression/movements Difficulty or inability to speak Inappropriate social skills/inability to socialize Inability to make/keep friends Social isolation What causes schizophrenia? What causes schizophrenia? Cause unknown Both biological predisposition and environment Schizophrenia Schizophrenia Env. factors ↑ chance of schizophrenia Ex: lead exposure during pregnancy Birth complications Extremely high stress experiences while young Drug use while a teenager Genetic Component of schizophrenia Genetic Component of schizophrenia Identical Twins Studies Identical Twins Studies The image to the left shows an MRI image of unaffected and schizophrenic identical twins. The brain structures pointed out are the ventricles. These differences clearly indicate non­genetic factors play a role in the pathology of schizophrenia. Brain Imaging Studies Brain Imaging Studies Mood Disorders Mood Disorders Disturbance in emotional feelings intrude on everyday living Ex: Major Depression Mania and Bipolar disorders Bipolar Disorders Schizophrenia Depression 1yr period, 9.5 % of US pop ~ 18.8 adults, suffer fromdepressive illness Affects eat/sleep, person’s feelings, perception of world Symptoms last for weeks, mos, or yrs. Women: men (2:1), hormones may contribute to menstrual cycle, pregnancy, postpartum, menopause. Criteria for Major Depression Criteria for Major Depression 5 of 9 symptoms for 2 weeks or more: Depressed mood ↓ level of interest or pleasure in activities. Loss or gain of weight or appetite Difficulty falling/staying asleep/or sleeping more than usual. Fatigued ↓ energy. Thoughts of worthlessness/extreme guilt. Inability to think, concentrate, or make decisions Frequent thoughts of death or suicide Symptoms cause great distress/difficulty fxn at home/work Symptoms not caused by substances, or grief over the death of a loved one Mania Mania Extended state of intense, wild elation. Intense happiness, power, invulnerability, energy. Wild schemes, will succeed at anything they attempt Mania Mania Excessive elation ↓ need for sleep Grandiose notions ↑ talking Racing thoughts ↑ sexual desire Markedly increased energy Inappropriate social behavior Bipolar Disorder Bipolar Disorder Old Manic Depression Dramatic mood swings episodes of mania to depression back and forth 1% US pop­ 2 mil. have bipolar disorder. Typically develops late adolescence/early adulthood. Bipolar and Creativity Bipolar and Creativity Disproportionate #’s in people w/creative talent artists, musicians, authors, poets, scientists Are the mechanisms which cause the disorder responsible for their creativity??? Famous Bipolar Sufferers Famous Bipolar Sufferers Vincent Van Gogh Dec 1888, psychotic episode threatened life of Gauguin Van Gogh cut off piece of left ear as gift to a prostitute. Sought mental asylum for yr, left in frustration July 27, 1890, Vincent walks to a wheat field and shoots himself in the chest. For depression­ SSRI’s­ Zoloft or Prozac, ↑ levels of serotonin For Bipolar disorder Mood stabilizers­ Lithium Treatments for mood Treatments disorders Personality Disorders Personality Disorders Characterized by set of inflexible, maladaptive personality traits keep a person from functioning properly in society People w/personality d/o not usually affected by them, little personal distress ­Antisocial Personality D/o ­Borderline Personality D/o ­Narcissistic Personality D/o Antisocial Personality disorder Antisocial Personality disorder Indiv. no regard for moral/ethical rules of society or rights of others Failure to conform to social norms Deceitfulness Impulsivity Irritability & aggressiveness Reckless disregard for safety of self or others Consistent irresponsibility Lack of remorse­ indifferent to or rationalizing hurting, mistreating, or stealing from another Antisocial Personality Disorder Antisocial Personality Disorder Psychopathic/Sociopathic personality disorder Approximately 3% of men and 1% of women Famous Antisocial Famous Antisocial Charles Manson convicted for 2 separate mass murders carried out by his followers Through his charisma, use of sex, drugs, pseudo­religious mantras Deep control over followers, believed he was Jesus Famous Antisocial Famous Antisocial Ted Bundy, serial killer confessed 30 murder est. above 100 Believed to be sociopath. Intelligent, educated, personable, handsome, charming, regularly brutally murdered women/girls, w/ blunt instrument or strangled. Often sexually assault victims before & after death. Borderline Personality disorder Borderline Personality disorder Unstable interpersonal relationships. Exhibits impulsive behaviors/frantic efforts to avoid real or imagined abandonment. 2% of pop, 75% female Indiv. difficulty developing secure sense of self Borderline Borderline Unstable/intense interpersonal relationships Unstable self­image Impulsivity­spending, sex, substances, binging Recurrent suicidal beh, self­mutilating beh Intense moods Chronic feelings of emptiness Intense anger or difficulty controlling anger Common co­occur Eating Disorders (Bulimia) Began body­cutting to "feel something emotionally" collects knives Japanese symbol "death" tattooed on shoulder , Latin words, 'Quod me nutrit me destruit,' on stomach "What nourishes me also destroys me." Battled eating disorders Married & divorced several times Borderline Personality D/o Borderline Personality D/o The DSM IV isn’t perfect The DSM IV isn’t perfect DSM changed over yrs D/o removed & added Manic­depression­ bipolar disorder Mult. Personality ­to dissociative ident. d/o Self­defeating personality disorder removed Premenstrual Dysphoric disorder added More ADHD diagnosed today Cultural differences Cultural differences What is normal/abnormal? Anorexia­ not present in all societies Dissociative Identity D/o not in societies where not a defined sense of self Koro d/o in SE Asian males, intense panic that penis is about to withdraw into abdomen. Medical Student’s Disease Medical Student’s Disease Psychology student’s disease Symptoms­ feeling having one, many, or all of disorders we just talked about Or trying to diagnose your friends Psychology a continuum Everyone exhibits some behaviors at some point in life When symptoms last signif. time, cause signif. ↓ in function or distress to indiv. or those around them, becomes d/o The end The end ...
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