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Psychological Disorder

Psychological Disorder - Psychological Disorders Disorders...

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