psychological disorders. i. defining and diagnosing disorders

Psychological disordersPsychological disorders

I. Defining and diagnosingI. Defining and diagnosingdisordersdisorders

Mental disorderMental disorder

Any behavior or Any behavior or emotional state that:emotional state that:• causes a person to suffercauses a person to suffer• is self-destructiveis self-destructive• seriously impairs the person’s ability seriously impairs the person’s ability to work or get along with othersto work or get along with others• endangers others or the communityendangers others or the community

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Diagnostic and Statistical Manual Diagnostic and Statistical Manual [DSM][DSM]

Axis I: Primary clinical problemAxis I: Primary clinical problem

Axis II: Personality disordersAxis II: Personality disorders

Axis III: General medical conditionsAxis III: General medical conditions

Axis IV: Social and environmental Axis IV: Social and environmental stressorsstressors

Axis V: Current and past levels of Axis V: Current and past levels of overall functioningoverall functioning

Explosion of mental Explosion of mental disordersdisordersSupporters Supporters of new of new categories answer that it categories answer that it is important to is important to distinguish disorders distinguish disorders precisely.precisely.

Critics Critics point to point to economics: diagnoses are economics: diagnoses are needed for insurance needed for insurance reasons for therapists to reasons for therapists to be compensated.be compensated.

Projective testsProjective tests

Projective testsProjective testsPsychological tests used to Psychological tests used to infer a person’s motives, infer a person’s motives, conflicts, and unconscious conflicts, and unconscious dynamics on the basis of the dynamics on the basis of the person’s interpretation of person’s interpretation of ambiguous stimuliambiguous stimuli

Rorschach inkblot testRorschach inkblot testA projective personality test A projective personality test that asks respondents to that asks respondents to interpret abstract, interpret abstract, symmetrical inkblotssymmetrical inkblots

Objective testsObjective tests

InventoriesInventoriesStandardized objective questionnaires Standardized objective questionnaires requiring written responsesrequiring written responses

Typically include scales on which people Typically include scales on which people are asked to rate themselvesare asked to rate themselves

““Evaluating Whether You Are Depressed”Evaluating Whether You Are Depressed”

II. Mood disordersII. Mood disorders

Symptoms ofSymptoms of depression depressionMajor depressionMajor depression

A mood disorder involving disturbances in:A mood disorder involving disturbances in:

•emotion emotion (depressed mood, excessive sadness)(depressed mood, excessive sadness)

•behaviorbehavior (reduced interest in one’s usual activities)(reduced interest in one’s usual activities)

•cognitioncognition (thoughts of hopelessness, feelings of (thoughts of hopelessness, feelings of worthlessness or guilt, reduced ability to concentrate, worthlessness or guilt, reduced ability to concentrate, recurrent thoughts of death)recurrent thoughts of death)

•body functionbody function (fatigue, loss of appetite, significant weight (fatigue, loss of appetite, significant weight loss or gain, sleeping too much or too little)loss or gain, sleeping too much or too little)

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DSM IV requires 5 of these within the past 2 weeks

Bipolar disorderBipolar disorder

A mood disorder in A mood disorder in which episodes of which episodes of depression and mania depression and mania (excessive euphoria) (excessive euphoria) occur.occur.AKA: manic-depressive AKA: manic-depressive disorderdisorder

Genetic factors in Genetic factors in depressiondepressionStudies of adopted children support genetic Studies of adopted children support genetic explanations of depression.explanations of depression.

5-HTT is a gene that is present in either a long or 5-HTT is a gene that is present in either a long or short form.short form.17% of individuals with the long form become severely depressed.17% of individuals with the long form become severely depressed.43% of individuals with 2 copies of the short form become depressed.43% of individuals with 2 copies of the short form become depressed.

Genetics may also influence levels of serotonin and Genetics may also influence levels of serotonin and other neurotransmitters.other neurotransmitters.

Biomedical therapy is common for depression.Biomedical therapy is common for depression. Major depressionMajor depression: Antidepressant medication: Antidepressant medication Bipolar disorderBipolar disorder: Lithium : Lithium (also antidepressants, antipsychotics)(also antidepressants, antipsychotics)

Life experiences and Life experiences and circumstancescircumstancesSocial explanationsSocial explanations emphasize the emphasize the stressful stressful circumstances in circumstances in people’s lives.people’s lives.• Loss of or problems with Loss of or problems with important relationshipsimportant relationships• Women are less satisfied Women are less satisfied with work and family and with work and family and more likely to live in poverty.more likely to live in poverty.•A health psychologist might A health psychologist might emphasize stress reductionemphasize stress reduction

Cognitive habitsCognitive habits

Cognitive explanations Cognitive explanations emphasize habits of thinking emphasize habits of thinking and ways of interpreting and ways of interpreting events.events.

Depressed people believe Depressed people believe their situation is permanent, their situation is permanent, uncontrollable.uncontrollable.

RuminationRuminationBrooding about negative Brooding about negative aspects of one’s lifeaspects of one’s life

Cognitive therapyCognitive therapy is often is often effective in treating effective in treating depressiondepression

III. Anxiety disordersIII. Anxiety disorders

Generalized anxiety Generalized anxiety disorderdisorder

Continuous state Continuous state of anxiety marked of anxiety marked by feelings of by feelings of worry and dread, worry and dread, apprehension, apprehension, difficulties in difficulties in concentration, concentration, and signs of motor and signs of motor tensiontension

Panic disorderPanic disorder

An anxiety disorder An anxiety disorder in which a person in which a person experiences experiences recurring panic recurring panic attacksattacksPanic attack:Panic attack: a feeling of a feeling of impending doom or death, impending doom or death, accompanied by physiological accompanied by physiological symptoms such as rapid symptoms such as rapid breathing and dizzinessbreathing and dizziness

Fears and phobiasFears and phobias

PhobiaPhobiaAn exaggerated, unrealistic fear of a specific situation, An exaggerated, unrealistic fear of a specific situation, activity, or objectactivity, or object

AgoraphobiaAgoraphobia

A set of phobias, A set of phobias, often set off by a often set off by a panic attack, panic attack, involving the basic involving the basic fear of being away fear of being away from a safe place or from a safe place or person.person.

Posttraumatic stress Posttraumatic stress disorderdisorder

An anxiety disorder in which a person who An anxiety disorder in which a person who has experienced a traumatic or life-has experienced a traumatic or life-threatening event has symptoms such as threatening event has symptoms such as psychic numbing, reliving the trauma, and psychic numbing, reliving the trauma, and increased physiological arousalincreased physiological arousal

Diagnosed only if symptoms persist for six Diagnosed only if symptoms persist for six months or longermonths or longer

May immediately follow event or occur May immediately follow event or occur laterlater

Obsessive-compulsive Obsessive-compulsive disorderdisorder

An anxiety disorder in An anxiety disorder in which a person feels which a person feels trapped in repetitive, trapped in repetitive, persistent thoughts persistent thoughts ((obsessionsobsessions) and ) and repetitive, ritualized repetitive, ritualized behaviors (behaviors (compulsionscompulsions) ) designed to reduce designed to reduce anxietyanxiety

Treatment of anxiety Treatment of anxiety disordersdisorders

•Biomedical therapyBiomedical therapy (antidepressant and (antidepressant and antianxiety medication)antianxiety medication)•Cognitive therapyCognitive therapy•Behavior therapyBehavior therapy

IV. Dissociative disordersIV. Dissociative disorders

Dissociative amnesiaDissociative amnesia

Involves memory loss caused by extensive Involves memory loss caused by extensive psychological stresspsychological stress

Dissociative identity Dissociative identity disorderdisorderA controversial disorder marked by the A controversial disorder marked by the appearance within one person of two or appearance within one person of two or more distinct personalities, each with its more distinct personalities, each with its own name and traitsown name and traitsCommonly known as Commonly known as Multiple Personality DisorderMultiple Personality Disorder

The MPD controversyThe MPD controversy

First viewFirst view•MPD is common but often unrecognized as such.MPD is common but often unrecognized as such.•Starts in childhood as a means of copingStarts in childhood as a means of coping•Trauma produced a mental splitting.Trauma produced a mental splitting.

Second viewSecond view•Created through pressure andCreated through pressure and

suggestion by clinicianssuggestion by clinicians•Handfuls to 10,000 since 1980Handfuls to 10,000 since 1980

Sociocognitive explanationSociocognitive explanation

MPD is an extreme form of our ability to MPD is an extreme form of our ability to present many aspects of our personalities present many aspects of our personalities to others.to others.

MPD is a socially acceptable way for some MPD is a socially acceptable way for some troubled people to make sense of their troubled people to make sense of their problems.problems.

Therapists looking for MPD may reward Therapists looking for MPD may reward patients with attention and praise for patients with attention and praise for revealing more and more personalities.revealing more and more personalities.

V. Personality disordersV. Personality disorders

Problem personalitiesProblem personalities

Personality disorderPersonality disorderRigid, maladaptive patterns Rigid, maladaptive patterns that cause personal distress that cause personal distress or an inability to get along or an inability to get along with otherswith others

Narcissistic personality Narcissistic personality disorderdisorderCharacterized by an Characterized by an exaggerated sense of self-exaggerated sense of self-importance and self-importance and self-absorption absorption

Criminals and psychopathsCriminals and psychopaths

Antisocial personality disorderAntisocial personality disorderCharacterized by a lifelong pattern of irresponsible, Characterized by a lifelong pattern of irresponsible, antisocial behavior such as lawbreaking, violence, and antisocial behavior such as lawbreaking, violence, and other impulsive, restless actsother impulsive, restless acts

VI. SchizophreniaVI. Schizophrenia

SchizophreniaSchizophrenia

A psychotic disorder marked by:A psychotic disorder marked by:DelusionsDelusionsHallucinationsHallucinationsDisorganized, incoherent speechDisorganized, incoherent speechInappropriate behaviorInappropriate behaviorImpaired cognitive abilitiesImpaired cognitive abilities

Typical onset: adolescence to early adulthoodTypical onset: adolescence to early adulthood

Delusions and Delusions and hallucinationshallucinations

Delusions Delusions False beliefs that often False beliefs that often accompany schizophrenia accompany schizophrenia and other psychotic and other psychotic disordersdisorders

Hallucinations Hallucinations Sensory experiences that Sensory experiences that occur in the absence of occur in the absence of actual stimulationactual stimulation

Genetic vulnerabilityGenetic vulnerability

The risk of The risk of developing developing schizophrenia schizophrenia increases as the increases as the genetic genetic relatedness with a relatedness with a diagnosed diagnosed schizophrenic schizophrenic increases.increases.

Structural brain Structural brain abnormalitiesabnormalitiesSeveral abnormalities Several abnormalities exist:exist:Decreased brain weightDecreased brain weightDecreased volume in Decreased volume in temporal lobe or temporal lobe or hippocampushippocampusEnlargement of ventriclesEnlargement of ventricles

About 25% do not About 25% do not have these have these observable brain observable brain deficiencies.deficiencies.

Neurotransmitter Neurotransmitter abnormalitiesabnormalitiesMany schizophrenics have Many schizophrenics have high levels of brain high levels of brain activity in areas served activity in areas served by dopamine, and greater by dopamine, and greater numbers of dopamine numbers of dopamine receptors.receptors.

Abnormalities may also Abnormalities may also involve serotonin, involve serotonin, glutamateglutamate

Biomedical therapyBiomedical therapy: : antipsychotic medicationantipsychotic medication

Prenatal or birth Prenatal or birth complicationscomplications

Damage to the fetal Damage to the fetal brain increases brain increases chances of chances of schizophrenia and schizophrenia and other mental other mental disorders.disorders.Damage may occur as a Damage may occur as a function of:function of:

maternal malnutritionmaternal malnutritionmaternal illnessmaternal illnessbrain injurybrain injuryoxygen deprivation at oxygen deprivation at

birthbirth