Psychology Chapter 16: Psychological Disorders

1. Psychology Chapter 16: Psychological Disorders

2. What are Psychological Disorders? Watch “What About Bob and complete worksheet • 1. Some behavior people see as normal while others see the same behavior as abnormal • a. Insanity has been defined as doing the same thing over and over, expecting a different result • b. The term insane is not used much more in the medical profession, replaced with psychopathology • 2. Deviation from Normality • a. Any deviation from the average or majority • b. Different cultural norms must be taken into consideration • i. Because the majority isn’t always right or best, this deviance approach is not in itself a useful standard • 3. Adjustment • a. Normal people are able to get along socially, physically and emotionally in the world • b. Can feed and clothe themselves • c. Abnormal people fail to adjust in these ways • d. But, behavior in one society may not be acceptable in other societies

3. What are Psychological Disorders cont. • 4. Psychological Health • a. Self-Actualization – Humanistic view that to be normal or healthy involves full acceptance and expression of one’s own individuality and humanness • i. Problem with this approach is that its hard to determine whether a person is actualizing themselves • b. Labeling a person as mentally ill because of their odd behavior is a mistake as well as cruel and irresponsible • c. Many of these people just have problems in living that causes conflicts • d. It is only when a psychological problem becomes severe enough to disrupt everyday life that it is thought of as an abnormality or illness • 5. The Problem of Classification • a. DSM – The Diagnostic and Statistical Manual of Mental Disorders • i. Currently in its 4th revision • ii. A classification manual that show such things as • 1. Features • 2. Diagnosis • 3. 5 Axis • Section 1 Review

4. Anxiety Disorders • 1. Anxiety – a general state of dread or uneasiness that a person feels in response to a real or imagined danger • a. Feeling anxiety out of proportion to the situation provoking it • b. Affects 19 million Americans annually • c. Characteristics: • i. Feelings of anxiety • ii. Personal inadequacy • iii. Avoidance of dealing with problems • iv. Unrealistic images of themselves • v. Unable to free themselves of recurring fears and worries • d. Expressed through: • i. Constant worrying • ii. Sudden mood swings • iii. Physical symptoms • a. headaches • b. sweating • c. muscle tightness • d. weakness • e. fatigue • e. Anxious people often have difficulty forming stable and satisfying relationships

5. Anxiety Disorders cont. • 2. General Anxiety Disorder • a. Feeling nervous for reasons they can’t explain • b. Can become full blown panic attacks • i. Choking sensation • ii. Chest pain • iii. Dizziness • iv. Trembling • v. Hot flashes • c. They neglect social relationships • d. Trouble dealing with friends, family or responsibilities • e. The more they worry the more difficulty they have, the more difficulty they have the more they worry – a vicious cycle • f. Physical symptoms attached include: poor appetite, frequent urination, indigestion and diarrhea • g. Causes: • i. Learned anxiety • ii. Inherited • iii. Environmental factors • iv. Uncertainties of modern life

6. Anxiety Disorders cont. • 3. Phobic Disorder (phobia) • a. Phobia/Phobic Disorder – when severe anxiety is focused on a particular object, animal, activity or situation that seems out of proportion to the real danger involved • b. Develop elaborate plans to avoid those situations • c. Can range from mild to severe • d. Treatment • i. Providing the person a experience their phobia under conditions where they feel safe • 4. Panic Disorder • a. Panic – a feeling of sudden, helpless terror • b. During a panic attack, the person experiences sudden, unexplainable, attacks of intense anxiety, leaving them fearing death and doom • c. Physical Symptoms: • i. Sense of smothering • ii. Choking • iii. Difficulty breathing • iv. Faintness or dizziness • v. Nausea • vi. Chest pains • d. Can last minutes or hours and occur without warning • e. Causes: • i. Inherited • ii. Environment • a. interpreting a physiological arousal (higher heart rate) as disastrous

7. Anxiety Disorders cont. • Obsessive-Compulsive Disorder • a. Obsession – an uncontrollable pattern of thoughts • b. Compulsion – repeatedly performing coping behaviors • c. Obsessive-Compulsive Disorder – experiencing both together • i. Everyone has obsessions and compulsions • ii. Problem when it interferes with what a person wants and needs to do • iii. Causes: • a. Serve as diversions from a person’s real fears and their origins and may reduce anxiety • b. May run in families, genetic • c. Most people with the disorder know that their thoughts and actions are irrational, but they feel unable to stop them

8. Anxiety Disorders cont. • 6. Post-Traumatic Stress Disorder • a. PTSD – a person who has experienced a traumatic event feels severe and long lasting aftereffects • b. Those who suffer include: • i. Veterans of wars • ii. Survivors of terrorist attacks • iii. Natural disaster victims: hurricanes, tornadoes • iv. Plane crashes • v. Assault and rape victims • c. The event that triggers the disorder overwhelms a person’s sense of reality and ability to cope • d. Can begin immediately after the event or later in life • e. Symptoms • i. Flashbacks • ii. Nightmares • f. Can be long lasting • g. People exposed to events repeatedly or over a long period of time are more likely to develop the condition Section 2 Review

9. Somatoform and Dissociative Disorders • Somatoform Disorders – when anxiety creates a variety of physical symptoms for which no physical cause is apparent • a. Also known as hysteria – unexplainable fainting, paralysis or deafness, used in Freud’s time • b. Conversion Disorders • i. Conversion Disorder – the conversion of emotional difficulties into the loss of a specific physiological function • a. No actual physical damage is present • ii. When someone is frightened and they can’t move (common), uncommon for it to persist • iii. Results in a real and prolonged handicap • iv. If a person wakes up paralyzed from the waist down and accepts it with calmness (la belle indifference), its known to be a psychological problem • v. Psychologists believe that people suffer from conversion disorders to gain freedom from unbearable conflict • vi. Very Rare!!

10. Somatoform and Dissociative Disorders cont. • c. Hypochondriasis • i. A person in good health who becomes preoccupied with imaginary ailments • ii. Hypochondriacs spend time looking for signs of serious illness and misinterprets minor aches, pains and bruises as early signs of fatal illness • a. Regardless of medical tests and diagnosis, they will continue to believe it • b. Occurs during young adulthood • c. Occurs when an individual represses emotions and then expresses them symbolically in physical symptoms 2. Dissociative Disorders – when a person experiences alterations in memory, identity or consciousness a. Can be normal, daydreaming and not hearing your name being called b. Amnesia and multiple personality are very, very rare

11. Somatoform and Dissociative Disorders cont. • c. Dissociative Amnesia • i. Memory loss that has no biological explanation • ii. May be an attempt to escape from problems by blotting them out entirely • iii. Remember how to speak and retain general knowledge, but don’t know who they are, where they are from, how they got where they are • iv. Most often results from a traumatic event – a terrible accident • d. Dissociative Fugue • i. Amnesia coupled with an active flight to a different environment • ii. Person disappears and then wakes up the next day long ways from home • iii. If not treated, they establish a new identity in the new place • iv. Represses all knowledge of a previous life • v. May last for days or years • vi. When they re-emerge, they have no memory of what had happened • vii. Escape from unbearable conflict or anxiety

12. Somatoform and Dissociative Disorders cont. • e. Dissociative Identity Disorder (multiple personality disorder) • i. A person exhibits two or more personality states, each with its own behavior and thinking patterns • ii. Different states may take controls at different times • iii. Famous Case – Eve White • a. Treatment for severe headaches and blackouts, conscientious, self-controlled, and shy • b. During one treatment, her expression and personality suddenly changed, became Eve Black • c. Child-like, fun-loving and irresponsible (opposite of her other self) • d. Eve Black was conscious of Eve White but considered her a separate person, Eve White didn’t know about Eve Black though nor Jane (a 3rd personality) • e. Film – The 3 Faces of Eve • f. Went on to write a book detailing 22 identities • g. Sybil (book and film as well) had 16 personalities • iv. Psychologists believe that dividing up the personality is the individual’s effort to escape from a part of the self that they fear • v. The secret self then emerges as a separate identity • vi. EXTREMELY RARE!!! And controversial • vii. People diagnosed usually suffered from severe physical, psychological or sexual abuse during childhood Section 3 Review

13. Schizophrenia and Mood Disorders Watch “A Beautiful Mind” and complete worksheet • 1. People with schizophrenia often have difficulty using language to communicate • a. They go from one phrase to another by random association • b. Schizophrenia affects the area of the working memory used to make sentences • c. Don’t remember the beginning of the sentence so they finish it with an unrelated thought • 2. People with schizophrenia withdraw from normal life, have distorted perceptions and whose behavior reach an irrational, fantastic, fear-laden, unimaginable levels • 3. Examples: • a. Marshall Applewhite and 38 members of Heaven’s Gate • b. Charles Manson (In Dispute) • c. Joan of Arc • d. Adolf Hitler • e. Jim Jones • f. Son of Sam – David Berkowitz (In Dispute) • g. Unabomber Ted Kaczynski (In Dispute) • h. Syd Barrett • i. Mary Todd Lincoln

14. Schizophrenia and Mood Disorders cont. • 4. What is Schizophrenia • a. Schizophrenia – involves confused and disordered thoughts and perceptions • i. Affects 1 in 100 worldwide • ii. Thoughts are disturbed and contact is lost with reality to a considerable extent • iii. Live life as an unreal dream • Read quote ending with “Naturally, I am growing my father’s hair.” • iv. Not a single problem, no single cause, no single cure • v. Symptoms • a. Delusions – false beliefs maintained in the face of contrary evidence • b. Hallucinations – perceptions in the absence of corresponding sensation • c. Incoherence – marked decline in thought process • d. Word Salad – lots of words thrown together • e. Disturbances of affect – emotions that are inappropriate for the circumstances • f. Deterioration in normal movement – slowed movement, nonmovement or highly agitated behavior • g. Decline in previous level of functioning – sharp drop off in productivity of work • h. Diverted attention – as if the person is unable to focus their attention

15. Schizophrenia and Mood Disorders cont. • b. Types of Schizophrenia • i. Paranoid Type • a. Involves hallucinations and delusions • aa. Grandeur – “I am the savior of my people” • bb. Persecution – “Someone is always watching me” • ii. Catatonic Type • a. Remain motionless for long periods • b. Exhibiting waxy, flexibility in which limbs in unusual positions may take a long time to return to a resting, relaxed position • iii. Disorganized Type • a. Incoherent language, inappropriate emotions, giggling for no apparent reason, generally disorganized motor behavior and hallucinations/delusions • iv. Remission Type • a. Anyone whose symptoms are gone or still exist but aren’t severe enough to have earned a diagnosis of schizophrenia in the first place • b. Belief is that the symptoms will return • v. Undifferentiated Type • a. Encompasses a large amount of the symptoms all in one person

16. Schizophrenia and Mood Disorders cont. • c. Treatment • i. Very complex condition • ii. Treatment is long term and usually requires hospitalization • a. Sometimes leads to burn-out – one who is not likely to function normally in society • iii. May go into remission but adjustment tends to deteriorate between successive episodes of the reappearance of symptoms • iv. No real cure for schizophrenia exists • d. Cause of Schizophrenia • i. Biological Influences/Genetics • a. Almost certainly involved • b. 1% of having schizophrenia, 10% if someone else in the family has it, in twins there is a 48% chance if one has it, the other will • c. Can’t specify the exact contribution hereditary factors have

17. Schizophrenia and Mood Disorders cont. • ii. Biochemistry and Physiology • a. Chemical imbalances in the brain • b. Too much or too little of a specific chemical in the brain has upset the processing of information, interferes with normal synaptic transmission (Page 157-158) • c. Dopamine Hypothesis – too much dopamine at the selected synapses • d. Using CAT and MRI scans, shows signs of deteriorated brain tissue • e. Exact role of the environment is fostering schizophrenia is unclear, but it is involved • iii. Family and Interactions • a. Pathogenic, unhealthful, families may contribute to problems in adult years, but don’t in and of themselves lead to schizophrenia • 5. Mood Disorders • a. Emotions that hamper the ability to function effectively • i. In extreme cases, a mood may cause them to lose touch with reality or threaten their health or lives

18. Schizophrenia and Mood Disorders cont. • b. Major Depressive Disorder • i. Spend at least 2 weeks feeling depressed, sad, anxious, fatigued and agitated • a. Causes a reduced ability to function and interact with others • b. Mild feelings of uneasiness, sadness and apathy to intense suicidal despair • c. CAN NOT be associated with bereavement – loss of a loved one • d. Marked by 4 symptoms • aa. Problems with eating, sleeping, thinking, concentrating and decision making • bb. Lacking energy • cc. Thinking about suicide • dd. Feeling worthless or guilty

19. Schizophrenia and Mood Disorders cont. • c. Bipolar Disorder– individuals are excessively and inappropriately happy or unhappy • i. High elation, hopeless depression or an alternation between the two • ii. Manic Phase • a. Elation, extreme confusion, distractibility and racing thoughts • b. Exaggerated sense of self-esteem and engages in irresponsible behaviors • aa. Shopping sprees or insulting remarks • c. Act as though they need less sleep, activity level increases as does the loudness and frequency with which they speak • iii. Depressive Phase • a. Failure, sinfulness, worthlessness and despair • b. Marked by lethargy, despair and unresponsiveness • c. Essentially the same as the major depressive disorder • d. May alternate between frantic action and motionless despair • iv. Some people have episodes separated by long intervals of normal behavior, others have no normal behavior and just alternate between the two

20. Schizophrenia and Mood Disorders cont. • d. Seasonal Affective Disorder • i. In winter these people develop a deep depression • ii. Spirits only lift with the coming of spring • iii. Tend to sleep and eat excessively during their depressed period • iv. Cause • a. Melatonin may play a role • aa. Less light (winter) more melatonin is secrete by the pineal gland • bb. High levels can cause Seasonal Affective Disorder • b. Can be treated by sitting under bright fluorescent lights during the evening or early morning hours

21. Schizophrenia and Mood Disorders cont. • e. Explaining Mood Disorders • i. Psychological Factors • a. Personality traits (self esteem) • b. Amount of social support • c. Ability to deal with stressful situations • ii. Beck Theory • Depressed people draw illogical conclusions about themselves, blame themselves for normal problems and consider every minor failure a catastrophic event • iii. Seligman Theory • a. Caused by feeling of learned helplessness • b. Learns to believe that they have no control over events in their lives and that it’s useless to try

22. Schizophrenia and Mood Disorders cont. • f. Suicide and Depression • i. Not all people who commit suicide are depressed and not all depressed people attempt suicide • ii. Many depressives do think about suicide though, and some translate these thought into action • iii. People commit suicide for a number of reasons • a. Escape from physical pain • aa. Terminal illness • b. Escape from emotional pain • aa. Loneliness of old age • c. An effort to end the torment of unacceptable feelings • d. To punish themselves for wrongs they committed • e. To punish others • f. Many times there is no explanation • iv. More than 30,000 Americans end their lives by suicide • a. 1 every 20 minutes • v. More women than men attempt suicide/More men than women succeed in suicide • vii. Most common among the elderly • viii. 2nd most cause of death for college students • ix. People who threaten or make an unsuccessful attempt are very serious • x. 70% of those who commit suicide have threatened to do so within 3 months preceding the suicide • a. An unsuccessful attempt is usually a trial run Section 4 Review

23. Personality Disorders and Drug Addiction • Personality Disorder • a. Generally don’t suffer from acute anxiety nor do they behave in bizarre, incomprehensible ways • b. Unable to establish meaningful relationships with other people, to assume social responsibilities or adapt to their social environment • c. Antisocial Personality (Sociopaths and Psychopaths) • i. Exhibit a persistent disregard for and violation of others’ rights • ii. Treat people as objects • iii. Live for the moment • iv. Seeking thrills is the major occupation • v. If they injure or hurt people along the way they feel no shame or guilt • vi. No matter how many times they get into trouble, jailed or punished, they never learn to stay out of trouble • vii. Usually intelligent, entertaining and fake emotions, they win confidence and affection of others

24. Personality Disorders and Drug Addiction cont. • 2. Drug Addiction • a. Become a major psychological problem • b. Millions depend so heavily on drugs that they hurt themselves physically, socially and psychologically • c. Psychological Dependence – depend so much on a drug that without it they feel nervous and anxious, that feeling of well-being • i. Alcohol • ii. Caffeine • iii. Nicotine • iv. Cocaine • v. Marijuana • vi. Amphetamines • d. Physical Addiction – when the drug state becomes the normal body state, without the drug there is extreme physical discomfort • i. Tolerance – developed when a person becomes so addicted to a drug that they have to continually increase the dosage to obtain the high that used to be achieved with lower doses • ii. Withdraw – a state of physical and psychological upset during which the body and mind revolt against and finally gets used to the absence of t he drug • aa. mild nausea, shakes, hallucinations, convulsions, coma and death

25. Personality Disorders and Drug Addiction cont. • e. Alcoholism • i. Most serious drug addiction • ii. 10 to 12 million Americans abuse alcohol • iii. 40% of all deaths in automobile accidents and 40% of all murders, alcohol is involved • iv. Social drug, causes one to lose some inhibition • v. Is actually a depressive • vi. Perceptions and sensations become distorted, behavior may become obnoxious • vii. People stumble, weave, slurred speech and slow reaction times • viii. Unconsciousness, coma, death • ix. Can produce psychological dependence, tolerance and addiction • x. Can develop from both environmental and genetic factors • aa. 3 to 4 times higher is a family member is an alcoholic • bb. Poor home life • xi. Treatment • aa. Get through delirium tremens, violent withdraw • bb. Drugs and/or psychotherapy • cc. Group Therapy – AA • dd. Medication – Antabuse, causes a person to become violently sick if they drink alcohol • ee. No cure!!

26. Personality Disorders and Drug Addiction cont. Section 5 Review Chapter 16 Study Guide Chapter 16 Test