Download to read offline
AP Psych disorders.ppt
- 2. Psychopathology What wasformerly known as mental illness or mental disorder is now often referred to as psychopathology. Some feel “mental illness” puts the basis for the illness on biology, even though psychologists have shown that environment is often the cause of the disorder. Psychopathology is any pattern of emotions, behavior, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals.
- 3. Prevalence of Psychopathology In America, mental illness is far more common than most people realize. Over 15% of the population suffers from diagnosable mental health problems. Another study found that during any given year, the behaviors of over 56 million Americans meet the criteria for a diagnosable psychological disorder (Carson et al. 1996). Over the lifespan, as many as 32% of Americans suffer from some psychological disorder (Regier et al., 1988).
- 4. What is PsychologicalDisorder? How do we discern what is normal and abnormal? Consider eccentric personalities like RobinWilliams, Dave Chapelle, Madonna, Marilyn Manson. What about a soldier who risks his life in war? A grief stricken mother who cannot return to her normal routines three months after losing her son?
- 5. 3 Classical Symptomsof Severe Mental Illness The more extreme a disorder is, the more easily it is detected.When trying to diagnose a patient, doctors look for three classic symptoms of sever psychopathology: Hallucinations-false sensory experiences. Delusions-extreme disorders that involve persistent false beliefs. Affect (emotion)-characteristically depressed, anxious, manic, or no emotional response.
- 6. Psychological Disorders asa Continuum No Disorder Mild Disorder Moderate Disorder Severe Disorder Absence of signs of psychological disorder Few signs of distress or other indicators of psychological disorder Indicators of disorders are more pronounced and occur more frequently Clear signs of psychological disorder, which dominate the person’s life Absence of behavioral problems Few behavior problems; responses usually appropriate to the situation More distinct behavior is often inappropriate to the situation Severe and frequent behavior problems; behavior is usually inappropriate to the situation No problems with interpersonal relationships Few difficulties with relationships More frequent difficulties with relationships Many poor relationships or lack of relationships Disorders are exaggerations of normal behavior and responses.
- 7. Two ContrastingViews Aswith most topics in psychology, there are multiple perspectives on psychological disorders. The medical model takes a “disease” view. Psychology, on the other hand, sees psychological disorders as an interaction of biological, mental, social and behavioral factors.
- 8. Historical Roots Inthe ancient world, psychopathology was thought to be caused by demons and spirits that had taken possession of the person’s mind and body. Part of daily life in ancient worlds was spent doing rituals aimed at outwitting or placating these supernatural beings.
- 9. Hippocrates In 400B.C. the Greek physician Hippocrates took the first step toward a scientific view of mental illness when he said that abnormal behavior had physical causes. He taught his disciples to interpret the symptoms of psychopathology as an imbalance among our body fluids called “humors.” Humors Origins Temperament Blood Heart Sanguine (cheerful) Choler (yellow bile) Liver Choleric (angry) Melancholer (black bile) Spleen Melancholy (depressed) Phlegm Brain Phlegmatic (sluggish)
- 10. Regression inThought Thenin the Middle Ages, superstition eclipsed the Hippocratic model. Under the influence of the medieval Church, physicians and clergy reverted to the old ways of explaining abnormal behavior. Hippocrates
- 11. SalemWitchTrials As aresult of erroneous thinking, thousands of mentally disturbed people were executed. In Salem Massachusetts, was one example of the problems with this type of thinking. A modern analysis of the Salem witch trials has concluded that the girls were probably suffering from poisoning by a fungus growing on rye grain-the same fungus that produces the hallucinogenic drug LSD.
- 12. The Medical Model In the late 18th century, the “disease view” reemerged. The result was the medical model, a view that mental disorders are diseases of the mind that, like ordinary physical diseases, have objective causes and require specific treatment.
- 13. Medical Model inPractice The medical model led to mental hospitals or “asylums.” In this supportive atmosphere, many patients actually improved, even thrived, on rest, contemplation and simple but useful work.
- 14. Problems with theMedical Model Despite its success, modern psychologists find fault with relying solely on the medical model. They suggest that treating the disorder as a “disease” leads to a doctor-knows-best approach in which the therapist takes all the responsibility for diagnosing and correcting the problem. In this model, the patient becomes a passive recipient of medication and advice.
- 15. Psychologists vs. Psychiatrists The other problem psychologists have with the medical model (doctor-knows-best), is that it takes responsibility away from psychologists and gives it to psychiatrists. According to our authors, it assigns psychologists to second-class professional status.
- 16. Social-Cognitive-Behavioral Approach Aspsychology has evolved, theories which were originally at odds, have now been combined to offer more thorough explanations, for example, cognitive psychology and behaviorism. Cognitive psychology looks inward, emphasizing mental processes. Behaviorism looks outward and emphasizes the influences of the environment. Psychologist from these perspectives see these two as complementary, and add that cognitions and behavior usually happen in social context, requiring social perspective.
- 17. Combining Perspectives Thebehavioral perspective tells us that abnormal behaviors can be acquired in the same fashion as healthy behaviors-- through behavioral learning. The cognitive perspective suggests that we must consider how people think about themselves and their relations with other people. Social-cognitive-behavioral approach, then, is an alternative to the medical model combining all three of psychology’s major perspectives.
- 18. The Biopsychology ofMental Disorder Modern biopsychology assumes that some mental disturbances involve the brain or nervous system in some way. Subtle changes in the brain’s tissue or its chemical messengers- the neurotransmitters- can profoundly alter thoughts and behaviors. Genetic factors, brain injury, infection, and learning are some of the factors that can tip the balance towards psychopathology.
- 19. Indicators of Abnormality While psychologists look for the three classical symptoms, not all disorders have such sever symptoms. A few others are: Distress: Does the individual show unusual or prolonged levels of anxiety? Maladaptiveness: Does the person act in ways that make others fearful? Irrationality: Does the person act or talk in ways that are irrational or incomprehensible to others? Unpredictability: Does the individual behave erratically and inconsistently at different times? Unconventional/undesirable behavior: Does the person act in ways that are statistically rare and violate social norms?
- 20. The More theBetter Clinicians are more confident in labeling behavior as “abnormal” when two or more of the indicators are present. Extremes and prevalence = greater confidence in diagnosis
- 21. DSM-IV The AmericanPsychologicalAssociation developed the most widely used classification system for psychological disorders. The book is called the Diagnostic and Statistical Manuel of Mental Disorders. *IV=4th edition
- 22. DSM-IV-TR The DSM-IV-TRoffers practitioners a common and concise language for the description of psychopathology. The DSM also contains language for diagnosing each of the disorders.
- 23. Mood Disorders Mooddisorders are abnormal disturbances in emotion or mood.They are also referred to as affective disorders. The two most common are major depression and bipolar disorder. See if you can identify which disorder Ms. Spears has.
- 24. Major Depression Majordepression is a form of depression that does not alternate with mania (happiness). It is normal to become depressed after a sad or unfortunate even but if a person remains depressed weeks or months after that event, it may be classified as major depression. Major depression does not give way to manic episodes.
- 25. Major Depression Bymany accounts, depression is under diagnosed and under treated. Globally speaking, studies indicate that depression is the single most prevalent disability. While some differences may be a result of reporting, other factors seem to be at work too: Taiwan/Korea = low divorce rate Lebanon = war in Middle East Taiwan 1.5% Korea 2.9% Puerto Rico 4.3% U.S. 5.2% Germany 9.2% Canada 9.6% New Zealand 11.6% France 16.4% Lebanon 19% Lifetime Risk of a Depressive Episode lasting a Year or More
- 26. Causes of Depression Some causes of major depression involve genetic predisposition. Severe bouts of depression often run in families. Further indication of a biological basis for depression are that drugs that affect the brains levels of certain neurotransmitters are very effective. However, biology alone cannot account for everything.
- 27. Cognitive Explanations Probablybecause of low self-esteem, depression- prone people are more likely to perpetuate the depression cycle by attributing negative events to their own personal flaws or external conditions they feel helpless to change. Martin Seligman calls this learned helplessness.
- 28. Cognitive-Behavioral Cycle ofDepression Low self-esteem and negative interpretations Social rejection and loneliness Negative events Depression Negative behaviors Fred decides to be more sociable, but when he asks Teresa for a date she already has plans. Fred concludes that he is not very interesting or attractive and that people don’t like him. Fred feels completely alone and unhappy Fred avoids people, skips school and neglects personal hygiene Because of Fred’s negative behaviors, people avoid him- reinforcing his symptoms.
- 29. The Cognitive Approach The cognitive approach to depression points out that negative thinking styles are learned and modifiable. *Think classical and operant conditioning.
- 30. Beck’s Basics AaronBeck suggests that depression is a result of negative thinking which he called ‘cognitive errors’ (errors in logic) Beck identified three negative thoughts that seemed to be really automatic and occurred without delay in depressed patients. The “CognitiveTriad:” Self External World Future Beck believes that faulty thinking leads to depression.The question remains though, which came first, the depression or the faulty thoughts.
- 31. WHO BECOMES DEPRESSED? Studies show that depression rates are higher in women. The difference may be in the way men and women handle emotional situations. Women tend to be introspective: Think about their feelings and what may be causing them. Men, on the other hand, try to distract themselves from the depressed feelings. This suggests the more ruminative response of women increases their vulnerability to depression. Depression breeds depression
- 32. Increasing Rates ofDepression Rates of depression have increased 10-20 times what they were 50 years ago. The average age of people experiencing depression has gone down. Seligman identifies three causes for this trend: 1. Out-of-control individualism/self-centeredness-focuses on individual successes and failures rather than group accomplishments.
- 33. Increasing Rates ofDepression 2. The self-esteem movement- teaching a generation of children they should feel good about themselves, irrespective of their efforts and achievements. 3. A culture of victimology- reflexively pointing the finger of blame at someone or something else.
- 34. Bipolar Disorder Formerlyknown as manic-depressive disorder, bipolar disorder is a mental abnormality involving swings of mood from mania to depression. A strong genetic component is well established, although the exact genes involved are not known. 1% of the population has bipolar attacks, having an identical twin with the problem inflates a person’s chances to about 70%
- 35. Anxiety Disorders Everyonehas experienced some level of anxiety in their life. For some people, a spider, or a tall ladder are enough to send chills down the spine. Psychopathology anxiety is far more sever than the anxiety associated with normal life challenges.
- 36. Prevalence of MentalDisorders =Anxiety Disorder
- 37. Generalized Anxiety Disorder Generalized anxiety disorder is a psychological problem characterized by persistent and pervasive feelings of anxiety, without any external cause. May experience times when your worries don't completely consume you, but you still feel rather anxious May feel on edge about many or all aspects of your life May have a general sense that something bad is about to happen, even when there's no apparent danger. May not remember when you last felt relaxed or at ease. GAD often begins at an early age, and the signs and symptoms may develop slowly.
- 38. Panic Disorder Panicdisorder is a disturbance marked by sudden and severe anxiety attacks that have no obvious connections with events in the person’s life. Usually free of anxiety between panic attacks Panic attack symptoms: * Rapid heart rate * Sweating * Trembling * Shortness of breath * Hyperventilation * Chills * Hot flashes * Nausea * Abdominal cramping * Chest pain * Headache * Dizziness * Faintness * Trouble swallowing * A sense of impending death
- 39. Panic Disorder Manypeople who suffer from panic disorder also have agoraphobia.A condition which involves panic that develops when people find themselves in situations from which they cannot easily escape: crowed places, open spaces, etc. Occurs in about 2% of Americans and affect women more than men.
- 40. Phobic Disorders Incontrast to panic disorder, phobias involve persistent and irrational fear associated with a specific object, activity or situation. While many of us have fears, or dislikes of specific objects or situations, these only become psychopathology when they have a cause substantial disruptions in our lives.
- 41. Preparedness Hypothesis Thistheory suggests that we carry an innate biological tendency, acquired through natural selection, to respond quickly and automatically to stimuli that posed a survival threat to our ancestors. May explain why we develop phobias for snakes and lightening much more easily than automobiles and electrical outlets
- 42. Obsessive-Compulsive Disorder OCDis a condition characterized by patterns of persistent, unwanted thoughts and behaviors. The obsessive component consists of thoughts, images or impulses that recur or persist despite a person’s efforts to suppress them.
- 43. Obsessive-Compulsive Disorder Thecompulsive component are repetitive, purposeful acts performed according to certain private “rules,” in response to an obsession. Many characters onTV and in movies have OCD: Jack Nicolson in As GoodAs It Gets; Monica on Friends; Monk Others?
- 44. Obsessive-Compulsive Disorder Whenthey are calm, people with obsessive- compulsive disorder view their compulsions as senseless. However, when anxiety arises, they cannot resist performing the compulsive behavior rituals to relieve tension. OCD has a tendency to run in families A clear genetic connection Environment seems to play a factor Behavioral therapy helps many OCD sufferers
- 45. Somatoform Disorders Somatoformdisorders are psychological problems appearing in the form of bodily symptoms or physical complaints such as weakness or excessive worry about disease. Conversion Disorder: A disorder marked by paralysis, weakness or loss of sensation but with no discernable physical cause. Hypochondriasis: A disorder involving excessive worry about health and disease. How a hypochondriac might see himself
- 46. Dissociative Disorders Dissociativedisorders are a group of pathologies involving the “fragmentation” of the personality, in which some parts of the personality have become detached from other parts. Dissociative Amnesia: A psychologically induced loss of memory for personal information, like one’s identity. Usually the result of a stressful situation, it is often associated with PostTraumatic Stress Disorder (PTSD).
- 47. PTSD PostTraumatic StressDisorder dates back to 6 B.C. where reports of battlefield stress had an adverse affect on soldiers. In the past PTSD has been referred to as railway spine, shell shock, battle fatigue, traumatic war neurosis, or post-traumatic stress syndrome. Today treatment involves therapy and anti-anxiety drugs. DuringWWI treatment looked much different: Shell Shock/ShockTherapy New PTSDTherapy
- 48. Dissociative Fugue Dissociativefugue is a combination of fugue, or “flight, and amnesia. Sufferers not only suffer from a lost sense of identity, they also flee their homes, jobs and families. While most episodes last only a few hours or days, it can last longer. Heavy use of alcohol may predispose a person to dissociative fugue.While this suggest that some brain impairment may be involved, no specific cause has been identified.
- 49. Dissociative Fuge TheDSM-IV-TRlists four criteria for diagnosing dissociative fugue: Unexplained/ unexpected travel from a person's usual place of living along with partial or complete amnesia. Uncertainty and confusion about one's identity, or in rare instances, the adoption of a new identity. The flight and amnesia that characterize the fugue are not related exclusively to DID, nor is it the result of substance abuse or a physical illness. An episode must result in distress or impairment severe enough to interfere with the ability of the patient to function in social, work or home settings.
- 50. Depersonalization Disorder Depersonalizationdisorder is an abnormality involving the sensation that mind and body have separated. Often times sufferers explain episodes as out of body experiences. Like all of the other dissociative disorders, depersonalization disorder occurs far more frequently following a prolonged period of stress or a traumatic event.
- 51. Dissociative Identity Disorder Once called multiple personality disorder, dissociative identity disorder is a condition where an individual displays multiple identities or personalities. Experts say this disorder appears first in childhood and may be a defensive response to abusive situations or terrifying events. Most of the emerging personalities contrast in some significant way with the original self. Hershel Walker was recently diagnosed with DID.
- 52. Schizophrenia Schizophrenia isa psychological disorder involving distortions in thoughts, perceptions and/or emotions. This is the disorder people are referring to when they use terms like “madness,” “psychosis,” or “insanity.”
- 53. What Does itLook Like For sufferers of schizophrenia, the mind can be twisted in terrible ways. May become bleak and devoid of meaning Can become very overwhelming and filled with stimuli, hallucinations and delusions. In schizophrenia, emotions become blunted, thoughts turn bizarre, and language takes a strange turn.Take the following for example:
- 54. Sample Speech FromSchizophrenic Patient The lion will have to change from dogs into cats until I can meet my father and mother and we dispart some rats. I live on the front ofWhitton’s head.You have to work hard if you don’t want to get into bed…It’s all over for a squab true tray and there ain’t no squabs, there ain’t no men, there ain’t no music, there ain’t nothing besides my mother and my father who stand along upon the Island of Capri where is no ice.Well it’s my suitcase sir. (Roger, 1982)
- 55. Prevalence of Schizophrenia One out of every 100 Americans, 2 million people over the age of 18-will be affected. For men, schizophrenia usually shows up before age 25, and between the ages of 25 and 40 for women. Currently, schizophrenia is the diagnosis for over 40% of patients in public mental hospitals.This may be due to the fact that there is no cure, and often times patients will need need therapy for the remainder of their lives.
- 56. 5 MajorTypes ofSchizophrenia Disorganized type: typical image of mental illness with incoherent speech, hallucinations, delusions and odd behaviors Catatonic type: a range of motor dysfunctions Stupor: long periods of coma like, motionless state Excitement: agitated and hyperactive Paranoid type: delusions and hallucinations but no catatonic symptoms and none of the incoherence of disorganized type Undifferentiated type: a catchall term for schizophrenia symptoms that are erratic and do not it into one of the other categories, but are clear symptoms of the disorder Residual type: the diagnosis for individuals who have suffered from schizophrenia, but have no major symptoms at the time
- 57. Positive and NegativeCategories Often times, researchers now simply characterize symptoms of schizophrenia into positive and negative categories. Positive symptoms refer to active process such as delusions, and hallucinations. Negative symptoms refer to passive processes like social withdrawal.
- 58. Causes of Schizophrenia Freud originally thought schizophrenia was a result of defective parenting or repressed childhood trauma. Impact of Drugs Major tranquilizers which inhibit dopamine, can suppress the symptoms of schizophrenia Drugs that provide excess dopamine can cause schizophrenic type behaviors in healthy people.
- 59. Causes of Schizophrenia Loss of grey matter: Magnetic resonance images (MRI scanswere created after repeatedly scanning 12 schizophrenia subjects over five years, and comparing them with 12 healthy controls, scanned at the same ages and intervals. •Severe loss of gray matter is indicated by red and pink colors, while stable regions are in blue. •STG =superior temporal gyrus •DLPFC =dorsolateral prefrontal cortex.
- 60. Causes of Schizophrenia While the exact cause of the disorder still remains somewhat of a mystery, there is very strong evidence that it has a genetic link. People who have an identical twin who suffers from schizophrenia have a 50% chance of suffering from the disorder too, even if they were raised in separate environments. Similarly, a child with one parent suffering from schizophrenia has a 13% chance of developing the disorder, but a child of two parents with the disorder has a 46% chance of developing schizophrenia.
- 61. SchizophreniaTreatments Much likethe treatment for all psychological disorders, the treatment of schizophrenia has come a long way: Lobotomies Insulin ShockTherapy Current treatment for schizophrenia is usually a combination of therapy and medication: Schizophrenia Medication
- 62. Lobotomies One ofthe earliest treatments were lobotomies.This procedure consisted of cutting the connections to and from, or simply destroying, the prefrontal cortex.
- 63. The Process Doctorswould access the frontal lobes through the eye sockets, instead of through drilled holes in the scalp. In 1945, he took an ice pick from his own kitchen and began to test the new surgical technique on cadavers.
- 64. The Process Thetechnique involved lifting the upper eyelid and placing the point of a thin surgical instrument under the eyelid and against the top of the eye socket. •A hammer was used to drive the pick through the bone, into the brain. It was then moved from side to side, severing nerve fibers connecting the frontal lobes to the thalamus.
- 65. OtherTypes of Disorders Most people get stuck thinking about depression and schizophrenia when they think about psychological disorders. In reality there are far more. Some of the more common, and more studied disorders are: Eating Disorders: Personality Disorders: Developmental Disorders:
- 66. Eating Disorders Ofthe eating disorders that exist, two are most prevalent and most studied: Anorexia nervosa: an eating disorder that causes a persistent loss of appetite that endangers an individuals health Stems from emotional or psychological reasons rather than natural causes Usually a distorted view of oneself 1% of population affected 3.4% with partial syndrome anorexia
- 67. The othercommon eating disorder is bulimia nervosa. Bulimia Nervosa: An eating disorder characterized by binges and purges Induced vomiting, or laxatives .6% of population affected with bulimia Up to 4.2% of females Eating Disorders
- 68. The History ofBulimia-Nervosa It was believed that the ancient Romans used a vomitorium to rid themselves of food. Bulimia was not established as a psychological disorder until the late 1970’s. 95-85% of cases of anorexia/bulimia are women in the US (National Institute of Mental Health)
- 69. Personality Disorders Personalitydisorders are conditions involving a chronic, pervasive, inflexible and maladaptive pattern of thinking, emotion, social relationships or impulse control Narcissistic Personality Disorder: Grandiose sense of self importance and preoccupation with fantasies of success Antisocial Personality Disorder: Longstanding pattern of irresponsible behavior indicating lack of conscience and responsibility towards others. Borderline Personality Disorder: Unstable and given to extreme impulses without clear reasoning.
- 70. Development Disorders Developmentaldisorders are a group of disorders that can appear at any age, but most commonly show signs during childhood. Autism: Marked by disabilities in language, social interaction and the inability to understand another person’s state of mind 1 in 500 children; recent increase in cases Dyslexia: A reading disorder where letters words and numbers are perceived out of order, upside down or completely incomprehensible True account of dyslexia