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Psychopathology NR.ppt
The document discusses psychopathology, which is defined as the scientific study of mental conditions involving significant pain, suffering, or distress that damages a person's sense of self. It summarizes different models that have been used to understand the origins and nature of mental illness, including biological, psychological, psychosocial, and biopsychosocial models. The biological model emphasizes genetic and neurological factors while psychological models focus on unconscious conflicts, learned behaviors, distorted cognitions, and fulfillment of needs. Psychosocial models examine family and social influences as well as person-environment interactions.
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Introduction to the study of psychopathology, emphasizing its roots in mental suffering and the human condition.
Explains psychopathology as the study and manifestation of mental illness, including a breakdown between mental distress and mental illness.
Distinguishes between mental distress, often temporary, and mental illness, which requires clinical significance for diagnosis.
Details DSM IV criteria for clinically significant mental disorders, focusing on symptoms, distress, and risk factors.
Surveys various factors influencing abnormal behavior, including predisposition, precipitation, and perpetuation.
Identifies key traits of mental illness, highlighting dysfunction and distress contrasted with mental health.
Introduces the 4 Ds framework (Deviation, Dysfunction, Distress, Dangerousness) for understanding psychological disorders.
Overview of spiritual and moral character models as historical explanations for mental illness.
Explains abnormality based on statistical deviations from averages, defining normalcy.
Explores genetic, neurological, and biochemical aspects influencing mental disorders, including brain structure and function. Reviews various psychological models (psychodynamic, behavioral, cognitive) in explaining mental illnesses.
Discusses psychosocial factors leading to mental illness, including social structures and communication.
Highlights the intersection of biological, psychological, and social factors in understanding mental health.
Presents the diathesis-stress model explaining the interaction of predisposition and stress in mental disorders.
Introduces the Positive and Negative Syndrome Scale (PANSS) as a measure of symptom severity in schizophrenia.
Details positive symptoms like hallucinations and delusions common in schizophrenia.
Highlights negative symptoms such as social withdrawal and diminished affect in schizophrenia.
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Psychopathology NR.ppt
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- 2. Psychopathology From ancient Greek….. •“Psyche” from psukhē -"soul, mind, life-breath, spirit” • “Pathos” from paskhō - "I feel, suffer” (= a condition/ state of experiencing pain, suffering, death, misfortune, or misery). • “-ology ” from logia - ”the study of” = The scientific study of a mental condition wherein the individual suffers significant pain and misery, even to the point that they feel as if their very "life-breath" (soul) is being damaged or sucked out of them.
- 3. Psychopathology defined…. ….refers toeither the study of mental illness or mental distress or the manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment.
- 4. Mental distress Vsmental illness Mental distress Mental illness A range of symptoms and experiences of a person's internal life that are troubling, confusing or out of the ordinary. A psychological or behavioural pattern that causes distress or disability that is not expected as part of normal development or culture. Induced by life situations like stress, lack of sleep, use of drugs or alcohol, assault etc Mental distress when endured for longer time Diagnosed as ‘Mental illness’ Resolves without further medical intervention Not actually ‘ill’ in a medical sense. Eg. anxiety, confused emotions, hallucination, rage, depression etc. A specific set of medically defined conditions. Eg. Schizophrenia, GAD, OCD
- 5. What makes aMental Disorder “Clinically Significant?”…. According to DSM IV – The symptoms must be present for a specified length of time for the diagnosis of the disorder. The disorder – Must reflect in a behavioral /psychological “syndrome” Must be associated with present distress, impairment in life, or serious risk to self or others Must lead to adoption of an unhealthy lifestyle Could lead to suicide, self mutilation etc Could result in punishment/ incarceration due to his criminal acts
- 6. Aetiology of abnormalbehavior
- 7. Predisposition, Precipitation & Perpetuation Predisposition-Inherent ability of an organism to develop the pathogenic trait (Eg. Heavy family h/o depression) Precipitation – Hastening of the occurrence of the disorder at a particular point of time (Eg. Divorce by spouse) Perpetuation – Continuation of the disease process (Eg. alcohol misuse)
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- 9. Central elements thatcharacterize people as mentally ill… 1. Feelings - levels of psychic distress and pain (as opposed to joy and contentment) being experienced 2. Functionality - The capacity (or lack thereof) to coordinate the flow of resources in a desired or adaptive way
- 10. Mental health andmental illness.. Mental health - when individuals effectively coordinate resources to achieve growth goals and feel good about it… Mental illness - from high levels of distress and dysfunction, with poor ‘functionality’ in managing them
- 11. The 4 Ds- The prominent themes that define abnormality, within a psychological disorder.
- 12. Models of MentalIllness
- 13. Spiritual Model The firstand oldest explanatory system for mental illness Consciousness - deeply connected to a supernatural force A religious narrative of good and bad forces in the world Suffering – Being possessed by the bad, falling out of favor with the good. Sin / ‘immoral behavior’ fear and contamination. Treatment - “Spirituotherapy”
- 14. Moral Character Model Virtueslike courage and stamina, honesty and integrity, compassion and grace, enable one to live a mentally healthy life.
- 15. The Statistical Model Derivedmore from mathematics than from psychology ‘Abnormality’ - any substantial deviation from a statistically calculated average Those who fall within the “Golden mean” are normal, while those outside the mean are abnormal.
- 16. Transmission of geneticfactors - Monozygotic twins, first degree relatives, polygenic Conditions - Affective disorders, Schizophrenia, Schizo-affective disorders, panic disorders, phobic anxiety disorders, OCDs and personality disorders The Biological Model 1. Hereditary
- 18. The Biological Model 2.Neurological & Biochemical Psychopathology Seen in…. Structural anomalies of brain Lighter & smaller brain; enlarged ventricles, <ed size of prefrontal cortex & temporal lobe. Limbic system - <ed size of hippocampus, cingulate gyrus & amygdalae Schizophrenia Schizo, neurotic disorders, GAD Cerebral blood flow …in dorsolateral prefrontal cortex (Hypofrontality), cingulate gyrus & basal ganglia. Depression Amygdala Activation of abnormally sensitized ‘Fear network’ by ‘panicogen's’ (CO2, Na lactate) Panic disorders Neuro- pathology Neurodevelopmental disorders – Infection, O2, malnutrition, prolonged labour Schizophrenia Brain dysfunction - pregnancy, childbirth, menopause, ac/ chr systemic diseases Affective disorders Neuro- transmitters ?Monoamines– Nor- epinephrine, dopamine, acetyl-choline - ……when <ed …...when >ed Depression Mania <ed GABA-Benzodiazepine binding, Sertotonergic dysregulation GAD, panic disorders
- 19. Enlarged ventricles andreduction in cortical volume
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- 21. The Biological/ MedicalModel 2. Neurological & Biochemical Psychopathology Seen in…. Endocrine Endocrine - Cushing’s syndrome, Addison’s disease, hypothyroidism, hyper parathyroidism Depression, psychotic disorders Drugs Drugs - INH, methyldopa, reserpine Affective disorders Glutamate Lowered Glutamate levels Schizophrenia NMDA (N methyl D aspartate) receptors Hypo activity Neuro developmental defects. Hyper activity Neurodegenerative changes Oestrogen & progesteron Delivery Fall in oestrogen & progesterone levels super sensitivity of dopamine receptors Post partum psychosis HPA axis Dysfunction GAD
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- 23. Psychological Models Poor adaptationto one’s environment maladaptation and dysfunction. Psychodynamic Model The Behavioural Model The Cognitive-behavioural Model Humanistic / Existential Model
- 24. Psychodynamic Model (S.Freud) Structural theory of mind - Behaviour is motivated by subconscious thoughts and feelings Unresolved conflicts between the Id, ego, superego Loss of self esteem, separation Depressive disorders Failure of ego defense mechanisms Frustration & over indulgence fixation Treatment : Psychoanalysis and psychodynamic therapy - Unconscious and repressed thoughts, feelings, and conflicts believed to cause anxiety are discovered and resolved after client gains insight
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- 28. The Behavioural Model Contiguitytheory (Guthrie) - S and R connected in time and/or space will tend to be associated Classical/ Respondent Conditioning Theory (Pavlov) – S R (School phobia) Operant Conditioning Theory (Skinner) – Impact of consequences on behaviour. Faulty associative learning Phobias Social learning theory (Bandura) - Learning in a social context through observation or direct instruction - OCDs, eating disorders… Positive and negative reinforcements– - Habituation to intrinsic fears, depression - Behaviour inhibition in childhood Learnt helplessness (passivity & resistance to undo -ve feelings) Depression Focus - On the study of directly observable behavior, the stimuli and reinforcing conditions that control it
- 29. Albert Bandura’s SocialLearning Theory
- 30. The Cognitive behavioural Model Distortedand dysfunctional thinking & perception Influence of negative life events GAD Meta-worry (worrying about one’s own worrying) Misinterpretation of socially ambiguous situations ‘Catastrophic misinterpretation’ of benign bodily arousal symptoms.. From ‘learnt alarm’ Panic disorders Treatment : Cognitive and behaviour therapy – to learn new responses and thoughts
- 31. Humanistic / ExistentialModel Human nature is “basically good” (Carl Rogers) Abraham Maslow’s hierarchy of needs Mental health problems – A signal of : Failure to ‘grow’ and to realize one’s potentials Focus is on – present conscious processes and the inherent capacity for responsible self-direction less attention to unconscious processes and past causes Emphasis on growth and self-actualizing rather than on curing diseases or alleviating disorders Does not believe in diagnostic labeling Treatment : Humanistic therapy, logotherapy, gestalt therapy
- 33. Psychosocial Model… Structure (Socialstructure / organization and social forces) – imposes restrictions on behaviour (like biological inheritance) • Lack of social relationships, insecurity, loneliness • Threatening life events/ life changes - death, separation, parental deprivation, unhappy marriage, unemployment, immigration, wars, natural disasters, change of house/ work place Process (pathological family process) – results in mental illness – Deviant role relationship – • Schisms - Strong split/ division • Skewed Families – One spouse passively accedes to the strange & bizarre concepts of the more dominant spouse • Pseudomutual (façade of harmony) and Pseudohostile (persistent bickering) families - due to fear of deviation from fixed expectations
- 34. …Psychosocial Model Disordered communication– • Double bind – faced with 2 or more conflicting messages • Amorphous - Loose and incoherent • Fragmented – incomplete and disrupted • Expressed Emotion - Nature, quality, quantity….. Interaction of psychological and social factors. psychological handicap less resourceful in coping with social events Basic categories of psychosocial causal factors: Early deprivation or trauma Inadequate parenting styles Marital discord and divorce Maladaptive peer relationship
- 35. Bio-psycho-social model Anxiety prone– ‘Avoidant personality disorder’ + environmental factors
- 36. Diathesis-stress model DISORDER Treatment :Reduction of stress and learning new coping mechanisms for times stress arises in the future
- 38. Positive and NegativeSyndrome Scale in Schizophrenia (PANSS) A medical scale used for measuring symptom severity of patients with schizophrenia – Positive symptoms - Cognitive, emotional, and behavioral excesses. Negative symptoms – Cognitive, emotional, and behavioral deficits
- 39. Positive Symptoms Delusions Hallucinations Bizarre behavior Formalthought disorder Loose associations Word salad
- 40. Negative Symptoms Apathy Avolition -Absence of motivation Social withdrawal Flattened/ blunted affect Diminished verbal expression (alogia) Poor judgment Poor personal hygiene Inattention Slowed speech/ no speech Decrease in activity level Decrease in self direction