PSYCHOLOGICAL DISORDERS ANXIETY DISORDERS A category of disorders where anxiety disables an individual. Neurosis Panic Attacks Frequent and overwhelming attacks of anxiety. Phobias Irrational fear of a specific object or situation. Specific Phobia Acrophobia Claustrophobia AGORAPHOBIA The fear of leaving a familiar environment. OBSESSIVE COMPULSIVE DISORDER OCD An uncontrollable pattern of recurring often unpleasant thoughts. The repetition of an irrational act. Ritualized behavior. Counting and checking. POSTTRAUMATIC STRESS DISORDER PTSD (Shell shock, Battle Fatigue) An event relived with pain. (3 months?) Intrusion (Flashbacks) Avoidance (Depression, Guilt) Hyperarousal (Insomnia, Irritable or explosive) HYSTERIA DISORDERS SOMATOFORM Disorders (Body disorders) NEUROSIS TWO TYPES HYSTERIA Conversion Reaction Loss of physiological functioning. Hypochondrasis: false belief of sickness. Psychosomatic: Physical ailments, rash, pain, ulcers. Dissociative Disorders Amnesia: loss of memory. Fugue: Memory loss with active flight. Dissociative Identity Disorder DISSOCIATIVE IDENTITY DISORDER (MPD) Each personality has a full range of mental functions. Different ages Early Trauma Amnesic Barriers NOT SCHIZOPHRENIA! MOOD DISORDERS Affective disorders 4 - 12% of population Dysthymic Disorder Greek=low spirits Common cold of disorders. Ex. Loss of a loved one. Will usually clear up without treatment. Depression Unipolar Depressive mood or pervasive loss of interest or pleasure. 2 weeks 4+ symptoms Sleep, weight, hunger, psychomotor, cognitive, energy, feelings of worthlessness or guilt, thoughts of death or suicide. Manic Unipolar Hypomanic (No Hospital) vs. Manic Predominate mood elevated, expansive or irritable. 1 week 3+ symptoms Excessive involvement in activities, poor judgement, pressure of speech, flight of ideas, loosened associations, inflated self-esteem,decreased need for sleep, destractibility, hypersexuality. BIPOLAR Manic Depression. History of alternating episodes of mania and major depression. Bipolar I Bipolar II (Hypomanic) SCHIZOPHRENIA Thought Disorder Split from Reality Psychosis 1% of Population Onset Late Teens – early 20’s Causes GENETIC CONNECTION 1 Parent = child 10 – 15% more likely. Both Parents = 40 X more likely. Environment Social Class Double Bind Environmental Stressors SYMPTOMS Positive symptoms generally imply occurrences beyond normal experience. Negative symptoms generally connote diminished experience. LANGUAGE – Thought Disorder Loosening of associations,Neologisms,Clanging, word salad. DELUSIONS – Persecution, Grandeur, Control. HALLUCINATIONS – visual, auditory… Louis Wain Schizophrenic Artist? TYPES CATATONIC: Disturbance of Movement. PARANOID: Suspiciousness, Grandeur, Persecution. DISORGANIZED: (Hebephrenic) Hallucinations, delusions not organized. Mirror gazing, grimace, obscene behavior. UNDIFFERENTIATED: Catchall category. PERSONALITY DISORDERS NARCISSISM: A preoccupation with self. HISTRIONIC: Exaggerated display of emotion (attention getters). PASSIVE AGGRESSIVE: Indirect nonconfrontational hostility at the demands of others (chronic lateness & intentional inefficiency). BORDERLINE PERSONALITY DISORDER Instability in interpersonal relationships and self Image. Unstable Emotions. Dependency and Manipulative Self Destructive Behavior. Test other peoples concern and sabotage their own relationships. BPD The symptoms of borderline patients are similar to those for which most people seek psychiatric help: depression, mood swings, the use and abuse of drugs and alcohol as a means of trying to feel better; obsessions, phobias, feelings of emptiness and loneliness, inability to tolerate being alone, problems about eating. Borderline people also show great difficulties in controlling ragefulness; they are unusually impulsive, they fall in and out of love suddenly; they tend to idealize other people and then abruptly despise them. A consequence of all this was that they typically look for help from a therapist and then suddenly quit in terrible disappointment and anger. Underneath all these symptoms, therapists see in borderline people an inability to tolerate the levels of anxiety, frustration, rejection and loss that most people are able to put up with, an inability to soothe and comfort themselves when they become upset, and an inability to control the impulses toward the expression, through action, of love and hate that most people are able to hold in check. What best defines the "borderline" personality, is great difficulty in holding on to a stable, consistent sense of one's self: "What am I?" these people ask. "My life is in chaos; sometimes I feel like I can do anything--other times I want to die because I feel so incompetent, helpless and loathsome. I'm a lot of different people instead of being just one person." BPD The one word that best characterizes borderline personality is "instability." Their emotions are unstable, fluctuating wildly for no discernible reason. Their thinking is unstable--rational and clear at times, quite psychotic at other times. Their behavior is unstable, often with periods of excellent conduct, high efficiency and trustworthiness alternating with outbreaks of babyishness, suddenly quitting a job, withdrawing into isolation, failing. Their self control is unstable -- ranging from the extreme self denial of anorexia to being at the mercy of impulses. And their relationships are unstable. They may sacrifice themselves for others, only to reach their limit suddenly and fly into rageful reproaches, or they may curry favor with obedient submission only to rebel, out of the blue, in a tantrum. Associated with this instability is terrible anxiety, guilt and self-loathing for which relief is sought at any cost -- medicine, drugs. The effect upon others of all this trouble is profound: family members never know what to expect from their volatile child, siblings, or spouse, except they know they can expect trouble: suicide threats and attempts, selfinflicted injuries, outbursts of rage and recrimination, impulsive marriages, divorces, pregnancies and abortions; repeated starting and stopping of jobs and school careers, and a pervasive sense, on the part of the family, of being unable to help. And, of course, the effect of the illness upon the life of the patient is equally profound: jobs are lost, successes are spoiled, relationships shattered, families alienated. The end result is all too often the failure of a promising life, or a tragic suicide. ANTISOCIAL PERSONALITY (SOCIOPATH & PSYCHOPATH) 1. 2. 3. 4. 5. CONSCIENCELESS MANIPULATIVE IMPULSIVE DIFFICULT TO REFORM SUPERFICIAL EMOTION