DISORDERS AND
TREATMENT
What is Abnormal?

Common characteristics
 1)
It is maladaptive (harmful) and disturbing to the
individual
 Agoraphobia-
afraid of public places do unable to leave
home
 2)
It is disturbing to others
 Zoophilia-
 3)
It is unusual; based on culture!
 Seeing
 4)
sexually aroused by animals
visions
It is irrational
 Depressed
when your family moves- rational
The DSM-IV

Insane-not a medical term but a legal term
The DSM-IV: Diagnostic and Statistical Manual
of Mental Disorders
Used to Diagnose Patients
(I) CLINICAL
SYNDROMES
(II)
PERSONALITY
DISORDERS
(III) GENERAL
MEDICAL
CONDITIONS
(IV)
PSYCHOSOCIAL
STRESSORS
(V) GLOBAL
ASSESSMENT OF
FUNCTIONING
Causes by Perspective
Perspective
Cause of Disorder
Psychoanalytic/Psychodynamic
Internal, Unconscious Conflicts
Trauma during psychosexual stages
Humanistic
Failure to strive toward one’s potential or being
out of touch with one’s feelings
Behavioral
Reinforcement history, the environment
Cognitive
Irrational, dysfunctional thoughts or ways of
thinking
Sociocultural
Dysfunctional society
Racism, sexism, poverty
Biological
Biochemical imbalances, Genetic predispositions
Categories of Disorders

6 Categories
 Anxiety
 Somatoform
 Dissociative
 Mood/Affective
 Schizophrenic
 personality
Anxiety Disorders- Phobias

Specific Phobia
 Intense
unwarranted fear of a situation or object
 Claustrophobia,

Agoraphobia
a

fear of open, public spaces
Social Phobia
 fear

Arachnophobia, etc.
of embarrassing oneself in public
Contact with the feared object or situation results in
anxiety
Anxiety Disorders

Generalized Anxiety Disorder (GAD)
 Constant,
low level anxiety
 Constantly feels nervous and our of sorts

Panic Disorder
 Acute
episodes of intense anxiety without any
provocation
 Often suffer anxiety due to anticipating
the attacks
Anxiety Disorders

Obsessive-Compulsive Disorder (OCD)
 Persistent,
unwanted thoughts- obsessions
 Feeling the need to engage in a particular
action- compulsions
 Obsessions result in anxiety that is reduced when the
compulsive behavior is performed

Post-Traumatic Stress Disorder (PTSD)
 Flashbacks
or nightmares following a person’s
involvement in or observation of an extremely
troubled event (wars, disasters, etc.)
 Memories cause anxiety
Causes of Anxiety Disorders
Psychoanalyt
ic
Behaviorist
Cognitive
• Result of
conflicts
between
the id, ego,
and
superego
• Learned
through
classical or
operant
conditioning
• Result from
dysfunctional
ways of
thinking/
irrationality
Somatoform Disorders

A person manifests a psychological problem through
a physiological symptom
 Physical

problem without a physical cause
Hypochondriasis
 Frequent
physical complaints with no medical cause
 May believe minor problems are severe physical illness

Conversion Disorder
 Report
a severe physical problem such as paralysis or
blindness with no physical reason
Causes of Somatoform Disorders
Psychodynamic
• Outward
manifestations
of unresolved
unconscious
conflicts
Behaviorist
• Continue
because
people are
reinforced for
their behavior
(attention)
Dissociative Disorders


Involve a disruption in conscious processes
Psychogenic Amnesia


Psychogenic Fugue


When a person cannot remember things for no
physiological reason
Not only have psychogenic amnesia but also find
themselves in an unfamiliar environment
Dissociative Identity Disorder (Multiple Personalities)



A person has several personalities rather than one integrated
personality
Personalities may have different ages, sexes
Commonly have a history of sexual abuse or childhood trauma
Causes of Dissociative Disorders
Psychoanalytic
Behaviorism
Social
• Result of an
extremely
traumatic
event so
strongly
repressed
that a split in
consciousness
results
• People who
have
experienced
trauma find
reward in not
thinking
about it
• Rare outside
the US,
where
numbers
have
increased
along with
publicizing
• Role play
disorder
inadvertenly
Mood or Affective Disorders

Major Depression
 Most
common
 Remain unhappy for more than two weeks with no clear
reason
 Loss of appetite, fatigue, sleep changes, feeling
worthless

Seasonal Affective Disorder (SAD)
 Only
depressed during certain types of year
 Use of phototherapy
Mood or Affective Disorders

Bipolar Disorder
 Manic
Depression- involves both depressed and manic
episodes
 Depressed- depression symptoms
 Manic- feelings of high energy
 Some
have a heightened sense of confidence and power,
others just feel anxious and irritable
 Usually engage in risky behavior
Causes of Mood Disorders
Psychoanalyst
Cognitive
• Product of
anger directed
inward, early
childhood lose,
or an overactive
superego
• Aaron BeckCognitive Triad
• Negative
thoughts about
1) themselves
2) their world
3) their future
• Attributionsexplaining
causes
• Internal vs.
external
• Global vs.
specific
• Stable vs.
unstable
CognitiveBehavioral
• Learned
Helplessness
(Seligman)
Biological
• Low levels of
serotoninunipolar
• Low levels of
acetylcholinebipolar
• Low levels of
norepinephrine
• Genetic
Component
Schizophrenic Disorders



Tends to strike people as young adults
Disordered, distorted thinking often demonstrated through
delusions and hallucinations
Delusions- beliefs that have no basis in reality






Delusions of persecution- believing people are out to get you
Delusions of grandeur- belief that you enjoy greater power and
influence than you do
Hallucinations- perceptions in the absence of any sensory
stimulation
Schizophrenics DO NOT have split personalities
Positive Symptoms- excesses of behavior
Negative Symptoms- correspond to deficits of behavior
Types of Schizophrenia
Paranoid
Disorganized
Catatonic
• Delusions of
persecution
• Belief that
others are “out
to get you”
• Odd uses of
language
• Make up own
words
• String together
nonsense words
that rhyme
• Inappropriate
affect- wrong
emotion at the
wrong time
• Flat affect- no
emotional
response
• Odd
movements
• Remain in
strange
positions for
hours at a time
• Will allow their
body to be
moved into any
shape and will
hold the new
pose
• Increasingly
rare
Undifferentiated
• Exhibit
disordered
thinking but no
symptoms of
one of the
other types
Causes of Schizophrenic Disorders
Biological Perspective
• Dopamine Hypothesis- high levels of dopamine are
associated with schizophrenia
• Antipsychotic drugs used to treat schizophrenia result in
lower dopamine levels
• Extensive use causes negative side effects- dyskinesia
(muscle tremors and stiffness)
• L-dopa, given to Parkinson’s patients, can cause
schizophrenic symptoms in excess
• Enlarged brain ventricles and brain asymmetry
• Genetic predisposition- possible abnormality on 5th
chromosome
• Identical twins more likely to both have than fraternal
Causes of Schizophrenic Disorders
Cognitive-Behavioral
• Certain kinds of environments may cause or increase the
likelihood
• Double binds- a person is giving contradictory messages
• People who live in environments full of conflicting
messages may develop distorted ways of thinking
Diathesis-Stress Model
• Environmental stressors can provide the circumstances
under which a biological predisposition for illness can
express itself
• Can explain other disorders as well
Personality Disorders





Generally less serious
Well-established, maladaptive ways, of behaving
Antisocial Personality Disorder- have little regard
for other people’s feelings (often criminals)
Dependent Personality D/o- depend too much on
others
Histrionic Personality Disorder- overly dramatic
Other Psychological Disorders





Paraphilias/Psychosexual Disorders- sexual
attraction to an object, person, or activity not
usually seen as sexual
Eating Disorders- Anorexia and Bulimia
Substance Abuse Disorder
Autism- atypical social development
ADHD
The Rosenhan Study (1978)

David Rosenhan and his associates sought admission to
mental hospitals, claiming that they had been hearing
voices; all were admitted as suffering from
schizophrenia
At that time, they ceased reporting any unusual symptoms
and behaved as usual
 None were exposed, all leftwith the diagnosis of
schizophrenia in remission




Should people who were once diagnosed carry it the
rest of their lives?
To what extent are disorders the product of the
environment?
What is the level of institutional care available of the
imposters could go undetected for weeks?
Types of Therapy- Generally Effective
Psychoanalytic
Psychotherapy
Somatic
Treating the mind
Treating
the
body
Behavioral
Cognitive
Humanistic
Biomedical
Psychoanalytic Therapy



Cause of disorders in unconscious conflicts; must
identify the underlying cause
Symptom substitution- happens in other types of
therapy when the underlying problem is not
addressed; person will have a new psychological
problem
Hypnosis- an altered state of consciousness where
people are less likely to repress troubling thoughts
Psychoanalytic Theory


Free Association- saying whatever comes to mind,
we cannot constantly sensor everything we say
Dream Analysis- the ego’s defenses are relaxed
during sleep
 Manifest
content- what a patient reports about their
dream
 Latent content- the hidden
content revealed by
interpretive work
Psychoanalytic Theory

Resistance- disagreeing with their therapist’s
interpretations
 Strongly

Transference- having strong feelings toward their
therapist
 Love,

voiced- close to getting at the actual problem
hate, etc.
Psychodynamic- after Freud
(Adler, Horney etc.)
Humanistic Theory



Focuses on helping people understand and accept
themselves and strive to self-actualize
People are innately good and possess free willcapable of controlling their own destinies (opposite
of determinism)
Carl Rogers (Client Centered Therapy)
 The
therapist provides the patient with
unconditional positive regard (support
no matter what)
 Essential to healthy development
Humanistic Therapy

Non-directive- do not tell client what to do, but seek
to help clients choose the best course of action for
themselves
 Active
listening- clarify feelings for client- (“So what
I’m hearing you say is…”)

Gestalt Therapy (Perls)- encourage client to get in
touch with their whole selves
 Body
position, minute actions
 Stress importance of the present
Behavioral Therapy

Counterconditioning- a kind of classical
conditioning in which an unpleasant conditioned
response is replaced with a pleasant one
 Give

Bentley a treat when he is put in his cage
Systematic Desensitization- teaching the client to
replace the feelings of anxiety with relaxation
 Teach
the client to relax
 Create an anxiety hierarchy- rank ordered list of what
the client fears and tackle each one
Behavioral Therapy




Flooding- address the most frightening scenario
first to realize fears are irrational
Modeling- learning by observing the behavior of
others
Aversive conditioning- pairing a habit one wishes
to break with an unpleasant stimulus
Token Economy- identify desired behaviors and
reward them for tokens that can be
exchanged
Cognitive Therapy




Changing unhealthy thought patterns
Attributional Style- healthy views failures as
external, specific, and temporary (vs. unhealthy)
Beliefs
Aaron Beck- Cognitive Therapy
about
themselves
(used to treat depression)
Cognitive Triad
DepressionCaused by
Irrational:
Beliefs
about their
futures
Beliefs
about their
world
Cognitive Behavioral Therapies (CBT)

Rational Emotive (REBT)- Albert Ellis
 Expose
and confront the dysfunctional thoughts of their
clients
 Question the likelihood of an event occurring and the
impact that would result
 Goal is to show the client that failure is an unlikely
occurrence but that even if it did occur, its not that big
of a deal
Somatic Therapy

Pharmacology/Chemotherapy- Drug Treatment
Type of Disorder
Treatment
Type of Drug
Drug Names
Anxiety Disorders
Depress CNS
activity
Barbiturates,
Benzodiazepines
Miltown, Zanax,
Valium
Unipolar
Depression
Increase Serotonin
MAOIs, Tricyclic
Antidepressants,
serotonin-reuptake
inhibitors
Zoloft, Prozac
Bipolar Depression
Lower manic phase
Lithium
Schizophrenia
Block dopamine
receptor sites
Antipsychotics,
Neuroleptics
Haldol
Somatic Therapy

Electroconvulsive Therapy (ECT)
 Passing
electric current through the brain, causing a
brief seizure
 Can result in memory loss
 Used as a last resort for severe depression
 Not completely understood

Psychosurgery
 Prefrontal
state
lobotomies- calmed patients to a vegetative
Practice Questions

1) All schizophrenics suffer from
 Depression
 Multiple
personalities
 Flat affect
 Distorted thinking
 Delusions of persecution

2) Juan hears voices that tell him to kill people.
Juan is experiencing
 Delusions
 Obsessions
 Anxiety
 Hallucinations
 Compulsions

3) Depression is associated with low levels of
 Acetylcholine
 Epinephrine
 Serotonin
 Dopamine
 GABA

4) What kind of psychologist would be most likely
to describe depression as the result of an
unconscious process in which anger is turned inward?
 Biomedical
 Psychoanalytic
 Cognitive
 Behavioral
 Sociocultural

5) Coretta’s therapist says little during their sessions
and never makes any recommendations about what
Coretta ought to do. What kind of therapy does
Coretta’s therapist most likely practice?
 Psychdynamic
 Behavioral
 Cognitive
 Biomedical
 Humanistic

6) Maria has been in analysis for over a year.
Recently, she has begun to suspect that she has
fallen in love with Dr. Chin, her analyst. When she
confesses her feelings, Dr. Chin is likely to tell Maria
that she is experiencing
 Resistance
 Transference
A
breakthrough
 Irrational expectations
 Unconditional positive regard
Resources



http://quizlet.com/10877015/ap-psychologypsychological-disorders-and-therapy-flash-cards/
http://quizlet.com/10877015/ap-psychologypsychological-disorders-and-therapy-flash-cards/
http://www.livebinders.com/play/play?id=502056