Psychological
Disorders
By Aaron, Kevin, Jason, and Munch
Abnormal Behavior
Can be distinguished with three criteria...
1. Deviant - atypical or statistically unusual
a. women taking 7 showers a day
2. Maladaptive - it interferes with a person’s ability to
function effectively in the world
a. isolating yourself because you might be dangerous
3. Involves personal stress over a long period of time
a. may cause shame, guilt, or despair
Theoretical Approaches
● Biological Approach
○ attributes disorders to organic, internal causes
■ brain, genetics, neurotransmitter functions
● Psychological Approach
○ emphasizes contributions of experiences, thoughts,
emotions, and personality characteristics
■ rewards/punishments
● Sociocultural Approach
○ cultural influences on developing psychological disorders
■ social, economic, technological, and religious
aspects
● Biopsychosocial Approach
○ a combination of all three listed above
Classifying Abnormal Behavior
Psychiatrists and psychologists have devised systems classifying abnormal
behaviors called the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV) classification system. It uses 5 axis.
Axis I - All diagnostic categories except personality disorders and mental
retardation
Axis II - Personality disorders and mental retardation
Axis III - General medical conditions
Axis IV - Physical and environmental problems
Axis V - Current level of functioning
Critiques of the DSM-IV
The most controversial aspects are…
1. The manual classifies individuals based off of symptoms, using the
traditional type of thinking that mental disorders are a type of disease. This
implies abnormalities have an internal cause that is independent of the
environment
2. It focuses strictly on pathology and problems, instead of emphasizing
strengths as well
https://www.youtube.com/watch?v=5leB-pmpxek
Dissociative Disorders
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Dissociative Disorders- Sudden loss of memory or change in identity due to
dissociation of conscious and memory
Dissociative Amnesia- amnesia caused by intense psychological stress
Dissociative Fugue- Amnesia + unexpected travel away from home (sometimes
assume a new identity)
Dissociative Identity Disorder (DID)- Formerly known as Multiple personality
disorder. Individuals develop two or more distinct personalities
Symptoms of Dissociative Disorders
Symptoms
Depression
Mood swings
Suicidal tendencies
Sleep disorders (insomnia, night terrors, and sleepwalking)
Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
Alcohol and drug abuse
Compulsions and rituals
Psychotic-like symptoms (including auditory and visual hallucinations)
Eating disorders
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Treatment of Dissociative Disorders
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Treatment- talk therapy or psychotherapy, medications, hypnotherapy, and art or
movement therapy.
Often anxiety or depression is also present
Dissociative disorders may be treated using the same drugs prescribed for those
disorders. Antidepressants or anti-anxiety medication
Case Studies- Dissociative Amnesia
http://emedicine.medscape.com/article/294508-overview
Dissociative Amnesia29-year-old female experienced the onset of dissociative amnesia
She was found in a hotel bathroom unconscious, with no signs of structural
or neurologic abnormalities or alcohol or chemical consumption
Could not remember her name, address, family, or any facts about her
home life
The amnesia persisted for nearly 10 months, until the feeling of blood on
the woman's fingers triggered a recollection of events
She had witnessed a murder that night in China
She recalled being unable to help the victim out of fear for her own safety
Most memories returned however some are still lost
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Case Study- Dissociative Fugue
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28-year old male final year medical student.
Declared missing for 10 days
He was later seen in a city in South-Western Nigeria, a distance of about 634km from SouthEastern Nigeria where he lived and schooled
Ten days before presentation, the patient suddenly saw a full human skeleton reading at the
same table with him, sitting at the opposite side. The patient claimed he felt unease and quite
uncomfortable.
After this he had overwhelming fears and did not know when he left the room.
Two days later, he discovered he was with his younger sibling in South-Western Nigeria.
The patient had no knowledge of how he made the journey that takes approximately 8 hours
by road.
He could not remember any of the journey including how he payed for it and where he slept.
The patient denied all memory of events for the 2 days from when he left his room at the
university to the time he suddenly realized he was at his brother’s house, 634km away
The brother, however, reported that the patient appeared unkempt, looked exhausted but
was fully conscious and alert on arrival at his house without any assistance.
Case study- DID
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Woman who had experienced physical and sexual abuse from her father
Exhibited at least 4 personalities as an adult.
Each personality was of a different age– a fearful child, a rebellious teenager, a
protective adult, and the woman's primary personality.
Only one of the personalities, the protective adult, was consciously aware of the
others.
When one of the secondary personalities took over, it often led to episodic
dissociative amnesia
During intensive therapy sessions, each personality was called upon as necessary
to facilitate their integration.
Schizophrenia
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Severe psychological disorder characterized by
highly disordered thought processes, referred to
as psychotic because they are so far removed
from reality.
Individuals with Schizophrenia often see things
that are not there, hear voices inside their
heads, and live in a strange world of twisted
logic (often withdrawn or isolated)
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Positive Symptoms
○ They are “positive” because they reflect something added above
and beyond normal behavior. The positive symptoms Include
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Hallucinations: Sensory experiences in the absence of real stimuli (seeing
things that are not there)
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Delusions: False, unusual, and sometimes magical beliefs that are not part of
an individual’s culture.
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Thought disorder: Unusual, sometimes bizarre thought processes (thoughts
often disorganized or confused)
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Disorders of movement: May show unusual mannerisms, body movements,
and facial expressions. In some cases this may cause them to become
Catatonic (a state of immobility and unresponsiveness that lasts for long
Negativeperiods
Symptoms
of time)
○ Reflect social withdrawal, behavioral deficits, and the loss or
decrease of normal functions. One negative symptom is the Flat
affect (the display of little or no emotion)
● Cognitive Symptoms
○ Include difficulty sustaining attention, problems holding
information in memory, and inability to interpret information
and make decisions.
Causes of Schizophrenia
Biological FactorsHeredity:
Research shows that Schizophrenia is at least partially caused by genetic
factors (as genetic similarity to a person with Schizophrenia increases, so
does a persons risk of developing Schizophrenia)
Structural brain abnormalities:
Imaging techniques such as MRI scans have shown enlarged ventricles in
the brains of those with Schizophrenia (fluid-filled spaces, and the
enlargement of the ventricles indicates deterioration in other brain tissue)
Small prefrontal cortex, and lower activity in this area of the brain than
those who do not have Schizophrenia.
changes in the brain most likely occur prenatally because they are not
accompanied by glial cells (which are always present when a brain injury
occurs after birth)
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Association of Genes with Schizophrenia
Psychological Factors
• Theorists believe that stress may contribute to the development of this
disorder
• The diathesis-stress model: View of Schizophrenia emphasizing that a
combination of biogenetic disposition and stress causes the disorder
Sociocultural Factors
• Sociocultural background is not considered a cause of Schizophrenia, but
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do appear to affect the course of the disorder (influence how
Schizophrenia progresses)
Across cultures, individuals with Schizophrenia in developing, nonindustrialized nations tend to have better outcomes than those in
developed industrialized nations (this may be due to the fact that those in
developing nations are more accepting and supportive of individuals with
Schizophrenia)
Case Study- Schizophrenia
■ young boy wouldn't eat his favorite fast food anymore because he
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thought his parents put things in his food to make it taste “funny”
he zoned out often and laughed out of nowhere
starting spending more time alone and his room and became very
aggressive when coming in contact with family
said that his mom was from a different planet and was sent here to
kill him and that his siblings were put on earth to protect him from
her
used a foreign language often when speaking to his family and told
them many times they were going to die
paced constantly or would do the complete opposite and not get
out of bed for long periods of time
started to eventually hallucinate and see things like bugs on his
walls
was eventually admitted to the hospital by parents
Personality Disorders
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Chronic, maladaptive, cognitive-behavioral
patterns that are thoroughly integrated into an
individual’s personality.
https://www.youtube.com/watch?v=BViqlxVjRn4
Antisocial Personality Disorder (ASPD)
● A psychological disorder characterized by guiltiness, law-breaking,
exploitation of others, irresponsibility, and deceit
○ Biological factors- genetic, brain, and autonomic nervous system
differences (like low levels of activation in the prefrontal cortex and an
underaroused autonomic nervous system)
The criteria for antisocial personality disorder include
■ failure to conform to social norms or obey the law
■ deceitfulness, lying, conning others for personal profit or
pleasure
■ impulsivity or failure to plan ahead
■ reckless disregard for safety of self or others
■ irritability and aggressiveness
■ consistent irresponsibility
■ lack of remorse
Borderline Personality Disorder (BPD)
● A psychological disorder characterized by a pervasive pattern
of instability in interpersonal relationships, self-image, and
emotions, and of marked impulsivity beginning by early
adulthood and present in a variety of contexts.
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women make up 75% of those with the disorder
many individuals with BPD report experiences of childhood sexual
abuse as well as physical abuse and neglect
Borderline Personality Disorder is indicated by the presence of
5 or more of the following symptoms
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frantic efforts to avoid being abandoned
markedly and persistently unstable self-image or sense of self
impulsivity in at least 2 areas that are potentially self-damaging (ex: spending,
sex, substance abuse)
recurrent suicidal behavior, gestures, or self-mutilating behavior
unstable and extreme emotional responses
chronic feelings of emptiness
inappropriate, intense anger or difficulty controlling anger
temporary stress-related paranoia or severe dissociative symptoms
Case Study- ASPD
Man hospitalized with symptoms of ASPD
■ had been in several fights by the age of 11
■ admits that he carried weapons and harmed others and
that he lacked remorse
■ said that he stole from his dad and stole comic books
from school and then sold them
■ stated that he is full of anger and said the more he hits
someone, the more anger builds up inside of him
Case Study- BPD
■ Woman tried to overdose multiple times and hoped maybe
someone would notice she was in need of help
■ had no hopes for tomorrow
■ tried to run away numerous times
■ felt panic, fear, and anger often
■ wanted to be respected, liked, and approved of but didn't know how
to “attain” these privileges and often thought she wasnt worthy of it
■ often overwhelmed by present pain that reminded her of the past
■ in several stressors occured in a sequence she would often start to
generalize, negatively.
Therapy and Antianxiety Drugs
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Biological Therapies = treatments that reduce
symptoms of psych. disorders by altering body function
Antianxiety drugs = tranquilizer, reduce anxiety,
addictive
o Benzodiazepines (fast): Xanax, Valium, Librium
 Drowsiness, loss of coordination, fatigue,
hazards, birth defects, depression
o Nonbenzodiazepine (slow): BuSpar
o Used for stress and/or anxiety
o Symptomatic relief
Therapy and Antidepressant Drugs
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Antidepressant drugs = regulate mood
o Tricyclics (Elavil) - 3 rings, slow, increase
norepinephrine and serotonin
o Tetracyclics (Avanza) - aka NaSSAs, increase same
hormones as tricyclics, “most effective”
o Monoamine Oxidase (MAO) inhibitors (Nardil) block MAO, allow norep. and sero. to stay, not
common, risky w/ food
o Selective serotonin reuptake inhibitors (Prozac,
Paxil, Zoloft) - prevent reabsorption of sero., fewer
side effects, more common
Antidepressants (cont.)
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10% take an antidepressant at some pt (2x
previous decade)
Used for both mood disorders and anxiety
disorders (panic, OCD, social phobia, PTSD,
eating/sleep, etc), sleeplessness, chronic pain
Lithium = lightest of solid elements, used for
bipolar disorder (may stabilize norep. and sero.
levels)
o weight gain effects, nearly toxic
Do Antidepressants Increase Suicide
Risk in Children?
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• Impulsive suicide
• 4% of antidepressant users reported
suicidal thoughts, vs. 2% of placebo group
• FDA “black box” warning, prescriptions
dropped
• 17% think of suicide, many not on
antidepressants, excluded from studies
Antipsychotic Drugs
• Antipsychotic drugs = powerful, reduce
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agitation, tension, hallucination, help
behavior, sleep, esp. schizophrenia
Neuroleptics = most common, treat
schizo., twitching (tardive dyskinesia)
Atypical antipsych. meds - lower risk
Small doses, combine w/ psychotherapy,
social training
see Figure 16.2 page 526
Electroconvulsive Therapy
(ECT)
• ECT = shock therapy, treatment for
depression, causes brain seizure
• Later resort, in sleep, may relapse
• Memory loss, impairment
• Deep brain stimulation = implanted
electrodes emit signals to alter brain
chem, severe depression, OCD
Psychosurgery
= irreversible surgery of brain tissue
Antonio Egas Moniz cut frontal fibers
Walter Freeman did prefrontal lobotomies
Damaging? Ethical?
Now a last resort, minimal invasion
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Duties of Group members
Kevin- Abnormal Behavior
Aaron- Dissociative Disorders
Taylor- Schizophrenia and Personality
Disorders
Jason- Therapy
Works Cited
http://emedicine.medscape.com/article/294508-overview
http://www.jmedicalcasereports.com/content/7/1/143
http://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder
https://www.youtube.com/watch?v=5leB-pmpxek
https://sites.google.com/site/consultingservicesinfo/mental-illness/anti-social-personality-disorder
http://ps.psychiatryonline.org/article.aspx?articleid=81024
http://www.schizophrenia.com/family/perstory5.htm