Psychological Disorders According to the Law The definition of mental disorders rests on whether: 1- the person is aware of of the consequences of his actions 2- can control his behavior If not the person may be declared insane. 1 Definitions of Mental Disorder A Harmful Dysfunction 1- Mental disorders as a violation of cultural standards or atypical 2- Mental disorder as maladaptive or harmful behavior 3- Mental disorder as a disturbing emotional distress. 4- Mental disorder as unjustifiable 2 Psychologists’ Definition • Any behavior or emotional state that 1- causes the individual great suffering or worry 2- is self-destructive, 3- is maladaptive and disrupts either the person’s relationships or the larger community. 3 Understanding Psychological Disorders The Medical Perspective Psychological disorders are sicknesses and can be diagnosed, treated, and even cured. The Bio-Psycho-Social Perspective How biological, psychological, and social factors interact to produce specific psychological disorders. 4 Diagnostic & Statistical Manual of Mental Disorders • DSM-IV (1994) contains more than 300 mental disorders. • Provides diagnostic categories • Does not provide information on causes • Does not provide information on treatment • It is organized in 5 axes 5 Axis I Clinical Syndromes Anxiety disorders Mood disorders Dissociative disorders Substance abuse disorders Schizophrenia 6 Axis II Developmental and Personality Disorders Ingrained aspects of the client’s personality that are likely to affect the person’s ability to be treated, such as self-involvement or dependency. 7 Axis III Physical Disorders and Conditions • Medical conditions that are relevant to the disorder, such as respiratory or digestive problems. 8 Axis IV Severity of Psychosocial Stressors • Social and environmental stressors that can make the disorder worse, such as job and housing troubles or having recently left a network of close friends. 9 Axis V Global Assessment of Functioning • The client’s overall level of functioning at work, relationships, and leisure time including whether the problem was of a recent origin or of long duration, and how incapacitating it is. 10 Diagnostic Criteria for AttentionDeficit Hyperactivity Disorder • Symptoms must persist for at least six months • Symptoms must have begun before age seven • Symptoms present in at least two situations • Disorder impairs functioning • Symptoms not explained by another disorder such as: 11 Diagnostic Criteria for AttentionDeficit Hyperactivity Disorder • • • • • • Anxiety Schizophrenia Mania Dissociative Disorder Personality Disorder Developmental Disorder 12 Anxiety Disorders • • • • • 1- Generalized Anxiety Disorder 2- Posttraumatic Stress Disorder 3- Panic Disorder 4- Fears and Phobias 5- Obsession Compulsions 13 Posttraumatic Stress Disorder • When people are in danger, they produce high levels of natural opiates, which can temporarily mask pain. They also produce stress hormones. • People with PTSD tend to continue producing these hormones. • Norepinephrine is higher than normal. It activates the hippocampus, which is involved with memory and long term memory. • At high levels, stress hormones can become toxic and can damage the brain. 14 Phobias • • • • • • Acrophobia: fear of heights Brontophobia: fear of thunder Claustrophobia: fear of closed places Porphyrophobia: fear of the color purple Mysophobia: fear of dirt and germs Agoraphobia: fear of being away from a safe place. • Triskaidekaphobia: fear of number 13 15 Obsession Compulsions • Obsessions Recurrent, persistent, unwished-for thoughts or images. Example: repetitive thoughts about killing a child or becoming contaminated by shaking hands. • Compulsions Repetitive, ritualized behavior that the person feels must be carried out to avoid disaster. Example: hand washing, counting, & checking 16 Obsession Compulsions • The orbital cortex sends messages of impending danger to the caudate nucleus (prepares the body to respond to external danger). • In people with OCD, the orbital cortex keeps on sending false alarms of danger. • But the caudate nucleus fails to turn them off. 17 Explaining Anxiety Disorders The Learning Perspective The Biological Perspective Fear Conditioning Stimulus Generalization Reinforcement Observational Learning Evolution Genes Physiology 18 Mood Disorders • 1- Depression • 2- Mania • 3- Bipolar 19 Symptoms of Depression • Feeling of despair and hopelessness • Exaggerating minor failings and ignoring positive events • Interpreting losses as signs of personal failures and concluding that happiness is not possible. Physical Changes • Overeating, insomnia, lack of appetite trouble concentrating, feeling tired all the time 20 Mania • • • • • • • An abnormally high state of exhilaration Excessive energy Irrational decisions Feeling of excessive hopefulness Speaking rapidly and dramatically Excessive feeling of ambition Inflated self esteem 21 Stages of Mania • 1-Hypomania Patients are energetic, extroverted, and assertive • 2-Mania Loss of judgment • 3-Delusion with Paranoid Themes Speech is generally rapid and hyperactive behavior may lead to violence. 22 Causes of Mania • Excessive production of one or two neurotransmitters: • 1-Norepinephrine • 2-Serotonin 23 Bipolar Disorder Manic-Depressive • When people alternate between episodes of depression and one or more episodes of mania. • Occurs equally in both sexes. • The onset is between 20-30 with a second peak at 40 • Those who have rapid cycling may experience more episodes of mania and depression that succeed each other without a period of remission. 24 People Who Had Bipolar • • • • • • Abraham Lincoln Van Gough Vivian Lee Charles Dickens Newton Mark Twain Edgar Allan Poe Virginia Wolf Walt Whitman Ernest Hemingway 25 Theories of Depression • 1- Biological explanations emphasize genetic and brain chemistry. • 2- Social explanations emphasize the stressful circumstances of people’s lives. • 3- Attachment explanations emphasize problems with close relationships. • 4- Cognitive explanations emphasize particular habits of thinking and interpreting events • 5- “Vulnerability-stress” explanations draw on all four explanations. 26 Biological Explanation • Genes may exert their influence by creating biochemical imbalances • The low production of the neurotransmitters norepinephrine and serotonin may be the cause of depression. • The brains of depressed people seem less active. • The frontal lobes are 7% smaller in severely depressed patients. 27 Cognitive Explanations • Internality The reason for misery is internal • Stability The situation is permanent • Lack of Control There is no control over the situation 28 Learned Helplessness • Pessimistic Explanatory Style • Brooding and Ruminating about Unhappiness 29 Vulnerability-Stress Model of Depression • Upsetting Events Loss of loved ones Loss of job Failure Trauma Violence Temporary unhappiness • Individual Vulnerability Biological predisposition Low self-esteem Insecure attachment Learned helplessness Negative thinking Pessimism Brooding 30 Personality Disorders • 1- Paranoid Personality Disorder • 2- Narcissistic Personality Disorder • 3- Antisocial Personality Disorder 31 Paranoid Personality Disorder • • • • • • Unfounded suspiciousness Mistrust of other people Irrational jealousy Secretiveness Doubt about the loyalty of others Delusions of being persecuted by others. 32 Narcissistic Personality Disorder • • • • • • Exaggerated sense of self-importance Self-absorption Fantasies of unlimited success & power Demand of constant attention & admiration Feeling of entitlement of special favors Narcissistic people cant find a good match because they expect perfection. 33 Symptoms of Antisocial Personality Disorder • • • • • 1- They repeatedly break the law. 2- They are deceitful, using lies to con others. 3- They are impulsive and unable to plan ahead. 4- They repeatedly get into fights or assaults. 5- They show reckless disregard to their own safety or that of others. • 6- They are constantly irresponsible, failing to meet their obligations. • 7- They lack remorse for actions that harm others. 34 Causes for APD • 1- Abnormalities in the brain and central nervous system • 2- Problems with impulse control • 3- Brain damage • 4- Vulnerability-stress explanations 35 Emotion • You perceive the sensory stimulus. • The adrenal gland sends two hormones: epinephrine and norepinephrine. • They activate the sympathetic nervous system. • That produces a state of arousal or alertness that provides the body with the energy to act (the pupils dilate, the heart beats faster, and breathing speeds up). 36 Vulnerability – Stress Explanation • Biological vulnerability Brain damage Genetic predisposition Birth complications Central nervous system abnormalities • Stressful Experiences Physical abuse Maternal rejection Lack of contact comfort 37 Dissociative Disorders • 1- Amnesia • 2- Fugue • 3- Dissociative Identity Disorder (Multiple Personality Disorder) 38 Causes of Addiction • 1- The Disease Model • 2- The Learning Model 39 The Disease Modal “The Disease Concept of Alcoholism” by E. M. Jellinek • Alcoholism is a disease over which an individual has no control and from which he or she never recovers • Addiction is due to a person’s biochemistry, metabolism, and genetic predisposition. • Genetic Predisposition: – Contribute to traits that predispose the person to become alcoholic. – May affect biochemical processes in the brain that make some people more susceptible than others. 40 The Learning Model of Addiction 1- Addiction patterns vary according to cultural practices and the social environment. 2- Policies of total abstinence tend to increase rates of addiction rather than reduce them. 3- Not all addicts have withdrawal symptoms when they stop taking a drug. 4- Addiction does not depend on properties of the drug alone, but also on the reason for taking it. 41 Active Symptoms of Schizophrenia • 1- Bizarre delusions (Paranoid/Identity) • 2- Hallucinations and heightened sensory awareness (auditory, visual, or tactile) • 3- Disorganized, incoherent speech • 4- Grossly disorganized and inappropriate behavior 42 Negative Symptoms of Schizophrenia • • • • • • • Loss of motivation Poverty of speech Making only brief and empty replies Diminished thought and emotionality Emotional flatness Unresponsive facial expressions Poor eye contact 43 Explanation of Schizophrenia • 1- Genetic predisposition • 2- Structural brain abnormalities • 3- Neurotransmitter abnormalities • 4- Prenatal abnormalities • 5- The Vulnerability-stress approach 44 Genetic Predisposition Risk of Developing Schizophrenia • • • • • Identical twins……less than 50% Child of 2 schizophrenic parents... 34-46% Fraternal twins ….less than 20% Children with 1 schizophrenic parent 12% Siblings ….. Less than 10% 45 Brain Abnormalities • Signs of cerebral damage • Decreased brain weight • Reduced numbers of neurons in the prefrontal cortex • Decrease in volume of the limbic regions • Abnormalities in the thalamus • Enlarged ventricles or spaces in the brain 46 Neurotransmitter Abnormalities • Serotonin • Glutamate • Dopamine 47 Prenatal Abnormalities • Malnutrition • Infectious virus during prenatal development • Mother’s exposure to influenza virus during the second trimester of pregnancy 48 Vulnerability – Stress Explanation • Biological Vulnerability Genetic predisposition Birth complications that damage the brain Prenatal damage due to viral infection • Stressful Experiences Unstable family life Extreme stress in late adolescence and early adulthood. 49