Chapter 15 Psychological Disorders © 2011 The McGraw-Hill Companies, Inc. Chapter Preview Defining/Explaining Abnormal Behavior Anxiety Disorders Mood Disorders Dissociative Disorders Schizophrenia Personality Disorders Psychological Disorders and Health and Wellness © 2011 The McGraw-Hill Companies, Inc. Abnormal Behavior Behavior that is… deviant (atypical) maladaptive (dysfunctional) personally distressing (despair) © 2011 The McGraw-Hill Companies, Inc. Theoretical Approaches Biological Approach: Medical Model disorders with biological origins Psychological Approach experiences, thoughts, emotions, personality Sociocultural Approach social context Biopsychosocial Model interaction of biological, psychological and sociocultural factors © 2011 The McGraw-Hill Companies, Inc. DSM-IV Classification System Advantages provides a common basis for communication helps clinicians make predictions naming the disorder can provide comfort Disadvantages stigma (shame, negative reputation) medical terminology implies internal cause focus on weaknesses ignores strengths © 2011 The McGraw-Hill Companies, Inc. Psychological Disorders – Real or Myth? Szasz & Cruise phrase “mental illness” is presumptuous medication of mental illnesses is presumptuous Response of Medical Professionals mental illnesses are real medical conditions drugs effectively alleviate symptoms ADHD: over-diagnosed or non-medical? should prescription drugs be used to treat ADHD? © 2011 The McGraw-Hill Companies, Inc. DSM-IV-TR Axes Multiaxial System Axis I and II: Psychological Disorders Axis III: General Medical Conditions Axis IV: Psychosocial/Environmental Problems Axis V: Current Level of Functioning © 2011 The McGraw-Hill Companies, Inc. Anxiety Disorders …uncontrollable fears that are disproportionate and disruptive generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder © 2011 The McGraw-Hill Companies, Inc. Generalized Anxiety Disorder Diagnosis and Symptoms persistent anxiety for at least 6 months inability to specify reasons for the anxiety Etiology biological factors - genetic predisposition, GABA deficiency, respiration psychological and sociocultural factors - harsh self-standards, critical parents, negative thoughts, trauma © 2011 The McGraw-Hill Companies, Inc. Panic Disorder Diagnosis and Symptoms recurrent, sudden onsets of intense terror that often occur without warning Etiology biological factors: genetic predisposition psychological factors: misinterpret arousal sociocultural factors: gender differences © 2011 The McGraw-Hill Companies, Inc. Phobic Disorder Diagnosis and Symptoms an irrational, overwhelming, persistent fear of a particular object or situation (e.g., social phobia) Etiology biological factors: genetic disposition psychological factors: learned © 2011 The McGraw-Hill Companies, Inc. Examples of Phobic Disorders © 2011 The McGraw-Hill Companies, Inc. Social Phobias in the U.S. © 2011 The McGraw-Hill Companies, Inc. Obsessive-Compulsive Disorder Diagnosis and Symptoms persistent anxiety-provoking thoughts and/or urges to perform repetitive, ritualistic behaviors to prevent or produce a situation Etiology biological factors: genetic predisposition psychological factors: life stress © 2011 The McGraw-Hill Companies, Inc. Post-Traumatic Stress Disorder Diagnosis and Symptoms Symptoms develop as a result of exposure to a traumatic event, oppressive situation, natural or unnatural disasters - flashbacks - constricted ability to feel emotions - excessive arousal - difficulties with memory and concentration - feelings of apprehension - impulsive outbursts © 2011 The McGraw-Hill Companies, Inc. Post-Traumatic Stress Disorder Etiology trauma - combat and war-related - sexual abuse and assault - natural and unnatural disasters vulnerability - previous history of trauma - genetic predispositions © 2011 The McGraw-Hill Companies, Inc. Mood Disorders …disturbance of mood that affects entire emotional state Symptoms may include cognitive, behavioral, or physical symptoms interpersonal difficulties Types major depressive disorder, dysthymic disorder bipolar disorder © 2011 The McGraw-Hill Companies, Inc. Major Depressive Disorder (MDD) Diagnosis and Symptoms significant depressive episode that lasts for at least two weeks defined by presence of at least 5 out of 9 symptoms daily functioning is impaired © 2011 The McGraw-Hill Companies, Inc. Dysthymic Disorder (DD) Diagnosis and Symptoms chronic depression - unbroken depressed mood lasting at least two years (adult) or one year (child) fewer symptoms than MDD - defined by presence of 2 out of 6 symptoms © 2011 The McGraw-Hill Companies, Inc. Major Depressive Disorder (MDD) Etiology biological factors: genetic disposition - underactive prefrontal cortex - regulation of neurotransmitters psychological factors: - learned helplessness - ruminating on negative, self-defeating thoughts - pessimistic attribution sociocultural factors - poverty - gender differences © 2011 The McGraw-Hill Companies, Inc. Childhood Depression Developmental Psychopathology risk factors for depression - parental psychopathology - genetics protective factors - supportive adult role model, or strong extended family - genetics © 2011 The McGraw-Hill Companies, Inc. Bipolar Disorder Characterized by extreme mood swings Bipolar I and Bipolar II Frequency and separation of episodes usually separated by 6 months to a year Etiology strong genetic component swings in metabolic activity in cerebral cortex levels of neurotransmitters © 2011 The McGraw-Hill Companies, Inc. Suicide Prevalence over 32,000 in year 2004 one completion for every 8 to 25 attempts 3rd leading cause of death in early adolescence © 2011 The McGraw-Hill Companies, Inc. Suicide Biological factors low levels of serotonin poor health Psychological Factors mental disorders trauma (recent/immediate and highly stressful) substance abuse Sociocultural Factors chronic economic hardship cultural and religious norms gender differences © 2011 The McGraw-Hill Companies, Inc. When Someone is Threatening Suicide © 2011 The McGraw-Hill Companies, Inc. Dissociative Disorders …sudden loss of memory or change in identity Dissociation protection from extreme stress or shock problems integrating emotional memories Types dissociative amnesia dissociative fugue dissociative identity disorder (DID) © 2011 The McGraw-Hill Companies, Inc. Dissociative Disorders Dissociative Amnesia individuals experience extreme memory loss caused by extensive psychological stress Dissociative Fugue individuals experience amnesia, unexpectedly travel away, and sometimes assume a new identity © 2011 The McGraw-Hill Companies, Inc. Dissociative Identity Disorder Diagnosis and Symptoms the same individual possesses two or more distinct personalities each personality has unique memories, behaviors, and relationships only one personality is dominant at a time personality shifts occur under distress Etiology extraordinarily severe abuse in early childhood social contagion mostly women runs in families © 2011 The McGraw-Hill Companies, Inc. Schizophrenia highly disordered thought split from reality (psychotic) typically diagnosed in early adulthood high suicide risk © 2011 The McGraw-Hill Companies, Inc. Symptoms of Schizophrenia Positive Symptoms hallucinations and delusions thought disorders and disorders of movement Negative Symptoms flat affect Cognitive Symptoms attention difficulties and memory problems impaired ability to interpret information and make decisions © 2011 The McGraw-Hill Companies, Inc. Etiology of Schizophrenia Biological Factors genetic predisposition structural brain abnormalities regulation of neurotransmitters Psychological Factors diathesis-stress model Sociocultural Factors influence how disorder progresses © 2011 The McGraw-Hill Companies, Inc. Personality Disorders …chronic maladaptive cognitive-behavioral patterns Antisocial Personality Disorder Diagnosis and Symptoms - guiltless lawbreaking, violence, deceit - impulsive, irritable, reckless, irresponsible Etiology - biological factors (genetic, brain, and ANS differences) © 2011 The McGraw-Hill Companies, Inc. Personality Disorders Borderline Personality Disorder Diagnosis and Symptoms instability in interpersonal relationships & self-image impulsive, insecure, unstable & extreme emotions Etiology genetic childhood abuse irrational belief one is powerless, unacceptable, and that others are hostile © 2011 The McGraw-Hill Companies, Inc. Psychological Disorders and Health and Wellness Stereotypes and Stigma Rosenhan’s study - fake psychiatric patients negative attitudes toward mentally ill physical health risk successfully functioning individuals with mental illness reluctant to “come out” © 2011 The McGraw-Hill Companies, Inc. Chapter Summary Discuss the characteristics, explanations, and classifications of abnormal behavior. Distinguish among the various anxiety disorders. Compare the mood disorders and specify risk factors for depression and suicide. Describe the dissociative disorders. Characterize schizophrenia. Identify behavior patterns typical of personality disorders. Explain the impact of the stigma associated with mental illness. © 2011 The McGraw-Hill Companies, Inc. Chapter Summary Abnormal Behavior deviant, maladaptive, or personally distressing Theoretical Approaches biological, psychological, and sociocultural biopsychosocial Classifying Abnormal Behavior DSM-IV-TR Axes advantages and disadvantages © 2011 The McGraw-Hill Companies, Inc. Chapter Summary Anxiety Disorders generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder © 2011 The McGraw-Hill Companies, Inc. Chapter Summary Mood Disorders major depressive disorder dysthymic disorder bipolar disorder suicide Dissociative Disorders dissociative amnesia dissociative fugue dissociative identity disorder © 2011 The McGraw-Hill Companies, Inc. Chapter Summary Schizophrenia positive, negative and cognitive symptoms etiology (biological, psychological, sociocultural) Personality Disorders antisocial personality disorder borderline personality disorder Psychological Disorders and Health & Wellness stigmas and stereotypes © 2011 The McGraw-Hill Companies, Inc.