 In the ancient world, psychopathology was thought to be caused by demons and spirits that had taken possession of the person’s mind and body.
 Part of daily life in ancient worlds was spent doing rituals aimed at outwitting or placating these supernatural beings.

 In 400 B.C. the Greek physician Hippocrates took the first step toward a scientific view of mental illness when he said that abnormal behavior had physical causes.
 He taught his disciples to interpret the symptoms of psychopathology as an imbalance among our body fluids called “humors.”
Humors
Blood
Choler (yellow bile)
Melancholer (black bile)
Phlegm
Origins
Heart
Liver
Spleen
Brain
Temperament
Sanguine (cheerful)
Choleric (angry)
Melancholy (depressed)
Phlegmatic (sluggish)

 Music or singing was often used to chase away spirits.
 In some cases
trephening was used:
 Cutting a hole in the head of the afflicted to let out the evil spirit.

 As a result of erroneous thinking, thousands of mentally disturbed people were executed.
 In Salem Massachusetts, was one example of the problems with this type of thinking.
 A modern analysis of the Salem witch trials has concluded that the girls were probably suffering from poisoning by a fungus growing on rye grain-the same fungus that produces the hallucinogenic drug LSD.

 What was formerly known as mental illness or mental disorder is now often referred to as psychopathology.
 Some feel “mental illness” puts the basis for the illness on biology, even though psychologists have shown that environment is often the cause of the disorder.
 Psychopathology is any pattern of emotions, behavior, or thoughts inappropriate to the situation and leading to personal distress or the inability to achieve important goals.

 Psychological disorders are incurable
 People with psychological disorders are dangerous
 People with psychological disorders behave bizarrely & are very different from “normal” people
What effect do these have on the likelihood of someone truly suffering seeking help?
Psychological Disorders/Abnormal Psych

 At various moments, all of us feel, think or act the way disturbed people do much of the time. We, too, get anxious, depressed, withdrawn, suspicious, or deluded, just less intensely and more briefly.
 Some 450 million people world wide suffer psychological disorders.
 No culture known to man is without some form of psychological disorders.

 In America, mental illness is far more common than most people realize.
 Over 15% of the population currently suffers from diagnosable mental health problems.
 Another study found that during any given year, the behaviors of over 56 million Americans meet the criteria for a diagnosable psychological disorder (Carson et al.
1996).
 Over the lifespan, as many as 32% of Americans suffer from some psychological disorder (Regier et al., 1988).

 How do we discern what is normal and abnormal?
 What about a soldier who risks his life in war? A grief stricken mother who cannot return to her normal routines three months after losing her son?
 Psychological disorders are persistently harmful thoughts, feelings and actions.
 When behavior is deviant, distressful and dysfunctional, psychologists label it a disorder.

 The more extreme a disorder is, the more easily it is detected. When trying to diagnose a patient, doctors look for three classic symptoms of sever psychopathology:
 Hallucinations-false sensory experiences.
 Delusions-extreme disorders that involve persistent false beliefs.
 Affect (emotion)-characteristically depressed, anxious, manic, or no emotional response.

No Disorder Mild Disorder
Moderate
Disorder
Severe
Disorder
Absence of signs of psychological disorder
Few signs of distress or other indicators of psychological disorder
Indicators of disorders are more pronounced and occur more frequently
Clear signs of psychological disorder, which dominate the person’s life
Absence of behavioral problems
Few behavior problems; responses usually appropriate to the situation
More distinct behavior is often inappropriate to the situation
Severe and frequent behavior problems; behavior is usually inappropriate to the situation
No problems with interpersonal relationships
Few difficulties with relationships
More frequent difficulties with relationships
Many poor relationships or lack of relationships
Disorders are exaggerations of normal behavior and responses.

 In the late 18 th century, the “disease view” reemerged.
 The result was the medical model, a view that mental disorders are diseases of the mind that, like ordinary physical diseases, have objective causes and require specific treatment.
**

 Despite its success, modern psychologists find fault with relying solely on the medical model.
 They suggest that treating the disorder as a
“disease” leads to a doctor-knows-best approach in which the therapist takes all the responsibility for diagnosing and correcting the problem.
 In this model, the patient becomes a passive recipient of medication and advice.

Psychological School/Perspective
Psychoanalytic/Psychodynamic
Humanistic
Cause of the Disorder
Internal, unconscious drives
Failure to strive to one’s potential or being out of touch with one’s feelings.
Behavioral
Cognitive
Sociocultural
Biomedical/Neuroscience
Reinforcement history, the environment.
Irrational, dysfunctional thoughts or ways of thinking.
Dysfunctional Society
Organic problems, biochemical imbalances, genetic predispositions.

 As psychology has evolved, theories which were originally at odds, have now been combined to offer more thorough explanations, for example, cognitive psychology and behaviorism.
 Cognitive psychology looks inward, emphasizing mental processes. Behaviorism looks outward and emphasizes the influences of the environment.
 Psychologist from these perspectives see these two as complementary, and add that cognitions and behavior usually happen in social context, requiring social
perspective.

 The behavioral perspective tells us that abnormal behaviors can be acquired in the same fashion as healthy behaviors-- through behavioral learning.
 The cognitive perspective suggests that we must consider how people think about themselves and their relations with other people.
 Social-cognitive-behavioral approach, then, is an alternative to the medical model combining all three of psychology’s major perspectives.

 Modern bio-psychology assumes that some mental disturbances involve the brain or nervous system in some way.
 Subtle changes in the brain’s tissue or its chemical messengers- the neurotransmitters- can profoundly alter thoughts and behaviors.
 Genetic factors, brain injury, infection, and learning are some of the factors that can tip the balance towards psychopathology.

Sociocultural
(Roles, expectations, definition of normality and disorder)
Biological
(Evolution, individual genes, brain structures and chemistry)
Psychological
(Stress, trauma, learned helplessness, mood-related perceptions and memories)
 In short, biological, socio-cultural and psychological factors contribute to psychological disorders

 The DSM-1 (1952), 106 disorders across several major categories, reflecting a psychodynamic perspective on etiology
 DSM II (1968), 182 disorders, similar framework as DSM-1; like
DSM-1, it lacked specification of specific symptoms of many disorders; distinguished among disorders at broader levels of neurosis, psychosis, and personality disturbance
 DSM-III (1980) and DSM-III-R (1987), which focused on standardization of diagnostic categories by linking them to specific criteria or symptom clusters, expressed in colloquial language; included 265 diagnoses in DSM-III and 292 in DSM-III-R, which changed some of the diagnostic criteria
 DSM-IV (1994) and DSM-IV-TR (2000), 297 disorders, relatively minor changes

Change
Elimination of multi-axial system a
Comment
Clinicians wanted simplified, diagnosisbased system; distinctions between Axis I and Axis II disorders were never clearly justified; clinicians can still specify external stressors; new assessment measures will be introduced
Establishes 20 diagnostic classes or categories of mental disorders
Categories based on groupings of disorders sharing similar characteristics; some categories represent spectrums of related disorders
Introduction of new diagnostic category of
Neurodevelopmental Disorders to include
Autism Spectrum Disorder and ADHD and other disorders reflecting abnormal brain development
Increasing emphases on neurobiological bases of mental disorders and the developing understanding that abnormal brain development underlies many types of disorders

Change
Introduces more dimensionality (severity ratings) but does not restructure personality disorders as some had proposed
Comment
Major changes in personality disorders held over until next revision, the DSM 5.1 (or maybe 5.2)
Roman numerals dropped: DSM-5, not
DSM-V
Removes obsessive-compulsive disorder from category of Anxiety Disorders and places it in new category of Obsessive-
Compulsive and Related Disorders
Allows for easier nomenclature for midcourse revisions, 5.1, 5.2, etc.
Recognizes a spectrum of obsessivecompulsive type disorders, including body dysmorphic disorder; however, anxiety remains the core feature of OCD, so questions remain about separating it from anxiety disorders

Change
Provides a means of rating severity of symptoms, such as for ASD
Comment
Encourages clinicians to recognize the dimensionality of disorders
Greater emphasis on comorbidity; e.g., use of anxiety ratings in diagnosing depressive and bipolar disorders
Provides more explicit recognition of comorbidity in having clinicians rate level of anxiety in mood disorders

Change
Comment
Elimination of term “somatoform disorders” (now Somatic Symptom and
Related Disorders)
Eliminates a term few people understood
(somatoform disorders) and now emphasizes the psychological reactions to physical symptoms, not whether they are medically based
Reorganization of mood disorders into two separate diagnostic categories of
Depressive Disorders and Bipolar and
Related Disorders
No major changes anticipated, but no clear basis for eliminating umbrella construct of mood disorders

Change
Comment
Hypochondriasis dropped as distinct disorder Eliminates the pejorative term
“hypochondriasis”; people formerly diagnosed with hypochondriasis may now be diagnosed with Somatic Symptom Disorder if their physical symptoms are significant or with Illness Anxiety Disorder if their symptoms are minor or mild
Factitious Disorder moved to Somatic
Symptom and Related Disorders
Associated with other somatic symptom disorders, but is distinguished by intentional fabrication of symptoms for no apparent gain other than assuming medical patient role

Diagnostic Category Examples of Specific Disorders
Neurodevelopmental Disorders Autism Spectrum Disorder
Specific Learning Disorder
Communication Disorders
ADHD, Motor Disorders, etc.
Schizophrenia Spectrum and Other
Psychotic Disorders
Bipolar and Related Disorders
Depressive Disorders
Schizophrenia
Schizophreniform Disorder
Schizoaffective Disorder
Delusional Disorder
Schizotypal Personality Disorder
Bipolar I Disorder, Bipolar II Disorder
Cyclothymic Disorder
Disruptive Mood Dysregulation Disorder
Major Depressive Disorder
Persistent Depressive Disorder
Premenstrual Dysphoric Disorder

Diagnostic Category Examples of Specific Disorders
Anxiety Disorders
Obsessive-Compulsive and Related
Disorders
Trauma and Stressor Related Disorders
Specific Phobia
Social Anxiety Disorder (Social Phobia)
Panic Disorder
Agoraphobia
Generalized Anxiety Disorder
Separation Anxiety Disorder
Selective Mutism
Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Hair-Pulling Disorder (Trichotillomania)
Excoriation (Skin-Picking) Disorder
Adjustment Disorders
Acute Stress Disorder
Posttraumatic Stress Disorder
Reactive Attachment Disorder
Disinhibited Social Engagement Disorder

Diagnostic Category
Dissociative Disorders
Somatic Symptom and Related
Disorders
Feeding and Eating Disorders
Elimination Disorders
Examples of Specific Disorders
Dissociative Identity Disorder
Dissociative Amnesia
Depersonalization/Derealization Disorder
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder (Functional Neurological
Symptom Disorder)
Factitious Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder
Pica, Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Enuresis
Encopresis

Sexual Dysfunctions
Diagnostic Category
Sleep-Wake Disorders
Examples of Specific Disorders
Insomnia Disorder
Hypersomnolence Disorder
Narcolepsy
Breathing-Related Sleep Disorders
Circadian Rhythm Sleep-Wake Disorders
Parasomnias: Sleepwalking, Sleep Terrors,
Nightmare Disorder, Rapid Eye Movement Sleep
Behavior Disorder
Restless Legs Syndrome
Delayed Ejaculation
Erectile Disorder
Female Orgasmic Disorder
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration Disorder
Male Hypoactive Sexual Desire Disorder
Premature (Early) Ejaculation

Diagnostic Category
Gender Dysphoria
Disruptive, Impulse-Control, and
Conduct Disorders
Substance-Related and Addictive
Disorders
Neurocognitive Disorders
Examples of Specific Disorder
Gender Dysphoria
Oppositional Defiant Disorder
Intermittent Explosive Disorder
Conduct Disorder
Antisocial Personality Disorder
Pyromania
Kleptomania
Substance Use Disorders
Substance-Induced Disorders
Gambling Disorder
Delirium
Major & Mild Neurocognitive Disorders

Diagnostic Category
Personality Disorders
Examples of Specific Disorders
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder

 While psychologists look for the three classical symptoms, not all disorders have such sever symptoms.
A few others are:
 Distress: Does the individual show unusual or prolonged levels of anxiety?
 Maladaptiveness: Does the person act in ways that make others fearful?
 Irrationality: Does the person act or talk in ways that are irrational or incomprehensible to others?
 Unpredictability: Does the individual behave erratically and inconsistently at different times?
 Unconventional/undesirable behavior: Does the person act in ways that are statistically rare and violate social norms?


Anxiety Disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety


We all experience anxiety at one point and time in our lives, however it is not intense and not persistent
Anxiety disorders are the most common mental
illness in the U.S., affecting 40 million adults in the United States age 18 and older (18% of U.S. population).


Symptoms:

Often jittery





Agitated
Sleep deprived
Difficulty concentrating
Depressed Mood
Apprehension may leak out through


Furrowed brows
Twitching eyelids



Trembling
Perspiration
Fidgeting


Generalized Anxiety Disorder


An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal
GAD affects 6.8 million adults, or 3.1% of the
U.S. population.
Women are twice as likely to be affected as men.

Anxiety Disorders :
Generalized Anxiety Disorder:
 High level of “free-floating” anxiety not tied to specific threat; pervasive & persistent stimulation of ANS
• Must last at least 6 months for diagnosis
 Brood over relatively minor issues

However, as time passes emotions tend to mellow and by age 50, generalized anxiety disorder becomes rare
 More common in females
Psychological Disorders/Abnormal Psych




Specific phobias focus on one thing

People tend to avoid that situation or particular thing
Social Phobias is basically shyness taken to the extreme

Intense fear of being scrutinized by others, avoid potentially embarrassing social situations, or will sweat, tremble, or have diarrhea when doing so

15 million, 6.8%
Equally common among men and women, typically beginning around age 13.
Agoraphobia

Fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikes


Phobias

Anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object or situation

19 million, 8.7%
Women are twice as likely to be affected as men.
Typically begins in childhood; the median age of onset is 7.

Anxiety Disorders
Phobic Disorder:
 Anxiety now has a specific focus: persistent, irrational fear of something presenting no real danger
 Beyond simple phobias – maladaptive, disruptive to everyday life (e.g., various social phobias, often w/ physical symptoms
 Remember conditioning!
Psychological Disorders/Abnormal Psych

Genetics
– Martin Seligman used photos of flowers and snakes to test this theory
Specific events
– Specific events can trigger a phobia
Phobias are likely linked to the amygdala, the part of the brain that controls aggression and fear

 Common and uncommon fears


Panic Disorder

An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, chocking, or other frightening sensations

6 million, 2.7%
Women are twice as likely to be affected as men.
Very high comorbidity rate with major depression.
 Recurring attacks of overwhelming anxiety, sudden & relatively brief
 May be mistaken for heart attack
 Often linked to agoraphobia; may “fear the fear itself”
 Onset late adolescence, early adulthood; may be rooted in limbic system
Psychological Disorders/Abnormal Psych


Understanding Anxiety Disorders

Learning perspective

Fear conditioning: researchers have demonstrated ability to condition fear in rats


Two specific learning processes contribute to anxiety

Stimulus generalization

Reinforcement
Observational Learning


Biological Perspective

Natural Selection: fear threats face by ancestors


Genetics: researchers are examining neurotransmitters that influence an anxiety gene
The Brain: Anxiety disorders are manifested biologically as an overarousal of brain areas involved in impulse control and habitual behaviors


Obsessive-Compulsive Disorder

An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions
(compulsions)

Crosses the line from normality to disorder when they persistently interfere with everyday living and cause the person distress

2-3% cross the line during their teens or early twenties


Obsessive thoughts and compulsive behavior become so ritualistic that effective functioning become impossible

Acute Stress Disorder

with an event where there was the threat of or actual death or serious injury.
The event may also have involved a threat to the person's or another person's physical well-being.
 The person responded to the event with

Acute Stress Disorder
 The person experiences at least three of the following dissociative symptoms during or after the traumatic event:
 Feeling numb or detached or having difficulties experiencing emotions.
 Feeling dazed or not entirely being aware of surroundings.
 Derealization , or feeling as though people, places, and things are not real.
 Depersonalization , or feeling separated and detached from oneself.
 Dissociative amnesia, or being unable to recall important parts of the traumatic event.

Acute Stress Disorder
 Studies of motor vehicle accident (MVA) survivors have found rates of ASD ranging from approximately 13% to 21%
 A study of survivors of a typhoon revealed an ASD rate of 7%
 While a study of survivors of an industrial accident revealed a rate of 6%
 A rate of 19% was found in survivors of violent assault
 While a rate of 13% was found in a mixed group consisting of survivors of assaults, burns, and industrial accidents.
 A study of victims of robbery and assault found that 25% met criteria for ASD.
 While a study of victims of a mass shooting found that 33% met criteria.

Acute Stress Disorder
 ASD and PTSD differ in two fundamental ways:
 The first difference is that the diagnosis of ASD can be given only within the first month following a traumatic event. If posttraumatic symptoms were to persist beyond a month, the clinician would assess for the presence of PTSD.
The ASD diagnosis would no longer apply.
 ASD also differs from PTSD in that it includes a greater emphasis on dissociative symptoms.

Trauma & Stressor Disorder
Post-Traumatic Stress Disorder (PTSD):
 Delayed (“post”) stress (“stress”) reaction to uncontrollable danger (“traumatic”)
 Haunting memories that constantly intrude on thoughts; nightmares; social withdrawal; depression
 Symptoms may last years
 Often seen in war veterans, victims of violent crime, etc.
Psychological Disorders/Abnormal Psych

7.7 million, 3.5%
Women are more likely to be affected than men.
Rape is the most likely trigger of PTSD: 65% of men and 45.9% of women who are raped will develop the disorder.
Childhood sexual abuse is a strong predictor of lifetime likelihood for developing PTSD.








PTSD
Cause: experiencing / witnessing a traumatic event
(fear, helplessness, horror)
Nightmares, flashbacks, social withdrawal, insomnia
Combat veterans, disaster or accident survivors, sexual assault victims, 2/3 of prostitutes
Basic trust erodes, sense of hopelessness
15% of Vietnam vets (45% for heavy combat)
1 in 6 Iraqi combat infantry veterans


Precursor to PTSD?

Trauma & Stressor Disorder
Etiology of Anxiety Disorders:
 Biological
• Concordance rates show some genetic basis
• Hypersensitivity to internal signs of anxiety
• GABA synapses affected by anti-anxiety meds (Valium,
Xanax, Prozac) that suppress the CNS
 Conditioning/Learning
• Phobias & preparedness
• Observational learning
 Cognitive factors: misinterpretation, inappropriate focus etc.
 Stress-related factors: duh
Psychological Disorders/Abnormal Psych

 Reactive attachment disorder is a rare but serious condition in which an infant or young child doesn't establish healthy attachments with parents or caregivers.
Reactive attachment disorder may develop if the child's basic needs for comfort, affection and nurturing aren't met and loving, caring, stable attachments with others are not established.

Withdrawal, fear, sadness or irritability that is not readily explained
Sad and listless appearance
Not seeking comfort or showing no response when comfort is given
Failure to smile
Watching others closely but not engaging in social interaction
Failing to ask for support or assistance
Failure to reach out when picked up
No interest in playing peekaboo or other interactive games

 Major depression is a form of depression that does not alternate with mania
(happiness).
 It is normal to become depressed after a sad or unfortunate event but if a person remains depressed weeks or months after that event, it may be classified as major depression.
 Major depression does not give way to manic episodes.

 By many accounts, depression is under diagnosed and under treated.
Lifetime Risk of a
Depressive Episode lasting a Year or More
 Globally speaking, studies indicate that depression is the single most prevalent disability.
 While some differences may be a result of reporting, other factors seem to be at work too:
 Taiwan/Korea = low divorce rate
 Lebanon = war in Middle East
Taiwan
Korea
Puerto Rico
U.S.
Germany
Canada
New Zealand
France
Lebanon
1.5%
2.9%
4.3%
5.2%
9.2%
9.6%
11.6%
16.4%
19%

 Canadian depression rates

 Some causes of major depression involve genetic predisposition. Severe bouts of depression often run in families-this indicates a biological basis.
 Further indication of a biological basis for depression are that drugs that affect the brains levels of certain neurotransmitters can be very effective.
 However, biology alone cannot account for everything.

 Probably because of low self-esteem, depressionprone people are more likely to perpetuate the depression cycle by attributing negative events to their own personal flaws or external conditions they feel helpless to change.
 Martin Seligman calls this learned helplessness.
 Locus of control-internal vs. external

Fred decides to be more sociable, but when he asks Teresa for a date she already has plans.
Fred concludes that he is not very interesting or attractive and that people don’t like him.
Negative
Event
Low Self-Esteem and Negative
Interpretations
Because of Fred’s negative behaviors, people avoid himreinforcing his symptoms.
Social Rejection and Loneliness
Depression
Fred feels completely alone and unhappy
Negative
Behaviors
Fred avoids people, skips school and neglects personal hygiene

 The cognitive approach to depression points out that negative thinking styles are learned and modifiable.
*Think classical and operant conditioning.

 Aaron Beck suggests that depression is a result of negative thinking which he called ‘cognitive errors’ (errors in logic)
 Beck identified three negative thoughts that seemed to be really automatic and occurred without delay in depressed patients.
 The “Cognitive Triad:”
 Self
 External World
 Future
 Beck believes that faulty thinking leads to depression. The question remains though, which came first, the depression or the faulty thoughts.

 Rates of depression have increased 10-20 times what they were 50 years ago.
 The average age of people experiencing depression has gone down.
 Martin Seligman identifies 3 causes of this trend:
1.
Out-of-control individualism/self-centeredness-focuses on individual successes and failures rather than group accomplishments.

2.
The self-esteem movement- teaching a generation of children they should feel good about themselves, irrespective of their efforts and achievements.
3.
A culture of victimology- reflexively pointing the finger of blame at someone or something else.


Four Major Types:
– Dissociative amnesia
– Dissociative identity disorder
– Dissociative fugue
– Depersonalization Disorder

Psychogenic Amnesia : Amnesia with no physiological basis
 biologically induced amnesia = organic amnesia )
Fugue = Psychogenic Amnesia + unfamiliar environment (fugue = flight / loss of identity and flee)






Memory loss (amnesia) of certain time periods, events and people
Mental health problems, including depression and anxiety
A sense of being detached from yourself
(depersonalization)
A perception of the people and things around you as distorted and unreal
(derealization)
A blurred sense of identity




Abuse
– Physical
– Sexual
– Emotional
Frightening home life
It is rare for adults to develop a dissociative disorder









AKA Multiple Personality Disorder
Usually from traumatic event / overwhelming stress (high % report child abuse) often at young age (3-5 years)
Self-protection / coping mechanism
Distinctive identities for different events
(toddler to adult)
Norm- 3-6 identities (2 to qualify)
Almost entirely confined to N. America
Very controversial as medical diagnosis

Dissociative Disorders
Depersonalization Disorder:
• Feeling that you aren’t “real”
• Sense of detachment from your own body, feeling as if you’re losing grip on reality, living in a dream
• Only a disorder if recurring
(est. 70% experience at some point)
Psychological Disorders/Abnormal Psych


“soma” = body
 Psychological problem manifested in a physiological symptom (IOW: physical problem without a physical cause)
 Common among those claiming disability
 Two major disorders :
 hypochondriasis : imagined or exaggerated illnesses (no medical cause)
 Conversion disorder : involves motor or sensory problems with no biological explanation / cause
 Conversion blindness, conversion paralysis

 Psychoanalytic
 Outward manifestations of unconscious conflict
 Behaviorists

Reinforcement for behavior (can’t work or sympathy / attention)

 Somatoform patient: unconscious of psychological causes (does not seek to maintain role of patient)
 Factitious patient: Consciously creating the symptoms, …prolonging role of patient

Somatoform Disorders
Body Dysmorphic Disorder:
• Characterized by excessive concern with bodily appearance
• Concern their nose is too big, hair too thin, over/underweight to the point of maladaptive behavior & personal distress
• Some become “plastic surgery addicts”
Psychological Disorders/Abnormal Psych

Somatoform Disorders
Etiology of Somatoform Disorders:
• Personality o Histrionic personality – attention?
o Neuroticism
• Cognitive factors o Misinterpret minor issues o Faulty stds of “good health”
• “Sick Role” o Like a defense mechanism – don’t have to deal w/ other problems
Psychological Disorders/Abnormal Psych


 a mood disorder marked by a hyperactive, wildly optimistic state

 a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania
 formerly called manic-depressive disorder


Disordered / distorted thinking
 Breakdown in selective attention (Can’t filter out information)
►
Disturbed perceptions
 Delusions: beliefs that have no basis in reality
►
Delusions of persecution = paranoia
►
Delusions of grandeur = greatness
 Hallucinations: Perceptions in the absence of sensory stimulation
►
Inappropriate actions / emotions

►
Most severe of psych disorders
►
Usually starts in late teens / early twenties
►
1 out of every 100 people have
Schizophrenia





Disorganized Schizophrenia
Paranoid Schizophrenia
Catatonic Schizophrenia
Undifferentiated Schizophrenia

Acute vs. Chronic Schizophrenia
 What’s the difference?
 Acute: Abrupt display of symptoms- can be short duration and never return or become longterm issue
 Chronic: Long-term struggle with Schizophrenia

►
Odd use of language (Word Salad = fragmented speech

Neologisms: made up words

Clang associations: string together nonsense words that rhyme
►
Inappropriate effect:
 Laugh in sorrowful setting
 Flat effect: no emotional response at all

►
Delusions of persecution
►
“out to get me”

►
Engage in odd movements
►
Remain motionless for hours (odd positions
/ poses / Waxy flexibility
► parrot-like repeating of speech, movement

►
Disordered thinking, but no symptoms of other types of Schizophrenia

►
Biological
 Dopamine hypothesis
►
Excessive levels = Schizophrenia (average 6x normal levels)
 Enlarged brain ventricles
 Genetic predispositions
 Abnormality of 5 th chromosome
►
Social-Cognitive
 Double binds: contradictory messages = distorted ways of thinking

Schizophrenic DisordeRs
Is a change in order for the DSM-V?:
Eliminate subcategories in favor of:
 Positive: behavioral excesses (hallucinations, delusions, bizarre behavior)
 Negative: behavioral deficits (poverty of speech, withdrawal, flat affect, apathy)
Psychological Disorders/Abnormal Psych

Schizophrenic DisordeRs
Etiology of Schizophrenic Disorders:
 Typically emerges in late adolescence; more significant in males
 Biological factors:
• Genetics
• Excess dopamine
• Structural abnormalities in brain
• Problems during prenatal neural development (viral infections?)
• Stress may be an important trigger
Psychological Disorders/Abnormal Psych

Schizophrenic DisordeRs
Psychological Disorders/Abnormal Psych

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 Antisocial disorder ( most serious )
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No regard for others’ feelings / world as hostile / look out for oneself / absence of conscience
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No fear, no shame
 serial criminals, serial killers (worst case)
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Electric shock: no increased anxiety in anticipation
Causes: Both Biological and Psychological
• Nurture influential: hero or villain …

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Borderline Personality
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Disorder of emotions (intense instability) self-mutilation
Severe anxiety, depression
Dependant personality disorder
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Overly dependant on attention, help from others
Paranoid Personality Disorder
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Feel persecuted, very distrustful
Narcissistic Disorder
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Self-love, grandiose self-importance, entitlement, failed relationships, “”narcissistic paradox”
Histrionic Disorder : (center of attention)
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Overly dramatic behavior
Obsessive-Compulsive Disorder
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Overly concerned with thoughts and behaviors