Unit 6 – Adjustment & Breakdown

Psychological Disorders

Psychological Disorders

Normal or Abnormal?

 What most people (majority) do is normal Deviation is abnormal  Getting along on the world is normal Failure to adjust physically, emotionally or psychologically is abnormal  Striving for ideal psychological functioning (self-actualization) is normal

Abnormal Behavior

Is normal better than abnormal?

 Oppression, stonings, tax evasion, speeding, smoking, drinking, late assignments, skipping class, … Why study abnormal behavior?

 Harmful behaviors (crime, drug use, violence) might be changed / stopped (i.e. BAU)

Abnormal Behavior

Depends on situation - where/ when ??

Abnormal Behavior

Depends on situation - where/ when ??

 (comfort in environment, clothes for season / venue, urgency) Cultural differences ??

 (hand holding, men kissing, bowing, evil spirits) Occasional abnormal behavior does not mean a psychological disorder (TRY IT)

Failure to adjust

Does abnormal behavior cause difficulty getting along in the world?

 (can’t leave house…can’t work) Everyone strives toward ideal functioning =

self-actualization

Sanity

Legal definition – far too simple for psychologists “most people labelled mentally ill are not ill at all” (Szasz)…simply have problems with daily living Convenient to label people ill and hospitalize them

Classification

DSM (Diagnostic and Statistical Manual of Mental Disorders) – classify mental illness DSM IV uses 5 major axes (dimensions): I.

II.

III.

IV.

V.

Explicitly defined categories (mood, schizophrenia & other psychotic, eating…) Developmental or long standing personality disorders Physical disorders or medical conditions Measures stress level Highest level of adaptive functioning

Mental Illness

Who is affected?

• Mental illness indirectly affects all Canadians at some time through a family member, friend or colleague.

• 20% of Canadians will personally experience a mental illness in their lifetime.

• Mental illness affects people of all ages, educational and income levels, and cultures.

• Approximately 8% of adults will experience major depression at some time in their lives.

• About 1% of Canadians will experience bipolar disorder (or “manic depression”).

Mental Illness

How common is it?

• Schizophrenia affects 1% of the Canadian population.

• Anxiety disorders affect 5% of the household population, causing mild to severe impairment.

• Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds.

• Suicide is one of the leading causes of death in both men and women from adolescence to middle age.

• The mortality rate due to suicide among men is four times the rate among women.

http://www.cmha.ca/media/fast-facts-about-mental-illness/

The Issues

How many undiagnosed / misdiagnosed?

Problem getting better or worse? Why?

Are awareness campaigns successful?

Why is there still such a stigma?

SECTION QUIZ 16-1

Types of Disorders

Mood Schizophrenia Somatoform Dissociative Personality Drug Addiction Anxiety

Mood Disorders

Types ??

 Major depressive disorder – fe e lings of worthlessness and diminished pleasure   Case study: Kari Bipolar disorder – cycle between alternating phases: manic (euphoria / frantic action) and depressive (deep despair)  Case study: Moira

Mood Disorders

 Seasonal Affective Disorder (SAD) – melatonin high (sleep) + serotonin low (mood)  Post partum depression (PPD) – 3-4 weeks after birth, cause may be hormone shift, may lead to other depressive disorders

Mood Disorders

Causes ??

 Self-esteem, social support, coping with stress  Draw illogical conclusions about self (Beck)   Learned helplessness (Seligman) No control – useless to try  Reduced serotonin and/or noradrenaline  Therefore, both biological & psychological Risk of suicide (3 rd leading cause of death for teens)

Schizophrenia

Chronic, severe, disabling brain disease Confused and disconnected thoughts, emotions, & perceptions, decline in functioning, diverted attention Incidence:  1% (10% if family history)  Typical onset late teens / early 20s

Schizophrenia

Types:  Paranoid (“positive” symptoms)  Delusions = false belief despite contrary evidence:  Grandeur (supreme power)  Persecution (suspicions)  Hallucinations = perceptions with no direct external cause (all 5 senses)  Case study: Tara, John Nash

Schizophrenia

 Disorganized (“negative” symptoms):  Incoherent language (word salad)  Case study: Nathaniel Ayers Jr  Disturbed affect (inappropriate emotional expression)  Disorganized movements  Diverted attention  Catatonic = motionless / deteriorated movement

Schizophrenia

Causes:  Heredity  Chemical imbalance (dopamine ++)  Deteriorated brain tissue (CAT / MRI)

Schizophrenia

Causes:  Heredity  Chemical imbalance (dopamine ++)  Deteriorated brain tissue (CAT / MRI)  Diasthesis hypothesis = inherit a predisposition + exposure to stressors (i.e. pathogenic / unhealthful family)  Maternal infection  Birth trauma

Schizophrenia

Prognosis:  No cure – recovery (remission possible)  Long term institutionalization in mental hospital -> burnout (inability to function in society)

SECTION QUIZ 16-4

Somatoform Disorders

Somatoform disorder (Freud’s

hysteria)

= physical symptoms with no apparent cause:  Conversion disorder: emotional difficulties > loss of physical function (paralysis / blindness…) calm acceptance (la belle indifference) suggests psychological  Hypochondriasis: imaginary symptoms (young adults,

WebMD)

Dissociative Disorders

Experience alterations in memory, identity, consciousness Examples ??

 Dissociative Amnesia = lost memory of personal events / info, no biological / physiological explanation, traumatic event  Dissociative Fugue = amnesia + active flight / travel away from home

Dissociative Disorders

 Dissociative Identity Disorder (DID):     2+ distinct personalities (patterns of thinking and behaving) Usually suffered abuse as children Formerly multiple personality disorder Case study: Bill Green

SECTION QUIZ 16-3

Personality Disorders

Maladaptive or inflexible ways of dealing with other people or situations Types ??

 Antisocial (a.k.a. sociopath, psychopath) – shallow emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers

Infamous Serial Killers

Name

Jack the Ripper Ed Gein (Buffalo Bill) The Zodiac Killer Charles Manson Ted Bundy David Berkowitz (Son of Sam) John Wayne Gracy

Date

1888 1954-1957 1968-1969 1969 1974-1978 1976 1972-1978

Country

England USA

Name

Alieen Wuornos Gary Ridgway USA (California) Albert Fish USA (California) USA (Florida) Jeffrey Dahmer (Milwaukee Killer) Robert Pickton USA (New York) Coral Eugene Watts Albert DeSalvo (Boston Strangler)

Date

1989-1992 1982-1998 1919-1930 1978-1991 1980’s 1974-1982 1960’s

Country

USA USA USA Canada (BC) USA USA

Personality Disorders

Maladaptive or inflexible ways of dealing with other people or situations Types ??

      Antisocial (a.k.a. sociopath, psychopath) – shallow emotions, irresponsibility, lack of conscience, disregard of others without remorse / shame / guilt, thrill seekers Dependent – submissiveness, excessive need for care Histrionic – excessive emotions, attention seeking Obsessive-compulsive – intense interest in order, perfection, control (no anxiety – not OCD) Paranoid – suspicion of evil motives, distrust (no hallucinations – not schizophrenia) Schizotypal – intense discomfort in close relationships

Drug Addiction

Addiction = ?

  Psychical dependence – overwhelming and compulsive desire to obtain and use a drug Psychological dependence – feeling nervous and anxious without the drug

Drug Addiction

Tolerance = ?

 Physical adaptation to a drug so that the person needs an increased amount in order to produce the original effect

Drug Addiction

Withdrawal = ?

  Symptoms that occur after an addicted person discontinues using the drug Nausea, the “shakes”, hallucinations, convulsions, coma, death

Drug Addiction

Most serious drug problem ?? Alcoholism 3 stages:  Social – reduce tension, boost self confidence, reduce social pressure   Psychological dependence, tolerance + physical addiction (heavy drink, hide habit, blackouts) Compulsive drink, eating less, sick when sober, health deteriorates

Alcohol Addiction

Effect of alcohol entering the bloodstream depends on weight, quantity, speed of consumption Treatment:  Antabuse (Rx) + alcohol ->violent illness  Psychotherapy

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Anxiety Disorders

Excessive fear, generalized apprehension, reaction to vague or imagined dangers Types??

 Social Anxiety Disorder (SAD)  Case study: Marley

Anxiety Disorders

Excessive fear, generalized apprehension, reaction to vague or imagined dangers Types??

  Social Anxiety Disorder (SAD)  Case study: Marley Generalized Anxiety Disorder (GAD):    Environmental factors, role of learning, heredity Physical symptoms – muscle tension, inability to relax, tense face Case study: Alana

Anxiety Disorders

  Specific Phobia:   Extreme fear of a specific object, person, or event Cope by avoiding the source:   Agoraphobia – public / outdoors Claustrophobia – small / enclosed spaces  Arachnophobia - spiders Panic disorder:  Sudden unexplainable attacks of intense anxiety  Breathing difficulty, faintness, dizziness, nausea, chest pains

Anxiety Disorders

 Post Traumatic Stress Disorder (PTSD):  Re-experience original trauma – nightmares or flashbacks   War veterans, survivors of natural disaster / human aggression Case study: Tom, Chris

Anxiety Disorders

 Obsessive Compulsive Disorder (OCD):   Obsession unpleasant – uncontrollable thoughts, can’t stop even if Compulsion – repeated performance of an irrational action (coping behavior)  Case study: Jason, Tricia

SECTION QUIZ 16-2

Famous People

Isaac Newton Beethoven Abe Lincoln Van Gogh Bipolar Bipolar Depression Winston Churchill Depression Virginia Woolf Bipolar John Nash Carrie Fisher Ernest Hemingway Bipolar (suicide) Brooke Shields John Keats Sylvia Plath Linda Hamilton Shawn Colvin Bipolar Depression Buzz Aldrin Roseanne Barr Schizophrenia Cocaine addiction Depression PPD Depression Depression (suicide) Depression Depression