Histrionics Obsessive Compulsive Schizophrenia Dissociative Disorder Bipolar or Manic-Depressive Disorder Borderline Personality disorder

Here are your chapter project options about psychological disorders.

Go to http://psimonciniohs.net/ and write a report on any of the topics listed for this chapter.

Observe the following film clip from the commercial film,

Patch Adams

.

Watch the characters. List what ever behaviors exhibited by them that you consider to be abnormal. Be prepared to discuss them.

15.4% of the population suffers from diagnosable mental health problems Any year: 56 million Americans meet the criteria for a diagnosable psychological disorder; Over the lifespan, 32% of Americans will suffer from some psychological disorder

Definitions of Abnormal Behavior Any deviation from the average or the majority Failure to adjust to the rules of society: physically, emotionally, and socially Thomas Szasz them (1984) : people who have problems “living”—serious conflicts with the world around

Three Classic Symptoms of Severe Psychopathology Hallucinations Delusions Affect

The Spectrum of Mental Disorder No Disorder Mild Disorder Moderate Disorder Severe Disorder Clear signs of psychological disorder, Severe and frequent behavior No problems with interpersonal More frequent difficulties with

Hippocrates and the 4 humors Blood (heart—sanguine or cheerful) Phlegm (mucus from brain—sluggish) Black bile (spleen—melancholy) Yellow bile (liver—angry or choleric)

Asylum Movement Political pressures eventually turned the initially therapeutic asylums into overcrowded warehouses of neglect

Weaknesses in medical model Assumption of disease leads to a doctor knows-best approach ; therapist takes all responsibility for diagnosing the illness and prescribing treatment. The patient may become passive and dependent on the doctor

Social-cognitive-behavioral approach Cognitive: looks inward, emphasizing mental processes ; Behaviorism: looks outward, emphasizing the influence of the environment The two now seen as complementary

Behaviorism and abnormal behaviors Acquired through behavioral learning Behavior and environmental conditions (rewards and punishments)

Cognitive and abnormal behaviors Also consider how people perceive them selves and their relations with others Cognitive variables : whether people believe they have control over their lives ; how they cope with stress and threat ; do they attribute behavior to situational or personal factors?

Albert Bandura: Reciprocal Determinism Proposes that behavior, cognition, and social/ environ mental all influence each other A fear of public speaking can be understood as a product of behavioral learning, cognitive learning, and social learning

Modern research and the brain It is a complex organ whose mental functions depend on a delicate balance of chemicals and ever-changing circuits Subtle alterations can profoundly alter thoughts and behaviors

Subtle signs that may also indicate psychological disturbances Distress: prolonged levels of un ease or anxiety Maladaptiveness: acts in a way that makes others fearful or interfere with his or her well-being Irrationality: act or talk in ways that are irrational or incomprehen sible to others; inappropriate behavior or emotional responses

Subtle signs that may also indicate psychological disturbances Unpredictability: behave erratically and inconsistently at different times or from one situation to another Unconventionality and undesirable behavior: behave in ways that are statistically rare and violate social norms of what is legally or morally acceptable or desirable

Classifying Emotional Disorders Challenges in doing so 1952: American Psychiatric Assn.

agreed on a standard system for classifying abnormal symptoms, published in the:

Diagnostic And Statistical Manual For Mental Disorders

(DSM) 4+ versions; 2000 (1994) latest update: DSM-IV-TR

Medical Students’ Disease In this chapter we shall be discussing psychological disorders. But please be careful to avoid. . .

Helps psychologists look at the entire person as they make evaluations.

Process called: multiaxial diagnosis— professionals consider not only abnormal behavior, but also general medical conditions

Classifying Emotional Disorders Five axes, or dimensions Axis I: classifies current symptoms into explicitly defined categories Axis II: describes developmental dis orders and long-standing personality disorders or maladaptive traits (com pulssiveness, over-dependency, etc.) Axis III: physical disorders or general medical conditions that are potentially relevant to understanding or caring for a person (brain damage)

Classifying Emotional Disorders Five axes, or dimensions Axis IV: a measurement of the current stress level at which the person is functioning (a rating of stressors based on what the individual has experienced in the past year) Axis V: describes the highest level of adaptive functioning present within the past year leisure time) (social relations, occupational functioning, use of

Oh noooooooo: Here’s a homework assignment.

Try one of the following behaviors.

Observe/record peoples’ reactions.

Shake hands; hold longer/normal Eye contact > 10 seconds from afar “Why do you want to know?”

Before 1980: neurosis and psychosis were the most commonly used diagnostic distinctions Now those terms have been replaced by more specific terms Neurosis: now called a disorder Psychosis: loss of contact with reality We shall now study those specific terms

I’m obviously in a BAD mood. Would someone please give us the definition of mood disorders?

As someone who suffers from shifts in moods, here goes: abnormal disturbances in emotion or mood.

Major Depressive Disorder Individuals suffering from this disorder spend at least two weeks feeling depressed, sad, anxious, fatigued, and agitated, experiencing a reduced ability to function and interact with others.

Cannot be attributed to bereavement

Major Depressive Disorder Marked by at least 4 of following: problems eating, sleeping, thinking, concentrating, decision making; lacking energy; thinking about suicide; and feeling worthless or guilty.

Associated with low levels of serotonin

Martin Seligman: depression is the common cold of psychological disorders Almost everyone has suffered from some sort of depression In the U. S. depression accounts for the majority of all mental hospital admissions— Still believed to be under-diagnosed and under-treated $43 Billion a year in the U.S.

Depression-Suicide Linkage Suicide claims 1 in 50 depression sufferers Suicide is a greater risk when a depressed person is on the way down in a depressive episode In the depths of a depressive episode, usually no energy or will to do anything, much less suicide

Seasonal Affective Disorder (SAD) Some people suffer from winter and sunlight deprivation) depression in spirits only lift with coming of spring (depression caused by

Seasonal Affective Disorder (SAD) Winter: SAD sufferers sleep and eat excessively The hormone melatonin may play a role: less light—more melatonin secreted by the brain’s pineal gland. High levels of melatonin can cause some to suffer from SAD.

Elements of Depression Dependency Need for others’ help and support Self-Criticism Negative assessment of one’s own worth.

Inefficacy “Nothing I do matters”

Elements of Depression •Draw illogical conclusions about themselves.

•Blame selves for normal problems •Consider every minor failure a catastrophe

Depression: a Vicious Cycle Negative Event Other people avoid Low self esteem Negative behaviors (crying) Negative Self evaluation Attribution of negative events to personal flaws: learned

Depression Greater in Women Susan Nolen-Hoeksema Differing response styles of women and men experiencing negative moods Women: tend to think about possible causes and implications of their feelings Men attempt to distract themselves from depressed feelings— shifting attention to something else or engaging in a physical activity

Depression Now Often a Teen Issue Still more prevalent in females Three factors 1. Out of control individualism and self-centeredness that focuses on individual success & failure 2. The self-esteem movement (should feel good about yourself irrespective of efforts & achievements 3. Culture of victimology—points the finger of blame at someone or something else

Bipolar disorder—individuals are excessively and inappropriately happy or unhappy High elation; hopeless depression or an alteration between the two Manic phase—a person experiences elation, extreme confusion, distractibility, and racing thoughts Often exaggerated self-esteem & irresponsible behavior (sprees, insulting remarks)

Depressive phase—the individual is overcome by feelings of failure, sinfulness, worthlessness, and despair Depressive-type reaction: lethargy, despair, unresponsiveness.

To illustrate bipolar disorder, we are going to watch a short film clip about a person who suffers from bipolar disorder: NBC News personality, Jane Pauley.

Most common mental illness in U. S.; 19 million Americans endure symptoms typical of anxiety-based disorders annually (15% of population) Common characteristics: Feelings of anxiety Feelings of personal inadequacy Avoid dealing with problems Unrealistic self-images Can’t get rid of recurring fears & worries

Anxious people often have difficulty forming stable and satisfying relationships.

That’ right Elizabeth. Also even though the behavior of anxious people may be self defeating and ineffective in solving problems, those driven by anxiety often refuse to give up their behaviors in favor of more effective ways of dealing with anxiety.

Generalized Anxiety Disorder Anxiety is a generalized apprehension that is a reaction to vague or imagined dangers.

Generalized Anxiety Disorder is a continuous, generalized anxiety. Fearing unknown and unforeseen circumstances, people suffering from the disorder are to make decisions or enjoy life.

unable

Generalized Anxiety Disorder So preoccupied with internal problems, people have :  Trouble dealing with family/ friends  Trouble fulfilling responsibilities  Feel trapped in a vicious cycle: Worry Difficulty Worry  Physical symptoms : muscle tension; can’t relax; strained face; poor appetite; indigestion, diarrhea; frequent urination

Panic Disorder Sudden, unexplainable attack of intense fear— sense of inevitable doom or even death.

Sx: smothering choking difficulty breathing nausea chest pains

Panic disorder probably can be traced back to the Amygdala in the limbic system of the brain (unconscious, emotional pathways)

Now, we’ll watch a brief film clip from the

Today Show

on NBC about panic disorder and its treatment.

Would somebody please define the term “agoraphobia ?

” 2% of the Population; more women than men Fear of the marketplace—fear may experience some kind of attack in large places; become prisoners in their own homes (Emily Dickenson)

Phobic Disorder Severe anxiety focused on a particular object, activity or situation when compared to real danger  Specific phobias  Social phobias  Agoraphobia Often elaborate plans to avoid feared situations. For example the situation in this film clip:

My therapist said I have many phobias. What kinds of phobias do people experience?

Mohini, there are many different phobias. Some examples are clowns, spiders, cats or chickens.

12% of all Americans

Acrophobia Aerophobia Agliophobia Alektorophobia Alliumphobia Amaxophobia Anuptaphobia Apiphobia Arachnophobia Atychiphobia Heights Drafts Pain Chickens Garlic Riding in a car Staying single Bees Spiders Failure

Aulophobia Autophobia Aviophobia Blennophobia Cacophobia Claustrophobia Coulrophobia Cynophobia Dementophobia Dromophobia Flutes Being alone Flying Slime Ugliness Confined spaces Clowns Dogs or rabies Insanity Crossing streets

Elurophobia Ephebiphobia Herpetophobia Hominophobia Katagelophobia Lachanophobia Metrophobia Necrophobia Photophobia Scotophobia Thalassophobia Vestiphobia Cats Teenagers Reptiles Men Ridicule Vegetables Poetry Dead things Light Darkness The sea Clothing

Now, we’ll watch two brief film clips from the

Today Show

treatment.

on NBC; one about phobias and their treatment, and the other about social phobias and their

Obsessive-Compulsive Disorder Obsession: Uncontrollably thinking same thoughts over and over again.

Compulsion: Repeatedly performing irrational actions We all have obsessions and compulsions. What are some of yours or of someone you know?

Obsessive-Compulsive Only a psychological problem when thoughts and activities interfere with what a person wants and needs to do.

Some people experience both obsession and compulsion together— Obsessive-Compulsive Disorder.

+

Obsessive-Compulsive Disorder Observe Melvin in the following film clip from James L.

Brooks’

As Good As It Gets

and list as many instances of his compulsive behavior as you can.

Have you ever known anyone who can be characterized as obsessive compulsive?

Now, we’ll watch another brief film clip from the

Today Show

on NBC about Obsessive Compulsive Disorder and its treatment.

Post-Traumatic Stress Disorder War veterans Person who has experienced a traumatic event feels severe and long-lasting after-effects.

Victims of natural disasters Victims of human aggression

Experiencing physical symptoms for which there is no apparent physical cause .

Conversion Disorder Hypochondriasis

Conversion Disorder

Convert emotional difficulties into the loss of a specific physiological function.

Real, prolonged handicap: Sudden paralysis, not caused by anything physical. . .

. . . the victim accepts the malady with relative calm Victims unconsciously invent physical symptoms to gain freedom from unbearable conflict.

Glove anesthesia: a pattern of insensitivity to touch or pain that fits the patient “like a glove;” but the symptoms do not match any possible pattern of nerve impairment

Hypochondriasis Person who is in good health preoccupied with imaginary ailments.

Spends much time looking for signs of serious illness —misinterprets minor aches, pains, etc. as something very serious.

becomes Hypochondriacs, such as the character Felix Unger in the

Odd Couple

.

A person experiences memory, identity, or consciousness: 3 types alterations in Dissociative amnesia: cannot recall important personal events or information Escape problems by blotting them out, often resulting from a traumatic event Dissociative fugue: amnesia plus flight

Depersonalization Disorder The sensation that mind and body have separated (also known as “out-of-body” experiences) External observers in own bodies or feel like in a dream OCD and personality disorders often accompany this condition

Dissociative identity disorder: a person exhibits two or more personality states, each with its own patterns of thinking and behaving.

Primarily a problem of cognition, rather than a problem of emotion Considerable loss of contact with reality

Emotions blunted Thoughts: bizarre; language: strange twists Memory may become fragmented Breaks the unity of the mind—sends the victim on meaningless mental detours Confused verbalizations (word salads)

Lives life as an unreal dream No single cause or single cure A collection of symptoms life that indicates an individual has serious difficulty in meeting the demands of Half of the patients in U.S. mental hospitals Confused & disordered thoughts and perceptions

Many experience Many experience delusions— false beliefs maintained in the face of contrary evidence hallucinations— sensations in the absence of appropriate stimulation Some experience marked decline in thought process Some experience incoherence— disturbances of affect—emotions that are inappropriate for circumstances a

Some experience a decline in previous levels of functioning— serious productivity decline at work Some experience marked diverted attention: often caused by “cognitive flooding” inability to focus attention

Disorganized schizophrenia– incoherent language, inappropriate emotions, giggling for no apparent reason, generally disorganized motor behavior, delusions and hallucinations Catatonic schizophrenia Motionless for long periods, exhibiting “waxy flexibility”– position.

limbs in unusual positions may take a long time to the resting, or relaxed,

Undifferentiated schizophrenia— hallucinations and delusions, scrambled speech and thought processes Paranoid Schizophrenia Delusions, including grandeur, or persecution Residual: individuals who have suffered from a schizophrenic episode in the past but currently have no major symptoms; rather, their thinking is mildly disturbed or emotional lives impoverished

Typical symptoms: chronic history of poor disturbances, disrupted social relationships, or lack of impulse control

Narcissistic Personality Disorder

Narcissistic Personality Disorder Pervasive pattern of grandiosity, need for admiration and lack of empathy Five or more of following success, power, etc.

Sense of entitlement : Grandiose sense of self-importance Preoccupied with fantasies of unlimited Believes is special and unique—only associate with other high-status people Requires excessive admiration

Narcissistic Personality Disorder Interpersonally exploitive Lacks empathy Often envious of others or believes others are envious of him/her Shows arrogant or haughty behaviors or attitudes

Antisocial Personality Disorder •Long-standing pattern of disregard  for other people’s rights •Occurred since age 15 •Majority of following symptoms Failure to conform to social norms  Deceitfulness  Impulsivity  Irritability & aggressiveness  Reckless disregard for safety  Consistent irresponsibility  Lack of remorse

Avoidant Personality Disorder Long-standing & complex pattern of feelings of inadequacy; Extreme sensitivity to what others think about them Social inhibition Majority of following :  Avoids occupational activities involving interpersonal contact Unibomber, Ted Kaczynski  Unwilling to get involved with people  Restraint within intimate relationships  Preoccupied with being criticized  Views self as socially inept  Usually reluctant to take personal risks

Borderline Personality Disorder Labile interpersonal relationships char acterized by instability labile \LAY-byl\, unstable. adjective : Paris Hilton Constantly or readily undergoing chemical, physical, or biological change or breakdown; May exhibit impulsive or unstable behaviors; unpredictable moods; stormy interpersonal relationships; little tolerance for frustration (substance abuse, promiscuity, gambling, binge eating, reckless driving, etc.)

Borderline Personality Disorder Majority of following real or imagined abandonment devaluation Identity disturbance : Frantic efforts to avoid Pattern of unstable & intense interpersonal relationships, characterized by alternating between extremes of idealization & Impulsivity in at least two of the following: spending, sex, substance abuse, reckless driving, binge eating Recurrent suicidal behavior, threats, etc.

Borderline Personality Disorder Affective instability Chronic feelings of emptiness Inappropriate, intense anger or difficulty controlling anger Transient, stress-related paranoid ideation or severe dissociative symptoms

Dependent Personality Disorder Long-standing need to be taken care of plus a fear of being abandoned or separated from important individuals; Clinging behavior; Majority of following : Difficulty making everyday decisions without an excessive amount of advice Need others to assume responsibility Difficulty expressing disagreement Difficulty initiating projects Excessive lengths to gain nurturance

Histrionic Personality Disorder Pattern of excessive emotionality & attention seeking Five or more of following attention or provocative behavior expression of emotions : Uncomfortable if not center of Interaction often characterized by inappropriate sexually seductive Rapidly shifting & shallow Consistently uses physical appearance to draw attention to self Impressionistic style of speech; lacking detail

Histrionic Personality Disorder Self-dramatization and exaggerated expression of emotion Easily influenced by others Considers relationships to be more intimate than they actually are She’s madly in love with me!.

What a weirdo!