1	Psychological Disorders
2	Historical Perspective Demonic views Witches Exorcisms Physiological views Humor imbalance (Hippocrates) Evidence from disease & injusry Syphilis Traumatic brain injury (TBI)
3	Reactions to Abnormality Caretaker responses Community integration (i.e. work, self-care) Family responsibility Rejection response Warehousing – Asylums & hospitals Criminalization – Prisons & executions
4	Theoretical Perspectives Psychodynamic Childhood origin – unresolved conflicts Neuroses No loss of contact with reality Excessively strong defense mechanisms Psychosis Loss of contact with reality Extreme psychic withdrawal
5	Theoretical Perspectives Humanistic Childhood influence & adult origin Distortion of reality Maladjustment Self-concept does not match behavior (inauthentic self) Self concept does not fit demands of life (negative self-image)
6	Theoretical Perspectives Behavioral Learning history (ongoing) De-emphasizes mental issues Focus on behaviors Thoughts follow from behaviors Change behaviors & thoughts will follow Behavior is shaped by experience (Lovaas-autism)
7	Theoretical Perspectives Cognitive Learning history (ongoing) Behavior + cognition are factors Cognitive distortions Perception = interpretation Memory is part of current experience Interpretation of our physical responses influences emotion
8	Theoretical Perspectives Biological Behavior has a physical origin Search for: Genetic predispositions Prenatal influences Brain abnormalities Neurochemical abnormalities
9	Diathesis-stress Model Disorder arises from: Predisposing factors (biological & environmental) Genetic Nervous system abnormalities Psychological traits Learning history Social condition (poverty & culture) Current trigger (stressor) Interpersonal problems High external demands Traumatic event Loss
10	Classification of Mental Disorders Diagnostic & Statistical Manual for Mental Disorders- Fourth Edition (DSM-IV) Multi-axial system Axis I – Clinical disorders Axis II – Personality disorders Axis III – General medical conditions Axis IV – Psychosocial & environmental problems Axis V – Global assessment of functioning
11	Diagnostic Issues What constitutes abnormal behavior? Diagnostic validity & reliability Specificity Sensitivity Labels Stigmatization Reification
12	Diagnostic Issues Diagnostic trends & over diagnosis Medical student syndrome Co-morbidity What to do with multiple disorders
13	Clinical Disorders (Axis I) Mood disorders Anxiety disorders Dissociative disorders Substace-related disorders Eating disorders Psychotice disorders Somatoform disorders Factitious disorders Sexual & gender identity disorders Sleep disorders Impulse control disorders Adjustment disorders
14	Mood Disorders Major depression Characterized by one or more major depressive episodes (2 or more weeks of depressed mood or loss of interest + four or more additional symptoms) Dysthymic disorder A more chronic disruption of mood Bipolar disorder Depression alternates with periods of mania
15	Symptoms of Depression Negative mood state Cognitive Difficulty concentrating Feelings of inferiority Low motivation Somatic Loss of appetite Sleep disturbances Loss of sexual desire
16	Major Depression Prevalence Lifetime = 20-25% Males = 15-20% Females = 25-30%
17	Major Depression Onset Usually, but not always trigger by major life stressor Loss of loved one Loss of relationship Loss of job Interpersonal problems Financial problems Traumatic event Often comorbid with other disorders
18	Major depression Course Average episode length = 6 mos. Approximately 50% recover without reoccurrence, which means there is a 50% reoccurrence rate If have 2^nd occurrence risk for future episodes is greatly increased Many recover spontaneously (on their own, without treatment) 10% of people who experience depression remain in a chronic state of depression (do not recover)
19	Gender Differences in Depression Women appear to be about twice as likely to suffer from unipolar depression Explanations include genetic factors, biochemical differences, traditional sex roles in Western cultures, stress and loss Are men just as depressed as women?
20	Biological Factors in Depression Genetics MZ twins are more similar than DZ twins, even when adopted Depression tends to run in families Neurotransmitters Abnormally low levels of serotonin, dopamine, and norepinephrine results in decreases in neural transmission and stimulation of reward and pleasure sites in the brain
21	Cognitive Factors in Depression Learned helplessness theory Individuals feel hopeless and helpless in the face of repeated negative life events that are beyond their control and basically give up trying Attribution theory People’s depression is the result of negative attributions for failures that are: Personal (‘It’s all my fault’) Stable (‘I’ll always be this way’) Global (‘I’m a total loser’)
22
23	Dysthymia Symptoms similar to Major Depression but in a milder form Must last 2 years without relief for over 2 months in order to meet diagnostic criteria Typical duration lasts 5-10 years Often followed by episode of Major Depression May indicate a continuum of depression severity
24	Bipolar Disorder At least one episode of major depression and episode/s of mania Mania = extremely high energy state Individual engages in risky or reckless behavior Sexual or financial irresponsibility common during mania Individuals tend to develop grand notions or plans Speech is rapid fire and telegraphic Flight of thoughts
25	Anxiety Disorders Anxiety responses have three components: A cognitive component Physiological responses A behavioral component
26	Phobias Phobias are strong and irrational fears of certain objects and situations Agoraphobia: Fear of public places Social phobias: Fear of situations in which evaluation is possible Specific phobias: fear of specific animals, objects, and situations
27	Generalized Anxiety Disorder A general sense of anxiety characterized by excessive and uncontrollable worry Accompanied by symptoms: Irritability Muscle tension Fatigue Feeling restless or keyed up Sleep problems
28	Panic Disorder Repeated panic that occurs suddenly, unpredictably, and is very intense The individual must be worried about the implications of panic attacks and/or worried about future attacks
29	Obsessive-Compulsive Disorder Obsessions Repetitive & uncontrollable thoughts, images, or impulses that invade consciousness Compulsions Repetitive & uncontrollable behavioral responses
30	Post-traumatic stress disorder Occurs as a result of an event a person believes threatens there life or great bodily harm or witnesses the same happen to another Four major symptoms: Experience of severe anxiety, arousal, and distress not present before the trauma Reliving of the trauma in flashbacks, dreams, and fantasy Becoming numb to the world Experiencing extreme guilt after others are killed in the trauma
31	Biological Factors in Anxiety Disorders Genetics MZ twins are more similar than DZ twins, even when adopted GABA Abnormally low levels of this neurotransmitter may cause highly reactive nervous systems
32	Cognitive Factors in Anxiety Maladaptive thought patterns and beliefs influence the development and maintenance of anxiety Overestimation of likelihood feared consequence will happen Overestimation of severity of consequences
33	Learning Factors in Anxiety Classical conditioning: Associating an object or situation with pain and trauma results in fear of it Avoidance behaviors prevent identification of evidence that would disconfirm fears
34	Dissociative Disorders Psychogenic amnesia Extensive but selective memory loss following trauma Psychogenic fugue Loss of all personal identity Dissociative identity disorder Multiple, distinct personalities are preset in one individual Often results from extreme childhood trauma
35	Characteristics of Schizophrenia Delusions False beliefs not based in reality Hallucinations False perceptions running the gamut of senses Disorganized thoughts and speech Blunted, flat, inappropriate affect
36	Types of Schizophrenia Paranoid Delusions of persecution and grandeur Disorganized Confusion, incoherence, severe deterioration of adaptive behavior Catatonic Muscular rigidity or repetitive movements Undifferentiated Combination of symptoms from other categories
37	Types of Schizophrenia Type I Predominance of positive symptoms such as delusions and disordered speech and thinking Type II Predominance of negative symptoms such as lack of emotional expression, loss of motivation, absence of normal speech
38	Biological Causes of Schizophrenia The dopamine hypothesis Symptoms of schizophrenia are produced by overactivity of the dopamine system in areas of the brain that regulate emotional expression, motivation, and cognitive functioning Genetic contributions Brain Atrophy
39	Personality Disorders Characterized by stable and enduring behaviors that are maladaptive Rigid thinking Interpersonal problems Little change across the lifetime
40	Personality Disorders 3 clusters Odd/Eccentric Includes schizoid, schizotypal, & paranoid Socially aloof & suspicious Anxious/Fearful Includes avoidant, dependent, & obsessive-complussive Problems with anxiety and control of anxiety in general Dramatic/Impulsive Includes antisocial, borderline, narcissistic, & histrionic Dramatic, emotional & erratic behavior
41	Borderline Personality Disorder Marked instability in interpersonal relationships, self-image, mood, & impulsive behavior Frantic efforts to avoid real or imagined abandoment Recurrent suicidal or parasuicidal behaviors High occurrence of depression Evidence for childhood abuse as causal factor
42	Antisocial Personality Disorder Exhibit little anxiety, guilt, or compassion for others Often commit acts at the expense of others History of criminal behavior High prevalence in the prison population
43	Diathesis-stress Model
44	Behavior on a Continuum