A deviant, distressful, and dysfunctional pattern of thoughts, feelings, and actions.

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1 Chapter 13

2 A deviant, distressful, and dysfunctional pattern of thoughts, feelings, and actions. Deviant: diverging sharply from what is considered customary, traditional or generally accepted standard. Distressful: causing someone to be extremely upset. Dysfunctional: inability to function emotionally or as a social unit, not performing as expected

3 Medical Model: the concept that psychological disorders have physical causes that can be diagnosed, treated and in most cases, cured, often through treatment in a hospital. Biopsychosocial Approach: biological, psychological and social-cultural factors interact to produce specific psychological disorders.

4 Called the DSM Currently use the DSM-IV TR DSM V in process of release in 2012 Researched and published by American Psychiatric Association. Developed in coordination with the World Health Organization s International Classification of Disorders. (ICD-10)

5 Used to help clinicians identify and diagnose mental health disorders. Does not discuss causes of disorders or treatment of disorders. US National Institute on Mental Health identifies that 26% of adults meet the criteria for a psychological disorder in any one year. 46% at sometime in their lives.

6 Psychological Disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. Anxiety: feeling of worry, nervousness or agitation Generalized Anxiety Disorder Panic Disorder Phobias Obsessive Compulsive Disorder Post-traumatic Stress Disorder

7 An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. Continual worry Cause of worry cannot be identified Free Floating by Freud Becomes rare with aging

8 An anxiety disorder marked by unpredictable minuteslong episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening associations. 1 person in 75 with this disorder Often misinterpreted as a heart attack Smokers have double the risk of disorder Nicotine is a stimulant

9 An anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation. Animals Insects Heights Blood Closed spaces Social Phobia: intense fear of being scrutinized by others so avoid potentially embarrassing situations Agoraphobia: fear or avoidance of situations in which escape might be difficult if a panic attack occurred

10 An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Obsessions: germs, dirt, toxins, fire, death, illness, order and symmetry Compulsions: excessive hand washing, bathing, grooming, repeated rituals such as checking locks, doors, car brakes, homework. More common in late teens and twenties 2-3% of people at some time cross from normal preoccupations to a debilitating disorders Seems to improve over time

11 An anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety and/or insomnia that lingers for four weeks or more after a traumatic experience. war, accidents, attacks, and disasters 8.5% of Manhattan residents had PTDS after 9/11 Living near the World Trade Centers-20 % Iraq war veterans: 1 in 6 Causes: increased emotional distress during trauma Sensitive limbic system Genetic influence

12 Learning Perspective: Fear Conditioning Classical Conditioning: able to condition rats to be chronically anxious and ulcer-prone by giving them unpredictable shocks, rats became apprehensive in their lab environment Link between conditioning fear and general anxiety Stimulus Generalization: become fearful of related situations Reinforcement: avoiding or escaping the feared situation reduces anxiety Observational learning: we learn fear by observing others parents transmit fears to their children

13 Biological Perspective Natural Selection: biologically predisposed to fear certain threats: snakes, spiders, heights, storms, darkness Genetics: increased vulnerability to anxiety rises when afflicted relative is an identical twin Identical twins have similar phobias even when adopted into different families The brain: biological over-arousal of brain areas associated with impulse control and habitual behaviors Anterior cingulate cortex hyperactive in OCD individuals Fear circuits created in the amygdala.

14 Psychological disorders characterized by emotional extremes. Major Depressive Disorder: a mood disorder in which a person experiences two or more weeks of significantly depressed moods, feelings of worthlessness and diminished interest or pleasure in most activities. Bipolar Disorder: a mood disorder in which a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

15 #1 reason people seek mental health services 13% of US adults experience a depressive disorder at some time in their lives. Depression is leading cause of disability worldwide. Depressed mood is often a response to a past or current loss. To be diagnosed with MDD: Two or more weeks experiencing at least 5 symptoms of depression.

16 Some people experiencing a depression rebound to a state of mania. Over talkative and loud Overactive Euphoric or elated Decreased need for sleep Hard to interrupt Poor judgment Fewer sexual inhibitions Less common than depression but more dysfunctional

17 Behavioral and Cognitive changes accompany depression Depression is widespread Women are more vulnerable to major depression Most major depressive episodes self terminate Stressful events often precede depression Depression is beginning earlier and affecting more people.

18 The biological perspective Genetic influences: increased risk of both disorders if you have a parent or sibling with the disorder Identical twin risk increases to 1:2 for depression Identical twin risk is 7: 10 for bipolar The depressed brain -Less activity in the brain when in a depressed state - More activity when in a manic state -left frontal is inactive during depressed states -Depressed individual frontal lobe is smaller than normal -Hippocampus is vulnerable to stress related damage

19 Neurotransmitters Norepinephrine: increases arousal ad boost mood Often scarce during depression Often overabundant during manic states SEROTONIN: scarce during depression *Drugs that increase serotonin and norepinephrine supplies by blocking reuptake or chemical breakdown decrease depression.

20 Explains the role of thinking and acting in depression People with depression have negative assumptions about themselves, their situation and their future Magnify bad experiences and minimize good ones. Self-defeating beliefs and a negative explanatory style feed depression. Negative thoughts and negative mood interact causing learned helplessness

21 Depressed people tend to view things as Stable Internal Global Cycle of Depression: 1.) negative, stressful events interpreted through 2.) a ruminating, pessimistic explanatory style creates 3.)a hopeless, depressed state that 4.)hampers the way a person thinks and acts. This then fuels 1.) negative stressful experiences

22 A group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions and inappropriate actions Symptoms: Disorganized Thinking: delusion thinking/word salad Result of breakdown in selective attention Disturbed Perceptions: hallucinations Inappropriate Emotions and Actions Positive symptoms: laughing or anger at inappropriate times Negative symptoms: flat affect, catatonia

23 Age of onset: young people who are maturing into adulthood Subtypes Paranoid: preoccupation with delusions and hallucinations often with themes of personality or grandiosity Disorganized: disorganized behaviors, flat or inappropriate emotions Catatonic: immobility, extreme negativism, and parrot-like repeating of another s speech or movements Undifferentiated: many varied symptoms Residual: withdrawal after hallucinations and delusions have disappeared.

24 Brain Abnormalities: Dopamine Over activity: excessive receptors for dopamine (6 times) Causes intensified brain signals creating positive symptoms Drugs that block dopamine receptors lessen symptoms Drugs that increase dopamine levels intensify them Abnormal Brain Activity and Anatomy -low activity in frontal lobes -increased activity in the thalamus -increased activity in the amygdala -shrinkage of cerebral tissue

25 Possible risk factors low birth weight and oxygen deprivation Maternal Virus during Midpregnancy Genetic Factors Possibility that people inherit a predisposition to schizophrenia

26 Psychological disorders characterized by inflexible and enduring behaviors that impair social functioning. Cluster A- expression of eccentric behaviors (Paranoid, Schizoid, and Schizotypal) Cluster B- exhibits dramatic, emotional, or erratic behavior (Antisocial, Borderline, Histrionic, and Narcissistic) Cluster C- anxious and fearful (Avoidant, Dependent, and Obsessive compulsive

27 Anti-social personality disorder Formerly called Sociopath or psychopath Disorder in which the person exhibits a lack of conscience for wrongdoing, even towards friends and family members. May be aggressive and ruthless or a clever con artist. Twin and Adoption studies show that biological relatives of those with antisocial and unemotional tendencies appears as a fearless approach to life. Children: begin to see signs at 3-6 years old Low autonomic nervous system arousal React with lower levels of stress hormones than others Studies show lower frontal lobe activity and tissue which controls impulses

28 A disorder in which the symptoms take a somatic (bodily) form without apparent physical cause. Conversion Disorder: a rare disorder in which a person experiences very specific genuine symptoms for which no physiological basis can be found. Conversion of anxiety to a real symptoms and disorder. Hypochondriasis: A person interprets normal physical sensations as symptoms of a disease.

29 Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Dissociative Identity Disorder: Previously called Multiple Personality Disorder A rare disorder in which a person exhibits two or more distinct and alternating personalities.

30 US National Institute of Mental Health: 26% of adult Americans suffer from a diagnosable disorder in any given year Risk factors: Poverty Typically strikes before early adulthood

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