Chapter 16. January 04, Nov 28 11:01 AM. Nov 28 10:58 AM. Nov 28 11:23 AM. Nov 28 11:28 AM. Adjustment. Nov 28 11:28 AM.

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caught on surveillance camera. The woman's family thanked the police for their restraint, even though the woman was threatening them with what appeared to be a weapon.

1 Chapter 16 Should people be able to refuse treatment? Chapter 16: Psychological Disorders Lesson 1 What are Psychological Disorders? Objectives: Define psychological disorder Distinguish between the concepts of normality and abnormality The events surrounding the theft of a police car by a woman with a psychological disorder were caught on surveillance camera. The woman's family thanked the police for their restraint, even though the woman was threatening them with what appeared to be a weapon. After the incident, her husband appealed to lawmakers to change the law that allows someone who has been diagnosed with a psychological disorder to refuse treatment. The woman's family believed that the incident could have been avoided if they had been allowed to admit her to psychiatric care. Should the laws that allow someone who has been diagnosed with a psychological disorder to refuse treatment be changed? Explain why or why not. Under what circumstances should someone's caregivers be able to force treatment? Nov 28 10:58 AM What variables dictate whether or not something is considered normal? location - rules society gender personality culture age Nov 28 11:01 AM Deviation from Normality One approach to defining abnormality is to say that what most people do is normal. Abnormality, then is a deviation from the majority. For example, most people do not take 10 showers a day, laugh when a loved one dies or wear bathing suits in the snow. Limitations Majority is not always right or best. The fact that someone is different doesn't necessarily mean that he or she is suffering from a psychological disorder Further, just because someone acts like others around him doesn't mean that he/ she does not have a problem (consider someone who uses drugs just like those around them) If most people are non creative, was Shakespeare abnormal? Also, different cultural norms must be taken into account. There are a number of ways to define abnormality. We will look at three of them. Nov 28 11:23 AM Adjustment Nov 28 11:28 AM Psychological Health Another way to distinguish normal from abnormal is to say that normal people are able to get along in the world physically, emotionally, and socially. The terms mental illness and mental health imply that psychological disturbance or abnormality is like physical sickness. By this definition, abnormal people are those who fail to adjust. They may be so unhappy that they refuse to eat or so lethargic that they can't hold a job. They may be so anxious that they avoid all people and end up living in a lonely world. This holds that there is an ideal way for people to function and if one is unable to function in this way, they have an illness. This has problems too. Not all people with psychological disorders are violent, destructive or isolated. Humanists believe that this means either having achieved or striving to achieve self actualization (full acceptance and expression of one's own individuality and humanness) Mild psychological disorders are common. It is only when the problem becomes severe enough to disrupt everyday life that it becomes classified as an abnormality or illness. This can be difficult to define. Nov 28 11:28 AM Nov 28 11:47 AM 1

Think of other famous people or fictional characters that could be considered abnormal. Under which definitions of abnormality do they fall. Explain.

themselves to the same sort of classification as physical illnesses do. The causes and cures of psychological disorders are rarely clear cut.

2 Think of other famous people or fictional characters that could be considered abnormal. Under which definitions of abnormality do they fall. Explain. Think of social situations that might encourage or even necessitate adaptive behaviours that would otherwise be considered abnormal The Problem of Classification Psychological disorders do not lend themselves to the same sort of classification as physical illnesses do. The causes and cures of psychological disorders are rarely clear cut. Psychological disorders are classified and diagnosed according to their symptoms. Standards for classifying abnormal symptoms are agreed upon by psychiatrists and published in the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM). The first DSM was published in The most current (DSM IV) was published in 1994 and revised in The APA is currently working on DSM V. Nov 28 12:02 PM Nov 28 3:13 PM Discuss the issues surrounding the classification of mental illnesses using the DSM. What are some of the problems associated with this classification? What are some of the benefits to using these labels? Lesson 2 Anxiety Disorders Objectives: Identify the behavioural patterns that psychologists label as anxiety disorders Explain what causes anxiety disorders What is your opinion of the medical model which is used to treat mental illness? Explain/ support your ideas. Nov 29 9:19 AM Nov 29 9:46 AM Anxiety Disorders Generalized Anxiety Disorder (GAD) It is normal to experience anxiety in some situations. People with Anxiety Disorders experience a form of anxiety that is out of proportion with the situation provoking it. DSM IV lists many disorders under the category of Anxiety Disorders. We will look at 5 of these. Anxiety is a vague, generalized apprehension or feeling that one is in danger. This differs from fear, which is a reaction to real, identifiable threats. People with GAD often have trouble dealing with family and friends can create a viscous cycle. Accompanied by physical symptoms muscular tension, furrowed brow, strained face, poor appetite, diarrhea, frequent urination, trouble sleeping. Theories about the causes include that it is learned, could be partly inherited, or influenced by environmental factors (such as traumatic experiences in childhood) Nov 29 9:50 AM Nov 29 10:01 AM 2

Chapter 16 Obsessive Compulsive Disorder (OCD) A person suffering from acute anxiety may think the same thoughts over and over, uncontrollably. This is called an obsession.

For example, a compulsive person may feel he needs to wash his hands 20 times a day or avoid stepping on cracks in the sidewalk. Experiencing both together is obsessive compulsive disorder (OCD).

Nov 30 11:25 AM Phobic Disorder A phobia is an intense and irrational fear of a particular object or situation.

The exact cause is not known, but they are learned (perhaps through classical conditioning) and maintained through reinforcement as people with phobias tend to deal with them by avoiding the thing

3 Chapter 16 Obsessive Compulsive Disorder (OCD) A person suffering from acute anxiety may think the same thoughts over and over, uncontrollably. This is called an obsession. For example, someone may not be able to rid himself of thoughts of dying. They may also perform irrational actions, called compulsions. For example, a compulsive person may feel he needs to wash his hands 20 times a day or avoid stepping on cracks in the sidewalk. Experiencing both together is obsessive compulsive disorder (OCD). People with OCD realize that their thoughts and behaviours are irrational, but they feel unable to stop them. Nov 30 11:25 AM Phobic Disorder A phobia is an intense and irrational fear of a particular object or situation. They range in intensity from mild to extremely severe and they can have a drastic impact on a person's everyday life. Specific phobias can include fear of almost anything. The exact cause is not known, but they are learned (perhaps through classical conditioning) and maintained through reinforcement as people with phobias tend to deal with them by avoiding the thing which they fear. They also tend to run in families. They can be treated by providing the person with opportunities to experience the feared object under conditions in which he/ she feels safe. Panic Disorder Panic is a feeling of sudden, helpless terror, such as the overwhelming fright you might experience if cornered by a predator. Panic disorder is an anxiety disorder that manifests itself in the form of panic attacks. Symptoms of panic attacks vary but they can include sense of smothering, choking or difficulty breathing faintness or dizziness nausea and chest pains. They can last an hour or more, but usually last a few minutes. Panic Disorder may be inherited, in part. Panic victim usually experiences the first attack after a stressful event. May be the result of interpreting physiological arousal (such as increased heart rate) as disastrous. Nov 30 11:08 AM Post Traumatic Stress Disorder (PTSD) Post Traumatic Stress Disorder is a disorder in which the victims of traumatic events experience the original event in the form of dreams or flashbacks. Common among veterans of military combat survivors of natural disasters victims of human aggression, such as rape and assault survivors of unnatural catastrophes, such as plane crashes. Fifth Estate "Broken Heroes" Not everyone who experiences a traumatic event develops PTSD. People exposed repeatedly over a long period of time are more likely to develop the disorder. PTSD can be long lasting. Studies have shown it to last decades. Social support, therapy and medication can help treat the effects of this disorder. Nov 29 10:09 AM Dec 1 8:52 AM Somatoform Disorders Lesson 3: Somatoform and Dissociative Disorders Objectives: Identify the behavioral patterns that psychologists label as somatoform disorders Describe the symptoms of dissociative disorders Dec 1 9:27 AM Somatoform Disorders involve physical symptoms for which there is no apparent physical cause. Two major types of somatoform disorders are conversion disorder and hypochondriasis. These disorders do not involve patients "faking" their symptoms. Rather, they really do suffer from physical symptoms, it is just that their cause is psychological rather than physical. Dec 1 9:30 AM 3

4 Conversion Disorders A conversion disorder is the conversion of emotional difficulties into the loss of a specific physiological function. The loss of the function is real but no actual physical damage is present. Symptoms may include things like a loss of hearing, loss of sensation in a particular region of the body or paralysis. People suffering from conversion disorder often react with calmness, rather than panic to their symptoms. They may, unconsciously, invent physical symptoms in order to gain freedom from conflict. For example someone who is terrified of blurting out things that s/he does not want to say, may lose the ability to speak. Hypochondriasis In hypochondriasis, a healthy person becomes preoccupied with imaginary ailments. This differs from conversion disorder, in which actually physical symptoms are present. Hypochondriacs misinterpret minor aches and pains as signs of fatal illness. Despite negative results in medical tests, they typically continue to believe that a disease exists. Psychoanalytic theory proposes that hypochondriasis, like conversion, occurs when an individual represses emotions and then expresses them, symbolically in physical symptoms. Dec 5 8:59 AM Dec 5 9:08 AM Dissociative Disorders Dissociative disorder involves a significant breakdown in a person's normal conscious experience, such as a loss of memory or identity. The DSM IV lists a number of specific dissociative disorders. Dissociative Amnesia Dissociative amnesia is memory loss that has no biological explanation. This is different from other types of memory loss that result from brain damage, normal forgetting or drug abuse. Amnesiacs remember how to speak and other general knowledge, but may forget who they are, where they live or who their family is. This often occurs after a traumatic event and psychoanalysts believe it may be an attempt to escape from problems by blotting them out completely. Dissociative Fugue Dissociative Fugue is a dissociative disorder in which a person suddenly and unexpectedly travels away from home or work and is unable to recall the past. Amnesia is paired with flight to a new environment. The person my suddenly disappear and "wake up" in a new place. They may establish a new identity in a new place. They may repress all knowledge of a previous life. This can last for days or decades. When the individual comes out of it, s/he will have no memory of the fugue state. This serves the same purpose as amnesia, escape from conflict and anxiety. Dec 5 9:17 AM Dec 5 10:01 AM Dissociative Identity Disorder A person with dissociative identity disorder, previously known as multiple personality disorder, exhibits two or more personality states, each with its own patterns of thinking and behaving. The different states may take control at different times. This disorder is extremely rare. May be the individual's effort to escape from a part of her/ himself that s/he fears. People diagnosed with this disorder usually suffered severe physical, psychological or sexual abuse during childhood reduce stress by selectively forgetting events. Lesson 4 Schizophrenia and Mood Disorders Objectives: Describe the disorder of Schizophrenia Describe several theories that try to explain mood disorders A famous case involves Chris Sizemore who inspired the book and movie, The Many Faces of Eve. She displayed 3 personalities, Eve White, Eve Black and Jane. Dec 5 9:44 AM Dec 6 10:47 AM 4

Schizophrenia Characterized as a psychotic disorder according to DSM IV Schizophrenia involves confused and disordered thoughts and perceptions.

It is a collection of symptoms not a single problem Many people experience: Delusions false beliefs maintained in the face of contrary evidence.

Treatment for schizophrenia is long term and usually requires hospitalization.

Catatonic type may remain motionless for long periods of time with limbs in unusual positions. May take a long time to return to a relaxed position (as if melting a wax statue).

Remission type symptoms are completely gone or are not severe enough to earn a diagnosis. Symptoms are expected to return. Hence "remission".

These symptoms are shared by all types. Symptoms may go in remission. While treatment is possible which can increase the quality of life, there is no cure.

5 Schizophrenia Characterized as a psychotic disorder according to DSM IV Schizophrenia involves confused and disordered thoughts and perceptions. Thought processes are somewhat disturbed and the person has lost contact with reality to a considerable extent. It is a collection of symptoms not a single problem Many people experience: Delusions false beliefs maintained in the face of contrary evidence. Hallucinations perceptions that have no direct external cause. Most often this involves hearing voices, though people with schizophrenia may experience hallucinations involving other senses as well. Treatment for schizophrenia is long term and usually requires hospitalization. Types of Schizophrenia Paranoid type involves hallucinations and delusions, including grandeur ("I am the saviour of my people") or persecution ("Someone is always watching me"). Catatonic type may remain motionless for long periods of time with limbs in unusual positions. May take a long time to return to a relaxed position (as if melting a wax statue). Disorganized type symptoms include incoherent language, inappropriate emotions, disorganized motor behavious, and hallucinations and delusions. Remission type symptoms are completely gone or are not severe enough to earn a diagnosis. Symptoms are expected to return. Hence "remission". Undifferentiated type encompasses the basic symptoms of schizophrenia deterioration of daily functioning, hallucinations, delusions, inappropriate emotions, thought disorders. These symptoms are shared by all types. Symptoms may go in remission. While treatment is possible which can increase the quality of life, there is no cure. Dec 6 10:51 AM Dec 7 9:12 AM Causes of Schizophrenia Causes of Schizophrenia Biological Influences Studies show that schizophrenia tends to run in families. However, psychologists cannot point out the exact genetic contribution. 1% of the general population will develop schizophrenia. However, the chances increase to 10% if it is in your family. Research has studied children born to mothers with schizophrenia and separated at birth. One study found that 16% of these children developed schizophrenia. Biochemistry and Physiology Many researchers believe that people with schizophrenia have too much or too little of certain brain chemicals. Correlational studies suggest that people with schizophrenia have an excess of dopamine at selected synapses. It is not known if this is the cause of schizophrenia or the result of it. Symptoms may also result from the typical lifestyle of someone with schizophrenia living in hospitals, little exercise, institutional food, medication. Dec 7 9:27 AM Dec 7 9:46 AM Family and Interactions Causes of Schizophrenia Studies show that families of individuals who develop schizophrenia are often on the verge of falling apart. Communication seems disorganized in the early family life of people with schizophrenia. Schizophrenia & Substance Use Why do people with schizophrenia use alcohol or drugs? How does using substances affect a person living with schizophrenia? Families tend to organize themselves around the unusually demanding behaviour of one member of the family. Thus, it is again unknown whether these trends in family are the cause or the result of schizophrenia. Dec 7 10:03 AM Dec 7 10:11 AM 5

Chapter 16 Dec 9 2:45 PM Dec 9 2:52 PM Major Depressive Disorder Mood Disorders People who suffer from mood disorders experience more intense and longer lasting mood swings than normal.

Symptoms include: Problems with eating, sleeping, thinking, concentrating, or decision making May feel like they cannot control their feelings. Emotions hamper their ability to function effectively.

Manic phase can be more difficult to detect because the person seems so optimistic.

Depressive phase involves same type of behaviour as someone with major depressive disorder. Basically the opposite of the manic phase lethargy, despair and unresponsiveness.

Dec 8 11:18 AM Lacking energy Suicidal thoughts Feeling worthless or guilty These can be made worse by environmental factors lack of a support system, stress, illness in self or loved one, legal

6 Chapter 16 Dec 9 2:45 PM Dec 9 2:52 PM Major Depressive Disorder Mood Disorders People who suffer from mood disorders experience more intense and longer lasting mood swings than normal. Major Depressive Disorder is a severe form of depression that interferes with functioning, concentration, and mental and physical well being. Symptoms include: Problems with eating, sleeping, thinking, concentrating, or decision making May feel like they cannot control their feelings. Emotions hamper their ability to function effectively. Dec 8 10:25 AM Bipolar Disorder Bipolar Disorder is a disorder in which an individual alternates between feelings of mania (euphoria) and depression. Manic phase can be more difficult to detect because the person seems so optimistic. It can involve extreme confusion, racing thoughts, distractibility, increased activity level, decreased sleep, irresponsible behavior such as shopping sprees or insults. Depressive phase involves same type of behaviour as someone with major depressive disorder. Basically the opposite of the manic phase lethargy, despair and unresponsiveness. Some experience either phase as well as periods of normal behaviour and emotion. Others alternate directly between the two phases. Dec 8 11:18 AM Lacking energy Suicidal thoughts Feeling worthless or guilty These can be made worse by environmental factors lack of a support system, stress, illness in self or loved one, legal difficulties, financial struggles, and job problems. ( These symptoms can also act as symptoms themselves Dec 8 11:10 AM Seasonal Affective Disorder (SAD) People with SAD develop deep depression during the midst of winter. Spirits lift with the coming of spring. It may be related to the hormone melatonin. The less light there is, the more melatonin is secreted. This may cause some people to experience SAD. Not known why some develop SAD and others do not. Can be treated by sitting under bright fluorescent lights during the evening or morning hours. Dec 8 11:42 AM 6

7 Explaining Mood Disorders Suicide and Depression Exact causes are complex and impossible to pin point exactly. Psychological factors include self esteem, social support, and the ability to deal with stressful situations. Depressed people may draw illogical conclusions about themselves blame themselves for every problem and consider minor failures catastrophic. Learned helplessness may be a factor. Research is being done involving the role that neurotransmitters may play. Genetic factors are also being researched. Not all people who commit suicide are depressed. Nor do all depressed people commit suicide. Many depressed people have suicidal thoughts and many take action. People who threaten suicide or make an attempt are serious. Studies show that about 70% of people who have killed themselves threatened to do so within 3 months before the successful attempt. If someone you know is having suicidal thoughts, listen/ talk to them and urge them to seek professional help or seek professional help/ guidance for them. Dec 8 11:50 AM Dec 8 11:57 AM Personality Disorders Lesson 5: Personality Disorders and Drug Addiction People with personality disorders have maladaptive or inflexible ways of dealing with others and with their environment. According to the DSM, personality disorders "cause enduring patterns of inner experience and behaviour that deviate from the expectations of society, are pervasive, inflexible and stable over time, and lead to distress or impairment." Dec 12 10:59 AM Dec 12 11:09 AM Antisocial Personality Disorder Antisocial personality disorder is characterized by irresponsible, shallow emotions and a lack of conscious. In the past, these people were called sociopaths or psychopaths. Characteristics: No regard for others' rights. Treat people as objects used for personal gratification and cast aside when not wanted. They live in the moment. They feel no shame or guilt for injuring people or breaking social rules. Punishment seems to have no impact on them. Many are intelligent and can fake emotions. Drug Addiction Drug addiction and alcoholism are covered in the DSM IV. Drug abuse involves psychological dependance use of a drug to such an extent that a person feels nervous or anxious without it. Users depend on the feeling wellbeing they obtain from the drug which compels them to continue using it. Drugs can also lead to physiological addiction characterized by an overwhelming and compulsive desire to obtain and use the drug. For people who are addicted to a drug, the drugged state becomes the body's normal. If the drug is not in the body, the person can experience extreme physical discomfort. Once a person is addicted to a drug, the body develops tolerance the body becomes accustomed to the drug so the dosage must be increased to obtain the high.. Without the drug, the addict will likely go through withdrawal symptoms. Withdrawal symptoms vary among people and drugs and can range from mild nausea to hallucinations, coma and death. Dec 12 11:13 AM Dec 12 11:29 AM 7

8 Critical Thinking Questions 1. Develop your own defination of psychological disorder. Is your defination free of social values, or are social values a necessary part of any defination? Explain. 2. Why do you think that it can be difficult for people with major depressive disorder to take action to overcome the disorder? 3. Why are people with schizophrenia more likely to use drugs than the general population? What effects does using drugs have on their experience with the disorder? 4. Why do you think people who have been treated for alcohol or drug abuse run the risk of relapse? Dec 12 4:09 PM 8

WHAT ARE PERSONALITY DISORDERS?

CHAPTER 16 REVIEW WHAT ARE PERSONALITY DISORDERS? How is abnormal behaviour defined? Statistically infrequent Violates of social norms Personally distressful Disability or dysfunction Unexpected DSM-IV