Psychological Disorders

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Esther Carroll
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1 Psychological Disorders Psychological Disorder a harmful dysfunction in which behavior is judged to be: atypical--not enough in itself disturbing--varies with time and culture maladaptive--harmful unjustifiable--sometimes there s a good reason

3 Generalized Anxiety Disorder (GAD) More or less constant worry about many issues Inability to identify or avoid the cause of certain feelings Physical symptoms headaches stomach aches muscle tension irritability

4 Panic Disorder Symptoms Minute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations. Anxiety is a component of both disorders. It occurs more in the panic disorder, making people avoid situations that cause it.

5 Phobia Marked by a persistent and irrational fear of an object or situation that disrupts behavior.

6 Kinds of Phobias Agoraphobia Acrophobia Claustrophobia Hemophobia Phobia of open places. Phobia of heights. Phobia of closed spaces. Phobia of blood.

8 Anxiety Disorders Obsessive-Compulsive Disorder unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

9 Psychological Disorders I felt the need to clean my room spent four to five hour at it At the time I loved it but then didn't want to do it any more, but could not stop The clothes hung two fingers apart I touched my bedroom wall before leaving the house I had constant anxiety I thought I might be nuts. Marc, diagnosed with obsessive-compulsive disorder (from Summers, 1996)

10 Anxiety Disorders

11 Anxiety Disorders PET Scan of brain of person with Obsessive/ Compulsive disorder High metabolic activity (red) in frontal lobe areas involved with directing attention

12 Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD): 1. Haunting memories 2. Nightmares 3. Social withdrawal 4. Jumpy anxiety 5. Sleep problems Bettmann/ Corbis

14 Mood Disorders Mood Disorders characterized by emotional extremes Major Depressive Disorder a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

15 Major Depressive Disorder Depression is the common cold of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002). Blue mood Gasping for air after a hard run Major Depressive Disorder Chronic shortness of breath

16 Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. Signs include: 1. Lethargy and fatigue 2. Feelings of worthlessness 3. Loss of interest in family & friends 4. Loss of interest in activities

17 Symptoms of Major Depression

18 Dysthymic Disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Blue Mood Dysthymic Disorder Major Depressive Disorder

19 Dysthymic Disorder Chronic, low-grade depressed feelings that are not severe enough to be major depression May develop in response to trauma, but does not decrease with time Can have co-existing major depression

20 Seasonal Affective Disorder Cyclic severe depression and elevated mood Seasonal regularity Unique cluster of symptoms intense hunger gain weight in winter sleep more than usual depressed more in evening than morning

21 Prevalence and Course Most common of psychological disorders Women are twice as likely as men to be diagnosed with major depression Untreated episodes can become recurring and more serious Seasonal affective disorder (SAD) onset with changing seasons

22 Mood Disorders Bipolar Disorder a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania formerly called manic-depressive disorder Manic Episode a mood disorder marked by a hyperactive, wildly optimistic state

23 Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Depressive Symptoms Manic Symptoms Gloomy Withdrawn Inability to make decisions Tired Slowness of thought Elation Euphoria Desire for action Hyperactive Multiple ideas

24 Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman Wolfe Clemens Hemingway

25 Prevalence and Course Bipolar Disorder Onset usually in young adulthood (early twenties) Mood changes more abrupt than in major depression No sex differences in rate of bipolar disorder Commonly recurs every few years Can often be controlled by medication (lithium)

26 Neurotransmitters & Depression A reduction of norepinephrine and serotonin has been found in depression. Norepinephrine Pre-synaptic Neuron Serotonin Drugs that alleviate mania reduce norepinephrine. Post-synaptic Neuron

27 The Depressed Brain PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

28 Somatoform Disorders Somatoform Disorders psychological disorders in which the symptoms take a somatic (bodily) form without apparent physical cause. Hypochondriasis a somatoform disorder in which a person misinterprets normal physical sensations as symptoms of a disease. Conversion Disorders a rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found.

30 Dissociative Amnesia Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers. Margie was unable to recall any details from the time of the accident until four days later.

31 Dissociative Amnesia Also known as psychogenic amnesia Memory loss the only symptom Often selective loss surrounding traumatic events person still knows identity and most of their past Can also be global loss of identity without replacement with a new one

32 Dissociative Fugue Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man. Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married.

33 Dissociative Fugue Also known as psychogenic fugue Global amnesia (forgets everything) with identity replacement leaves home develops a new identity apparently no recollection of former life called a fugue state If fugue wears off old identity recovers new identity is totally forgotten

34 Dissociative Identity Disorder (DID) Norma has frequent memory gaps and cannot account for her whereabouts during certain periods of time. While being interviewed by a clinical psychologist, she began speaking in a childlike voice. She claimed that her name was Donna and that she was only six years old. Moments later, she seemed to revert to her adult voice and had no recollection of speaking in a childlike voice or claiming that her name was Donna.

35 Dissociative Identity Disorder Dissociative Identity Disorder rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities formerly called multiple personality disorder

36 Dissociative Identity Disorder Pattern typically starts prior to age 10 (childhood) Most people with disorder are women Most report recall of torture or sexual abuse as children and show symptoms of PTSD

37 Dissociative Disorder Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Symptoms 1. Having a sense of being unreal. 2. Being separated from the body. 3. Watching yourself as if in a movie.

38 Dissociative Identity Disorder (DID) Is a disorder in which a person exhibits two or more distinct and alternating personalities, formerly called multiple personality disorder. Chris Sizemore (DID) Lois Bernstein/ Gamma Liason

39 Causes of Dissociative Disorders? Repeated, severe sexual or physical abuse However, many abused people do not develop DID Combine abuse with biological predisposition toward dissociation? people with DID are easier to hypnotize than others may begin as series of hypnotic trances to cope with abusive situations

40 Schizophrenic Disorders Symptoms Disorganized Thoughts Hallucinations Delusions Garbled Speech Word Salad Clanging

41 What is Schizophrenia? Comes from Greek meaning split and mind split refers to loss of touch with reality not dissociative state not split personality Equally split between genders, males have earlier onset 18 to 25 for men 26 to 45 for women

42 Delusions-false beliefs about self Delusions of persecution they re out to get me paranoia Delusions of grandeur God complex Belief you are more powerful than you actually are Delusions of being controlled the CIA is controlling my brain with a radio signal Thinking someone or something is attempting to control you

43 Disorganized Thinking Word Salad jumping from one idea to another even within sentences. Clang Associations rhyming the last word of a sentence.

44 Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars I m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday. (Sheehan, 1982) This Other monologue forms of delusions illustrates include, fragmented, delusions bizarre of thinking persecution with distorted ( someone beliefs is following called delusions me ) or grandeur ( I m Mary ( I Poppins ). am a king ).

45 Disorganized Thinking

46 Symptoms of Schizophrenia Hallucinations hearing or seeing things that aren t there contributes to delusions command hallucinations: voices giving orders Disorganized speech Over-inclusion jumping from idea to idea without the benefit of logical association Paralogic on the surface, seems logical, but seriously flawed e.g., Jesus was a man with a beard, I am a man with a beard, therefore I am Jesus

47 Schizophrenic Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory.

49 Inappropriate Emotions & Actions A schizophrenic person may laugh at the news of someone dying or show no emotion at all (apathy- Inappropriate Emotions ). Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia-awakenings).

50 Schizophrenia

51 Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Brain Abnormalities Chemical Factors: Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.

52 Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed. Genain Sisters Courtesy of Genain Family The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors.

53 Warning Signs Early warning signs of schizophrenia include: A mother s long lasting schizophrenia. Birth complications, oxygen deprivation and low-birth weight. Short attention span and poor muscle coordination. Disruptive and withdrawn behavior. Emotional unpredictability. Poor peer relations and solo play.

54 Biological Factors Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

55 Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health

56 Personality Disorders Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. Cause a person to deviate from social expectations.

57 Personality Disorders These people have unstable and intense relationships with others. They are dependent on others and yet, sabotage those relationships. They have problems controlling their impulses; their perceptions and thoughts are distorted.

58 Antisocial Personality Disorder A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath.

59 Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat offenders had 11% less frontal lobe activity compared to normals (Raine et al., 1999; 2000). Normal Murderer

60 Borderline Personality Disorder Chronic instability of emotions, selfimage, relationships Self-destructive behaviors Intense fear of abandonment and emptiness Possible history of childhood physical, emotional, or sexual abuse 75% of diagnosed cases are women

61 Paranoid Personality Disorder Pervasive mistrust and suspiciousness of others are the main characteristic Distrustful even of close family and friends Reluctant to form close relationships Tend to blame others for their own shortcomings

62 Histrionic Personality Disorder Histrionic Personality Disorder displays a shallow, attention-getting emotionality. Histrionic individuals go to great length to gain others praise and reassurance.

63 Narcissistic Personality Disorder Narcissistic Personality Disorder exaggerate their own importance, aided by success fantasies. They find criticism hard to accept, often reacting with rage or shame.

Bipolar Disorder. Bipolar Disorder. Theory of Depression. Explaining Mood Disorders. Theory of Depression. Suicide

Bipolar Disorder. Bipolar Disorder. Theory of Depression. Explaining Mood Disorders. Theory of Depression. Suicide Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Depressive Symptoms Manic Symptoms Bipolar Disorder Many great writers,