SAT6A Psychopathology II. Unit : I V

Transcription

1 SAT6A Psychopathology II Unit : I V

2 TM Unit 1: Syllabus Mood disorders Unipolar disorder Bipolar disorders Causal factors, Treatment and outcome: Biological Psychosocial Sociocultural SAT6A Psychopathology II 2

3 Mood disorder Mood disorders are disturbance of mood that are intense and persistent enough to be clearly maladaptive. Mood disorder are those in which extreme variations in mood- either low or high- are the predominant feature. There are two types of mood disorder: Unipolar disorders Bipolar disorders SAT6A Psychopathology II 3

4 Mood Disorders Unipolar Disorders Bipolar Disorder Major Depressive disorders Bipolar I Disorder Dysthymic Disorders Bipolar II Disorder Cyclothymic Disorder SAT6A Psychopathology II 4

5 Unipolar disorder The term depression is often used to describe general sadness or unhappiness. Clinical depression can bring severe and long-lasting psychological pain that may intensify over time Prevalence Female 9-26% Males 5-12% SAT6A Psychopathology II 5

6 Major Depression Disorder Sad/depressed mood Decreased interest in pleasurable activities Motoric changes: retardation or agitation Sleep changes: too much or too little Appetite changes: anxious eating or no eating Fatigue or loss of energy Cognitive changes: indecisiveness, lack of attention, concentration, Guilt, worthlessness, hopelessness, Suicidal ideation (15-20% more likely suicide) SAT6A Psychopathology II 6

7 Dysthymic Disorders Depressed mood most of the day more days than not for at least 2 yrs. While depressed presence of 2 of: poor appetite or overeating insomnia or hypersomnia low energy or fatigue low self-esteem poor concentration hopelessness SAT6A Psychopathology II 7

8 Bipolar disorder Bipolar disorder is when one experiences both a significantly low mood (depression) and significantly high moods (mania), which cannot be explained by one s surroundings. Rapid cycling occurs when the individual has four or more episodes of major depression, mania, and/or mixed episode within one year. Bipolar II Disorder occurs in about.5% of the population and is diagnosed more in women Similarly to Bipolar I, age of onset is in the early 20 s SAT6A Psychopathology II 8

9 Bipolar I disorder It is mainly when manic or mixed episodes that last at least sever days or more. SAT6A Psychopathology II 9

10 Bipolar II disorder It involves minimum of one hypomanic episode lasting at least 4 days and one or more episode of major depression. SAT6A Psychopathology II 10

11 Cyclothymic Disorder Cyclothymic Disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and numerous periods of depressive symptoms SAT6A Psychopathology II 11

12 Causal Factor, Treatment and Outcome On both Unipolar and Bipolar disorder 6ETbQE SAT6A Psychopathology II 12

13 SAT6A Psychopathology II 13

14 SAT6A Psychopathology II 14

15 Unit II -Syllabus Schizophrenia Types of schizophrenia Causes Treatment and outcome SAT6A Psychopathology II 15

16 Schizophrenia The psychological disorder of schizophrenia represents at once the misconceptions of the past, the solutions of the present, and the promise of the future. The variety of symptoms that represent this disorder range from hallucinations to paranoia. SAT6A Psychopathology II 16

17 Schizophrenia - PET SAT6A Psychopathology II 17

18 Clinical features of schizophrenia SAT6A Psychopathology II 18

19 Schizophrenic Delusions False belief Common delusions: Being cheated Being harassed Being poisoned Being spied upon Being plotted against Mostly delusions are very grandiose and involve the patient at the centre of some large plot or scheme. SAT6A Psychopathology II 19

20 Schizophrenic Hallucinations A hallucination is non-existent stimulus that is perceived as real. The most common schizophrenic hallucination is hearing voices, however the patient may also have visual hallucinations where they see a person or object that does not exist. Hallucinated voice often interact with the patients: By commenting on their behaviour By ordering them to do things By warning of impending dangers By talking to other voices about the patient. SAT6A Psychopathology II 20

21 Symptoms of Schizophrenia SAT6A Psychopathology II 21

22 Diagnosis Diagnosis based upon clinical symptoms. Physical tests usually done to rule out other conditions. Person must display at least two symptoms of criteria that is listed in the current DSM-IV with each having been present for a considerable amount of time during one-month period. Type I vs. Type II SAT6A Psychopathology II 22

23 Types of Schizophrenia q5d8 SAT6A Psychopathology II 23

24 Causal factor Psychodynamic: Freud (1924) Regression to pre-ego state Attempts to re-establish ego control Cognitive: Acknowledges biological factors Further features appear due to person trying to understand them Perceptual differences SAT6A Psychopathology II 24

25 Causal factor Biological Genetics Environment Biochemical abnormalities Abnormal brain structure Viral causations Socio-cultural: Labelling Self-fulfilling prophesy Family dynamics Family stress Downward drift theory SAT6A Psychopathology II 25

26 Treatment and outcome Medication Psychotherapy Insight therapy Family therapy Community based approaches Antipsychotic medications in conjunction with therapy Group therapy Family therapy Psychotherapy Self-help methods SAT6A Psychopathology II 26

27 Schizophrenia MRI SAT6A Psychopathology II 27

28 Unit III: syllabus Personality disorders Categories of personality disorder Treatment and outcome Antisocial personality disorder and psychopathy Etiology and treatment SAT6A Psychopathology II 28

29 Personality Enduring pattern of experience and behavior -cognition, affect, interpersonal functioning, Impulse control Cross situation stability-inflexibility Leads to impaired functioning, distress CLASSIFICATION: Cluster:A Cluster:B Cluster:C SAT6A Psychopathology II 29

30 CLUSTER:A Paranoid Schizoid Schizotypal CLUSTER:B Antisocial Borderline Histrionic Narcissistic CLUSTER:C Avoidant Dependent Obessive compulsive disorder SAT6A Psychopathology II 30

31 CLUSTER A PERSONALITY DISORDER PARANOID PERSONALITY DISORDER: Marked by a pervasive distrust and suspiciousness of others.often misinterpret the motives and actions of others as malevolent. Unlike schizophrenics,they have no hallucination or formal thought disorder. SAT6A Psychopathology II 31

32 Schizotypal personality disorder Pronounced interpersonal defects marked by acute discomfort with, and reduced capacity for close relationship as well as by cognitive or perceptual distortion and eccentricities of behavior. May meet criteria for both schizotypal and borderline SAT6A Psychopathology II 32

33 Cluster B personality disorder ANTISOCIAL PERSONALITY DISORDER A disregard for and violation of the rights of others occurring since age 15. Also marked by an inability to conform to the social norms that ordinarily govern many aspects of people s adolescent and adult behavior. SAT6A Psychopathology II 33

34 Border Line personality disorder Pervasive pattern of unstable interpersonal relationships, self image, and affects and marked impulsivity by early adulthood. SAT6A Psychopathology II 34

35 Histrionic personality disorder Pattern of excessive emotionality and attention seeking, beginning by early adulthood. SAT6A Psychopathology II 35

36 Narcissistic personality disorder A pattern of grandiosity(in fantasy or behavior),need for admiration, and lack of empathy, beginning by early adulthood. SAT6A Psychopathology II 36

37 Cluster C personality disorder AVOIDANT PERSONALITY DISORDER: Show an extreme sensitivity to rejection and may lead socially withdrawn lives. Appear shy and need unusually strong guarantees of uncritical acceptance. Often described ass having an inferiority complex. SAT6A Psychopathology II 37

38 Dependent personality disorder A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. SAT6A Psychopathology II 38

39 Obsessive- compulsive disorder Characterized by emotional constriction, orderliness, Perseverance, stubbornness and indecisiveness. The essential feature is a pervasive pattern of perfectionism and inflexibility. SAT6A Psychopathology II 39

40 Psychopathy Psychopathy is among the most difficult disorders to spot. The psychopath can appear normal, even charming underneath, he lacks conscience and empathy, making him manipulative, volatile and often criminal. The term psychopath and sociopath" are often used interchangeably, but in correct parlance a sociopath refers to a person with antisocial tendencies that are ascribed to social or environmental factors, whereas psychopathic traits are more innate, through a chaotic or violent upbringing may tip the scales for those already predisposed to behave psychopathically. SAT6A Psychopathology II 40

41 PERSONALITY DISORDERS SAT6A Psychopathology II 41

42 Unit IV: syllabus Alcohol abuse and dependents Drug abuse and dependents Treatment and outcome SAT6A Psychopathology II 42

43 Alcohol abuse and dependents ALCOHOL: Alcoholic drinks have been prepared and drunk for thousands of years, and the problem that can accompany excess alcohol intake have undoubtedly been around just as long. SAT6A Psychopathology II 43

44 Alcoholism Alcoholism or alcohol dependence is a medical term with a deliberately more precise meaning than the problem that can occur, sometimes as one-offs through an uncharacteristic binge. SAT6A Psychopathology II 44

45 Alcohol withdrawal symptoms Alcohol withdrawal occurs when a physiologically dependent person abruptly stops using alcohol. Physiological dependence can develop after prolonged and heavy drinking. Withdrawal is most common early in voyage. Alcohol withdrawal can be a life threatening emergency. Alcohol withdrawal is diagnosed when the symptoms are due to cessation of alcohol and not due to another medical or psychiatric disorder. SAT6A Psychopathology II 45

46 Problem caused by alcohol Depression Liver cirrhosis Heart failure Damage to the brain and nervous system SAT6A Psychopathology II 46

47 Mental health and alcoholism Mental health problems are common in alcoholism. Each can lead to or reinforce the other. Depression is a common cause of alcoholism. Anxiety can be temporarily relived by alcohol. SAT6A Psychopathology II 47

48 Treatment Alcohol dependence and abuse are difficult to manage and treat aboard ship For someone who has the determination to quit drinking,attending meettings in the various ports of call can be helpful. Chapters of alcoholic anonymous are found world wide. Referal for formal evaluation and treatment in the homeport are appropriate. Most importantly alcohol use must be prevented from interfering with the safe operation and management of the ship SAT6A Psychopathology II 48

49 Drug abuse DRUG ABUSE has a wide range of definitions related to taking a psychoactive drug or performance enhancing drug for nontherapeutic or non-medical effect. Common drug include alcohol, amphetamines,barbiturates, cocaine, methaqualone, opium alkaloids and minor tranquilizers. SAT6A Psychopathology II 49

50 Types of drug STIMULANTS: They increase the activity of the central nervous system. DEPRESSANTS: They reduce the activity of the central nervous system. HALLUCINOGENS: They alter perceptions of reality and may result in hallucinations. SAT6A Psychopathology II 50

51 Cannabis All forms of cannabis have negative physical and mental effects. SAT6A Psychopathology II 51

52 Cocaine Cocaine stimulates the central nervous system. SAT6A Psychopathology II 52

53 Other stimulants SAT6A Psychopathology II 53

54 Depressants The effects of depressants are in many ways similar to the effect of alcohol. SAT6A Psychopathology II 54

55 Hallucinogen SAT6A Psychopathology II 55

56 Treatment SAT6A Psychopathology II 56

57 Unit V: Syllabus Sexual and gender variants Sexual abuse Sexual dysfunction Treatment SAT6A Psychopathology II 57

58 Paraphilias Paraphilia Fetishism Transvestic fetishism Voyeurism Exhibitionism Sadism Masochism Pedophilia Frotteurism SAT6A Psychopathology II 58

59 Gender Dysphoria Boys Homosexuality Common outcomes Girls May lead to homosexuality but only small studies done SAT6A Psychopathology II 59

60 Gender Dysphoria Transsexuals Adults with gender dysphoria who want to change their sex Autogynephilia Paraphilia characterized by man s sexual arousal at thought of being a woman Surgical sex reassignment typically effective Treatment Psychotherap y is usually not effective SAT6A Psychopathology II 60

61 Sexual abuse Childhood sexual abuse Pedophilia Sexual abuse Incest Rape Treatment and recidivism of offenders SAT6A Psychopathology II 61

62 Pedophilia Adult has recurrent, intense sexual urges or fantasies about sexual activity with prepubescent child Almost all pedophiles are male Two-thirds of victims are female SAT6A Psychopathology II 62

63 Incest Culturally prohibited sexual relations between family members Prevalence and incidence Universal taboo Incidence unclear due to non-reporting SAT6A Psychopathology II 63

64 Rape Sexual activity involving actual or threatened forcible coercion Prevalence Definition used Statistics SAT6A Psychopathology II 64

65 Potential consequences Rape Physical trauma Psychological trauma Post-traumatic stress disorder SAT6A Psychopathology II 65

66 Sex offenders therapy goals Treatment of sex offenders To modify patterns of sexual arousal To modify cognitions and social skills to allow more appropriate sexual interactions with adult partners To change habits and behavior that increase the chance of reoffending To reduce sexual drive SAT6A Psychopathology II 66

67 Psychological therapies Treatment of sex offenders Aversion therapy Covert sensitization/assisted covert sensitization Cognitive restructuring Social-skills training SAT6A Psychopathology II 67

68 Sexual dysfunction Impairment in desire for sexual gratification and/or ability to achieve it Desire phase Four human sexual response phases Excitement phase Orgasm Resolution SAT6A Psychopathology II 68

69 Male dysfunction Hypoactive sexual desire disorder Erectile disorder Early ejaculation disorder Delayed ejaculation disorder Little or no sex drive or interest May be based on anxiety about sexual performance or physiological dysfunction Persistent and recurrent orgasm and ejaculation with little sexual stimulation Inability to ejaculate during intercourse SAT6A Psychopathology II 69

70 Female dysfunction Female sexual interest/arousal disorder Low sexual desire and low sexual arousal Genito-pelvic pain/penetration disorder Genital pain during intercourse with muscle tension and fear and anxiety related to genital pain or penetrative sexual activity Female orgasmic disorder Persistent or recurrent delay in, or absence of, orgasm following normal sexual excitement phase SAT6A Psychopathology II 70

71 Treatment Sex therapy (CBT& Master s & Johnson) Pharmacotherapy & Medical devices A systematic approach Bibliotherapy SAT6A Psychopathology II 71