Chapter 12 Psychological Disorders Part Two Anxiety Disorders Obsessive-Compulsive Disorder Condition characterized by patterns of persistent, unwanted thoughts and behaviors Obsessions: Thoughts, images, behaviors, impulses reappear despite the person s effort to suppress them. A Mild Obsessive Experience: rechecking a door to see if it s locked Compulsions: Repetitive, purposeful acts performed according to certain rules in response to an obsession. Somatoform Disorders Psychological problems appearing in the form of bodily symptoms or physical complaints Conversion Disorder A somatoform disorder marked by paralysis, weakness, or loss of sensation, but with no discernable physical cause. Treatment Psychotherapy and stress management training may help reduce symptoms. The affected body part or physical function will need physical or occupational therapy until the symptoms disappear 1
Somatoform Disorders Glove Anesthesia A disorder involving loss of sensitivity in the hand and wrist. Since no combination of nerves serve this area, a glove anesthesia is clearly psychogenic in origin. Hypochondriasis Somatoform disorder involving excessive concern about health and disease Disorders Disorders Group of pathologies involving fragmentation of the personality Disorders Disorders amnesia Depersonalization disorder fugue identity disorder Amnesia fugue Depersonalization disorder identity disorder A psychologically induced loss of memory for personal information 2
Disorders amnesia Disorders amnesia Fugue Depersonalization disorder identity disorder amnesia with the addition of flight from one s home, family, and job Fugue Depersonalization Disorder identity disorder Abnormality involving the sensation of mind and body having separated. The sense of having an out of body experience Disorders amnesia Fugue Depersonalization disorder Identity Disorder Condition in which the individual displays multiple identities. (formerly called Multiple Personality Disorder) Eating Disorders Anorexia Nervosa Eating disorder involving persistent loss of appetite that endangers an individual s health stemming from psychological reasons rather than organic causes. 3
Eating Disorders Bulimia Eating disorder characterized be eating binges followed by purges, induced by vomiting or laxatives. Schizophrenic Disorders Schizophrenia Psychotic disorder involving distortions in thoughts, perceptions, and/or emotions. Residual Positive Negative Residual Type Features incoherent speech, hallucinations, delusions, and bizarre behavior. For example talking to imaginary people 4
Involves either stupor or extreme excitement. Residual Type Two forms Stupor: Patients may remain motionless for hours, even days,. sometimes holding rigid, statue like poses. Excitement: Patients become agitated, hyperactive Residual Type Prominent feature: combination of delusions and hallucinations. Residual Type Persons displaying a combination of symptoms that do not clearly fit in one of the other categories Residual Type Individuals who have had a past episode of schizophrenia but are free of symptoms Positive Schizophrenia Negative Schizophrenia Any form in which the person displays active symptoms (e.g. delusions, hallucinations) Positive Schizophrenia Negative Schizophrenia Any form distinguished by deficits, such as withdrawal and poverty of thought processes 5
Possible Causes of Schizophrenia Evidence for the causes of schizophrenia has been found in a variety of factors including A. genetics B. abnormal brain structure C. Biochemistry Possible Causes of Schizophrenia Diathesis-Stress Hypothesis The theory that says genetic factors place the individual at risk and environmental stress factors transform this potential into an actual schizophrenic disorder Fundamentally it is a brain disorder no longer seen as a result of defective parenting or repressed childhood trauma Personality Disorders Personality Disorders Conditions involving a chronic, pervasive, inflexible, and maladaptive pattern of thinking, emotion, social relationships, or impulse control. Narcissistic Personality Disorder An exaggerated sense of self-importance. Characterized by a grandiose sense of self-importance, a preoccupation with fantasies of success and power, and a need for constant attention Antisocial Personality Disorder Characterized by a long-standing pattern of irresponsible behavior indicating a lack of conscience and a diminished sense of responsibility to others. 6
Borderline Personality Disorder An unstable personality given to impulsive behavior. Main signs: instability, impulsivity Unpredictable moods Stormy interpersonal relationships Becoming upset and abusive in response to perceived slights Little tolerance for frustration Tendency for substance abuse Suicide Promiscuity Binge eating, wreckless driving, selfmutilation Adjustment Disorders and Other Conditions That May Be a Focus of Clinical Attention Mild depression Physical complaints Parent-child problems Bereavement Marital problems Academic problems Job problems Malingering Developmental Disorders Autism A developmental disorder marked by disabilities in language, social interaction, and the ability to understand another person s state of mind. A fundamental brain disorder with genetic influences Asperger s Syndrome/Disorder A milder variant of Autistic Disorder. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. People with Asperger's often display intense interests. Dyslexia/ Developmental Reading Disorder A reading disability, thought by some experts to involve a brain disorder in the language processing center. It is estimated that dyslexia affects between 5% and 17% of the U.S. population. 7
ADHD Attention-Deficit Hyperactivity Disorder A developmental disability involving short attention span, distractibility, and extreme difficulty in remaining inactive for any period of time.. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development. Percent of Youth 4-17 ever diagnosed with Attention-Deficit/Hyperactivity Disorder: National Survey of Children's Health, 2003 Ritalin Methylphenidate It is believed that it works by activating the brain stem arousal system and cortex. Pharmacologically, it works on the neurotransmitter dopamine, and in that respect resembles the stimulant characteristics i of cocaine. Street Name / Slang Terms Kibbles & Bits, Kiddy-Cocaine, Skippy, Smarties, Vitamin R. 8
Adjustment Disorders Relatively mild problems that do not fit well under other headings The largest group of people fit into this category. Examples include. Mild depression Job, marital or academic problems Physical complaints Parent-child problems Bereavement Malingering (faking an illness) Shyness A distressing pattern of avoiding or withdrawing from social contact. It is treatable, but it is not a DSM-IV disorder What are the Consequences of Labeling People? Ideally, accurate diagnoses lead to proper treatments, but diagnoses may also become labels that depersonalize individuals and ignore the social and cultural contexts in which their problems arise. The Plea of Insanity Insanity A legal term, not a psychological or psychiatric one, referring to a person who is unable, because of a mental disorder or defect, to confirm his or her behavior to the law. John Hinckley Jr. Found not guilty" for reason of insanity in the 1982 trial for his attempted assassination of President Ronald Reagan. 9
Jeffrey Dahmer Dahmer was convicted of the murder of 15 young men, whose mutilated, cannibalized bodies had been found in his Milwaukee apartment. At trial, he admitted the killings, but pled not guilty by reason of insanity. His plea was rejected, and the jury found Dahmer to be legally sane at the time of the murders. He was sentenced to 15 life terms. The Dahmer conviction was hailed by many as the death of the insanity defense. If such a clearly deranged killer could not be found legally insane, it seemed unlikely that the defense would ever be successful, at least in a high profile case involving a violent crime. End of Chapter 12 10