PSYCHOLOGICAL DISORDERS AND

TREATMENT

FRIDAY, DECEMBER 1ST

Good morning!

As you come in, please:

Testing over, but please still sit alphabetically

Front table – pick up a Unit 9 Overview and begin

completing your vocabulary with your textbook

Behavior Therapy – page 579

Cognitive Therapy – page 584

Cognitive-Behavior Therapy – page 586

PSYCHOLOGICALDISORDERS

What isn’t normal?

What is normal?

https://study.com/academy/lesson/what-is-abnormal-psychology-definition-

and-common-disorders-studied.html

PSYCHOLOGICAL DISORDER

A “harmful dysfunction” in which thoughts

and behaviors are maladaptive, unjustifiable,

disturbing, and atypical

A mnemonic device to help you remember =

UMAD

PSYCHOLOGICAL DISORDER

Unjustifiable

A behavior which does not have a rational basis

Maladaptive

An exaggeration of normal, acceptable behaviors

Destructive to oneself or others

Atypical

A behavior so different from other people’s behavior that it violates a norm

Norms vary from culture to culture

Disturbing

A behavior which is troublesome to self and/or others

CLASSIFYING DISORDERS: DSM-V

Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (2013)

Published by the American Psychiatric Association

Lists and describes all the currently accepted categories of mental disorders

DSM-V

Divides mental disorders into 17 major

categories

Includes the symptoms and statistics

about but not the causes of each disease

Has changed significantly since the first

edition

LABELING DISORDERS USING THE DSM-V

So are labels good/helpful or bad/harmful?

Positive effects:

Disorder can be identified and treated

Insurance claim can be made

Negative:

Can create social stigma(s)/prejudice

ANXIETY DISORDERS

ANXIETY AND ANXIETY DISORDERS

Anxiety: A vague feeling of

apprehension or nervousness

Anxiety disorder: where anxiety begins

to take control and dominate a person’s

life

MAJOR TYPES OF ANXIETY DISORDERS

Anxiety disorders include:

Generalized Anxiety Disorder

Panic Disorder

Phobic Disorders (specific phobias)

GENERALIZED ANXIETY DISORDER

An anxiety disorder characterized by

disruptive levels of persistent,

unexplained feelings of apprehension and

tenseness

SYMPTOMS OF GENERALIZED ANXIETY

Must have at least three of the following:

Restlessness

Feeling on edge

Difficulty concentrating/mind going blank

Irritability

Muscle Tension

Sleep Disturbance

PANIC DISORDER

An anxiety disorder characterized by

sudden bouts of intense, unexplained

panic

Panic attacks may happen several times a

day

Usually co-occurs with Agoraphobia

PHOBIA

An anxiety disorder characterized by

disruptive, irrational fears of specific

objects or situations

The fear must be both irrational and

disruptive.

OBSESSIVE-COMPULSIVE

AND RELATED DISORDERS

OBSESSIVE-COMPULSIVE DISORDER

An disorder characterized by unwanted,

repetitive thoughts and actions

Obsessions – repetitive thoughts

Compulsions – repetitive actions

The obsessions/compulsions begin to

take control of the person’s life.

OTHER DISORDERS IN THIS CATEGORY:

Body Dysmorphic Disorder

Hoarding Disorder

Trichotillomania (Hair-Pulling Disorder)

Excoriation (Skin-picking Disorder)

TRAUMA AND STRESSOR-

RELATED DISORDERS

POST-TRAUMATIC STRESS DISORDER

Some people who suffer through traumatic events may develop this. 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

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CAUSES OF ANXIETY, OBSESSIVE-COMPULSIVE AND

TRAUMA/STRESSOR DISORDERS: LEARNING

FACTORS

Through classical and operant conditioning

people may associate fear with an object.

Fear of an object may be reinforced when by

avoiding the feared objects.

Stimulus generalization

Observational learning--watching another

experiencing fearfulness--may result in

developing fear.

DEPRESSIVE

DISORDERS

(USED TO BE CALLED

MOOD DISORDERS)

MAJOR DEPRESSIVE DISORDER

Signs of depression last 2 weeks or more and are not caused by drugs or medical conditions

Patient must experience at least 5 of the following 9 symptoms: Depressed mood

Little interest or pleasure in almost all activities

Significant changes in weight or appetite

Sleeping more or less than usual

Agitated or decreased level of activity

Fatigue or loss of energy

Feelings of worthlessness or inappropriate guilt

Diminished ability to think or concentrate

Recurrent thoughts of death or suicide

BIPOLAR DISORDER

BIPOLAR DISORDER

A disorder in which the person alternates between the hopelessness of depression and the overexcited and unreasonably optimistic state of maniaUsed to be called manic-depressive disorder

Used to be part of Depressive Disorders but not it is its own class

Many times will follow a cyclical pattern

A lot of creative minds

CAUSES OF DEPRESSIVE AND BIPOLAR

DISORDERS: BIOLOGICAL FACTORS

Disorders of mood have a hereditary

nature to them.

Depressed individuals tend to have

depressed brains.

PET scans indicate less activity during

periods of depression.

CAUSES OF MOOD AND BIPOLAR

DISORDERS: SOCIAL-COGNITIVE

FACTORSDepression may be a variation of learned

helplessness.

Depressed individuals attribute events using the following characteristics:Stable: the bad situation will last for a long time

Internal: they are at fault

Global: all of life is bad

DISSOCIATIVE DISORDERS

DISSOCIATIVE DISORDERS

Disorders in which the sense of self has

become separated (dissociated) from

previous memories, thoughts, or feelings

DISSOCIATIVE AMNESIA

A dissociative disorder characterized by loss of memory in reaction to a traumatic event

Example: soldiers in combat

Sub-Type: Dissociative Fugue

loss of identity and travel to a new location

The person may develop a new identity and begin a new life

DISSOCIATIVE IDENTITY DISORDER

A rare and controversial dissociative disorder in which an individual experiences two or more distinct and alternating personalities

Used to be called multiple personality disorder

Personalities can have different ages, gender, speech patterns, etc.

CBS News

PSYCHOTIC DISORDER: SCHIZOPHRENIA

SCHIZOPHRENIA

According to WHO, nearly 1 in 100 suffer from

schizophrenia

24 million people worldwide

Generally strikes young people as they mature into

adults

Affects men and women equally but men suffer more

severely

SYMPTOMS

Literal translation is “split mind”

Group of severe cognitive disorders

characterized by:

Disorganized & delusional thinking

Disturbed perceptions (hallucinations)

Inappropriate emotions and actions

DELUSIONS

False beliefs of schizophrenia and other

serious psychological disorders

Four major types of delusions:

Grandeur

Persecution/Paranoia

Sin or guilt

Influence

HALLUCINATIONS

False perceptions of schizophrenia or

other serious psychological disorders

Types of hallucinations:

Auditory (hearing voices)

Visual (seeing things)

Tactile (feeling skin sensations)

Can also have distorted smell and taste

INAPPROPRIATE EMOTIONS/BEHAVIORS

Flat affect – showing little or no

emotional response

Word salad – nonsense talk

Clanging – rhyming nonsense talk

Waxy flexibility – the person’s arms and

legs will remain in place after being

moved there

BIOLOGICAL FACTORS - GENETICS

Schizophrenia tends to run in families.

Genetics appears to produce a

predisposition (increased likelihood) to

develop schizophrenia.

BIOLOGICAL FACTORS – BRAIN

STRUCTURE

Brain structure of those with

schizophrenia is different than the normal

brain

Those with schizophrenia have smaller

amounts of brain tissue and larger fluid

filled spaces.

The thalamus is smaller in those with

schizophrenia.

BIOLOGICAL FACTORS – BRAIN

FUNCTION

The brain of those with schizophrenia

operates differently than the normal

brain.

The frontal lobes show less activity.

Those with schizophrenia have a larger

number of receptor sites for the

neurotransmitter dopamine.

BIOLOGICAL FACTORS – PRENATAL VIRUSES

A viral infection during the middle of

pregnancy may increase schizophrenia

risk.

PSYCHOLOGICAL FACTORS

Two main areas:

Stress

Disturbed family

It’s unclear whether these are causes or

consequences of schizophrenia.

TUESDAY, DECEMBER 12TH

Good morning!

Hope you enjoyed our

Winter Wonderland!

As you enter, please:

Choose your seat wisely (or I’ll help you )

Front table – pick up a Review Crossword/Unit 9 Cover Page and

complete your Review Crossword

CLASS UPDATES

Friendly Reminders:

Tomorrow :

Unit 9 Summative on Abnormal Psych

You’ll also get your Final Exam Study Guide

Thursday:

Teacher Coverage due to Econ Milestones Test

You should work on your Final Exam Study Guide and completing any make-up work

Friday

Final due date for ALL Make-Up Work

ABNORMAL PSYCH REVIEW

Crash Course Psychological Disorders

UNIT NINE STUDY GUIDE

Work on your Unit Nine Study Guide!

PERSONALITY

DISORDERS

PERSONALITY DISORDERS

Psychological disorders characterized by

inflexible and lasting behavior patterns

that disrupt social functioning

Divided into three clusters:

Related to anxiety

With odd and eccentric behaviors

With dramatic or impulsive behaviors

SOME PERSONALITY DISORDERS

Avoidant Personality Disorder – the person commonly withdraws due to fear of rejection

Schizoid Personality Disorder – the person is emotionally disengaged (flat affect)

Schizotypal Personality Disorder – the person enjoys social isolation, usually displays strange behavior and thinking

Histrionic Personality Disorder – the person engages in attention-grabbing emotional outbursts and tries to gain other’s approval

Narcissistic Personality Disorder – the person is very self-absorbed and have delusions of grandeur

SOME PERSONALITY DISORDERSBorderline Personality Disorder – the person (usually

female) has unstable emotions and relationships and ultimately an unstable identity

Antisocial Personality Disorder – the person (usually male) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath.

Dependent Personality Disorder – the person is abnormally dependent on other people

Paranoid Personality Disorder – the person has paranoid thoughts and feelings and doesn’t trust others

Obsessive Compulsive Personality Disorder - the person is concerned with following rules, keeping order, and being in control.

SOMATIC SYMPTOM AND RELATED

DISORDERSDisorders that usually involve abnormal bodily sensation: Hypochondriasis – believing that you have illnesses that you don’t really

have

Pain disorder

Conversion disorder – developing physical symptoms without an actual biological cause

Factitious Disorders – disorders in which the person fakes symptoms or inflicts symptoms on self or others to gain attention/sympathy

Munchausen Syndrome – person claims to have symptoms and undergoes many treatments/surgeries to receive attention

Munchausen Syndrome by Proxy – person induces illnesses in others (usually parents do this to kids) to receive indirect attention

Causes? Perhaps person was given great care by a doctor growing up and neglected by parents? Other, underlying personality disorders?

NEURODEVELOPMENTAL DISORDERSAttention-Deficit Hyperactivity Disorder (ADHD)

3 key symptoms – Inattention, Hyperactivity,

Impulsivity

The Big Questions:

Is it over-diagnosed?

Is it a real syndrome at all? Is it a set of

syndromes?

How can it be better diagnosed?

What causes it?

NEURODEVELOPMENTAL DISORDERS Autistic Spectrum Disorders

Key symptoms

Impaired speech

Impaired social interaction (such as decreased eye contact and inability to carry on a conversation)

Impaired theory of mind (understanding of others’ point of view)

Behaviorally inflexible – stick to routine; distress when it changes

Tends to occur more in males than in females

Possible Causes?

Differences/damage in the brain’s neural connections?

Genetic Factors?

Mercury in Vaccines?

TREATMENT OF

PSYCHOLOGICAL

DISORDERS

PSYCHOTHERAPY

A planned, emotionally charged,

confiding interaction between a trained

therapist and someone who suffers from

psychological difficulties

There are over 250 different types of

therapy.

FOUR TYPES OF PSYCHOTHERAPY

Most therapies can be divided into:

Psychoanalytic

Humanistic

Behavioral

Cognitive

PSYCHOANALYTIC

THERAPIES

PSYCHOANALYSIS

Freud’s therapeutic technique that

attributes one’s thoughts and actions to

unconscious motives and conflicts

PSYCHOANALYSIS ASSUMPTIONS

Psychological problems are the result of

repressed conflicts and impulses from

childhood.

The therapist must bring the repressed

problems into the conscious mind to help

patients have an insight about the original

cause of the problem.

FREE ASSOCIATION

Freudian technique of discovering the

unconscious mind--where the patient

relaxes and says whatever comes to

mind, no matter how trivial or

embarrassing

RESISTANCE

In psychoanalysis, the blocking from

consciousness of anxiety-filled material

TRANSFERENCE

In psychoanalysis, the patient’s transfer

to the analyst of emotions linked with

other relationships

The patient projects feeling from the past

to the therapist.

INTERPRETATION

The analyst’s ideas of the meaning

behind the patient’s dreams, resistance,

transference and other behaviors

interpretation of what is in the

unconscious

PSYCHOANALYTIC INFLUENCE

Few therapists follow strict Freudian

therapy anymore.

Heavily influenced other types of

therapy (interpersonal therapy)

Modern approach is the psychodynamic

perspective

PSYCHODYNAMIC APPROACH

A more modern view that retains some aspects of Freudian theory but rejects other aspects

Retains the importance of the unconscious mind

Less emphasis on unresolved childhood conflicts

HUMANISTIC

THERAPIES

PERSON-CENTERED THERAPY

Used to be called Client-centered Therapy

Developed by Humanistic psychologist, Carl Rogers

Therapist uses techniques such as:

Active Listening

Empathy

Acceptance

Genuineness

ACTIVE LISTENING CHARACTERISTICS

Active listening entails:

Paraphrasing: uses the words of the

client to summarize the conversation

Clarifying: encouraging the client to

say more by asking leading questions

Reflecting feelings: mirrors the

feelings of the client

BEHAVIORAL

THERAPIES

BEHAVIOR THERAPY

Applies learning principles to the elimination of unwanted behaviors

Uses both classical and operant conditioning

Primary concern is to eliminate the disorder’s behavior, not find the cause of the disorder

FLOODING

Person who has a phobia is completely and repeatedly exposed to the thing(s) that cause him/her to be afraid

Does it work?

SYSTEMATIC DESENSITIZATION

A type of classical conditioning that

associates a pleasant, relaxed state with

gradually increasing, anxiety-triggering

stimuli

Usually used to treat phobias

Created by Mary Cover Jones

SYSTEMATIC DESENSITIZATION

PROCESS

Establish a hierarchy of the anxiety-

triggering stimuli

Learning relaxation methods

(progressive relaxation)

Slowly think through the hierarchy,

working to relax whenever anxiety is felt

SYSTEMATIC DESENSITIZATION VARIATIONS

Virtual reality--systematic

desensitization by way of computerized,

anxiety-triggering 3-D stimuli

Combined with models by having the

subjects watch someone perform the

anxiety-causing behavior

AVERSIVE CONDITIONING

A type of classical conditioning that associates an unpleasant state (such as nausea) with an unwanted behavior

The person is replacing a positive but harmful response with a negative response

Example with alcoholism: Lace a drink with a drug that makes the person becomes sick

AVERSIVE CONDITIONING

TOKEN ECONOMY

An operant conditioning procedure that

attempts to modify behavior by giving

tokens (reinforcements) for desired

behavior.

The tokens can be exchanged for various

privileges or treats

Form of secondary reinforcement

COGNITIVE

THERAPIES

COGNITIVE THERAPY

Teaches people new, more adaptive ways

of thinking and acting

Based on the assumption that thoughts

intervene between events and our

emotional reactions

RATIONAL-EMOTIVE THERAPY

Albert Ellis developed a theory that irrational thoughts led to self-defeating emotions.

Ellis developed the ABCD model to explain this:

A = Activating event that triggers the emotion (e.g. failing a test)

B = Belief System: how person appraises the event (e.g. “I’m stupid and no good at this subject”)

C = emotional/behavioral Consequences of the appraisal in step B (e.g. feeling worthless and dumb)

D = Disputing their erroneous beliefs in step B (e.g. “I’m not dumb. I just did not study hard enough and go in for the extra help that I needed”) This is what Ellis wanted to train his clients to be able to do through Rational Emotive Therapy.

COGNITIVE THERAPY FOR DEPRESSION

Aaron Beck (1979) suggests that depressed patients believe that they can never be happy

(thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for

their depression.

Beck believes that cognitions such as “I can never be happy” need to change in order for depressed patients to recover. This change is brought about

by gently questioning patients.

SELF-SERVING BIAS

Tendency to judge oneself favorably

Severely depressed patients tend to not

have a self-serving bias and tend to

blame themselves for problems and credit

the environment for successes

COGNITIVE-BEHAVIOR THERAPY

A therapy that combines cognitive

therapy (changing self-defeating

thinking) with behavior therapy

(changing inappropriate behaviors)

FAMILY AND

GROUP THERAPIES

GROUP THERAPY

Having a therapist work with a number

of patients at one time

Groups usually consist of 6 to 10 people

Cognitive, behavior, and humanistic

therapists all can lead group therapies.

ADVANTAGE OF GROUP THERAPY

Therapists can help more than one

person at a time.

Overall session cost is lower.

Patients interact with others having the

same problems as they have.

Builds a sense of community

FAMILY THERAPY

Therapy that treats the family as a system

Views the patient’s problems as influenced

by or directed at family members

Attempts to guide the family toward

positive relationships and improved

communication

STUDIES ON PSYCHOTHERAPY

Studies researching the effectiveness of psychotherapy have found:Clients believe therapy is effective.

Clinicians believe therapy is effective.

Researchers are still debating psychotherapy’s effectiveness.

The more clear cut the problem, the more effective the therapy is.

No one therapy is absolutely more effective.

ALTERNATIVE

THERAPIES

THERAPEUTIC TOUCH

Therapists move their hands above the

person’s body to “push energy fields into

balance.”

No evidence has been found to support

the effectiveness of this therapy

SEASONAL AFFECTIVE DISORDER (SAD)

Form of depression where the patient

becomes depressed during the winter

months of decreased amounts of sunlight

LIGHT EXPOSURE THERAPY

Therapy for Seasonal Affective Disorder

by exposing the patient to artificial light

mimicking that of the sun

Research supports a connection between

exposure to light and melatonin levels in

the blood, which affects levels of

alertness

BIOMEDICAL

THERAPIES

BIOMEDICAL THERAPIES

Treatment of psychological disorders

that involve changing the brain’s

functioning by using prescribed drugs,

electroconvulsive therapy, or surgery

DRUG THERAPIES:

ANTIPSYCHOTIC

DRUGS

ANTIPSYCHOTIC DRUGS

A category of medications used primarily

to treat schizophrenia

Reduces the levels of hallucinations and

delusions and distorted thinking

Drugs work by blocking the activity of

dopamine

THORAZINE

One of the first antipsychotic drugs

Side effects include: dry mouth, blurred

vision, constipation, and tardive

dyskinesia

Tardive dyskinesia – a permanent

condition of muscle tremors

CLOZARIL AND RISPERDAL

Clozaril: less side effects than thorazine

but can cause damage to white blood

cells therefore patients need to be tested

Risperdal: no damage to white blood

cells

Both Clozaril and Risperdal are very

expensive.

DRUG THERAPIES:

ANTIANXIETY

DRUGS

ANTIANXIETY DRUGS

A category of medication used to treat people

with anxiety disorders or suffering stress

Work by boosting levels of the

neurotransmitter GABA

Can produce dependency

Include: Valium, Librium, and Xanax

Can cause death if mixed with alcohol

DRUG THERAPIES:

ANTIDEPRESSANT

DRUGS

ANTIDEPRESSANT DRUGS

A category of medications used primarily

to treat major depression

Work by influencing levels of serotonin

in the brain

Many take about a month before they

become fully effective

SELECTIVE SEROTONIN REUPTAKE

INHIBITORS

Classification of antidepressants which

work by blocking the reuptake of

serotonin after it has been released

(SSRIs)

Includes: Prozac, Zolof, and Paxil

LITHIUM

Medication used primarily to treat

bipolar disorder

Not known how or why lithium works

but a large number of bipolar patients

report improvement with the drug

ELECTROCONVULS

IVE THERAPY

INSULIN THERAPY

Depressed patients are given an overdose

of insulin to cause a convulsion.

Difficulties in determining the proper

dosage of insulin led to a decline in use

of this therapy.

Was replaced by Electroconvulsive

Therapy (ECT)

ELECTROCONVULSIVE THERAPY (ECT)

A therapy for major depression in which

a brief electrical current is sent through

the brain of an anesthetized patient

The current causes a convulsion.

Was preceded by insulin therapy.

Sometimes called “shock therapy.”

ECT FACTS

Used when antidepressants fail

Most (80%) patients report

improvement

Side effect is memory loss

How and why the process works is

unknown

ECT

PSYCHOSURGERY

LOBOTOMY

A form of psychosurgery where the nerves connecting the frontal lobes of the brain to the deeper emotional centers are cut

Used to try to calm uncontrollably emotional or violent patients

Regularly done before the advent of antipsychotic drugs

Rarely used today