Psychological Psychological

DisordersDisorders

What are Psychological What are Psychological Disorders?Disorders?

Man of the OzarksMan of the Ozarks Often difficult to draw a line between Often difficult to draw a line between

normal & abnormal behavior.normal & abnormal behavior. Behavior that is normal to some Behavior that is normal to some

people seems abnormal to others.people seems abnormal to others. Some believe that having visions & Some believe that having visions &

hearing voices is part of a religious hearing voices is part of a religious experience while others feel this is a experience while others feel this is a symptom of a psychological disorder.symptom of a psychological disorder.

What are Psychological What are Psychological Disorders?Disorders?

Just because a person is different Just because a person is different doesn’t mean they are suffering from a doesn’t mean they are suffering from a mental disorder.mental disorder.

How do you differentiate normal from How do you differentiate normal from abnormal?abnormal?

Number of ways to define abnormality.Number of ways to define abnormality. No definition is entirely satisfactory No definition is entirely satisfactory

and much controversy exists over and much controversy exists over labeling someone mentally ill.labeling someone mentally ill.

Deviation from NormalityDeviation from Normality

One definition of normality is that One definition of normality is that whatever most people do is normal. whatever most people do is normal. (bathe daily, grieve, & dress warmly). (bathe daily, grieve, & dress warmly). This approach has limitations.This approach has limitations.

Different cultural norms must be Different cultural norms must be considered.considered.

The majority is not always right so The majority is not always right so this approach must be used with other this approach must be used with other approaches.approaches.

Deviation from NormalityDeviation from Normality

AdjustmentAdjustment Normal people are able to get along in the Normal people are able to get along in the

world, physically, emotionally and socially.world, physically, emotionally and socially. Abnormal people fail to adjust using this Abnormal people fail to adjust using this

definition.definition. Not all people with psychological disorders Not all people with psychological disorders

are violent, destructive or isolated.are violent, destructive or isolated. Behavior that is socially acceptable in one Behavior that is socially acceptable in one

society may not be in another.society may not be in another.

Psychological HealthPsychological Health

Many psychologists think that mental Many psychologists think that mental illness is different from physical illness.illness is different from physical illness.

Self- actualization – normal and healthy Self- actualization – normal and healthy person who is functioning ideally or at person who is functioning ideally or at least striving toward ideal functioning. least striving toward ideal functioning. Involves full acceptance and expression of Involves full acceptance and expression of one’s own individuality and humanness.one’s own individuality and humanness.

Difficult to judge if a person is doing his Difficult to judge if a person is doing his or her best or if and when they are or her best or if and when they are beginning to struggle.beginning to struggle.

Psychological HealthPsychological Health Some believe that labeling a person as Some believe that labeling a person as

mentally ill is cruel and irresponsible due to mentally ill is cruel and irresponsible due to arbitrary definitions of mental illness.arbitrary definitions of mental illness.

Thomas Szasz argued that most people Thomas Szasz argued that most people whom we call mentally ill are not ill at all.whom we call mentally ill are not ill at all.

Szasz believes they simply have problems Szasz believes they simply have problems living and need assistance instead of being living and need assistance instead of being institutionalized. institutionalized.

Most psychologists disagree with Szasz.Most psychologists disagree with Szasz. Mild psychological disorders are common. Mild psychological disorders are common.

Only when the problem becomes severe Only when the problem becomes severe enough to disrupt every day life is it enough to disrupt every day life is it considered an abnormality or illness.considered an abnormality or illness.

ClassificationClassification

Classifying is difficult because causes Classifying is difficult because causes and cures for psychological disorders and cures for psychological disorders are rarely clear-cut.are rarely clear-cut.

APA (American Psychiatric APA (American Psychiatric Association) developed the DSM to Association) developed the DSM to classify abnormal symptoms.classify abnormal symptoms.

DSM = Diagnostic and Statistical DSM = Diagnostic and Statistical Manual of Mental DisordersManual of Mental Disorders

DSM-IV updated in 1994.DSM-IV updated in 1994.

ClassificationClassification

Neurosis & psychosis have been Neurosis & psychosis have been replaced by more specific diagnoses replaced by more specific diagnoses they are still used by psychologists.they are still used by psychologists.

Classification is based on the Classification is based on the medical model.medical model.

ClassificationClassification

Each diagnostic category has the Each diagnostic category has the following descriptions:following descriptions: Essential features – characteristics that define Essential features – characteristics that define

the disorderthe disorder Associated features – additional features that Associated features – additional features that

are usually presentare usually present Information on differential diagnosis – how to Information on differential diagnosis – how to

distinguish a particular disorder from another distinguish a particular disorder from another similar onesimilar one

Diagnostic criteria – list of symptoms needed Diagnostic criteria – list of symptoms needed to have a particular labelto have a particular label

ClassificationClassification

Reduces the chances that a patient is Reduces the chances that a patient is diagnosed differently by different diagnosed differently by different doctors.doctors.

Very complex at times to diagnose a Very complex at times to diagnose a person.person.

People may exhibit more than one People may exhibit more than one disorder.disorder.

ClassificationClassification DSM-IV uses 5 axes to describe a person’s mental DSM-IV uses 5 axes to describe a person’s mental

functioningfunctioning Axis I – classifies symptoms into categoriesAxis I – classifies symptoms into categories Axis II – describes developmental disorders and long-Axis II – describes developmental disorders and long-

standing personality disorders. (language, reading & standing personality disorders. (language, reading & writing, MR, autism and speech)writing, MR, autism and speech)

Axis III – physical disorders or general medical Axis III – physical disorders or general medical conditionsconditions

Axis IV – measures the current stress level at which a Axis IV – measures the current stress level at which a person is functioning. Uses stressors to rate patients.person is functioning. Uses stressors to rate patients.

Axis V – describes the highest level of adaptive Axis V – describes the highest level of adaptive functioning within the past year. Categorized into functioning within the past year. Categorized into social relations, occupational functioning and leisure social relations, occupational functioning and leisure time.time.

ClassificationClassification

DSM-IV labels a person which may DSM-IV labels a person which may have a negative influence on a have a negative influence on a person in the long runperson in the long run

Can affect how a person views Can affect how a person views themselves or how others view them.themselves or how others view them.

Many people develop a disorder at Many people develop a disorder at some point in their life. Most of some point in their life. Most of those disorders are temporary.those disorders are temporary.

Anxiety DisordersAnxiety Disorders

Anxiety – a general state of dread or Anxiety – a general state of dread or uneasiness that a person feels in uneasiness that a person feels in response to real or imagined dangerresponse to real or imagined danger

People with anxiety disorder have People with anxiety disorder have anxiety that is out of proportion to anxiety that is out of proportion to the situation provoking the anxiety.the situation provoking the anxiety.

Most common type of mental illness Most common type of mental illness affecting about 19 million Americans affecting about 19 million Americans annuallyannually

Anxiety DisordersAnxiety Disorders People with anxiety disorders may avoid dealing People with anxiety disorders may avoid dealing

with problems and have unrealistic images of with problems and have unrealistic images of themselves.themselves.

May constantly worry, have sudden mood swings May constantly worry, have sudden mood swings or have physical symptoms (headaches, or have physical symptoms (headaches, dizziness, fatigue, sweating & muscle tightness).dizziness, fatigue, sweating & muscle tightness).

May struggle to form stable satisfying May struggle to form stable satisfying relationships. relationships.

Categorized in DSM-IV into five areas: Categorized in DSM-IV into five areas: generalized anxiety disorder, phobic disorder, generalized anxiety disorder, phobic disorder, panic disorder, obsessive-compulsive disorder panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (OCD), and post-traumatic stress disorder (PTSD)(PTSD)

Anxiety DisordersAnxiety Disorders

Generalized Anxiety DisordersGeneralized Anxiety Disorders Anxiety – a vague, generalized apprehension or Anxiety – a vague, generalized apprehension or

feeling that one is in dangerfeeling that one is in danger Panic Attacks – choking, chest pain, dizziness, Panic Attacks – choking, chest pain, dizziness,

trembling and hot flashestrembling and hot flashes Some people feel continuous, generalized Some people feel continuous, generalized

anxiety and have difficulty with day to day life anxiety and have difficulty with day to day life and relationships.and relationships.

Anxiety may be hereditary or due to Anxiety may be hereditary or due to environmental factors such as childhood trauma, environmental factors such as childhood trauma, a major life change, or the uncertainties of life.a major life change, or the uncertainties of life.

Anxiety DisordersAnxiety Disorders Phobic DisorderPhobic Disorder

Phobia – an intense and irrational fear of a Phobia – an intense and irrational fear of a particular object or situationparticular object or situation

Specific phobias – can focus on almost Specific phobias – can focus on almost anything (heights & enclosed spaces)anything (heights & enclosed spaces)

Social phobias – fear of embarrassing Social phobias – fear of embarrassing themselves in public places (speaking, eating, themselves in public places (speaking, eating, dating, public restrooms & meeting dating, public restrooms & meeting strangers).strangers).

People develop elaborate plans to avoid People develop elaborate plans to avoid situations they fear.situations they fear.

Phobias can be mild or extremely severe.Phobias can be mild or extremely severe. Treated by allowing someone to experience Treated by allowing someone to experience

the fear under safe conditions.the fear under safe conditions.

Anxiety DisordersAnxiety Disorders

Panic Disorder – an extreme anxiety that Panic Disorder – an extreme anxiety that manifests itself in the form of panic manifests itself in the form of panic attacksattacks Sudden and unexplainable attacks of intense Sudden and unexplainable attacks of intense

anxietyanxiety Feel a sense of impending doom or that they Feel a sense of impending doom or that they

may die.may die. Usually last a few minutes and happen without Usually last a few minutes and happen without

warning.warning. First attack usually occurs after a stressful First attack usually occurs after a stressful

event and may also be inherited.event and may also be inherited.

Anxiety DisordersAnxiety Disorders Obsessive-Compulsive Disorder (OCD)Obsessive-Compulsive Disorder (OCD)

Obsession – same thoughts over and over in an Obsession – same thoughts over and over in an uncontrollable patternuncontrollable pattern

Compulsions – repeatedly perform coping Compulsions – repeatedly perform coping behaviorsbehaviors

Everyone has obsessions and compulsions but Everyone has obsessions and compulsions but it only becomes a problem when it interferes it only becomes a problem when it interferes with what a person wants and needs to do.with what a person wants and needs to do.

Compulsions may make a person feel that they Compulsions may make a person feel that they are accomplishing something.are accomplishing something.

Most suffering from this realize it but are Most suffering from this realize it but are unable to stop the behaviors.unable to stop the behaviors.

Anxiety DisordersAnxiety Disorders

Post-Traumatic Stress Disorder (PTSD)Post-Traumatic Stress Disorder (PTSD) PTSD – disorder in which a victim of traumatic PTSD – disorder in which a victim of traumatic

events experience the original event in the form of events experience the original event in the form of dreams or flashbacksdreams or flashbacks

Occurs with soldiers, terror victims, natural Occurs with soldiers, terror victims, natural disasters, plane crashes, and human aggression.disasters, plane crashes, and human aggression.

Overwhelms a person’s sense of reality and ability Overwhelms a person’s sense of reality and ability to cope.to cope.

Can develop immediately or later & can be long Can develop immediately or later & can be long lastinglasting

Symptoms – flashbacks, insomnia and guiltSymptoms – flashbacks, insomnia and guilt Social support is very helpful.Social support is very helpful.

Somatoform DisordersSomatoform Disorders

Somatoform disorder – physical Somatoform disorder – physical symptoms for which there is no symptoms for which there is no apparent physical causeapparent physical cause

Term replaces hysteriaTerm replaces hysteria 2 types – conversion disorder & 2 types – conversion disorder &

hypochondriasishypochondriasis

Somatoform DisordersSomatoform Disorders Conversion Disorders – changing emotional Conversion Disorders – changing emotional

difficulties into a loss of a specific voluntary body difficulties into a loss of a specific voluntary body functionfunction

Loss of functioning is real with no actual physical Loss of functioning is real with no actual physical damagedamage

Conversion disorder persists unlike momentarily Conversion disorder persists unlike momentarily not being able to move when frightenednot being able to move when frightened

May not be able to feel with a hand, move legs or May not be able to feel with a hand, move legs or have certain normal physical functions, but do not have certain normal physical functions, but do not worry about the disablement.worry about the disablement.

Believed to suffer because they invent physical Believed to suffer because they invent physical symptoms to gain freedom from unbearable conflict.symptoms to gain freedom from unbearable conflict.

Conversion disorders are rare.Conversion disorders are rare.

Somatoform DisordersSomatoform Disorders Hypochondriasis – person who is in good health Hypochondriasis – person who is in good health

becomes preoccupied with imaginary ailmentsbecomes preoccupied with imaginary ailments Spend time looking for signs of serious illness Spend time looking for signs of serious illness

and takes minor symptoms as signs of a fatal and takes minor symptoms as signs of a fatal illness.illness.

Continue to believe in ailment despite medical Continue to believe in ailment despite medical testing.testing.

Occurs often in young adults and is equal Occurs often in young adults and is equal among men and women.among men and women.

Believed that people repress emotions and show Believed that people repress emotions and show them through physical symptoms. them through physical symptoms.

Somatoform DisordersSomatoform Disorders Dissociative Disorders – a disorder in which a Dissociative Disorders – a disorder in which a

person experiences alterations in memory, person experiences alterations in memory, identity, or consciousnessidentity, or consciousness

Very rare but often in the newsVery rare but often in the news Dissociative Amnesia – the inability to recall Dissociative Amnesia – the inability to recall

important personal events or information. important personal events or information. Usually associated with stressful events.Usually associated with stressful events.

Amnesiacs can speak and have a fund of Amnesiacs can speak and have a fund of memory.memory.

Should not be confused with memory loss Should not be confused with memory loss from physical trauma or drug abuse.from physical trauma or drug abuse.

Many amnesiacs have experienced a Many amnesiacs have experienced a traumatic event.traumatic event.

Somatoform DisordersSomatoform Disorders Dissociative Fugue – a person suddenly Dissociative Fugue – a person suddenly

and unexpectedly travels away from home and unexpectedly travels away from home or work and is unable to recall the past.or work and is unable to recall the past.

Dissociative Identity Disorder – (multiple Dissociative Identity Disorder – (multiple personality disorder) – person who personality disorder) – person who exhibits 2 or more personality traits each exhibits 2 or more personality traits each with its own patterns of thinking and with its own patterns of thinking and behaving.behaving.

People who suffer from this usually have People who suffer from this usually have suffered severe physical, sexual or suffered severe physical, sexual or psychological abuse during childhood.psychological abuse during childhood.

SchizophreniaSchizophrenia

The most complex and severe psychological The most complex and severe psychological problem we encounter.problem we encounter.

Schizophrenia – a group of disorders Schizophrenia – a group of disorders characterized by confused and disconnected characterized by confused and disconnected thought, emotions, and perceptions.thought, emotions, and perceptions.

Affects 1 in 100 or 1 in 10 if it is in familyAffects 1 in 100 or 1 in 10 if it is in family Person has lost contact with reality to a Person has lost contact with reality to a

considerable extent.considerable extent. Is not a single problem with a single cause Is not a single problem with a single cause

or cure.or cure.

SchizophreniaSchizophrenia

Many experience delusions or Many experience delusions or hallucinations.hallucinations.

Delusions – false beliefs that a person Delusions – false beliefs that a person maintains in the face of contrary evidencemaintains in the face of contrary evidence

Hallucinations – perceptions that have no Hallucinations – perceptions that have no direct external causedirect external cause

Signs – hear voices, decline in thought Signs – hear voices, decline in thought process, speedy language, slowed process, speedy language, slowed movement, loss of productivity & diverted movement, loss of productivity & diverted attentionattention

SchizophreniaSchizophrenia Paranoid schizophrenia – have delusions Paranoid schizophrenia – have delusions

and hallucinations with paranoiaand hallucinations with paranoia Catatonic schizophrenia – may remain Catatonic schizophrenia – may remain

motionless for long periods of timemotionless for long periods of time Disorganized schizophrenia – incoherent Disorganized schizophrenia – incoherent

language & inappropriate emotionslanguage & inappropriate emotions Remission schizophrenia – symptoms Remission schizophrenia – symptoms

are gone or not severe; expectation is are gone or not severe; expectation is that symptoms will return that symptoms will return

SchizophreniaSchizophrenia

Treatment is long-term and usually Treatment is long-term and usually requires hospitalizationrequires hospitalization

No real cure existsNo real cure exists Causes believed to be genetic, Causes believed to be genetic,

biochemical or physiologicalbiochemical or physiological

Mood DisordersMood Disorders

Major Depressive Disorder – sever form of Major Depressive Disorder – sever form of lowered mood in which a person experiences lowered mood in which a person experiences feelings of worthlessness and diminished feelings of worthlessness and diminished pleasure or interest in many activitiespleasure or interest in many activities

Bipolar Disorder – disorder in which an Bipolar Disorder – disorder in which an individual alternates between feelings of individual alternates between feelings of mania (euphoria) and depressionmania (euphoria) and depression

Seasonal Affective Disorder – (SAD) struggle Seasonal Affective Disorder – (SAD) struggle with depression in winter, sleep & eat with depression in winter, sleep & eat excessively excessively

Personality DisordersPersonality Disorders

Personality Disorders – maladaptive Personality Disorders – maladaptive or inflexible ways of dealing with or inflexible ways of dealing with others and one’s environment.others and one’s environment.

Variety of types from shy to show-Variety of types from shy to show-offsoffs

Difficult to establish meaningful Difficult to establish meaningful relations with othersrelations with others

Personality DisordersPersonality Disorders TypesTypes

Antisocial – disregarding or violating the rights Antisocial – disregarding or violating the rights of others without remorseof others without remorse

Dependent – submissiveness & excessive need Dependent – submissiveness & excessive need to be taken care ofto be taken care of

Histrionic – display excessive emotions, Histrionic – display excessive emotions, excessively seeks attentionexcessively seeks attention

Obsessive-Compulsive – intense interest in being Obsessive-Compulsive – intense interest in being orderly, having control, & achieving perfectionorderly, having control, & achieving perfection

Paranoid – distrusts others, perceives others as Paranoid – distrusts others, perceives others as having evil motiveshaving evil motives

Schizotypal – feels intense discomfort in close Schizotypal – feels intense discomfort in close relationships, has distorted thinking and relationships, has distorted thinking and eccentric behavioreccentric behavior

Personality DisordersPersonality Disorders Drug addiction Drug addiction Psychological Dependence – use of a drug Psychological Dependence – use of a drug

to such an extent that a person feels to such an extent that a person feels nervous and anxious without itnervous and anxious without it

Addiction – drug use that involves Addiction – drug use that involves overwhelming and compulsive desire to overwhelming and compulsive desire to obtain and use the drugobtain and use the drug

Tolerance – physical adaptation to a drug so Tolerance – physical adaptation to a drug so that a person needs an increased amount to that a person needs an increased amount to produce original effectproduce original effect

Withdrawal – symptoms that occur after use Withdrawal – symptoms that occur after use is discontinued once someone is addictedis discontinued once someone is addicted

Personality DisordersPersonality Disorders

AlcoholismAlcoholism Country’s most serious drug problemCountry’s most serious drug problem 80% of HS seniors80% of HS seniors 50% in last month50% in last month