list all the disorders you know psychological disorders
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Psychological DisordersChapter 14
Consider:
List all the disorders you know (clinical names if possible)What movies, books, TV shows (etc.) have you seen that portray clinical disorders?What makes psychological disorders abnormal?
What is “abnormal”? What is “normal”?Characteristics
Statistical devianceCultural devianceEmotional distressDysfunction; maladaptive behavior
Psychological disorder as an illnessMedical modelBiological, cognitive, social, and cultural factors
Labeling effects and Rosenhan et al. (1973) studyHow long until doctors recognize ptnts aren’t “abnormal”?
Classification of disordersDSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders 4th Ed w/ revisionsFive axes:
Axis I: clinical disordersAxis II: personality disordersAxes III – V: medical conditions, environmental problems, global functions
TerminologyDiagnosisPrognosisEtiology: cause of an illnessEpidemiology: prevalence (pp458)
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Psychological disordersAnxiety disordersSomatoform disordersDisorders of moodDissociative disordersSchizophreniaPersonality disorders
Anxiety disordersGeneralized anxiety disorder
Feeling of chronic, excessive apprehensionNot tied to one specific threatPhysical symptoms
Panic disorderSpecific intense fear w/o realistic dangerRecurrent: Interferes with everyday behaviorPanic attacks: unexpected and feared
Anxiety disordersSpecific phobic disorder
Animals – spidersLocations – heightsSocial situations
AgoraphobiaFear of going out to public
Phrenophobia:Fear of going crazy
Epidemiology:Portion of population reporting each phobia (%)
0 5 10 15 20 25
Bugs, snakes, bats
Heights
Water
Storms
Closed places
Public speak
Eat in public
Public transport
Tunnel or bridges
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Obsessive-compulsive disorderObsessions: thoughtsCompulsions: actions
Rituals to temporarily relieve anxietyHand-washingLocking door
Prevalence:Anxiety: 17% OCD: 2.5%
http://www.metacafe.com/watch/84755/true_life_living_with_ocd/
Eating disordershttp://www.anred.com/toc.html
Anorexia nervosaWeighs 85% or less of normal weight Denies dangers of low weightTerrified of becoming fat Can also have depression, anxiety, withdrawal, OCD
Bulimia NervosaBinge-purge cyclesCan have normal body weight
PrevalenceAnorexia: 1% (only 10% of people with anorexia are male)Bulimia: 4%
Newsweek headline 11/05
Fighting Anorexia: No One to BlameThe age of their youngest patients has slipped to 9 years old, and doctors have begun to research the roots of this disease. Anorexia is probably hard-wired, the new thinking goes, and the best treatment is a family affair.
Somatoform disordersSomatization disorder
History of physical complaintsAppear to be psychological origin
Conversion disorderParalysis or weaknessNo clear physical cause and no correspondence to neural substrate“Glove anesthesia”
HypochondriasisExcessive concern over disease
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Disorders of moodE.g.: Abraham Lincoln, Marilyn Monroe, Ernest Hemingway, Winston Churchill, Janis Joplin, Leo TolstoyMajor depressive episode
Persistent feeling of sadness and despairLoss of interest in previous source of pleasureChanges in weight, sleep, activity, energy, concentration
Bipolar disorderDepression plus manic state
Prevalence: Depression: 7 to 17%Bipolar: 1%+
http://mixednuts.net/depression-famous.html
http://en.wikipedia.org/wiki/List_of_people_with_major_depressive_disorder
Vincent Van Gogh
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Etiology of mood disordersTwin studies: Concordance rates
Identical twins: 67%Fraternal twins: 15%
Neurochemical factorsNorepinephrineSerotonin
Cognitive factorsLearned helplessnessRumination of negative thoughts
Dissociative disordersLoose contact with portion of consciousness resulting in disrupting sense of identityDissociative amnesia
Loss of memory for personal informationDissociative fugue
Dissociative amnesia with “flight” or escapeDissociative identity disorder
Coexistence of different personalitiesUsually unaware of multiple personalitiesEach personality has own name, traits, and behaviorsE.g.: Dr. Jekyll & Mr. Hyde; Sybil
Picture of movie “Sybil”
Dissociative identity disorder Dissociative identity disorderIs it a legitimate disorder?Co-occurs with other disordersOrigin unknownAble to be fakedResearch support for existence: Differences in optical tests with distinct personalities!
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SchizophreniaDistorted thought and perceptionSymptoms
Delusions and irrational thoughtDeterioration in routine functioningHallucinationsDisturbed emotion
Categories of symptomsPositive: addedNegative: removed
Prevalence: 1 to 1.5% (1 out of 100 people!)
Types of schizophreniaParanoid type
Delusions of grandeur, persecution, and jealousyCatatonic type
Frozen or rigid postureExtreme resistance
Disorganized typeInappropriate behavior and emotionsIncoherent language
Undifferentiated typeMix of other typeshttp://www.mtv.com/videos/true-life-full-episode-i-have-schizophrenia-three-people-deal-with-severe-mental-illness/1586145/playlist.jhtml
Paranoid Schizophrenia
http://www.schizophrenia.com/famous.htm
http://www.npr.org/templates/story/story.php?storyId=1136856
SchizophreniaJohn Hinckley, Jr.: attempted to assassinate President Reagan
To Jodi Foster: “Over the past seven months I've left you dozens of poems, letters and love messages in the faint hope that you could develop an interest in me. Although we talked on the phone a couple of times I never had the nerve to simply approach you and introduce myself. [...] the reason I'm going ahead with this attempt now is because I cannot wait any longer to impress you.”
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Schizophrenia
SchizophreniaDopamine hypothesisEnlarged ventriclesLoss of gray matter in frontal and parietal lobes
http://www.schizophrenia.com/
Personality disordersChronic, enduring pattern of behaviorAnxious/fearful
Dependent personality disorder
Odd/eccentricSchizoid and schizotypal personality disorderParanoid personality disorder
Dramatic/impulsiveHistronic and narcissistic personality disorderBorderline personality disorderAntisocial personality disorder
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Antisocial personality disorderPsychopath or sociopath (previous terms)Disregard for rights of others
Fail to conform to social norms/lawsRepeated lyingImpulsiveAggressiveRecklessLack of remorse
Prevalence: 2 to 5% (5:1 male:female ratio)Other statistics:
80% abuse drugs and/or alcohol~ 65-80% legal offenders have ASPD
ASPD: Ted Bundy
Hare’s Psychopath Checklist
Scoring: 0-absent; 1-maybe; 2-definitely thereInterpersonal
Superficial charm, grandiose, pathological lying, manipulative
AffectiveLacks remorse, shallow affect, callous, no responsibility
LifestyleParasitic lifestyle, lacks goals, impulsivity, irresponsibility
AntisocialPoor behavioral control, early juvenile delinquency
Hollywood ASPDHigh intelligenceSomewhat vein, stylish
SuccessfulCalm, calculating, in control
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Etiology: ASPDTwin concordance rates
Identical: 50%Fraternal: 20%
Neurochemical factorTestosteroneSerotonin
Brain functions:Frontal lobeLimbic system
Social-CognitiveRejectionHarsh parenting
Deficient arousalLow resting HRSlow EEGLess fear/anxietyDiminished startle
Borderline personality disorderAffect
DepressionIntense anger (quick mood shifts)Fear of abandonment
CognitionImpaired perception of selfDistorted thoughts: Magical thinking, omnipotence
ImpulsiveSelf-destructive behaviorSubstance abuseSexual deviance
RelationshipsIntense, unstable personal relationships
Borderline personality disorder List of psychological disorders discussedAnxiety disorders
Phobic disordersObsessive-compulsive
Eating disordersAnorexiaBulimia
Dissociative disordersDissociative amnesiaDissociative fugueDissociative identity disorder
Substance abuse disorders
Somatoform disordersConversion disorderHypochondriasis
Disorders of moodMajor depressionBipolar disorder
SchizophreniaPersonality disorders
Borderline personality disorderAntisocial personality disorder