psychological disorders hand-out

8/4/2019 Psychological Disorders Hand-Out

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PsychologicalDisordersAguilar.Decimar.Viaa

Statistics:

USA

44millionAmericanseachyearsufferfromapsychologicaldisorder

Outof20,000individualsintheUSA:

32%hadexperiencedapsychologicaldisorderintheirlifetime

20%currentlyhadanactivedisorder

17%hadasubstanceabusedisorder

Philippines

In88millionFilipinos,880,000areexpectedtobeschizophrenic

NSOSurvey(2000)

Mental illness 3rd

most common form of disability after visual and hearing

disabilities

Averageof88reportedcasesofmentalillnessper100,000Filipinos

0.7% of the total household in the Philippines during the year, 2004, have a

memberwithmentaldisability

threeprimaryhealthcenters inManila,oneoutof5adultsandoneoutof10

childrenages5to15consultingtothesecentershavementaldisorders

Commonmisconceptions

MYTH:Abnormalbehaviorisalwaysbizarre.

FACT:Thebehaviorofmanypeoplewhoare diagnosedashavingamentaldisorderoftencannotbe

distinguishedfromthatofnormalpeople

MYTH:Normalandabnormalbehavioraredifferent inkind

FACT: Few, if any types, of behavior displayed by people with a mental disorder often cannot be

distinguished from that of normal people. Abnormal behavior consists of a poor fit between the

behaviorandthesituationinwhichitisenacted.

MYTH:Oncepeoplehaveamentaldisorder,theywillalwayshaveit.

FACT:Mostpeoplecanbesuccessfullytreatedforamentaldisorder.

AbnormalBehaviorDefined

Insanity legal term referring toan inability toappreciate thenatureandqualityorwrongfulnessof

onesacts


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Abnormalbehavior

Amentalillnessthataffectsorismanifestedinapersonsbrainandcanaffectthewaya

personthinks(APA)

Behaviorthatisdeviant(atypicalbehaviorwhichdeviatesfromwhatisacceptableina

culture), maladaptive (behavior which interferes with a persons ability to function

effectively

in

the

world),

or

personally

distressful.

Only

one

of

the

three

criteria

is

neededforabehaviortobeclassifiedasabnormalbehavior.

TheoreticalApproachestoPsychologicalDisorders

1.BiologicalApproach

Medicalmodel(psychologicaldisordersasmedicaldiseaseswithabiologicalorigin.

Brainandgenetics

Mentalillnesses abnormalities,patients afflictedindividuals,doctors

Drugtherapyfrequentlyusedtotreatdisorders

Structuralviewsabnormalitiesinthebrainstructure

Biochemicalviewsimbalancesinneurotransmittersorhormones

Geneticviewsdisorderedgenes

2.PsychologicalApproach

Psychodynamic perspective unconscious conflicts that produce anxiety and result in maladaptive

behavior.

Behavioralandsocialcognitiveperspective

Behavioral rewardsandpunishmentsintheenvironment

Socialcognitive observationallearning,expectancies,selfefficacy,selfcontrol,beliefabout

oneselfandtheworld

Humanisticperspective

capacityforgrowth,freedomtochooseonesowndestiny,andpositivepersonalqualities

Psychologicaldisorder inabilitytofulfillonespotentialarisingfromsocietalpressures

Personwithadisorderlowselfconcept

3.SocioculturalApproach

Environmentalexperiences

Emphasisonlargersocialconceptsinwhichapersonlives

Marriageorfamily,neighborhood,socioeconomicstatus,ethnicity,gender,orculture

Individualsfromlowincome,minorityneighborhoodshighestrateofmentaldisorders

Socioeconomicstatusstrongerrolethanethnicity


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Gender (woman are more likely to suffer from internalized disorders while men from

externalizeddisorders)

Culturerelateddisorders(amok,anorexia,windigo)

ClassifyingAbnormalBehavior

Advantages

Providesabasisforcommunicating

Helpscliniciansmakepredictions

DSMIVClassificationSystem

DiagnosticandStatisticalManualofMentalDisorders,,fourthedition(1994)

1952,AmericanPsychiatricAssociation

17majorclassifications,200specificdisorders

Multiaxialsystem

Classifiesindividualsonthebasisoffivedimensions,oraxes,thattakeintoaccountthe

individualshistoryandhighestleveloffunctioninginthepreviousyear

Ensuresthatanindividualiscategorizedaccordingtoclinicalfactors

FiveaxesofDSMIV

AxisI.Allpersonalitydisordersexceptpersonalitydisordersandmentalretardation

AxisII.Personalitydisordersandmentalretardation.

AxisIII.Generalmedicalconditions

AxisIV.Psychosocialandenvironmentalproblems

AxisV.Currentleveloffunctioning

ControversiesandIssues:

MorenonpsychiatriststhaneverwereresponsiblefordraftingtheDSMIV

Labelsaspsychologicaldisorderswhatareoftenthoughtofaseverydayproblems

The system focuses strictly on pathology and problems, with a bias toward finding

somethingwrongwithanyonewhobecomestheobjectofdiagnosticstudy

Labelscanbedamagingwhentheydrawattentiontooneaspectofapersonandignore

others

TextualrevisionsinDSMIVTR

correctionoffactualerrorsinthetextofDSMIV

reviewofcurrencyofinformationinDSMIV

changes reflecting research published after 1992, which was the last year included in the

literaturereviewpriortothepublicationofDSMIV

ImprovementstoenhancetheeducationalvalueofDSMIV

UpdatingofICDdiagnosticcodes,someofwhichwerechangedin1996


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Changes in the criteria for several disorders: diagnosis of paraphilias (exhibitionism and

voyeurism)

ANXIETYDISORDERS

Psychological disorders that feature motor tension (jumpiness, trembling, inability to relax),

hyperactivity (dizziness, racing heart, or perspiration) and apprehensive expectations and

thoughts

19.1millionor13.3%ofadultsfrom18to54arediagnosedwithanxietyperyear

GeneralAnxietyDisorder

Persistentanxietyforatleastonemonth

Unabletospecifyreasonsfortheanxiety

Nervousmostofthetimeandworriesaboutminorthings

4millionAmericansor2.8%ofadultsfrom18to54

Etiology

BiologicalfactorsgeneticpredispositionandadeficiencyintheneurotransmitterGABA

Psychologicalandsocioculturalfactors

harshselfstandardsthatareimpossibletomaintain

Verystrictandcriticalparents(lowselfesteem)

Automaticnegativethoughtsinthefaceofstress

Historyofuncontrollablestressorsortraumas

PanicDisorder

Anxietydisordermarkedbyrecurrent,suddenonsetofintenseapprehensionorterror

Feelingofimpendingdoombutmaynotgetanxiousallthetime

Often strike without warning and produce severe palpitations, extreme shortness of breath,

chestpains,trembling,dizziness,andafeelingofhelplessness

Victimsseizedbyfearthattheywilldie,gocrazy,ordosomethingthattheycannotcontrol

2.4millionor1.7%ofadultsfrom18to54

Gowithorwithoutagarophobia(fearsofpublicplacesandinabilitytoescapeandfindhelp)

Being in crowded places, traveling away from home, being separated from

someone

2.5%ofindividualsintheUS

Remainhomebound

Etiology

Stressfullifeevent6monthspriortothedisorder

Agarophobiafearoffearhypothesis

Gendersocializationandtraumaticexperiences


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Biological

overreactiontolacticacidwhenstressed

Genetic

Overlyactiveautonomicnervoussystem

Hyperventilationoroverbreathing

Problems

involving

norepinephrine

or

GABA

PhobicDisorder

Irrational,overwhelming,persistentfearofaparticularobjectorsituation

Canpinpointthecauseofanxiety

6.3millionsor4.4%ofadults

Socialphobia

Intensefearofbeingembarrassedinsocialsituations

Avoidspeakingup inaconversation,givingaspeech,goingout toeat,orattendinga

party

Etiology

Genetic

Thalamus,amygdala,andcerebralcortexneuralcircuit

Serotonin

Defensemechanismtowardoffthreateningorunacceptableimpulses

Learnedfears

ObsessiveCompulsiveDisorder(OCD)

ananxietydisorderinwhichtheindividualhasanxietyprovokingthoughtsthatwillnotgoaway

and/orurgestoperformrepetitiveritualisticbehaviors

topreventorproducesomefuturesituation

Obsessionideas,imagesandimpulsesthatrunthroughtheperson'smindoverandoveragain

Fearofdirt/germs

Disgustofbodilywaste/fluids

Concernwithsymmetry/balance

Compulsion behaviors according to certain rules in order to alleviate the feeling of

obsession

Cleaningandgrooming,suchaswashinghands,showeringorbrushingteeth

overandoveragain

Checkingdrawers,doorlocksandappliancestobesuretheyareshut,locked

orturnedoff

Repeating actions, such as going in and out of a door, sitting down and

gettingupfromachair,ortouchingcertainobjectsseveraltimes


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EtiologyofOCD

Biological

Geneticcomponent,hereditary

Brainimaging studies frontal cortex or basal ganglia are so

active in OCD that numerous impulses reach the thalamus,

generatingobsessivethoughtsorcompulsiveactions.

DepletionofSerotonin

PostTraumaticStressDisorder(PTSD)

Psychological disorder that develop through exposure to a traumatic event, such as war;

severelyoppressive situations, suchasHolocaust; severeabuse,as in rape;naturaldisasters,

suchasfloodsandtornadoes;andunnaturaldisasters,likeplanecrashes

SYMPTOMS

Flashbacks

Constrictedabilitytofeelemotions

Excessivearousal

Difficultieswithmemoryandconcentration

Feelingsofapprehensions,includingnervoustremors

Impulsiveoutburstsofbehavior

DISSOCIATIVEDISORDERS

Involveasuddenlossofmemoryorchangeinidentity

Dissociatedseparatedorsplit

Difficultyinintegratingtheactiveandpassivedimensionsofconsciousness

Dissociative Amnesia characterized by extreme memory loss that is caused by extensive

psychologicalstress.

Dissociative Fugue the individual not only develops amnesia but also unexpectedly travels

awayfromhomeandassumesanewidentity

DissociativeIdentityDisorder

Multiplepersonalitydisorder

Probablythemostdramaticbutleastcommondissociativedisorder

IndividualssufferingfromDIDhavetwoormoredistinctpersonalitiesorselves

Eachpersonalityhasitsownmemories,behaviors,andrelationships

Onepersonalitydominatesatonetime;andanothertakesoveratanothertime.

Shiftsusuallyoccurunderdistress


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CausesandEffects

Inordinatelyhighrateofsexualorphysicalabuseduringearlychildhood

Mostlyadultfemaleshavethisdisorder

Whenmalesdevelopthisdisorder,theyshowmoreaggressionthanfemales

MOODDISORDERS

Disorders inwhichthere isaprimarydisturbanceofmood(prolongedemotionthatcolorsthe

individual'sentireemotionalstate)

Includecognitive,behavioral,andsomaticsymptoms,aswellasinterpersonaldifficulties

DepressiveDisorder mooddisorder inwhich the individualsuffersdepressionwithoutever

experiencingmania(stateofabnormalarousal)

CLASSIFICATIONS

Majordepressivedisorder

Individuals experience a major depressive episode and depressed

characteristics,suchaslethargyandhopelessness,foratleast2weeks

Dailyfunctioningbecomesimpaired

Symptoms

Depressedmoodmostoftheday

Reducedinterestorpleasureinallormostactivities

Significantweightlossorgain

Troublesleepingoroversleeping

Psychomotoragitationorretardation

Fatigue

Feelingofworthlessness

Problemsinthinking,concentrating,ormakingdecisions

Recurrentthoughtsofdeathandsuicide

DysthymicDisorder

MorechronicandhasfewersymptomsthanMDD.

The individual is inadepressedmood formostdaysforat least2yearsasan

adultoratleast1yearasachildoradolescent

Amajordepressiveepisodemustnothaveoccurred,andthe2yeardepression

mustnothavebeenbrokenbyanormalmoodlastingmorethat2months

Twoormoreofthesesymptomsmustbepresent:

Poorappetiteorovereating

Sleepproblems


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Lowenergy

Lowselfesteem

Poorconcentrationordifficultyinmakingdecisions

Feelingofhopelessness

BipolarDisorder

Isamooddisorder that ischaracterizedbyextrememoodswings that include

oneormoreepisodesofmania(anoverexcited,unrealisticallyoptimisticstate)

Bipolarexperienceofbothdepressionandmania

DepressiveEpisode

ManicEpisodeapersonfeelseuphoricandontopoftheworld.Astheepisode

unfolds,onecanexperiencepanicandeventuallyfallintodepression

CausesofMoodDisorders

Biologicalfactors

Heredity

Depressiveandbipolardisorderstendtoruninfamilies

And individual with an identical twin who has bipolar disorder has more than 60%

chanceofhavingthesamedisorder

Recent studies suggest that chromosome 22maybe the genetic locationofBipolar

disorder

NeurobiologicalAbnormalities

Alteredbrainwaveactivitiesduringsleep

Individualswithdisorders tend toexperience less slowwave sleepandgo into

REMsleepearlierinthenightthannondepressedindividuals

Neuroimaging studies decreasedmetabolic activity in the cerebral cortex of

thosewithsevermajordepressivedisorder

Neurondeathanddisability

Hormones

slowchronichyperactivityintheneuroendocrineglandularsystem

women's increased vulnerability to depression is linked to their ovarian

hormones,estrogenandprogesterone

PsychologicalFactors

PsychodynamicExplanations

Depression stems froman individuals' childhood experiences thatprevented

themfromdevelopingastrongpositivesenseofself

Freud'stheory depressionisaturninginwardofaggressiveinstincts

Loveobject Loveandhate


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BehavioralExplanations

reduction of positive reinforcers in a person's life leads to depression

(Lewinsohn&Gottlib)

stress >withdrawal >reductionofpositivereinforcers >furtherwithdrawal >

furtherpositivereinforcersreduction

learned

helplessness

inability to avoid aversive stimulation produces an apathetic state of

helplessness.

whenindividualscannotcopewiththestresstheyencounter,theyfeelhelpless

anddepressed.(Seligman,Martin,1975)

ruminativecopingstyle(SusanNolenHoeksema) individualsfocusintentlyon

how they feel but do not try to do anything about the feelings. They just

ruminateabouttheirdepression.

Recommended:actionorientedcopingstyle

CognitiveExplanations

depressedindividualsrarelythinkofpositivethoughts.

negativeexpectationsaboutthefuture

negative thoughts reflect schemas that shape the depressed individual's

experiences(Gilbert,2001)

Catastrophicthinking actionsleadtonegativeresultssuchasfailure,etc.

CognitiveDistortions

AllornothingThinking

Overgeneralization

MentalFilter

Disqualifyingthepositive

Jumpingtoconclusions

MagnificationorMinimization

EmotionalReasoning

Shouldstatements

Labelingandmislabeling

Personalization

SocioculturalFactors

Interpersonalrelationship

Oneviewofdepressionisthatitmaystemfromproblemsthatdevelopin

relationshipswithotherpeople.

Socioeconomicandethicvariations

Individualswithalowsocioeconomicstatus(SES);especiallythoselivingin

poverty,aremorelikelytodevelopdepressionthantheirhigherSES

counterparts.

Culturalvariations


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Depressivedisordersarefoundinvirtuallyallculturesintheworld,buttheir

incidence,intensity,andcomponentsvaryacrosscultures.

Gender

Bipolardisorderoccursaboutequallyamongwomenandmen,butwomen

areabouttwiceaslikelyasmentodevelopdepression.

Suicide

- Severedepressionandotherpsychologicaldisorderscancauseindividualstowanttoendtheir

lives.Isabnormalbehavior,itisnotuncommonforindividualstocontemplatesuicideatsome

pointintheirlives

BiologicalFactors

- Geneticfactorsappeartoplayaroleinsuicide,whichtendstoruninfamilies.

- Anumberofstudieshavelinkedwithlowlevelsoftheneurotransmitterserotonin.

- Individualswhoattemptsuicideandwhohavelowlevelsofserotoninare10timeslikelierto

attemptsuicideagainthanarethoseattempterswhohavehighlevelsofserotonin.

- Anotherriskfactorforsuicideisthepoorphysicalhealth,especiallywhenitislongstandingand

chronic.

Psychologicalfactors

- Cancontributetosuicideincludementaldisordersandtraumas,suchassexualabuse.

- Themostcommonmentaldisorderamongindividualswhocommitsuicideisdepression.

SocioculturalFactors

Thelossoflovedonethroughdeath,divorce,orseparationcanleadtoasuicideattempt.

SCHIZOPHRENIA

- Aseverepsychologicaldisorderthatischaracterizedbyhighlydisorderedthoughtprocesses.

TypesofSchizophrenia

Disorganizedschizophrenia

- Anindividualhasdelusionsandhallucinationsthathavelittleornorecognizablemeaning.


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PsychologicalFactors

- Stressmaybeacontributingfactor.

- Thediathesisstressmodelarguesthatacombinationofbiogeneticdispositionandstresscauses

schizophrenia.

- Diathesismeanspsychologicalvulnerabilityorpredispositiontoaparticulardisorder.

SocioculuturalFactors

- Thetypeandincidenceofschizophreniadisordersmayvaryfromculturetoculture.

- Individualslivinginpovertyarelikeliertohaveschizophreniathanpeopleathigher

socioeconomiclevels.

PERSONALITYDISORDERS

Arechronic,maladaptivecognitivebehavioralpatternsthatarethoroughlyintegratedintothe

individual'spersonality.

Arenotasbizarreasschizophrenia,andtheydonothavetheintense,diffusefeelingsoffearand

apprehensionthatcharacterizedtheanxietydisorders.

ThreeClustersofPersonalitydisorder

1. Odd/EccentricCluster

Paranoid

- Theseindividualshavealackoftrustinothersandaresuspicious.

Schizoid

- Theydonotformadequatesocialrelationships.

Schizotypal

- Theyshowoddthinkingpatternsthatreflecteccentricbeliefs,overtsuspicion,andovert

suspicion,andoverthostility.

2. Dramatic/EmotionallyProblematicCluster

Histrionic

- Theseindividualsseekalotofattentionandtendtooverreact.


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Narcissistic

Theyhaveanunrealisticsenseofselfimportance,canttakecriticism,manipulatepeople,andlack

empathy.

Borderline

- Theseindividualsareoftenemotionallyunstable,impulsive,unpredictable,irritable,and

anxious.

Antisocial

- Theyareguiltless,lawbreaking,exploitive,selfindulgent,irresponsible,andintrusive.

- Thecausesofantisocialpersonalitydisorder

Biologicalfactor

-

Ageneticpredispositionforthedisordermaybepresent.

PsychologicalFactor

- Theimpulsiveandaggressivebehaviorthatcharacterizesindividualswithantisocialpersonality

disorderssuggeststhattheyhavenotadequatelylearnedhowtodelaygratification.

ocioculturalFactor

- Inadequatesocializationregularlyappearsinthehistoryofindividualswhodevelopantisocial

personalitydisorder.

3. ChronicFearfulness/AvoidantCluster

Avoidant

- Theseindividualsareshyandinhibitedyetdesireinterpersonalrelationships,which

distinguishesthemfromtheschizoidandschizotypaldisorders.

- Theyoftenhavelowselfesteemandareextremelysensitivetorejection.

- Thisdisorderclosetobeing ananxietydisorderbutisnotcharacterizedbyasmuchpersonal

distress.

Dependent

- Theylackselfconfidenceanddonotexpresstheirownpersonalities.

- Theyhaveapassiveneedtoclingtostrongerpersonalities,whomtheyallowtomakedecisions

forthem.

- Thedisorderisfarmorecommoninwomenthaninmen.


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Passiveaggressive

- Theseindividualsoftenpoutandprocrastinate;Theyarebornorareintentionallyinefficientin

anefforttofrustrateothers.

Obsessivecompulsive

- Thepersonalitydisorderisoftenconfusedwithobsessivecompulsiveanxietydisorder.

However,anindividualwithobsessivecompulsivepersonalitydisorderrarelybecomesobsessed

aboutissues.

- Inpersonalitydisorder,thepersondoesnotbecomeupsetordistressedabouthisorher

lifestyle.Theseindividualsareobsessedwithrules,areemotionallyintensive,andareoriented

towardalifestyleofproductivityandefficiency.

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