PSYCHOLOGICAL DISORDERS

Psychological disorders: a “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive, and unjustifiable

• Disorders must cause the person distress in order to be classified as disordered

• ADHD: attention-deficit hyperactivity disorder

• Extreme inattention, hyperactivity, and impulsivity can derail social, academic, and

  vocational achievements, and these symptoms can be treated with medication and other

  treatment

• Medical model: concept that diseases, in this case psychological disorders, have physical

  causes that can be diagnosed, treated, and, in most cases, cured, often through treatment

  in a hospital

Early theories:

• Abnormal behaviors were believed to be caused by evil spirits trying to escape the

  body

• Trephination: was often used (cutting into people’s skulls to get the spirits out)

• Later on, the policy turned to institutionalization, but treatments were quite brutal

  because the goal was to get rid of their disorders completely (they’d beat them,

  pull their teeth out, and even use animal blood)

• Philippe Pinel tried to revolutionize the field with “moral treatment,” where

  patients could do things they enjoyed to help them cope with their disorders

• The DSM-V: is the Diagnostic Statistical Manual of Mental Disorders

  5 different axes of DSM:

★Clinical syndromes

★Personality disorder or mental retardation

★General medical conditions

★Psychosocial & environmental problems

★Global Assessment of Functioning (GAF) Scale

• DSM classifies disorders and describe the symptoms of them

• DSM won’t explain any causes or possible cures for mental disorders

• There are two major classifications for disorders

Neurotic: distressing but one can still function in society and act rationally

(ADHD, depression, anxiety)

Psychotic: person loses contact with reality, experiences distorted perceptions

(schizophrenia)

Each school of psychology has different causes for psychological disorders

★Psychoanalytic/psychodynamic: internal, unconscious drives

★Humanistic: failure to strive to one’s potential or being out of touch with your

feelings

★Behavioral: reinforcement history and the environment you’re in

★Cognitive: irrational, dysfunctional thoughts or ways of thinking

★Sociocultural: a dysfunctional society

★Biomedical/neuroscience: organic issues, biochemical imbalances, genetic

predispositions

Anxiety Disorders

• Anxiety disorders: a group of conditions where the primary symptoms are anxiety or

  defenses against anxiety

• The patient fears that something awful WILL happen to them

• They are always in a state of uneasiness, uncertainty, or fear

• Freud said that the anxiety is free-floating b/c the cause isn’t known

Phobias: when a person experiences episode of intense dread or fear (the fear must be

irrational or not normal)

• Examples include claustrophobia (fear of closed spaces), arachnophobia (fear of

  spiders), acrophobia (fear of heights), agoraphobia (fear of not being safe), and

  social phobia (shyness taken to an extreme)

• Flooding may be used to help the person overcome the phobia

Generalized Anxiety Disorder (GAD): when a person is continuously tense,

apprehensive, and in a state of autonomic nervous system arousal (always in fight-or-

flight mode)

• The patient is constantly tense & worried, feels inadequate, is oversensitive, can’t

  concentrate, and suffers from insomnia

• Persists for 6 months or more

• Many people with GAD were maltreated and inhibited as children (it goes away

  as you get older though)

Panic disorder: marked by minutes-long episodes of intense dread in which a person

experiences terror and accompanying chest pain, choking, and other frightening

sensations

Obsessive-Compulsive Disorder (OCD): persistent unwanted thoughts (obsessions)

causing someone to feel the need (compulsion) to engage in a particular action (obsession

about dirt and germs may lead to compulsive hand washing)

Post-Traumatic Stress Disorder (PTSD): flashbacks or nightmares following a person’s

involvement in or observation of an extremely stressful event

• Memories of the event cause anxiety

• PTSD growth: when a person overcomes their PTSD and succeeds more in life

Two perspectives that explain anxiety disorders:

★Learning: classical conditioning & observational learning

★Biological: natural selection, genes, and overarousal of brain areas involved in

• impulse control & habitual behaviors (GABA plays a key role)

Somatic Symptom Disorders

• Occur when a person manifests a psychological problem through a physiological

  symptom

There are two types:

★Illness anxiety disorder:

• Formerly known as hypochondriasis

• Person has frequent physical complaints, but doctors can’t find the cause

• They usually believe that the minor issues (headache, upset stomach) are

  indicative of a more severe illness (aka, “I have a headache, I MUST have

  a brain tumor.”)

★Conversion disorder:

• Report the existence of a severe physical problem with no biological

  reason (blindness or paralysis)

Dissociative Disorders

• These disorders involve a disruption in the conscious process (they lose periods of

  awareness)

• A person’s conscious awareness is said to dissociate from painful memories, thoughts, &

  feelings

There are three types

★Psychogenic amnesia:

• Person cannot remember past memories (retrograde amnesia) but there is

  no actual physiological cause behind it

• NOT organic amnesia (organic amnesia can be retrograde or anterograde)

★Dissociative Fugue:

• You can’t have this without having psychogenic amnesia

• People with psychogenic amnesia that find themselves in an unfamiliar

  environment and most times just start a whole new life

★Dissociative Identity Disorder:

• Used to be known as Multiple Personality Disorder

• Occurs when the person has several personalities rather one integrated

  personality

• People with DID (Dissociative identity Disorder) commonly have a history of childhood abuse or trauma

Mood Disorders

• People experience extreme or inappropriate emotion

Major Depressive Disorder: people become unhappy for at least 2 weeks with no

apparent cause

• Other symptoms include depressed or irritable mood, diminished interest or loss

  of pleasure, significant weight change, sleep disturbance, fatigue, and

  psychomotor agitation or retardation)

• Depression is common among all psychological disorders (everyone gets sad)

Seasonal Affected Disorder:

• Experience depression during winter months

• Based on amount of sunlight available, not temperature

• Treated with light therapy

Bipolar Disorder:

• Formerly known as manic depression

• Involves periods of depression and mania (being really hyperactive)

• Manic episodes involve feelings of high energy (they tend to differ a lot though;

  some may feel confident and others may get irritable)

• Engage in risky behaviors during manic episodes

-Norepinephrine & serotonin levels affect mood disorders (low serotonin = depression)

Personality Disorders

• Well-established, maladaptive ways of behaving that negatively impact people’s ability to

  function

Antisocial Personality Disorder:

★Lack of empathy

★Little regard for other’s feelings and people are impulsive

★View the world as hostile and look out for themselves

Dependent Personality Disorder: people rely too much on the attention and help of

others

Histrionic Personality Disorder: needs to be the center of attention (whether acting silly

or dressing provocatively)

Narcissistic Personality Disorder: having an unwarranted sense of self-importance &

thinking you’re the center of the universe

Obsessive-Compulsive Personality Disorder: overly concerned with certain thoughts

and performing certain behaviors (not as extreme as OCD anxiety)

Borderline Personality Disorder (the self-sabotage disorder):

★Emotional instability

★Person feels worthless, insecure, is impulsive, and has impaired social

relationships

Schizophrenic Disorders

• About 1 in every 100 people are diagnosed with schizophrenia

• Symptoms of schizophrenia

Disorganized thinking

★Thinking is fragmented, bizarre, & distorted with false beliefs

★Disorganized thinking comes from a breakdown in selective attention

(they can’t filter out information)

Delusions

★Delusions of persecution (someone’s out to get them)

★Delusions of Grandeur (beliefs that are impossible, like being king

of Mars)

Disturbed perceptions

★Hallucinations: sensory experiences without sensory stimulation

★Hearing voices is a common example

Inappropriate emotions and actions

• Laugh at inappropriate times

• May experience flat affect where they don’t feel any emotion

• May engage in senseless, compulsive acts

• Catatonia: when you can move their limbs in uncomfortable positions and

  they’ll just stay like that for hours (motionless waxy flexibility)

Positive vs. Negative Schizophrenic symptoms

★Positive: presence of inappropriate symptoms

★Negative: absence or diminishing of normal thoughts, feelings, or behaviors

Types of Schizophrenia (NOTE: the DSM-V today does not recognize different types of

schizophrenia)

★Disorganized Schizophrenia: disorganized speech or behavior, or flat or

inappropriate emotion

★Paranoid Schizophrenia: preoccupation with delusions or hallucinations

★Catatonic Schizophrenia:

• Flat effect

• Waxy flexibility

• Person repeats others’ speech and movements

★Undifferentiated Schizophrenia: person exhibits behaviors which fit into 2 or

more of the other types of schizophrenia

Other Disorders

★Paraphilias (pedophilia, zoophilia, & hybristophilia, or attraction to criminals)

★Fetishism

★Sadism or masochism (sadist = people suffer & masochist = you suffer)

★Eating disorders (bulimia, anorexia, binge-eating disorder)

★Substance abuse disorders

★ADHD and ADD

The Rosenhan Study

• Rosenhan’s associates were faking symptoms of hearing voices

• They were ALL institutionalized for schizophrenia

• None were exposed as imposters

• They all left diagnosed with schizophrenia in remission (the doctors were told that the

  people were fine, but they didn’t believe them)

• This made psychologists question, “How do we actually know who has schizophrenia or

• not?”

THERAPY

• It used to be that if someone showed abnormal behavior, they were institutionalized

• However, new drugs and better therapy made the U.S. go to a policy of

  deinstitutionalization

Psychoanalytic/Psychodynamic Therapy

• Psychoanalysis: is used by getting manifest and latent content through hypnosis, free

• association, and dream interpretation

• Unconscious

• Transference: where the feelings, desires, and expectations of one person are redirected

  and applied to another person

• Other therapies will result in symptom substitution (the development of a symptom to

  replace one that has cleared up as a result of treatment; it’s said to occur if the

  unconscious impulses and conflicts responsible for the original symptom are not dealt

  with effectively)

• Resistance happens when your mind goes blank or you find yourself unable to remember

  mportant details

Humanistic Therapy

• Client-centered therapy by Carl Rogers

• These are non-directive therapies and use active listening

• Self-actualization, free-will, and unconditional positive regard

• Gestalt Therapy by Fritz Perls encourages clients to get in touch with their whole self

Behavioral Therapy

• Counterconditioning

• Classical conditioning

• Aversive conditioning (making someone not like something that they liked)

• Systematic desensitization (gradually introducing person to their fear)

• Flooding (bombarding person with whatever they fear)

• Virtual Reality exposure therapy (putting person in the environment they’re afraid

  of virtually and helping them overcome their fears)

• Operant conditioning: token economy

• Proponents say that maladaptive symptoms (like phobias or sexual disorders) are learned

  behaviors that can be replaced by constructive behaviors

Cognitive Therapy

• Changing the way that we view the world (changing our schemas)

• Aaron Beck and Cognitive Therapy: challenges the negative, automatic thoughts

• Albert Ellis and Rational-Emotive Behavioral Therapy: tries to adjust irrational

  thinking

Somatic/Biological Therapy

• Psychopharmacology

  ★Antipsychotics (for schizophrenia): Thorazine, Haldol, Risperdal, Zyprexa

  ★Anti-anxiety: Valium, barbiturates, Xanax, Ativan

  ★Mood disorders (depression): selective serotonin reuptake inhibitors (SSRIs)

  ★Mood stabilizing (bipolar): lithium

Somatic therapies

★Electroconvulsive Therapy (ECT): giving brief shocks to stimulate the brain

while person is under anesthesia (mainly for severe major depression or bipolar

disorder)

★Psychosurgery

★Prefrontal lobotomy(cuts neural fibers that connect frontal lobe to emotion

controlling centers, but this practice is not really used anymore) (made by

Portuguese physician Egas Moniz)

Extra Things from Textbook

• Cognitive-behavior therapy: aims to alter the way people think AND the way they act

• Family therapy helps relieve tension between members and family stress

• Eye Movement Desensitization and Reprocessing (EMDR): therapy in which patient

• rapidly moves eyes while recalling traumatic events to help relieve & prevent anxiety

Three elements shared by all forms of psychotherapy:

★Hope for demoralized people

★A new perspective

★An empathetic, trusting, caring relationship

• Long-term use of antipsychotic drugs may lead to tardive dyskinesia (involuntary

  movements of facial muscles, tongue, and limbs)

• Repetitive Transcranial Magnetic Stimulation (rTMS): application of repeated

• magnetic energy pulses to the brain (either to stimulate or suppress brain activity)

  (doesn’t produce seizures, memory loss, or other side effects unlike ECT)