Psychological Disorders

  1. The Nature of Abnormality
    1. Abnormal behavior is defined by how it is:
      1. Atypical
      2. Disturbing
      3. Maladaptive
      4. Unjustifiable
  2. Supernatural Theories
    1. From early man, through bible thought to be caused by spirits or demons. Treatment often purgative, or religious
    2. Middle Ages Influenced by thought of Church treated by exorcism
  3. Biogenic Theories
    1. Medical Model - The concept that disorders have physical causes that can be diagnosed and treated. Until reacently the treatment was "medical" as well including often stays in pyschiatric hospitals and use medications
      1. Hippocrates - Greek physcian an early proponent of this model. He believed in biological causes of disorders specificall the inbalance of the 4 humors(blood, phlegm, black bile, yellow bile)
  4. Psychological Theories
    1. Bio-Psycho-Social Model
      1. A contemporary model that assumes that biological, socio-cultural and psychological factors interact and may result in a psychologial disorder
  5. Anxiety Disorders: 2-4%of population shows severe anxiety
    1. Fears and Phobias
      1. Phobic Disorders are irrational fear of specific object, activity, or situation, results in compelling desire to avoid them.
      2. Agoraphobia is marked fear of being alone or in public places, the fears dominate the persons life.
      3. Appears to be maintained by principles of operant conditioning, negative reinforcement, which works by reinforcing the phobia by removing aversive stimulus of fear of going outside. The fear is never permitted to become extinguished.
      4. Social Phobia is fear of scrutiny by others, avoids social or public things
      5. Simple Phobia is fear of object or situation than the above, usually referred as "specific" phobias
  6. Panic Disorder, 4-10 million Americans, overwhelming physiological symptoms become present and affect ability to function in the situation
  7. Obsessive Compulsive Disorder (less than 5% of population)
    1. Recurrent obsessions (ideas, thought, images, etc). that are ego- dystonic ( not voluntary), they invade consciousness, attempts are made to repress them.
    2. Compulsions are repetitive behaviors that are performed according to certain rules, senseless results, only release of tension. No pleasure is derived from them!
  8. Somatoform Disorders - physical symptoms suggesting physical disorders
    1. Somatization disorder is loss of physical function, related to need or conflict, enables avoidance of activities, allows secondary gains. Does not fit natural dermatomes or nerve patterns
    2. Somatoform Pain Disorders - Primary symptom is Pain, of no physical cause.
  9. Dissociative Disorders are alteration in normal consciousness, identity, or perception
    1. Psychogenic Fugue- sudden unexpected travel with new identity an inability to recall one's previous identity.
    2. Dissociative Identity Disorder (Previously called Multiple Personality Disorder_- more than one distinct personalities
    3. Depersonalization Disorder - self estrangement, some mild cases in 30- 70% of young adults, misperceptions about psychological and physical characteristics, impairs social & psychological functioning.
  10. Schizophrenic Disorders - dysfunctional state for period of time
    1. Always involves deterioration of functioning Psychological processes of thought, perception, affect, self, relationship to external world, and psychomotor behavior
    2. Thought delusions are prosecutory, reference, Though broadcasting - sent to world, thought insertion - inserted into his mind, thought withdrawal - feelings removed from head and word salad - confabulations
    3. Hallucinations involve all senses
    4. Affect - inappropriateness of affect, blunting, flattening
    5. Motor - disturbed motor behavior catatonic
    6. Types of Schizophrenia
      1. Disorganized- incoherence, delusions, inappropriate affect
      2. Catatonic - stupor, rigidity, movement, posturing
      3. Paranoid - delusions of grandeur, persecution, jealousy, hallucinations
      4. Undifferentiated - catchall or combinations or symptoms
      5. Residual - without psychoses
    7. What are the causes of Schizophrenia?
    8. Not yet finding a biological marker, but, twin studies indicate a genetic risk, if one is schizophrenic the other has a 50% chance.
    9. Brian differences in schizophrenics
      1. Dopamine Theory - belief from fact that increases in Dopamine increase brain activity, some drugs the phenothiazines decrease dopamine and reduce activity, Schizophrenics have double the dopamine receptors than normals.
      2. Amphetamines which increase dopamine can cause similar symptoms as in paranoid schizophrenia
      3. PET & CAT scans indicate brains of schizophrenics have significantly larger fluid filled cavities (ventricles) and differing levels of activity.
  11. Paranoid Disorders
    1. Paranoid disorder - delusion of jealousy, or prosecutory delusions
      1. Paranoia - unshakable delusional system, 6 month. duration
  12. Affective Disorders - disturbances of mood
    1. Manic episode - one or more periods with elevated, expansive or irritable mood. Duration of at least one week, and at least 3 of the following:
      1. Increase in activity, Talkative, more so, Flight of ideas, racing thoughts, Inflated self esteem, Less need for sleep, Distractibility, Excessive involvement in activities, often reckless
    2. Depressive episode - dysphoric mood or loss of interest or pleasure in all usual activities and pastime. 4 of the following:
      1. poor appetite, insomnia or hypersomnia, psychomotor agitation, loss of interest, or pleasure in usual activities, loss of energy, guilt and worthlessness, decreased decision skills, recurrent thoughts of death or suicide
    3. Bi-Polar Disorders (previously called manic depressive disorder) are both manic and depressive symptoms
    4. Major Depression - one or more episodes of depression, no mania affects 5-10% of and 10-20% of women in their lifetimes
      1. What we know about depression
      2. Can affect anyone, mostly 20-40 years, know 4-10% suffers from it
      3. Twice as common in women as men
      4. 50% recover from clinical depression with no relapse
      5. Time is a factor in diagnosis
      6. Classifying depression
        1. Sometimes hear of neurotic or psychotic depression
        2. Endogenous - "coming from within", usually biological in nature, `respond well to medications
        3. Primary - only problem, dominating symptoms
        4. Secondary - existing psychiatric disorder.
        5. Melancholia - a depression with no apparent cause
      7. Biology
        1. Neurotransmitters involve dopamine, acetylcholine, serotonin, norepinephrine
        2. A certain group of neurotransmitters are called catecholamines which are thought to be in low levels in depression, some researchers have use the DST (Dexamethasone suppression test) to measure these levels to look for a biological marker of depression.
        3. These neurotransmitters are broken down by chemical substances into metabolites. The process is assisted by enzymes like MAO.
        4. Delayed reaction to drugs suggests there is adjustment to sensitivity of receptor sites
        5. Electrolytes are important in transmission, Lithium's success may be of similar value in treating bi-polar depression
  13. Personality Disorders - Inflexible and maladaptive personality traits
    1. Paranoid Personality disorder - pervasive unwarranted suspiciousness and mistrust of people
    2. Schizoid personality disorder - emotional coldness, indifference, limited friendships
    3. Narcissistic personality disorder - Grandiose sense of self importance. Preoccupation with fantasies of unlimited success, power brilliance etc. Exhibitionism, requiring constant attention or admiration. Cool indifference to others, inferiority, shame etc.
    4. Antisocial personality disorder: 3 or more of the following:
      1. truancy, expulsion or suspension from school, running away, persistent lying, casual sex thefts, vandalism, chronic violation of rules, fights, low grades
    5. Borderline personality disorder, 5 of the following:
      1. Impulsiveness & unpredictability (spending, sex, gambling), unstable and intense, interpersonal relationships, anger, lack of control, identity disturbance, affective instability intolerance of being alone, physically self damaging
  14. Sexual Disorders
    1. Transvestism - dressing in clothes of opposite sex
    2. Transsexualism - change of sex, feeling trapped in body of opposite sex
    3. Voyeurism - obtaining pleasure by watching others undressing or engaging in sexual activity
    4. Exhibitionism - exposing genitals to others
    5. Fetishism - obtaining sexual arousal from inanimate objects
    6. Sadism - pleasure from inflicting pain on others
    7. Masochism - receiving pain is exciting
    8. Male erectile disorder - impotence
    9. Premature ejaculation or ejaculatory disorders
    10. Inhibited female orgasm, Vaginismus, and Dyspareunia

  15. Alcohol abuse - Pattern of pathological alcohol use - need for daily use, inability to control drinking quit or cut down, continuing in light of physical or health risks. Impairment of social or occupational functioning, relationship problems, loss of job, legal trouble, troubles with family or friends. Alcohol Dependence is similar but includes Tolerance & Withdrawal.

Key Terms

Psychological Disorder In order to be classified as a psychological disorder, or abnormal behavior, a behavior must be atypical, disturbing, maladaptive, and unjustifiable.
Medical Model The medical model holds that psychological disorders are illnesses that can be diagnosed, treated, and cured, using traditional methods of medicine and psychiatry.
DSM-IV DSM-IV is a short name for the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), which provides a widely used system of classifying psychological disorders.
Anxiety Disorders Anxiety disorders involve distressing, persistent anxiety or maladaptive behaviors that reduce anxiety.
Generalized Anxiety Disorder In the generalized anxiety disorder, the person is continually tense, apprehensive, and in a state of autonomic arousal for no apparent reason.
Phobic Disorder The phobic disorder is an anxiety disorder in which a person has a persistent, irrational fear of a specific object or situation.
Obsessive-Compulsive Disorder The obsessive-compulsive disorder is an anxiety disorder in which the person experiences unwanted repetitive thoughts (obsessions) and/or actions/behaviors (compulsions).
Panic Attack A panic attack is an episode of intense dread accompanied by chest pain, dizziness, or choking. It is essentially an escalation of the anxiety associated with generalized anxiety disorder.
Somatoform Disorders Somatoform disorders involve physical symptoms with no apparent physical cause. Somatic means "bodily." A somatoform disorder is one in which the disorder appears in bodily form.
Conversion Disorder The conversion disorder is a somatoform disorder in which there are very specific physical symptoms (e.g., paralysis, blindness, or inability to swallow) with no apparent physiological cause. The conversion disorder is so named because Freud believed that in this disorder anxiety was converted into bodily symptoms.
Dissociative Disorders Dissociative disorders involve a separation of conscious awareness from one's previous memories, thoughts, and feelings. To dissociate is to separate or pull apart. In the dissociative disorder a person becomes dissociated from his or her memories and identity.
Fugue Fugue is a dissociative disorder in which forgetting occurs and the person physically runs away from home and identity. Fugue and fugitive both derive from the same Latin root, meaning "to flee."
Dissociative Identity Disorder The dissociative identity disorder is a dissociative disorder in which a person exhibits two or more distinct and alternating personalities.
Mood Disorders Mood disorders are characterized by emotional extremes.
Major Depressive Disorder Major depressive disorder is the mood disorder that occurs when a person exhibits the passive, resigned, and self-defeating thoughts and behaviors of depression for more than a 2-week period and for no notable reason.
Bipolar Disorder The bipolar disorder is the mood disorder in which a person alternates between depression and the euphoria of a manic state. Bipolar means having two poles, that is, two opposite qualities. In the bipolar disorder, the opposing states are mania and depression.(Previously call Manic-Depressive Illness)
Mania Mania is the euphoric, hyperactive state that alternates with depression in the bipolar disorder.
Schizophrenia Schizophrenia refers to the group of severe disorders whose symptoms may include disorganized and deluded thinking, inappropriate emotions and actions, and disturbed perceptions.
Delusions Delusions are false beliefs that often are symptoms of schizophrenia.
Personality Disorders Personality disorders are characterized by inflexible and enduring maladaptive character traits. These disorders may, but need not, involve anxiety, depression, or dissociation from reality.