Your are requested to describe hypothetically the symptoms of a psychological disorder from a first person scenario (as if they apply to you). Which means that you have to imagine that you actually have that disorder (without really having it, just by learning about it from the text) and you are explaining it to your therapist. Others have to try to guess what it is so you want to be clear and provide a few clues.. here’s an example:dr. therapy: thank you for coming. what can i do to help.me: dont thank me please. thank the judge that made me. (mumble: as if i have time for this.).dr. yes, yes, of course. maybe you can tell me why they sent you here.me: really? telling me you do not even know? everyone out in your waiting room, including nurses and secretaries and patients know why i am here and they are surely enjoying their gossip.dr. yes. you are right.. i do know that you were sent here because you threatened to rearrange the school principal’s face with the mirror you broke in his office. but maybe you can tell me with your own words. after all, there is two sides to the story.me: nope. i did. i broke the mirror and i really wanted to scare the stupid principal.dr. tell me why you did all that so i can help you ?me: (mumbling) sure you want to help me. you just want to hear my story so you can go home and blot about how sick i am and what a healer you are)dr. you said what? are you talking to yourself?me: yes.dr. do you often do that?me: only if it makes you believe i am crazy.dr. ok, back to what happened today. tell me please. what let to the incident.me: you mean what lead to the incident from the start or from my discussion with the holy educator?dr. nono not from the start dear. just tell me the story. before you went to the principle, what happened.me: well, it might be interesting to you to know that i told my boss to eat s–t and die before i left to my son’s school too.dr. you did? why? that means you lost your job too?me: well, it might be hard for you to believe but if my son’s school calls with an urgent matter, and my boss does not allow me to leave early, then she can eat s–t and die.dr. oh, so they called you to school but the boss wouldn’t let you leave.me: you got it big shot. she drove me crazy. if she had a problem, then it is ok for her but not for us. i feel good i sent her to hell.dr. yes, but now you have no job.me: you call that job? honestly, couldn’t even have enough for the couple of drinks i enjoy before bed. i made out better from government assistance.dr. but you are young and strong, tell me why they wanted you at school anyway.me: they wanted to inform me that my child must repeat his class for the second time. they said he has a speech problem and that they warned me to only speak englishto him but my father does not know english and they love to talk to each other. so now the kid is going to be hearbroken again.dr. i see. i totally understand. you sound like a good parent who cares about her kids.me: whispering to myself. oh yes, totally. you understand me. we are just the same. you with your tailored suit and clean office and spotless shoes and me, with my …. yes…. we are very similar and you are very blind.dr. would you please stop talking to yourself and talk to me? tell me what is bothering you? why so angry? do you drink often?me: oh great. now i am alcoholic too.dr. why do you treat me with such hostility? i am on your side and want to help you.me: great, another helpful person wants to feel good about himself. help me. let me go home to finish the laundry and that would help me.dr. you seem to have a lot hanging on your shoulders. do you have help.me: yes, i have a maid and a butler and my car actually drives from a to z without breaking down. and i have so much money i do not have to work stupid jobs. all perfect.dr. i want to help you become better and i want to send you home with an assignment. i want you to eat well so you can lose some weight and improve your self esteem. i want you to walk twenty minutes a day and i want you to write a list of what would help you do when you feel angry so you do not lash out. and then i want you to come back next week so i can start your treatment.me: ok, so i am crazy. good. thank you.dr. next week. same time please. we will start your treatment.me: i can not. i do not have the money or the time. next week i have to take my disabled elderly mother to the hospital for a surgery. and i already do not know who is going to watch the kids. so please do not add to my troubles. what is my disorder?(really, i would very much like it if you try to guess my disorder:-)due date: july 7.Psychological
Disorders
Chapter 14
Prepared by
Melissa S. Terlecki,
Cabrini College, PA
Dr.
Identifying Psychological Disorders: What
Is Abnormal?
• Medical model: the conceptualization of
psychological disorders as diseases that, like
physical diseases, have biological causes,
defined symptoms, and possible cures
– Diagnosis of symptoms underlying a syndrome
– Not every abnormal thought or behavior can be
traced to an underlying disease.
Questions
• What’s the first step in helping someone with
a psychological disorder?
Classification of Disorders
• Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV-TR; 4th ed., text revision): a classification
system that describes the features used to diagnose
each recognized mental disorder and indicates how the
disorder can be distinguished from other similar
problems
– Involves disturbances in behavior, thoughts, or emotions
– Causes significant distress or impairment.
– Stem from internal dysfunction (biological and/or
psychological).
– Global Assessment of Functioning (GAF score)
– Comorbidity: the co-occurrence of two or more disorders in a
single individual
Table 14.1
Main
DSM-IV-TR
Categories of Mental Disorders
Causation of Disorders and the Dangers of
Labeling
• An integrated perspective incorporates biological, psychological,
and environmental factors.
• Different individuals may experience a similar psychological
disorder for different reasons.
• Diathesis-stress model: suggests that a person may be
predisposed for a mental disorder that remains unexpressed until
triggered by stress
• The intervention-causation fallacy assumes treatment addresses
the cause of the disorder.
– The brain is likely not the only cause.
• Stigmas are likely attached to labeling people with psychological
disorders.
–
–
–
–
Roughly 70% of sufferers do not seek treatment.
Education does not dispel the stigma.
May result in unnecessary incarceration
May lead to low self-esteem
Anxiety Disorders and GAD
• Anxiety disorder: the class of mental disorder in which
anxiety is the predominant feature
– Anxiety can be adaptive or maladaptive, when it is
disproportionate to real threats and challenges.
• Generalized anxiety disorder (GAD): a disorder
characterized by chronic excessive worry accompanied
by three or more of the following symptoms:
restlessness, fatigue, concentration problems,
irritability, muscle tension, and sleep disturbance
– Roughly 5% of North Americans suffer
– Occurs more in lower SES groups
Phobic Disorders
• Phobic disorders: disorders characterized by
marked, persistent, and excessive fear and
avoidance of specific objects, activities, or
situations
– Specific phobia: a disorder that involves an irrational
fear of a particular object or situation that markedly
interferes with an individual’s ability to function
– Social phobia: a disorder that involves an irrational fear
of being publicly humiliated or embarrassed
Panic Disorder
• Panic disorder: a disorder characterized
by the sudden occurrence of multiple
psychological and physiological
symptoms that contribute to a feeling of
stark terror; panic attacks
– Approximately 22% of the U.S. population
reports having at least one panic attack.
• Agoraphobia: an extreme fear of
venturing into public places; correlates
with panic disorder
Obsessive-Compulsive Disorder
• Obsessive-compulsive disorder (OCD): a
disorder in which repetitive, intrusive,
thoughts (obsessions) and ritualistic behaviors
(compulsions) designed to fend off those
thoughts interfere significantly with an
individual’s functioning
– Roughly 1.3% of the population suffers
– Moderate heritability
Mood Disorders and Depressive Disorders
• Mood disorders: mental disorders that have mood disturbances as
their predominant feature
• Major depressive disorder: a disorder characterized by a severely
depressed mood that lasts 2 wks. or more and is accompanied by
feelings of worthlessness and lack of pleasure, lethargy, and sleep
and appetite disturbances
• Dysthymia: a disorder that involves the same symptoms as in
depression only less severe, but the symptoms last longer,
persisting for at least 2 yrs
• Double depression: a moderately depressed mood that persists for
at least 2 yrs. and is punctuated by periods of major depression
• Seasonal affective disorder: depression that involves recurrent
depressive episodes in a seasonal pattern
• Women experience depression at twice the rate of men, as in
postpartum depression
Questions
• What is the difference between depression
and sadness?
• Why do more women than men experience
depression?
Biological and Psychological Factors
• Heritability estimates for major depression range from
33% to 45%.
• Depression may involve norepinephrine and serotonin,
and/or diminished activity in the left prefrontal cortex and
increased activity in the right prefrontal cortex.
• Aaron Beck (1921- ) noted dysfunctional attitudes and
negative mood states in depressed individuals.
– Helplessness theory: the idea that individuals who are prone to
depression automatically attribute negative experiences to
causes that are internal, stable, and global
– Depressed individuals tend to have depressive biases in thinking
and memory.
Bipolar Disorder
• Bipolar disorder: an unstable emotional condition
characterized by cycles of abnormal, persistent high
mood (mania) and low mood (depression)
– Approximately 1.3% of people suffer
– Rapid cycling bipolar disorder
• Bipolar disorder has the highest heritability
(polygenic) among the psychological disorders.
• Biological causes (specific neurotransmitters) are
difficult to substantiate.
• Stressful life experiences often precede episodes.
Dissociative Disorders: Going to Pieces
• Dissociative disorder: a condition in which normal cognitive
processes are severely disjointed and fragmented, creating
significant disruptions in memory, awareness, or personality that
can vary in length from a matter of minutes to many years
• Dissociative identity disorder (DID): the presence within an
individual of two or more distinct identities that at different times
take control of the individual’s behavior
– .5% – 1% of the population suffers; female to male prevalence 9:1
• Dissociative amnesia: the sudden loss of memory for significant
personal information
• Dissociative fugue: the sudden loss of memory for one’s personal
history, accompanied by an abrupt departure from home and the
assumption of a new identity
– Dissociative amnesia and fugue usually occur later in life and memory
loss may be temporary.
Schizophrenia: Losing the Grasp on Reality
• Schizophrenia: a disorder characterized by the profound disruption of basic
psychological processes, a distorted perception of reality, altered or blunted
emotion, and disturbances in though, motivation, and behavior
– Occurs in about 1% of the population
– Delusion: a patently false belief system, often bizarre and grandiose, that is
maintained in spite of its irrationality.
– Hallucination: a false perceptual experience that has a compelling sense of being real
despite the absence of external stimulation
– Disorganized speech: a severe disruption of verbal communication in which ideas shift
rapidly and incoherently from one to another unrelated topic
– Grossly disorganized behavior: behavior that is inappropriate for the situation or
ineffective in attaining goals, often with specific motor disturbances
• Catatonic behavior: a marked decrease in all movement or an increase in muscular rigidity and
overactivity
– Negative symptoms: emotional and social withdrawal, apathy, poverty of speech, and
other indications of the absence or insufficiency of normal behavior, motivation, and
emotion
• Subtypes include: paranoid, catatonic, disorganized, undifferentiated, and
residual
Table 14.3
Types of Schizophrenia
Biological and Psychological Factors
• Concordance rates increase greatly with biological
relatedness.
• Prenatal and perinatal environments may also have
effects.
• Dopamine hypothesis: the idea that schizophrenia
involves an excess of dopamine activity
– Effects and treatments related to neurotransmitters
have yet to be completely determined.
• Disturbed family environment may affect
development and recovery of schizophrenia.
Hot Science: Autism and Childhood
Disorders
• Early onset disorders are recognized in the DSM,
and some resolve into adulthood while others do
not.
• Autistic disorder involves abnormal or impaired
development of communication and social
interaction, and a markedly restricted repertoire of
activities/interest.
– Recent increased prevalence
• Variations of the disorder lie along a spectrum,
including Asperger’s syndrome.
• Individuals with the disorder may display unique,
gifted talents.
Personality Disorders: Going to Extremes
• Personality disorder: disorder characterized by deeply
ingrained, inflexible patterns of thinking, feeling, or
relating to others or controlling impulses that cause
distress or impaired functioning
– Organized into three clusters: odd/eccentric, dramatic/erratic,
and anxious/inhibited
– 14.8% of the population has a personality disorder.
– Common feature is failure to take others’ perspectives
• Diagnosis is controversial and complicated.
• Peer nomination measures may be more valid
assessments.
Table 14.4
Clusters of Personality
Disorders
Questions
• Why is self-reporting a problem in diagnosing
personality disorders?
Antisocial Personality Disorder
• Antisocial personality disorder(APD): a pervasive
pattern of disregard for and violation of the rights of
others that begins in childhood or early adolescence
and continues into adulthood
– 3.6% of the population suffers; males outnumber females 3:1
– Individuals typically have a history of conduct disorder and
many commit crimes.
• Sociopathology and psychopathology describe people
with APD.
• Newer theories suggest internal (biological) causes.
– Less sensitive to fear in the brain.
Questions
• What are some of the factors that contribute
to APD?
Hot Science: Positive Psychology
• Positive psychology is an
approach that seeks to
understand what makes our
lives pleasant, good, and
meaningful, began by Martin
Seligman (1942- ).
• Character Strengths and
Virtues (CSV) classifies
positive characteristics, as
complimentary to the DSM.
• The movement has been
effective in spurring
happiness research.
– Various findings are cited.
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