Chp 15 Psychological Disorders

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Dissociative Fugue

"Running away" state; wandering away from one's life, memory, and identity, with no memory of these

The Diagnostic and Statistical Manual

It's easier to count cases of autism if we have a clear definition. Versions: DSM-IV-TR, DSM-V (May 2013) The DSM is used to justify payment for treatment. It's consistent with diagnoses used by medical doctors worldwide.

Bipolar Disorder

once called "manic-depressive disorder" Two polar opposite moods are depression and mania.

Disorder

a state of mental/behavioral ill health.

Depressed mood

exaggerated pessimism social withdrawal lack of felt pleasure inactivity and no initiative difficulty focusing fatigue and excessive desire to sleep

Which people get PTSD?

with less control in the situation traumatized more frequently with brain differences who have less resiliency who get re-traumatized

Psychosis

A mental split from reality and rationality

PTSD

About 10%-35% of people who experience trauma not only have burned-in memories but also four weeks to a lifetime of: repeated intrusive recall of those memories. nightmares & other re-experiencing. social withdrawal or phobic avoidance. jumpy anxiety or hypervigilance. insomnia or sleep problems.

Negative Effects of Schizophrenia

Absence of healthy behaviors Flat affect (no emotion showing in the face) Reduced social interaction Anhedonia (no feeling of enjoyment) Avolition (less motivation, initiative, focus on tasks) Alogia (speaking less) Catatonia (moving less)

Axis IV

Are psychosocial or environmental problems, such as school or housing issues, also present?

Major Depressive Disorders

Depressed mood most of the day, and/or Markedly diminished interest or pleasure in activities Significant increase or decrease in appetite or weight Insomnia, sleeping too much, or disrupted sleep Lethargy, or physical agitation Fatigue or loss of energy nearly every day Worthlessness, or excessive/inappropriate guilt Daily problems in thinking, concentrating, and/or making decisions Recurring thoughts of death and suicide one or both of the first two PLUS three or more of the rest.

Chronic/Process Schiz

Develops slowly, with more negative symptoms such as flat affect and social withdrawal. With treatment and support, there may be periods of a normal life, but not a cure. without treatment, this type of schizophrenia often leads to poverty and social problems

Deviant

Differing from the norm In psychology, a behavior or mental state is considered deviant by a culture when it is different from what would be expected in that culture.

Schiz Symptoms: Problems in thinking and Speaking

Disorganized speech, including the "word salad" of loosely associated phrases Delusions (illusory beliefs): often bizarre and not just mistaken; most common are delusions of grandeur and of persecution Problems with selective attention: difficulty filtering thoughts and choosing which thoughts to believe and to say out loud

GAD

Emotional-cognitive symptoms include: worrying, having anxious feelings and thoughts about many subjects, and sometimes "free-floating" anxiety with no attachment to any subject. Anxious anticipation interferes with concentration. Physical symptoms include autonomic arousal trembling, sweating, fidgeting, agitation, and sleep disruption.

Biological Influences on Psychological Disorder

Evolution Individual genes brain structure and chemistry

Patterns

Finding a collection of symptoms that tend to go together, and not just seeing a single symptom.

Anxiety Disorders

GAD: Generalized anxiety disorder Panic disorder Phobias OCD: Obsessive-compulsive disorder PTSD: Post-traumatic stress disorder

Seasonal Affective Disorder (SAD)

Involves recurring seasonal pattern of depression, usually during winter's short, dark cold days.

Axis I

Is a clinical syndrome present?

Axis III

Is a general medical condition, such as diabetes, arthritis, or hypertension also present?

Axis II

Is a personality disorder or mental retardation (intellectual developmental disorder) present?

Dissociative amnesia

Loss of memory with no known physical cause; inability to recall selected memories or any memories

Undifferentiated Schizophrenic

Many varied symptoms

Eating Disorders

May involve: Unrealistic body image and extreme body ideal. A desire to control food and the body when one's situation can't be controlled Cycles of depression Health problems

The Biopsychosocial Approach: Psychological Disorder

Mental disorders can arise in the interaction between nature and nurture caused by biology, thoughts, and the sociocultural environment.

Dissociative Identity Disorder (D.I.D.)

Multiple Personality Disorder Development of separate personalities. In rare cases personalities: e distinct, and not present in consciousness at the same time. may or may not appear to be aware of each other. Alternative Explanations for D.I.D. Dissociative "identities" might just be an extreme form of playing a role. Cases of D.I.D. might be created or worsened by therapists encouraging people to think of different parts of themselves.

Prevalence of Schiz

Nearly 1 in 100 people develop schizophrenia, slightly more men than women

OCD

Obsessions are intense, unwanted worries, ideas, and images that repeatedly pop up in the mind. A compulsion is a repeatedly strong feeling of "needing" to carry out an action, even though it doesn't feel like it mass sense.

Schiz Symptoms: Inappropriate Emotions

Odd & socially inappropriate responses such as looking bored or amused while hearing of a tragedy or death Flat affect: facial/body expression is "flat" with no visible emotional content Impaired perception of emotions, including not "reading" others' intentions and feelings

Schiz Symptoms: Inappropriate Actions and Behavior

Odd and socially inappropriate behavior can be caused by symptoms such as: errors in social perception. disorganized, unfiltered thinking. delusions and hallucinations. The schizophrenic body exhibits symptoms such as: repetitive behaviors such as rocking and rubbing. catatonia, such as sitting motionless and unresponsive for hours.

Psychological Disorders

Patterns of thought, feelings, or actions that are deviant, distressful, and dysfunctional/

Schiz Symptoms: Disturbed Perceptions

People with schizophrenia often experience hallucinations, that is, perceptual experiences not shared by others. The most common form of hallucination is hearing voices that no one else hears, often with upsetting (e.g. shaming) content. Hallucinations can also be visual, olfactory/smells, tactile/touch, or gustatory/taste.

Mania

Period of hyper-elevated mood that is euphoric, giddy, easily irritated, hyperactive, impulsive, overly optimistic, and even grandiose.

Pinel's new Approach

Philippe Pinel (1745-1826) and others sought to reform brutal treatment by promoting a new understanding of the nature of mental disorders. Pinel proposed that mental disorders were not caused by demonic possession, but by environmental factors such as stress and inhumane conditions. Pinel's "moral treatment" involved improving the environment and replacing the asylum beatings with patient dances.

Paranoid Schizophrenic

Plagued by hallucinations, often with negative messages, and delusions, both grandiose and persecutory

Positive effects of Schizophrenia

Presence of problematic behaviors Hallucinations (illusory perceptions), especially auditory Delusions (illusory beliefs), especially persecutory & grandeur Disorganized thought and nonsensical speech Bizarre behaviors

Disorganized Schizophrenic

Primary symptoms are flat affect, incoherent speech, and random behavior

the Medical Model

Psychological disorders can be seen as psychopathology, an illness of the mind. Disorders can be diagnosed, labeled as a collection of symptoms that tend to go together. People with disorders can be treated, attended to, given therapy, all with a goal of restoring mental health.

Catatonic Schizophrenic

Rarely initiating or controlling movement; copies others' speech and actions

Dissociative Disorder

Refers to dysfunction and distress caused by chronic and severe dissocition

Panic Disorder

Repeated and unexpected panic attacks, as well as a fear of the next attack, and a change in behavior to avoid panic attacks. May Include: many minutes of intense dread or terror chest pains, choking, numbness, or other frightening physical sensations. a feeling of a need to escape

Social-Cultural Influences on Psychological Disorder

Roles Expectations Definitions of normality and disorder

Psychological Influences on Psychological Disorder

Stress Trauma Learned helplessness Mood-related perceptions and memories

Development of Schiz

The course of schizophrenia can be acute/reactive or chronic.

Schizophrenia

The mind is split from reality, a split from one's own thoughts so that they appear as hallucinations. Symptoms include: Disorganized and/or delusional thinking. disturbed perceptions inappropriate emotions and actions

Onset of Schiz

Typically, schizophrenic symptoms appear at the end of adolescence and in early adulthood, later for women than for men.

Axis X

What is the global assessment os this person's functioning?

Classifying Psychological Disorders

What is the value of talking about diagnoses instead of just talking about individuals? Diagnoses create a verbal shorthand for referring to a list of associated symptoms. Diagnoses allow us to statistically study many similar cases, learning to predict outcomes. Diagnoses can guide treatment choices.

Residual Schizophrenic

Withdrawal continues after positive symptoms have disappeared

Social Phobia

an intense fear of being watched and judged by others. It is visible as a fear of public appearances in which embarrassment or humiliation is possible, such as public speaking, eating, or performing.

Acute.Reactive Schiz

in reaction to stress, some people develop positive symptoms such as hallucinations. Recovery is likely

Dissociative

s separation of conscious awareness from thoughts, memory, bodily sensations, feelings, or even from identity. It can serve as a psychological escape from an overwhelmingly stressful situation

Distress and Dysfunction

sufficiently severe to interfere with one's daily like and well being.

Depression is everywhere

the "common cold" of disorders The #1 reason people seek mental health services. Depression appears worldwide: Per year, depressive episodes happen to about 6% of men and about 9% of women. Over the course of a lifetime, 12% of Canadians and 17% of Americans experience depression. is more dangerous because of suicide risk. has fewer observable symptoms. is more lasting than a cold, and is less likely to go away just with time. is much less contagious.

Agoraphobia

the avoidance of situations in which one will fear having a panic attack, especially in which it is difficult to get help, and from which it difficult to escape.


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