Chapter 14 Notes
Chapter 14 Notes 11762-002
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This 12 page Bundle was uploaded by Colean Notetaker on Wednesday December 9, 2015. The Bundle belongs to 11762-002 at Kent State University taught by John Updegraff in Fall 2015. Since its upload, it has received 25 views. For similar materials see General Psychology in Psychlogy at Kent State University.
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Date Created: 12/09/15
Colean Bowman John A. Updegraff Disorders (Chapter 14) Psychological Disorders Issues in diagnosing disorders Mood disorders Major depressive disorder, bipolar disorder Anxiety disorders Panic disorder, phobias, obsessive compulsive disorder Dissociative disorder a.k.a, “multiple personality disorder” Schizophrenia Classifying Disorders Diagnostic and Statistical Manual of Mental Disorders (DSMIV) Provides set of criteria for diagnosing mental disorders Classification describes clusters of symptoms Describes the symptoms Predicts its future course Implies the appropriate treatment Stimulates research into its causes Over 400 categories of disorders in today’s DSMIV DSMIV Criteria for Depression FIVE or more of the following symptoms present for 2week period (but must have one of the first two) Depressed mood most of day, nearly every day Loss of interest or pleasure in almost all activities most of the day, nearly every day Weight change of 5%, or significant change in appetite Too much or too little sleep nearly every day Observable psychomotor agitation or retardation every day Loss of energy nearly every day Feelings of worthlessness or excessive guilt nearly every day Diminished ability to think or concentrate nearly every day Recurrent thoughts of death, suicidal ideation, or suicidal attempt Symptoms cause distress or impairment in functioning Symptoms not due to substance use, medical condition, or bereavement Issues in Understanding Disorders Disorders are defined not only by their deviance, but also by how much distress and impairment it causes in a person’s life Diagnosis is important for understanding and treating psychological disorders Diagnosis can also create stigma, false expectations and erroneous perceptions Prevalence of Various Disorders Anxiety disorders: 21% Phobias: 14% Generalized anxiety: 4% Obsessivecompulsive disorder: 3% Mood disorders: 8% Antisocial personality: 3% Schizophrenia: 1% Alcohol dependence: 14% Major Depressive Disorder Will affect about 17% of people It’s the “common cold” of mental disorders Symptoms Person experiences 2+ weeks of Depressed moods Feelings of worthlessness Sleep difficulties Loss of interest in pleasure and activities …All for no obvious reason Women are almost twice as likely to be diagnosed with depression Most often diagnosed in late adolescence through adulthood Most depressive episodes last a few weeks But 5060% of those who suffer one episode will eventually have a more severe recurrence Causes of Depression Biological factors Genetics: If identical twin has had it, 50% chance you’ll get it Norephinephrine and serotonin levels are lower in depressed brains Social factors Loneliness Disruptions in social relations often lead to episodes of depression Causes of Depression Cognitive factors Learned helplessness: the belief that you can’t control important things in life Negative explanatory style: tendency to blame negative events on factors that are Internal (“It’s my fault”) Stable (“It won’t change”) Global (“It affects every part of my life”) Rumination: brooding, repetitive thinking about negative events Treatment – usually includes a combination of Cognitive techniques Identifying negative thought patterns Replacing them with more adaptive thoughts Selective serotonin reuptake inhibitors (SSRI’s) Prozac, Paxil, Zoloft, Luvox, Celexa… In extreme cases, electroconvulsive (“shock”) therapy Bipolar Disorder Marked by uncontrollable cycles between Episodes of depression Mania, a state of hyperactivity and wild optimism Early stages of mania are usually very enjoyable They will feel lots of energy, creativity, optimism, exhilaration, confidence Later stages of mania can be destructive Sleeplessness, distraction, delusions of grandeur (ex: thinking you’re the second coming of Jesus) People get into trouble financially, socially, and sexually When mania is over, depression hits HARD Causes Bipolar has a strong genetic component If identical twin has it, odds are 72% that you’ll get it Half of bipolar sufferers have a parent with a mood disorder Treatment Most common treatment is lithium Lithium act’s as a mood stabilizer Panic Disorder Will affect about 13% of population More common in females Symptoms Person experiences sudden episodes of intense dread and anxiety, including: Heart palpitations, hyperventilation, occasional fainting Often, feelings of unreality and detachment from body Person often fears going crazy, losing control, or dying After the first attack, person often develops: Fear of fear – fear of having another panic attack Agoraphobia – fear of going outside Causes Unclear, but first panic attack often happens after a stressful life event, such as an illness, or miscarriage. Treatment Can often successfully treat w/o use of drugs Therapy often includes some combination of: Relaxation training Exposure therapy Generalized Anxiety Disorder (GAD) Will affect about 4% of population Symptoms Person feels continually aroused, but often doesn’t know why Person worries constantly and excessively about things like: Money, work, family matters, illness Person is highly sensitive to criticism Person has difficulty making decisions Causes Frequent and unpredictable traumatic experiences in childhood can predispose a person to GAD Often, it first appears following a stressful experience Treatment Typically tranquilizers, such as Xanax, Valium, Libruim Dangerous when combined with alcohol Specific Phobic Disorders Will affect about 10% of population Phobias Persistent, irrational fear and avoidance of specific object or situation Most common specific phobias are: Ophidiophobia – fear of snakes Acrophobia – fear of heights Aerophobia – fear of flying in airplanes Claustrophobia – fear of small, enclosed spaces Arachnophobia – fear of spiders Brontophobia – fear of thunderstorms Monophobia – being alone Causes Some phobias may be based on actual experiences A bad experience flying Witnessing a plane crash Observing another person’s fear of flying Some phobias may be based in evolution Fear of darkness, heights, and snakes may be genetically programmed Treatment Phobias can often be successfully treated w/o drugs Therapy usually includes behavioral techniques such as: Flooding Systematic desensitization Virtual reality systematic desensitization ObsessiveCompulsive Disorder Will affect about 3% of population Symptoms Obsessions: Person has unwanted repetitive thoughts Compulsions: Behavior rituals performed in response to the obsessions To qualify for OCD, obsessions and compulsions must: Consume more than 1hr per day Interfere with work or social relationships Common manifestations of OCD Contamination/germs People will go to excessive lengths to wash hands, sanitize homes Need for symmetry Person’s environment must be orderly and symmetrical Causes of OCD remain unclear, but… Biological causes People with OCD have increased activity in the caudate nucleus, a part of the brain involved in initiating habitual behaviors Strep throat infections may cause earlyonset OCD in children Learning through operant conditioning Compulsions are rewarding because they help reduce a person’s anxiety surrounding obsessive thoughts Treatment Usually includes a combination of Behavioral techniques: Exposure and response prevention Cognitive techniques: Relabeling obsessions/compulsions as symptoms of a medical disorder Refocusing attention to a constructive behavior (such as hobbies or exercise) whenever an obsession appears Dissociative Identity Disorder a.k.a., Multiple personality disorder EXTREMELY, EXTREMELY RARE! Person has two or more identities (“alters”) that alternately control the person’s behavior Often, the original personality denies any awareness of the others May be caused by physical or sexual abuse as a child A very controversial disorder Symptoms often emerge and are most dramatic after beginning therapy. “Alters” often appear during hypnosis by a therapist who tries to probe for multiple personalities Most reported cases of DID come from a small group of therapist What is Schizophrenia? Schizophrenia is NOT multiple personality disorder. Schizophrenia is“split mind” – mind is split from reality It is a disorder that affects how people think, perceive, feel, and act. It only affects about 1% of the population, but is a very severe and very costly disorder. What are the costs? Approximately 1015% of homeless people have schizophrenia Rates of drug and alcohol addiction are very high (~50%) Approximately 10% of people with schizophrenia commit suicide. Schizophrenia: Positive Symptoms Delusions: Irrational beliefs about the world. “My landlord is trying to poison me” (delusion of persecution) “I invented the internet” (delusion of grandeur) “The CIA are monitoring my thoughts” (thought broadcasting) Hallucinations: Perceiving things that aren’t there “I hear voices” (auditory hallucination) “I see demons” (visual hallucination) Disordered thinking Incoherent speech, odd trains of thought Schizophrenia: Negative Symptoms Lack of motivation Leads to problems with work, school, even basic selfcare Flattened or inappropriate emotions Poverty of speech Reduced talking, reduced verbal fluency Schizophrenia: Possible causes Schizophrenia is a strongly genetic disorder If identical twin has it, odds are about 50% that you’ll get it Schizophrenia also linked to nongenetic fx: Prenatal viral infections Oxygen deprivation at birth Schizophrenia: Brain abnormalities Schizophrenia related to brain abnormalities Enlarged ventricles Reduction in gray matter Dopamine overreactivity May explain positive symptoms Low brain activity in the frontal lobes May explain negative symptoms Par Schizophrenia: Treatment Treatment is primarily through medications Schizophrenia follows a “rule of quarters” ¼ will get well and will not get sick again ¼ will need to take medications but can live independently ¼ will need to take medications and live in a group facility ¼ will not recover 15% will not respond to medication, 10% will commit suicide Recovery often depends on type of onset Acute onset – prognosis is relatively good Chronic onset – prognosis is not so good
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