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Psychological Disorders - Lecture #23
Intro To Psychology (PSYC 201)
University of Louisville
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Psychological Disorders - Lecture
11/21/
Psychological Disorders ● Deviant. ○ Different from the “normal”. ■ Defined by culture and context. ■ Changes over time. ● Distressful. ○ Causes distress to the person or others. ○ Dangerous to themselves or to others. ● Dysfunctional. ○ Interferes with normal day-to-day life. Understanding Psychological Disorders ● Until about 200 years ago psychological disorders were caused by demons. ○ Ancient treatments of psychological disorders included: boring holes in the skull, exorcism, beatings, and transfusions of animal blood. ● When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of other psychological disorders. ● The medical model holds that psychological disorders have physical causes that can be diagnosed, treated, and in most cases cured, often through hospital treatment. Biopsychosocial Approach ● Psychological disorders are the result of: ○ Genetic predispositions and physiological states. ○ Inner psychological dynamics like stress appraisal and coping. ○ Social and cultural circumstances.
Classifying Psychological Disorders ● The American Psychiatric Association created a handbook for classifying psychological disorders. ○ 541 categories! ● The WHO uses the International Classification of Diseases ○ DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders) ■ Some DSM-5 criteria for a specific phobia are: ● Marked and out of proportion fear within an environmental or situational context to the presence or anticipation of a specific object or situation ● The phobic situation(s) is avoided or else is endured with intense anxiety. ● The avoidance, anxious anticipation or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. Diagnostic Classification: General Criticism ● The DSM has been criticized for using labels. ○ May stigmatize individuals. ■ Labels bias our thoughts and behavior. ● “gifted” children may get special treatment. ● No one hires a “mentally-ill” babysitter. ● Labels do have benefits: ○ describe a disorder. ○ predict its course. ○ suggest appropriate treatment. ○ stimulate research into causes. ● Necessary to label someone before insurance can be billed and treatment can be prescribed. DSM-5 Issues ● Pharmaceutical influence on mental health diagnoses. ○ Some psychologists (Cosgrove & Bursztajn, 2009) have pointed out that 18 out of 27 members of the DSM-5 task force had direct links to the pharmaceutical industry. ○ Antipsychotic and antidepressant medication is a billion dollar industry. ● “Medicalizing” mental health or “casting too wide a net” ○ Past versions were criticized for including experiences that were too “normal” to be considered as disorders. ■ Rambunctiousness or ADHD. ○ In the DSM-5, diagnostic thresholds were lowered for some disorders and new disorders were added that could lead to inappropriate medical treatment ■ Medicalizing grief is most notorious. ● In the DSM-IV, The criteria for Major Depressive Disorder made a specific exception for people recently bereaved. This was removed in the DSM-5,
■ Hoarding ■ Trichotillomania Obsessive-Compulsive Disorder ● Characterized by unwanted repetitive thoughts (obsessions) and urges to perform certain actions (compulsions). ○ This behavior is considered a disorder when it brings significant distress (from resisting these thoughts and actions) or when the time spent on obsessions and/or compulsions interferes with daily life. ■ Checking the door once or 10 times.
Hoarding ● Compulsion to collect large quantities of objects that leads to impairment. ○ Issues with physical and mental health. ○ May be conscious of the behavior, but the emotional attachment to the objects outweighs the desire to remove them. Trichotillomania (Hair Pulling) ● A compulsive urge to pull out hair, which brings pleasure or relief from tension. ○ Typically only pull 1 hair at a time, but sessions can last for hours. ○ May not even realize they are pulling out their hair. Post-Traumatic Stress Disorder ● Previously an anxiety disorder, but the DSM-5 classifies it as a Trauma- and Stressor-Related Disorder. ○ Characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety and/or insomnia that lingers for longer than four weeks after the traumatic experience. ■ Arises from traumatic experiences such as combat or being the victim of a natural disaster, terrorist incident, or violent crime. ■ The worse the trauma the greater the chance of PTSD. ■ Most survivors show remarkable resilience against traumatic situations. ● Only about 10% of women and 5% of men react to traumatic situations and develop PTSD. Understanding Anxiety Disorders Learning Perspective ● Fear conditioning:
○ Learning theorists suggest that fear conditioning leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced because avoiding the feared situation reduces our anxiety. ● Observational Learning: ○ Parents may transmit fears to their children. ○ Young monkeys develop fear when they watch other monkeys who are afraid of snakes. Understanding Anxiety Disorders Biological Perspective ● Genes: ○ Some people may be predisposed to anxiety. ■ Twins are more likely to share phobias. ● Brain: ○ Anxiety disorders, OCD, and PTSD are linked with overarousal in brain regions linked to impulse control and habitual behaviors. ● Natural Selection: ○ Humans seem biologically prepared to fear specific threats such as snakes, spiders, and heights. Mood Disorders ● Most people have an occasional “mood swing,” but a mood disorder involves significant and persistent disruptions in mood or emotions that cause impaired cognitive, behavioral, and physical functioning. ○ These changes often don’t relate to the environment Major Depressive Disorder ● Characterized by extreme and persistent feelings of despondency, worthlessness, and hopelessness, combined with lethargy and a lack of interest in and enjoyment of most activities. ○ Change in emotions, thoughts, and behaviors ● Depression is the “common cold” of psychological disorders. ○ Most common reason for seeking mental health services (about 7% of Americans yearly). ○ It is the leading cause of disability worldwide afflicting at least 350 million people (WHO, 2012).
○ The risk is usually the worst when people start to get better. ● Suicidal urges increase when people feel: ○ Disconnected from others. ○ A burden to others. ○ Defeated and trapped by a situation. ● Non-suicidal self-injury may escalate to suicidal thoughts and attempts. ○ If a friend talks about suicide or engages in self-injury you may want to direct them to get professional help. ● Watch out for hindsight bias. – it’s always easier to predict the past than to predict the future. Understanding Mood Disorders ● Common facts about depression: ○ Behavioral and cognitive changes. ■ People become inactive, recall negative information, and expect negative outcomes. ○ Depression is worldwide. ■ Rates vary by culture but the cause must be universal to all humans. ○ Major depression is twice as likely in women. ■ Begins in adolescence; maybe. ● Most depressive episodes self-terminate. ● Stressful events often precede depression. ● Depression is increasing and striking earlier in life ○ Three times more likely than your grandparents to report having ever suffered depression. ■ More stress today? ■ Differences in reporting? ■ Forgetting? Causes of Depression
Psychological Influences
● Explanatory style plays a major role in becoming depressed. Depression Cycle ● Negative stressful events. ● Pessimistic explanatory style. ● Hopeless depressed state. ● These hamper the way the individual thinks and acts, fueling personal rejection.
Psychological Disorders - Lecture #23
Course: Intro To Psychology (PSYC 201)
University: University of Louisville
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