PSYCHOLOGICAL DISORDERS

 

　

　

 

DEFINING AND EXPLAINING ABNORMAL BEHAVIOR

 

 

For ex. Taking 7 showers a day

 

For ex. - agoraphobia - won’t go out of the house

 

For ex. - bipolar disorder - mood swings distressing to self and others

 

 

Abnormal behavior is the basis for psychological disorders.

 

There are many theoretical approaches to understanding psychological disorders, but the biopsychosocial model is the predominant viewpoint. -

 

It is the interactionist approach - which means that psychological disorders can best be explained as resulting from an interaction of

 

 

 

 

 

Depletion of neurotransmitters is the set - up for developing many of the psychological disorders that we will discuss - in particular depression

 

When someone first comes to counseling with , for example, symptoms of depression, they will often say, “I don’t know why I feel this way”…..I was unemployed for six months last year, but I handled it well, and now I have a new job that I love…so it doesn’t make sense…

 

If we look at the role of depletion, however, it does make sense…the stress of losing a job is depleting and the stress of starting a new job is depleting.

 

 So, psychologically the person might have felt that the new job was the solution to the problem…when in fact it may have been the straw that broke the camels back…

 

In all of the psychological disorders that we will discuss…stress plays a role in the onset , in the recurrence, and in the severity of symptoms

 

 

Simple definition of stress - any demands placed upon you.

 

This definition includes “positive” stress. It all counts.

 

Finding a healthy balance is so crucial to preventing illness - and each time you add on a stressor, try to add on an equivalent stress buster

 

If you’re not able to add on Both , then don’t take on the stressor if it can be avoided.

　

 

 

 

　

Disadvantages and criticism -

 

1. Stigma - on the one hand, a label might bring initial relief/validation…it is generally accompanied by stigma - stereotypes re mental illness

 

It is this fear of stigma that continues to prevent many people from seeking help at all and from seeking help at the earliest possible point.

 

2. Manual includes too many “disorders” that we do not consider a mental health disorder - includes problems with handwriting and math

 

3. Follows the medical model and defines disorders by symptoms and the # of symptoms that must be present to warrant the diagnosis - controversy about how some disorders are defined.

 

For ex. ADHD..used to require that it was realized prior to age 6...so adults were not included since ADHD was not defined as such during their childhoods…

 

 

When diagnoses are made according to DSM-IV, the diagnoses are coded according to a multi-axial system

 

There are 5 axes

 

Axis I: All diagnostic categories except personality disorders and mental retardation

 

Axis II: Personality disorders and mental retardation

 

Axis III: General Medical Conditions

 

Axis IV: Psychosocial and environment problems

 

Axis V: Current level of functioning - GAF score - Global Assessment of Functioning Score

 

 

See textbook page 529 for Major Categories of Psychological Disorders

　

　

Dimensional approach - rather than thinking about psychological disorders as different categories which suggests that people with disorders are “different” to the point of needing a category of their own….the dimensional approach looks at disorders along a dimension or a continuum - so that disorders are just an extreme form of traits that we see in the general population

 

symptoms are diagnosed on a continuum of severity - mild, moderate, severe…

 

 

 

Levels of anxiety that, if left untreated, would impair their ability to function effectively

 

Important to note that many individuals have these disorders, but are able to function effectively due to treatment…..usually medication and counseling

 

 

Types of anxiety disorders include :

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1. Generalized anxiety disorder

 

2. Panic disorder

 

3. Phobic disorder

 

4. Obsessive-compulsive disorder

 

5. Post-traumatic stress disorder

　

　

 

Persistent anxiety for at least 6 months

 

Inability to specify reasons for the anxiety - not completely true -

They are the “worriers” - they worry about everything and they also have feelings of anxiety that they can’t attach to something

 

Prevalence is 3% of adults or 6.8 million

　

 

For generalized anxiety disorder -

 

1. Genetic

 

2. GABA deficiency

 

3. Respiratory system abnormalities - breathing problems = anxiety

 

Psychosocial factors

 

4. Harsh self - standards perfectionism

 

5. Overly strict and critical parents

 

6. Automatic negative thoughts in the fact of stress - pessimism

 

7. A history of uncontrollable stressors or traumas - persistent stress

　

　

　

 

Recurrent panic attacks - that may occur without warning

 

Doesn’t necessarily feel anxious all the time

 

Symptoms of panic attacks include -

 

- heart palpitations

- shortness of breath

Chest pains

Trembling

Sweating

Dizziness

Feeling of helplessness

Fear of dying

Fear of going crazy

Worry that they are having a heart attack

 

Prevalence - 2% of adult population - or 6 Million

　

When making a diagnosis, panic disorder is classified as with or without agoraphobia.

 

With agoraphobia means that panic disorder is accompanied by avoidance of public places out of fear that the panic attack will occur in front of other people and result in humiliation or embarrassment -

 

 or because of feeling trapped in crowded areas and therefore unable to escape if a panic attack occurs -

 

 

Some individuals become so fearful of having a panic attack, that they become housebound and a “true” agoraphobic - afraid to go out of the house

 

Some people will not leave the house unless with a trusted person - and others will not leave at all - years

 

Etiology - causes

 

Biological causes -

 

1. Genetic - runs in families

 

2. Perhaps an overactive autonomic nervous system

 

3. Deficits in GABA and/or norepinephrine

 

4. Hormonal factors - women more likely than men…or are men underreported?

 

Psychosocial causes -

 

1. Do men underreport panic disorder - more common in women in U.S…but in India, men have a higher incidence of panic disorder - this could be due to cultural factors there, where women seldom leave home alone - and feel safer - less likely to panic

 

2. A stressful life event usually occurred in the 6 months prior to the onset of panic disorder - usually a separation from a loved one or a change in job

 

3. History of trauma can contribute to the development of panic disorder

 

 

Many people have fears of certain things, but a fear becomes a phobia when the thing or situation becomes so dreaded that a person goes to almost any length to avoid it.

 

Phobias are fears that are uncontrollable, disproportionate, and disruptive

 

Social phobia - is an intense fear of being humiliated or embarrassed in social situations

 

30% of adults have experienced social phobia - social anxiety disorder

 

Singers Barbra Streisand and Carly Simon have battled this throughout their lives

 

 

Biological

 

1. Genetic predisposition - with claustrophobia and social phobia

 

2. Low levels of seratonin for social phobia / social anxiety disorder

 

Psychosocial

 

1. Psychodynamic theorists say that the phobias develop as a defense mechanism

To ward off unacceptable impulses

Ex. Fear of heights is actually fear of the impulse to jump off of a high place

 

2. Learning theorists - say that phobias are learned fears.

 

 

 

 

Obsessive-compulsive disorder is an anxiety disorder in which the individual has

anxiety-provoking thoughts that will not go away and/or urges   to perform repetitive behaviors to prevent or produce some future situation.

 

Some individuals with this disorder repeat the behaviors hundreds of times a day.

 

　

 

There is some genetic component because OCD runs in families. The frontal cortex or basal ganglia are active in individuals with OCD. There may also be depletion in serotonin.

 

 

In terms of psychological factors, OCD usually occurs during a stressful life event.

 

Video www.dsc.discover.com     OCD Part 2    first half of video *******

 

 

Compulsive hoarding or pathological hoarding -  the excessive acquistion of possessions ( and failure to use or discard them), even if the items are worthless, hazardous, or unsanitary

 

Hoarding - is considered by some to be a form of obsessive-compulsive disorder because of the compulsive aspect and the anxiety associated with it - may end up being a separate disorder in the next DSM - currently not in the DSM-IV.  Hoarding has also been associated with ADHD because of chronic and severe disorganization found with both disorders.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prevalence - 16.2% of adults have had a major depressive episode in their lifetime.