DISORDERS AND TREATMENT

Review Session 10

What is Abnormal?

Common characteristics 1) It is maladaptive (harmful) and

disturbing to the individual Agoraphobia- afraid of public places do unable

to leave home 2) It is disturbing to others

Zoophilia- sexually aroused by animals 3) It is unusual; based on culture!

Seeing visions 4) It is irrational

Depressed when your family moves- rational

The DSM-IV

Insane-not a medical term but a legal term

Causes by Perspective

Categories of Disorders

6 Categories Anxiety Somatoform Dissociative Mood/Affective Schizophrenic personality

Anxiety Disorders- Phobias

Specific Phobia Intense unwarranted fear of a situation or

object Claustrophobia, Arachnophobia, etc.

Agoraphobia a fear of open, public spaces

Social Phobia fear of embarrassing oneself in public

Contact with the feared object or situation results in anxiety

Anxiety Disorders

Generalized Anxiety Disorder (GAD) Constant, low level anxiety Constantly feels nervous and our of sorts

Panic Disorder Acute episodes of intense anxiety without

any provocation Often suffer anxiety due to anticipating

the attacks

Anxiety Disorders

Obsessive-Compulsive Disorder (OCD) Persistent, unwanted thoughts- obsessions Feeling the need to engage in a particular

action- compulsions Obsessions result in anxiety that is reduced

when the compulsive behavior is performed Post-Traumatic Stress Disorder (PTSD)

Flashbacks or nightmares following a person’s involvement in or observation of an extremely troubled event (wars, disasters, etc.)

Memories cause anxiety

Causes of Anxiety Disorders

Somatoform Disorders

A person manifests a psychological problem through a physiological symptom Physical problem without a physical cause

Hypochondriasis Frequent physical complaints with no medical

cause May believe minor problems are severe physical

illness Conversion Disorder

Report a severe physical problem such as paralysis or blindness with no physical reason

Causes of Somatoform Disorders

Dissociative Disorders

Involve a disruption in conscious processes Psychogenic Amnesia

When a person cannot remember things for no physiological reason

Psychogenic Fugue Not only have psychogenic amnesia but also find

themselves in an unfamiliar environment Dissociative Identity Disorder (Multiple

Personalities) A person has several personalities rather than one

integrated personality Personalities may have different ages, sexes Commonly have a history of sexual abuse or

childhood trauma

Causes of Dissociative Disorders

Mood or Affective Disorders

Major Depression Most common Remain unhappy for more than two weeks

with no clear reason Loss of appetite, fatigue, sleep changes,

feeling worthless Seasonal Affective Disorder (SAD)

Only depressed during certain types of year Use of phototherapy

Mood or Affective Disorders

Bipolar Disorder Manic Depression- involves both depressed

and manic episodes Depressed- depression symptoms Manic- feelings of high energy

Some have a heightened sense of confidence and power, others just feel anxious and irritable

Usually engage in risky behavior

Causes of Mood Disorders

Schizophrenic Disorders

Tends to strike people as young adults Disordered, distorted thinking often demonstrated

through delusions and hallucinations Delusions- beliefs that have no basis in reality

Delusions of persecution- believing people are out to get you

Delusions of grandeur- belief that you enjoy greater power and influence than you do

Hallucinations- perceptions in the absence of any sensory stimulation

Schizophrenics DO NOT have split personalities Positive Symptoms- excesses of behavior Negative Symptoms- correspond to deficits of

behavior

Types of Schizophrenia

Causes of Schizophrenic Disorders

Causes of Schizophrenic Disorders

Personality Disorders

Generally less serious Well-established, maladaptive ways, of

behaving Antisocial Personality Disorder- have

little regard for other people’s feelings (often criminals)

Dependent Personality D/o- depend too much on others

Histrionic Personality Disorder- overly dramatic

Other Psychological Disorders Paraphilias/Psychosexual Disorders-

sexual attraction to an object, person, or activity not usually seen as sexual

Eating Disorders- Anorexia and Bulimia

Substance Abuse Disorder Autism- atypical social development ADHD

The Rosenhan Study (1978)

David Rosenhan and his associates sought admission to mental hospitals, claiming that they had been hearing voices; all were admitted as suffering from schizophrenia At that time, they ceased reporting any

unusual symptoms and behaved as usual None were exposed, all leftwith the diagnosis

of schizophrenia in remission Should people who were once diagnosed

carry it the rest of their lives? To what extent are disorders the product of

the environment? What is the level of institutional care

available of the imposters could go undetected for weeks?

Types of Therapy- Generally Effective

Psychoanalytic Therapy

Cause of disorders in unconscious conflicts; must identify the underlying cause

Symptom substitution- happens in other types of therapy when the underlying problem is not addressed; person will have a new psychological problem

Hypnosis- an altered state of consciousness where people are less likely to repress troubling thoughts

Psychoanalytic Theory

Free Association- saying whatever comes to mind, we cannot constantly sensor everything we say

Dream Analysis- the ego’s defenses are relaxed during sleep Manifest content- what a patient reports

about their dream Latent content- the hidden

content revealed by interpretive work

Psychoanalytic Theory

Resistance- disagreeing with their therapist’s interpretations Strongly voiced- close to getting at the

actual problem Transference- having strong feelings

toward their therapist Love, hate, etc.

Psychodynamic- after Freud (Adler, Horney etc.)

Humanistic Theory

Focuses on helping people understand and accept themselves and strive to self-actualize

People are innately good and possess free will- capable of controlling their own destinies (opposite of determinism)

Carl Rogers (Client Centered Therapy) The therapist provides the patient with

unconditional positive regard (support no matter what)

Essential to healthy development

Humanistic Therapy

Non-directive- do not tell client what to do, but seek to help clients choose the best course of action for themselves Active listening- clarify feelings for client-

(“So what I’m hearing you say is…”) Gestalt Therapy (Perls)- encourage client

to get in touch with their whole selves Body position, minute actions Stress importance of the present

Behavioral Therapy

Counterconditioning- a kind of classical conditioning in which an unpleasant conditioned response is replaced with a pleasant one Give Bentley a treat when he is put in his cage

Systematic Desensitization- teaching the client to replace the feelings of anxiety with relaxation Teach the client to relax Create an anxiety hierarchy- rank ordered list of

what the client fears and tackle each one

Behavioral Therapy

Flooding- address the most frightening scenario first to realize fears are irrational

Modeling- learning by observing the behavior of others

Aversive conditioning- pairing a habit one wishes to break with an unpleasant stimulus

Token Economy- identify desired behaviors and reward them for tokens that can be exchanged

Cognitive Therapy

Changing unhealthy thought patterns Attributional Style- healthy views

failures as external, specific, and temporary (vs. unhealthy)

Aaron Beck- Cognitive Therapy (used to treat depression)

Cognitive Triad

Cognitive Behavioral Therapies (CBT) Rational Emotive (REBT)- Albert Ellis

Expose and confront the dysfunctional thoughts of their clients

Question the likelihood of an event occurring and the impact that would result

Goal is to show the client that failure is an unlikely occurrence but that even if it did occur, its not that big of a deal

Somatic Therapy

Pharmacology/Chemotherapy- Drug Treatment

Type of Disorder

Treatment Type of Drug Drug Names

Anxiety Disorders

Depress CNS activity

Barbiturates, Benzodiazepines

Miltown, Zanax, Valium

Unipolar Depression

Increase Serotonin

MAOIs, Tricyclic Antidepressants, serotonin-reuptake inhibitors

Zoloft, Prozac

Bipolar Depression

Lower manic phase

Lithium

Schizophrenia Block dopamine receptor sites

Antipsychotics, Neuroleptics

Haldol

Somatic Therapy

Electroconvulsive Therapy (ECT) Passing electric current through the brain,

causing a brief seizure Can result in memory loss Used as a last resort for severe depression Not completely understood

Psychosurgery Prefrontal lobotomies- calmed patients to a

vegetative state

Practice Questions

1) All schizophrenics suffer from Depression Multiple personalities Flat affect Distorted thinking Delusions of persecution

2) Juan hears voices that tell him to kill people. Juan is experiencing Delusions Obsessions Anxiety Hallucinations Compulsions

3) Depression is associated with low levels of Acetylcholine Epinephrine Serotonin Dopamine GABA

4) What kind of psychologist would be most likely to describe depression as the result of an unconscious process in which anger is turned inward? Biomedical Psychoanalytic Cognitive Behavioral Sociocultural

5) Coretta’s therapist says little during their sessions and never makes any recommendations about what Coretta ought to do. What kind of therapy does Coretta’s therapist most likely practice? Psychdynamic Behavioral Cognitive Biomedical Humanistic

6) Maria has been in analysis for over a year. Recently, she has begun to suspect that she has fallen in love with Dr. Chin, her analyst. When she confesses her feelings, Dr. Chin is likely to tell Maria that she is experiencing Resistance Transference A breakthrough Irrational expectations Unconditional positive regard