Chapter 14: Psychological Disorders

Chapter 14: psychological Disorders

"Anyone who has actually been that sad can tell you that there's nothing beautiful or literary or mysterious about depression." ~ Jasmine Warga, My Heart and Other Black Holes

Content

Understanding Psychological Disorders

Personality Disorders

Anxiety

Dissociative Disorders

PTSD

Psychopathology

What is a Psychological Disorder

Schizophrenia

OCD

Depressive disorders

Close

Prevalence of....

Understanding Psychological Disorders

To understand psychological disorders, this includes considerations of their origins, symptoms, and development, as well as how behavior relates to cultural and social norms.

There is a belief that "crazy" or "abnormal" is very different from "normal." But what is "normal?" The difference in typical and atypical is determined by social and cultural context.

Psychopathology- scientific study of the origins, symptoms, and development of psychological disorders

When we see whose behavior strikes us as weird, unpredictable, or baffling, it is easy to dismiss them, even if their behavior is seriously disturbing. We will label them as "crazy," but that tells us nothing. What are their symptoms? What might be causing the symptoms? How did they develop? How might they be helped?

What is a psychological Disorder?

Lifetime prevalence of psychological disorders

This graph shows the lifetime prevalence for some of the major categories of psychological disorders based on findings from the National Comorbidity Survey Replication (NCS-R). The NCS-R reconfirmed that the lifetime prevalence of experiencing a psychological disorder is almost one out of two.

INTERACTIVE QUESTION

INTERACTIVE QUESTION

Anxiety Disorders, Posttraumatic Stress Disorder (PTSD), and Obsessive-compulsive disorder (OCD)

Anxiety

Anxiety disorders are as if you triggered a faulty car alarm that activates at the slightest touch and has a broken "off" switch. Pathological anxiety is irrational, uncontrollable, and disruptive. Anxiety occurs in different psychological disorders, but can manifest differently. PTSD and OCD are not technically anxiety disorders, but they include anxiety as a symptom.

An unpleasant emotional state characterized by physical arousal and feelings of tension, apprehension, and worry. Anxiety, even though it is unpleasant it can be helpful sometimes. Think of it as your personal internal alarm system that tells you something is wrong (ex., anxiety about your grades may motivate you to study harder). Anxiety can put you on physical alert as well as mental alert (you can become vigilant, scanning the environment for potential threats). Anxiety Disorders- a category of psychological disorders in which extreme anxiety is the main diagnostic feature and causes significant disruptions in the person's cognitive, behavioral, or interpersonal functioning.

"Worry is like a rocking chair: it gives you something to do but never gets you anywhere." ~Unknown

INTERACTIVE QUESTION

Depressive and Bipolar Disorders

In the depressive and bipolar disorders, disturbed emotions cause psychological distress and impair daily functions. are oftern referred to as "mood disorders" and are in their own distinct category in the DSM-5-TR. We all have our ups and downs. When things are going well, we feel cheerful and optimistic, and when events are more negative, our mood shifts to miserable and pessimistic. In the depressive, bipolar, and related disorders, emotions violate the criteria of typical moods. Mood changes persist much longer than the typical fluctuations (a person may feel pervasive sadness despite the best of circumstances, or they may be extremely energetic with no justification. Major Depressive Disorder (MDD)- a mood disorder characterized by extreme and persistent feelings of despondency, worthlessness, and hopelessness, causing impaired emotional, cognitive, behavioral, and physical functioning. symptoms; emotionally- feelings of sadness, guilt, or worthlessness. Cognitive- difficulty thinking, concentrating, and remembering. Behavioral- crying and withdrawal from social activities. Physical- changes in appetite and weight, sleep difficulties, and diminished sexual interest. Sucide is always a potential risk in MDD; people are more than three times as likely as others to attempt suicide.

Personality Disorders, Dissociative Disorders, Schizophrenia

"Had I not been Dissociative, I never would have survived."

~Wendy Hoffman, Whit Witch in a Black Robe: A True Story About Criminal Mind Control

Antisocial Personality Disorder

Personality Disorder

Involve inflexible, maladaptive, and stable patterns of thoughts, emotions, behavior, and interpersonal functioning that deviate from the expectations of the indidvidual's culture.

Personality disorder characterized by a pervasive pattern of disregarding and violating the rights of others.

Borderline Personality Disorder (BPD)

Dissociative Disorder

A category of psychological disorders in which extreme and frequent disruptions of awareness, memory, and personal identity impair the ability to function

A personality Disorder characterized by instability of interpersonal relationships, self-image, and emotions, and marked impulsivity.

INTERACTIVE QUESTION

"The best thing that people around you can do is to listen. Remember, a person with schizophrenia is trying to process the things that are happening. You may not be able to see or hear the voices or things that are happening in that person's brain."

~Mindy Tsai, Becoming Whole

Schizophrenia

Prevalence- every year, approximately 1 million people are treated for schizophrenia. The World Health Organization estimates less than 1 %, with more than 24 million people having schizophrenia worldwide. Extremely complex disorder, enormous individual variability in the onset, symptoms, duration of and recovery. Onset occurs during young adulthood. Twin studies were conducted, and it has been determined that there are genetic factors along with environmental factors that contribute to the development of this diagnosis.

A psychological disorder in which the ability to function is impaired by severely distorted beliefs, perceptions, and thought processes. Positive Symptoms (presence of)- an excess or distortion of typical functioning, including delusions, hallucinations, and disorganized thoughts and behavior. Negative Symptoms (absence or lack of)- reflect defects or deficits in typical functions, including flat affect. DSM-5-TR: diagnosed when two or more of characteristic symptoms are actively present for a month or longer- delusions, hallucinations, disorganized speech. Six months or more of odd behaviors, beliefs, perceptual experiences, and other less severe signs of mental disturbance. Symptoms often vary across cultures. U.S. people tend to experience auditory hallucinations, while people in Ghana and India are more likely to report a positive relationship with their voices

"Perhaps we are the real experts in schizophrenia. Ask us. Involve us. Acknowledge us. We can offer hope to others who are trapped in the snares of this illness. We can show a light on the path toward recovery." ~Andrew Dugmore

**Warning**

This video is a simulation of experiencing a moment of living with schizophrenia. This is an intense video; watch at your discretion and with care. I felt some anxiety while watching and found it stressful. Do not feel obligated to watch the full video; I have not. I like this video to show what it would be like to live with this disorder, and I think it is important to gain understanding and empathy.

INTERACTIVE QUESTION

The Suicide and Crisis Lifeline is 988. Life is hard sometimes, if you are facing mental health struggles please reach out!

Psych for your life

Hundreds of studies have identified psychosocial and environmental factors associated with an increased risk of suicidal behavior. Factors that increase the risk of suicidal behavior.

• feelings of hopelessness and social isolation
• recent relationship problems (cooped up together during the pandemic) or lack of significant relationships
• poor coping and problem-solving skills
• poor impulse control and impaired judgment
• rigid thinking or irrational beliefs

• major psychological disorder, esp. MDD, bipolar disorder, or schizophrenia, untreated
• childhood physical or sexual abuse
• prior self-destructive behavior
• a family history of suicide

THANK YOU

What would you like to add to this chapter? What questions do you have for me?

Have you ever seen someone walking alone talking to themselves? Does this seem like typical behavior to you? It depends. How would you decide whether or not the person's behavior seems "typical," "quirky," or "disturbing?" We can be judgmental when it comes to understanding behaviors that appear unusual.

Explaining OCD

Conditioning can reinforce OCD once someone develops an anxious response. An unpleasant feeling of anxiety can be temporarily relieved by giving in to compulsive behaviors like excessive handwashing. While it provides short-term relief, reinforcement has occurred, so the behavior is likely to be repeated. OCD has been linked to broad deficits in the ability to manage cognitive processes, such as attention. It may also be linked to dysfunction in brain areas involved in the fight-or-flight response, as well as the frontal lobes, which affect our ability to think and plan ahead. Deficiencies in the neurotransmitters norepinephrine and serotonin have been implicated in OCD. An excess of the neurotransmitter glutamate has also been found to be associated with OCS symptoms.

Obsessive-Compulsive Disorder (OCD)

Posttraumatic Stress Disorder (PTSD)

Disorder characterized by intrusive, repetitive, and unwanted thoughts (obsessions) and repetitive behaviors or mental acts that an individual feels driven to perform (compulsions). Obessions- repeated, intrusive, and uncontrollable irrational thoughts or mental images that cause extreme anxiety and distress. Compulsions- repetitive behaviors or mental acts that a person feels driven to perform to prevent or reduce anxiety and distress or to prevent a dreaded event or situation. Some people trivialize the term OCD, saying "I'm so OCD," to describe a behavior or a tendency to be extremely neat. People who are perfectionists and describe themselves in this way are most likely not suffering from OCD. People who have an actual diagnosis find this use of the phrase offensive and state that "OCD isn't cute." Examples: checking to stove 30 times to make sure it is off, repeatedly checking the coffee pot to make sure it is off, checking to door to make sure it is locked,

A disorder triggered by extreme trauma that results in intrusive memories, avoidance of stimuli, negative changes in thoughts and emotions, and a persistent state of heightened physical arousal. Extreme traumas are events that produce intense feelings of horror and helplessness, such as serious physical injury or threat of injury to yourself or a loved one. They have the same patterns of emotion, cognition, and behavior mark both PTSD and anxiety disorders. Originally and primarily associated with military combat but it can be developed in nonmilitary personnel exposed to violent conflicts. Survivors of natural disasters, physical or sexual assault, or terrorist attacks. They frequently recall the event, replaying it in their mind. can be triggered by unrelated events.

Prevalence of Psychological Disorders

How common are psychological disorders? Ronald Kessler and colleagues surveyed 9,000 Americans, 18 and older. This study was called the National Comorbidity Survey (NCS-R), which involved more than two years of face-to-face interviews, and participants were asked if they had experienced specific symptoms of psychological disorders in the previous 12 months and at any point in their lives. This study found that one out of four participants (26%) reported experiencing the symptoms of a psychological disorder during the previous year, and almost one in two adults (46%) experience symptoms at some point in their lives. A quarter of people in the U.S. with a mental illness have reported that they do not have access to treatment; the trend is shared globally. Reasons include lack of insurance, low income, lack of access to mental health care, lack of awareness, fear of stigmatization, and belief that treatment would not help.

It is a myth that most people with a psychological disorder are violent. Only about 4% of all violent acts are committed by people with a mental illness. If they are experiencing extreme psychological symptoms, the rate of violent events can be slightly higher. This is when the individual is in the middle of paranoid delusional ideas and auditory hallucinations. Violent behaviors can be exaggerated in media portrayals, which contributes to the stigma of mental illness.

• In the media, people with psychological disorders are portrayed in highly negative, stereotypical ways
• One stereotype is that mentally disturbed people are helpless victims; another is that they are evil villains who are unpredictable, dangerous, and violent.
• Are people with psychological disorders more violent than other people?

A traditional Hindu woman who refuses to eat onions, garlic, or other "hot" foods following her husband's death. Does this seem like "typical" or "abnormal" behavior?

Example

A pattern of behavioral or psychological symptoms that causes significant personal distress, impairs the ability to function in one or more important areas of life, or both.

What is it?

The qualification is the pattern of behavioral or psychological symptoms that must represent a serious departure from prevailing social and cultural norms

Qualification

Diagnostive and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)

This is the manual that is used to determine whether a given pattern of symptoms or behaviors qualifies as a psychological disorder. The first edition was published in 1952; each new edition was due to an increase in the number of distinct disorders. Most of the disorders are fairly common, such as Attention-Deficit/Hyperactivity Disorder and Anxiety. Prolonged grief disorder is a newer disorder that was recently added. Prolonged grief disorder is intense grief after the loss of a loved one that interferes with daily life beyond what is typically expected, given the cultural context. Diagnosed after more than six months of extreme grief for children and adolescents, and more than a year for adults.

• In the media, people with psychological disorders are portrayed in highly negative, stereotypical ways
• One stereotype is that mentally disturbed people are helpless victims; another is that they are evil villains who are unpredictable, dangerous, and violent.
• Are people with psychological disorders more violent than other people?

DSM-5-TR

Disorders such as homosexuality were dropped because we understand that sexual orientation is not pathological. Describes more than 260 specific psychological disorders and numerous additional conditions, like child physical abuse and educational problems. There are a total of more than 500 diagnostic categories. There are codes for each disorder that include the symptoms, criteria to make a diagnosis, and the frequency, typical course, and risk factors for each disorder. There are 10,130,814 different ways to be diagnosed. The most accepted diagnostic model right now, the U.S. National Institute of Mental Health (NIMH) is leading long-term efforts to develop a new diagnostic system called Research Domain Criteria or RDoC. Critiques- arbitrary cutoffs to draw a line between people with and without a disorder, two people with the damw diagnosis may not have overlapping symptoms, possible bias from the link between the authors and pharmaceutical industry

A mood disorder involving periods of incapacitating depression alternating with periods of extreme euphoria and excitement, formerly called manic depression Onset of the disorder occurs in the early 20s, typically, and is rarely diagnosed in childhood. Far less common than MDD. Stronger genetic roots than MDD.

• Personality disorders involve pervasive patterns of perceiving, relating to, and thinking about the self, other people, and the environment that interfere with long-term functioning.
• Researchers believe these reflect conditions in which typical personality traits are taken to an atypical extreme (it's not unusual to feel uneasy or sad when separated from a loved one. However, responses reach pathological extremes. This results in unbearably intense feelings of abandonment and emptiness.
• Maladaptive personality traits consistently cause personal or social turmoil; however, they tend to blame others for their difficulty.
• DSM-5-TR has 10 distinct personality disorders.

• Often referred to as a psychopath or sociopath.
• The individual has the ability to lie, cheat, steal, manipulate, and harm others.
• When caught, the person will show little or no remorse for having caused pain, damage, or loss to others. It is as though they have no conscience, empathy, or sense of guilt.
• Example: a mass murderer described his lack of empathy years before he committed his crimes- "as I hug my family, I look into their faces, I see nothing, it is like I am looking at a video game, but less."
• This pattern of blatantly disregarding and violating the rights of others is the central feature of antisocial personality disorder.

• BPD is more common in women than in men
• It is characterized by impulsiveness and chronically unstable emotions, relationships, and self-image.
• Moods and emotions are intense, fluctuating, and extreme, often vastly out of proportion to the triggering incident and seemingly uncontrollable.
• there are unpredictable swings from one mood to another, inappropriate, intense, and often uncontrollable anger.
• Relationships are chaotic and unstable; the person with BPD has a sense of emptiness and is desperately afraid of abandonment. They will cling to and then push people away.
• Caused by a combination of iological, psychological, and environmental factors

Dissociative Amnesia and Dissociative Fugue

Dissociative amnesia involves the partial or total inability to recall important information and is not due to a medical condition, such as illness, an injury, or a drug. Amnesia for personal events and information, rather than for general knowledge or skills (ex. The person may not be able to remember their spouse's name, but does remember how to read and who Martin Luther King, Jr. is. Dissociative fugue is a type of dissociative amnesia involving sudden and unexpected travel away from home, extensive amnesia, and identity confusion. Amnesia with dissociative fugue the person seems fine, but is confused abut their identity, and they may suddenly and inexplicably travel away from the home. Fugues are thought to associated with traumatice events or stressful periods and is unclear how a fugue state develops or why this is experienced

Dissociative Identity Disorder (DID)- involves extensive memory disruptions for personal information along with the presence of two or more distinct identities, or "personalities" within a single person. Typically, each personality has its own name and is experienced as if they have its own personal history and self-image. Not all health professionals are convinced that DID is a genuine psychological disorder. suggests that patients with DID learned "how to behave like a multiple' from media portrayals of sensational cases. Explaining DID- One explanation is that it represents an extreme form of dissociative coping. A high percentage report having suffered extreme physical or sexual abuse in childhood (over 90%). To cope with the trauma, the child "dissociates" from it, creating alternate personalities to experience the trauma.. Personality is created to deal with memories and emotions linked to painful experiences.