Psychological Disorders and Treatments

Marshall High School Mr. Cline Psychology Unit Five AA * Psychological Disorders

• Much of psychology is concerned with studying and understanding the way healthy minds naturally think and behave.

• For example, psychologists might look at how you perceive things with your senses and how you learn new information and behaviors.

• You can't go a single day without learning (though there are some teachers who might make you feel like you do!) and certainly not without perceiving.

• These are normal functions of the brain that allow you to experience and interact with the world around you.

• But imagine someone whose perception is out of whack.

• Where most of us would hear silence, this person--let's call him Tom--hears a few distinct voices talking amongst themselves.

• These voices aren't actually in the real world; they're created in Tom's head, but to Tom they seem just like a conversation you might overhear on a bus or in a restaurant. * Psychological Disorders

• He perceives voices that aren't real.

• This is called a hallucination, and it's typically a symptom of a disorder called schizophrenia.

• Tom's psychological disorder is the result of something going wrong with his brain's normal functioning.

• Tom's disorder interferes with his ability to perceive.

• Jenny has a different problem. Jenny is deathly afraid of birds. She can blame her unusual fear or phobia to disordered learning.

• When she was growing up, Jenny's mailbox was right underneath a mean blackbird's nest, and when her parents sent her out to get the mail, the blackbird would attack her to protect its babies.

• This happened enough times that Jenny became conditioned to fear all birds.

• A natural and necessary process like 'learning' can lead to unusual or disordered patterns of thinking. * Psychological Disorders

• Psychologists who specialize in treating and diagnosing disorders like Tom's and Jenny's are known as clinical psychologists.

• Unlike research psychologists, who study how the average, healthy mind processes information, clinical psychologists help patients who are hurting or are in trouble due to psychological disorders.

• In the same way most doctors deal with problems of the body, psychological therapists deal with problems of the mind.

• Clinical psychologists, along with psychiatrists--medical doctors trained to specialize in mental illness--social workers and counselors are collectively known as therapists.

• Psychological disorders are defined as normal brain functioning gone wrong.

• There are many ways that our perception and learning can be off, but luckily, there are many treatments that can help.

• Tom took antipsychotic drugs to quiet the voices in his head, and behavioral therapy helped Jenny get over her extreme fear of birds. * Psychological Disorders

• Diagnosis

• When you go to the doctor with a fever and a sore throat, he'll talk to you, examine you, maybe listen to your breathing, and he'll use this information to figure out an explanation for your symptoms.

• This explanation is his diagnosis, which is the identification of a nature and cause of an illness.

• In other words, the doctor's diagnosis is what he thinks has gone wrong with you and why he thinks it's gone wrong.

• The doctor determines that your sore throat is infected (that's the 'what') and does a quick swab test to determine that it's caused by the bacteria strep (that's the 'why').

• Diagnosis in psychology is the same thing.

• If you think about it, though, it can be a lot harder to figure out what's going on in someone's mind than what's going on in someone's body. * Psychological Disorders

• Diagnosis

• You can describe to your doctor that your throat is sore and he can look at you and run tests to figure out why.

• If you're depressed or if you're suffering from hallucinations or delusions, your description of your own symptoms can be more difficult to follow and interpret, and there's no equivalent of a throat swab to test for depression.

• There are some ways that psychologists can diagnose patients, though.

• Let's look closer at the diagnosis and classification of mental illness, and the book that makes it possible for psychologists to figure out what's wrong with patients.

• Problems with Diagnosis

• Over the years, psychologists have worked hard to figure out ways to improve diagnoses. * Psychological Disorders

• Problems with Diagnosis

• Psychologist David Rosenhan suspected that psychiatric hospitals often gave patients the wrong diagnoses.

• To prove it, he decided to send in pseudopatients, or healthy people pretending to be mentally ill, to test the doctors and nurses in the hospitals.

• The pseudopatients (including Rosenhan himself) pretended to hear voices.

• Once admitted to the psychiatric hospital, though, they acted normal and said their symptoms had stopped.

• So, you might think, 'well, if they were acting normal, then they must have been released, right?' That's where the story gets interesting.

• They were not released and were not identified as having faked their symptoms. * Psychological Disorders

• Problems with Diagnosis

• Because they had said they had one symptom at the very beginning, they were considered to have a mental illness for the rest of their life.

• Interestingly, the actual patients in the hospital were suspicious of the pseudopatients.

• It turned out that the patients were better at identifying pretenders than the staff!

• After Rosenhan announced these rather embarrassing results, one prominent hospital asked him to send them some pseudopatients, confident that in their hospital, the pretenders would easily be identified.

• Following the challenge, the hospital identified 48 pseudopatients out of the next 195 people who were admitted. But Rosenhan hadn't actually sent anyone! * Psychological Disorders

• The DSM

• Experiments like Rosenhan's show how difficult it is to come up with a reliable scientific system of diagnosing mental illness.

• For this reason, the psychiatric community has a book that's used to identify mental illness, based on the symptoms that a patient presents with.

• The Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, has been undergoing constant revision since its creation in 1952.

• The DSM lists all the recognized mental disorders and their symptoms, so that when a patient comes to a psychologist and says, 'I feel this,' or 'I experience that,' the psychologist can look up the symptoms and know what mental disorder the patient has and how to treat it.

• It's just like when you go to the doctor and tell him that you have a sore throat: the psychologist is gathering information about your symptoms to diagnose you. * Psychological Disorders

• The DSM

• The most recent edition of the DSM is the DSM-5, which groups mental illnesses together based on similarities.

• For example, someone with a phobia and someone with social anxiety disorder both have high levels of anxiety.

• As such, they are both found together under the umbrella of anxiety disorders.

• Grouping psychiatric disorders together is called classification.

• The DSM-5 has twenty different classifications, all with multiple disorders.

• As you might imagine, it's a very big book!

• Examples of DSM-5 classifications include neurodevelopmental disorders, bipolar and related disorders, sexual dysfunctions, dissociative disorders, and personality disorders, among others. * Psychological Disorders

• The DSM

• When do we cross the boundary between natural worry and the debilitating types of anxiety associated with disorders?

• Let’s explore some common anxiety disorders and their potential causes.

• Have you ever felt anxious, maybe before a big test or an important job interview?

• A half an hour, or even an hour before, you get butterflies in your stomach or find yourself nervously pacing your living room.

• You go over questions and answers in your head, and despair that you should have started prepping months ago instead of just last week.

• Once the test or interview is over, you feel relieved; it went fine, you remembered everything you needed to and your heart rate's returned to normal.

• This kind of anxiety is a natural and normal response to a stressor like an interview. * Psychological Disorders

• The DSM

• But imagine if you'd started worrying about that interview a week in advance and had been unable to concentrate on anything else in the meantime; imagine if afterward, instead of feeling relieved, you continued to worry.

• This kind of anxiety is out of proportion to the stressor that triggered it and represents one kind of anxiety disorder, a disruptive condition that can interfere with functioning in daily life.

• Generalized Anxiety Disorder

• There are many types of anxiety disorder.

• The kind we just described, which would cause you to worry for weeks about an interview, is known as Generalized Anxiety Disorder, abbreviated GAD. * Psychological Disorders

• Generalized Anxiety Disorder

• GAD affects approximately 3% of American adults and is characterized by excessive and uncontrollable worry that is disproportionate to circumstances; it's fine to worry about the interview, but it's worrying all week that is the symptom of the disorder.

• GAD can also cause physical symptoms like fatigue, headache, nausea, trembling and insomnia.

• You may have felt some of these in response to normal, passing anxiety.

• Maybe you've felt queasy before a big important test. But imagine feeling that way all the time, in response to little things, and you've got some idea of what it's like to live with GAD.

• The disorder seems to have many possible casuses. * Psychological Disorders

• Generalized Anxiety Disorder

• It's probably genetic, since it tends to run in families, but has environmental causes as well, since it's sometimes triggered by experiencing normal stress.

• It's also been associated with addictions to alcohol or sedatives.

• The part of the brain that processes fear, called the amygdala, has also been related to GAD; it seems like if its connections to the rest of the brain are interrupted, it can result in increased anxiety.

• But with all of these factors, it is difficult to tell if they cause GAD or if they are simply further symptoms of it.

• Phobias

• Another anxiety disorder you might be familiar with is called a phobia. * Psychological Disorders

• Phobias

• You've probably heard some of the long, complicated names like arachnophobia and triskaidekaphobia which really just mean fear of spiders and fear of the number 13.

• These are known as specific phobias.

• Someone with arachnophobia has an out-of-proportion anxious response to a specific trigger--spiders--but not in other situations.

• Indiana Jones isn't somebody we'd think of as having generalized anxiety, but he certainly has ophidiophobia: a fear of snakes.

• Some people also have social phobias, or anxiety that is produced by having to interact with other people.

• Fear in general of social interactions is known as social anxiety. * Psychological Disorders

• Phobias

• Have you ever felt nervous before going to a party where you might not know everybody?

• Or before you've had to go to an event where you were expected to network?

• If so, you've experienced mild (and temporary) social anxiety; like with GAD, social anxiety only becomes a disorder when it is out of proportion, constant or debilitating.

• If your anxiety actually prevented you from attending any social functions, you'd have 'social anxiety disorder.'

• Just as people with a 'specific phobia'--like Indiana Jones' fear of snakes-- experience anxiety only with certain triggers, some people have social anxiety set off by particular situations.

• This is known as a specific social phobia * Psychological Disorders

• Phobias

• You've probably felt uncomfortable using a public restroom at some point in your life--they're kind of gross, and the whole process is ripe for potential embarrassment.

• But for someone with paruresis, using public restrooms induces debilitating anxiety--they literally cannot use the bathroom while other people are around.

• This is played for laughs in a number of TV shows, but it can really make life difficult for those whose activities are limited by needing to find a private restroom.

• Phobias are often understood in terms of classical conditioning.

• Pavlov caused dogs to drool at the ring of a bell by presenting food and ringing the bell at the same time.

• Though the dogs initially drooled because of the food, they came to associate the presence of food with the bell's sound and would drool in anticipation when only the bell was rung. * Psychological Disorders

• Phobias

• Some psychologists think that phobias may be formed by classical conditioning in a negative sense.

• Indiana Jones was fine with snakes as a child, but as a teenager fell into a cage filled with snakes during a stressful chase scene in the beginning of the Last Crusade.

• In his case, it only took one negative association to make him fear snakes the rest of his life.

• Obsessive-compulsive disorder

• The last anxiety disorder we'll discuss is obsessive-compulsive disorder, known as OCD.

• As portrayed in the media, OCD is the neat-freak's disease; TV characters like detective Adrian Monk are shown pouring boiling water over toothbrushes and carefully arranging rows of identical suits. * Psychological Disorders

• Obsessive-compulsive disorder

• It's true that many with obsessive-compulsive disorder are overly concerned about germs and need to keep their things tidy, but these are just some of the many manifestations of the basic condition.

• At its heart, OCD is characterized by both--wait for it--obsessions and compulsions.

• Obsessions are intrusive ideas and thoughts that a person with OCD can't stop thinking about.

• Imagine what it feels like to have a song stuck in your head; now imagine if that song were instead a worry that you'd forgotten to turn off the oven.

• Being unable to get rid of these kinds of thoughts can understandably cause anxiety, and that's where the compulsions come in.

• Compulsions are behaviors that are used to cope with anxiety. * Psychological Disorders

• Obsessive-compulsive disorder

• They're often ritualistic, like washing your hands seven times or tapping your doorknob three times before you leave the house.

• These rituals can become extremely disruptive, even causing anxiety that they are supposed to relieve.

• OCD is the fourth most-common psychological disorder, affecting approximately one in fifty American adults.

• Psychologists have offered many potential causes.

• The neurotransmitter serotonin is often present at abnormal levels in the brain in people with OCD, and the disease seems to be somewhat heritable--especially if it develops early during childhood. * Psychological Disorders

• Obsessive-compulsive disorder

• Some psychologists speculate that OCD may represent the extreme forms of behaviors that are normally evolutionarily adaptive; being persistent enough to check under every bush--not just some of them--for snakes, for example, is a useful trait that could develop into the kind of compulsive behavior that people with OCD display today.