Myers’ PSYCHOLOGY Psychological Disorders James A. McCubbin, PhD Clemson University Worth Publishers David Rosenhan suspected that terms such as sanity, insanity, schizophrenia, mental illness, and abnormal might have fuzzier boundaries that the psychiatric community thought. He also suspected that some strange behaviors seen in mental patients might originate in the abnormal atmosphere of the mental hospital, rather than the patients themselves. Education ･AB, Yeshiva College, 1951 ･MA, Columbia University, 1953 ･PhD (psychology), Columbia University, 1958 Professor, Stanford University Dangers of Labeling David Rosenhan Rosenhan & seven associates had themselves committed to different mental hospitals Being Sane in complaining of hearing voices. All but one were Insane Places diagnosed as schizophrenic. •Once admitted, they acted totally normal. In 1973 sociologist David Rosenhan •Remained hospitalized for average 19 days (9 to designed a clever 52) study to examine the •Only the patients detected their sanity difficulty that people •When discharged their chart read, have shedding the “schizophrenia in remission” "mentally ill" label. He was particularly No professional staff member at interested in how staffs in mental any of the hospitals ever realized institutions process that any of Rosenhan’s information about patients. pseudopatients was a fraud. According to a study conducted by the National Institute of mental health: *15.4% of the population suffers from diagnosible mental health problems *56 million Americans meet the criteria for a diagnosible psychological disorder (Carson 1996, Regier 1993) *Over the lifespan, +/- 32% of Americans will suffer from some psychological disorder. (Regier1988) Normal or Abnormal? Not easy task: *Is Robin Williams normal? Marilyn Manson? *Is a soldier who risks his life or her life in combat normal? *Is a grief-stricken woman unable to return to her routine three months after her husband died normal? Is a man who climbs mountains as a hobby normal? Some abnormalities are easy: Hallucinations (false sensory experiences) Delusions (extreme disorders of thinking) Affective problems (emotion: depressed, anxious, or lack of emotion) CORE CONCEPT: Medical model: takes a “disease” view Psychology model: interaction of biological, mental, social, and behavioral factors Psychological Disorder – a “harmful dysfunction” in which behavior is judged to be: • atypical- (not enough in itself) • disturbing- (varies with time & culture) • maladaptive- (harmful) • unjustifiable- (sometimes there’s a good reason) Show THE WORLD OF ABNORMAL BEHAVIOR: #1 Looking at Abnormal Behavior #2 The Nature of Stress Carol D. Ryff argues that we must define mental illness in terms of the positive. She names 6 core dimensions: 1) Self-acceptance: positive attitude towards self multiple aspects of self positive about past life 2) Positive self relations with other people: warm, trusting, satisfying interpersonal relationships capable of empathy, affection, intimacy 3) Autonomy independent, self-determined able to resist social pressures 4) Environmental mastery: sense of mastery and competence makes good use of opportunities creates contexts that support their personal needs 5) Purpose of Life: has goals and directedness feels there is meaning to past and present life 6) Personal Growth: see oneself as growing and expanding open to new experiences change in ways that reflect self-knowledge and effectiveness Historical Perspective Perceived Causes *movements of sun or moon *lunacy- full moon *demons & evil spirits Ancient Treatments *exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood Historical Perspective Hippocrates (400 bc) *first step in scientific view of mental disturbance. *imbalance (excess) among four body fluids called “humors” Humors Origin Temperament Blood heart sanguine (cheerful) Choler (yellow bile) liver choleric (angry) Melancholer spleen melancholy (depressed) (black bile) Phlegm brain phlegmatic (sluggish) Psychological Disorders Medical Model *concept that diseases have physical causes *can be diagnosed, treated, and in most cases, cured *assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital Psychological Disorders Biological (Evolution, Bio-psycho-social individual Perspective genes, brain structures *assumes that biological, and chemistry) sociocultural, and psychological factors combine and interact to produce psychological disorders Psychological (Stress, trauma, Sociocultural learned helplessness, (Roles, expectations, mood-related perceptions definition of normality and memories) and disorder) Psychological Disorders- Etiology DSM-IV-TR *American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) *a widely used system for classifying psychological disorders *presently distributed as DSM-IV-TR (text revision) *today used as “convenient shorthand” to avoid labeling. DSM-IV-TR organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of the disorder or disability: 1) Axis 1 -- Clinical disorders including major mental disorders, as well as developmental or learning problems. Common disorders in this category include depression, bipolar, anxiety, ADHD, and schizophrenia. 2) Axis 2 -- Pervasive or personality disorders, including mental retardation. Common disorders in this category include borderline PD, schizotypal PD, narcissistic PD, antisocial PD, paranoid PD. DSM-IV-TR continued: 3) Axis 3 -- Acute medical conditions and physical disorders. Common disorders in this category include brain trauma, brain injury, brain disease.. 4) Axis 4 -- Psychosocial and environmental factors contributing to the disorder. Common factors in this category include a man suffering from depression after losing his job, or his wife dying, et. al. 5) Axis 5 -- Global Assessment of Functioning or Children’s Global Assessment Scale (under 18) Additions to DSM-IV The Insanity Defense Psychological Disorders- Etiology Neurotic disorder (term seldom used now) *usually distressing but that allows one to think rationally and function socially *Freud saw the neurotic disorders as ways of dealing with anxiety Psychotic disorder *person loses contact with reality *experiences irrational ideas and distorted perceptions PREPAREDNESS HYPOTHESIS: Suggests that we have an innate biological tendency, acquired through natural selection, to respond quickly and automatically to stimulti that posed a survival threat to our ancestors. (Ohman & Mineka, 2001) QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. QuickTime™ and a TIFF (Uncompres sed) decompres sor are needed to see this picture. This explains why we develop phobias for snakes and lightening more easily than others. •ANXIETY DISORDERS •MOOD DISORDERS •DISSOCIATIVE DISORDERS •SCHIZOPHRENIA •PERSONALITY DISORDERS •BIOPSYCHOSOCIAL DISORDERS •SUBSTANCE ABUSE DISORDERS •SEXUAL DISORDERS •DEVELOPMENTAL (CHILDHOOD) DISORDERS ANXIETY DISORDERS 1) PANIC DISORDER w/AGORAPHOBIA 2) GENERALIZED ANXIETY DISORDER 3) PHOBIAS a) simple b) social c) agoraphobia 4) OBSESSIVE-COMPULSIVE DISORDER (OCD) 5) POST TRAUMATIC STRESS DISORDER (PTSD) 6) SOMOTOFORM a) hypochondria b) conversion (hysteria) Anxiety Disorders Anxiety Disorders *distressing, persistent anxiety or maladaptive behaviors that reduce anxiety Anxiety Disorders 1) Panic Disorder *marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, racing heart, sweating, muscle- spasms, or other frightening sensations *common thinking patterns include: "I’m losing control.....” "I feel like I’m going crazy.....” "I must be having a heart attack.....” "I’m smothering and I can’t breathe.....” 1a) Panic Disorder w/Agoraphobia *fear of leaving home for fear of having a panic attack 2) Generalized Anxiety Disorder person is tense, apprehensive, and in a state of autonomic nervous system arousal *Chronic (6 months) unrealistic or excessive worry about 2 or more elements in one’s life. 3) Phobias a) Simple Excessive, irrational fear of objects or situations b) Social Persistent fear of scrutiny by others doing something humiliating (stage fright or speech phobia) c) Agoraphobia Fear of being in a place or situation with no escape. (childhood environments in which one did not feel safe) Anxiety Disorders Phobias persistent, irrational fear of a specific object or situation Ablutophobia: washing, bathing Genophobia: sex Acrophobia: heights Gynephobia: women Algophobia: pain Ichthyophobia: fish Arachibutyrophobia: peanut butter Lutraphobia: otters sticking to roof of mouth Macrophobia: long waits Caligynephobia: beautiful women Medorthophobia: erect penis Cleptophobia: stealing Parthenophobia: virgins Demophobia: crowds Pophyrophobia: color purple Ecclesiophobia: church Somniphobia: sleep Ergophobia: work Testophobia: taking a test Anxiety Disorders Common and uncommon fears 100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 Snakes Being Mice Flying Being SpidersThunder Being Dogs Driving Being Cats in high, on an closed in, and and alone a car In a 0 exposed airplane in a insectslightning In a crowd places small house of people place at night Afraid of it Bothers slightly Not at all afraid of it Anxiety Disorders 4) Obsessive-Compulsive Disorder *unwanted repetitive thoughts (obsessions) and/or actions