Psychology : Semester I : Stress and Mental Illness |
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Introduction | Section 1 | Section 2 | Section 3 | Section 4 |
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Psychology : Stress and Mental Illness : Section 3 Disorders Science museum Today there are six perspectives that explain psychological disorders. Not every perspective explains every disorder. All six perspectives are listed below, along with each description, in the flashcards.
Psychologists believe that it is important to classify the disorders. It is important to classify the disorders so that they can be diagnosed correctly and that there can be some universal agreement on diagnosing disorders. The classification system that is used in psychology is a book called the Diagnostic and Statistical Manual of Mental Disorders, 4th edition TR, usually shortened to the DSM-4TR. It is published by the American Psychological Association and it is a widely used diagnostic classification system. It provides a set of criteria for psychologists to make assessments and it also predicts the future course of each illness and suggests appropriate treatments.
Disorders have been distinguished more precisely for better treatment and with advancing knowledge, more information has been gained. There have been some criticisms of the use of the DSM’s and one of them is the possibility of over diagnosing. For example, ADHD (attention deficit-hyperactivity disorder) has become the fastest growing disorder in America. Because of the criteria listed for it, it can easily be applied to children, especially boys that would have been looked at as just “typical boys” in the past. The second criticism of the use of the DSM is that it applies a label. People are being recognized as the label and not the person. Labels also follow people and there are stereotypes and stigmas that exist in society concerning the mentally ill.
The first group of disorders that we will look at is the anxiety disorders. These disorders are characterized by overwhelming feelings of anxiety that disrupt social or occupational functioning or produce significant distress. The anxiety experienced will have a three part response: cognitive, behavioral and somatic. The cognitive element would be thoughts of worry to overwhelming fear with the possibilities of doom. Behavioral manifestations of anxiety would be avoiding anxiety provoking situations. Somatic responses would be shakiness, stomach problems, headaches, etc.
A panic attack is a short period of intense fear and physiological discomfort involving a pounding heart and difficulty breathing. Some people mistake panic attacks for heart attacks and end up in emergency rooms. People with panic attacks fear these attacks because they do not seem to have any specific reason for occurring and this only increase the anxiety. Generalized anxiety disorder is characterized by excessive and persistent high levels of anxiety over life’s situations. These symptoms have to be felt for at least six months for it to be considered a disorder. Phobic disorders are excessive and irrational fears toward an object or situation. For example, hydrophobia is an excessive fear of water, acrophobia is a fear of high places, agoraphobia is a fear of open spaces and people will fear leaving their homes. Any situation or object can become the object of a phobia. One phobia that has been of interest lately is social phobia or an excessive fear of social situations where the person fears being observed, talked about and made fun of by others. The result might be that the person will avoid some or all social situations. Obsessive-compulsive disorders are the most acute of the anxiety disorders. People suffering from obsessions cannot rid of reoccurring thoughts. Compulsions are the reoccurring behaviors that the person engages in to relieve the anxiety of a situation. For example, a person may feel that there are germs everywhere and that they will pick up the germs and give them to others so they wash their hands repeatedly (100’s of times a day) to relieve the anxiety that they have acquired germs. The person knows that the obsessions and compulsions are unjustified but they cannot let go of them.
An anxiety disorder that has been added since the Vietnam war is post traumatic stress disorder (PTSD). This disorder is characterized by flashbacks, nightmares and increased tension concerning the trauma that was faced. These symptoms may occur six months after the experience. The flooding that occurred in New Orleans caused many residents of that area to suffer from PTSD. Likewise, 9-11 caused many people incidences of PTSD. Explanation of anxiety disorders by perspective
A second group of disorders are the somatoform disorders. These disorders are characterized by complaints of physical symptoms that have no organic cause. The symptoms are psychological and not under conscious control. Explanation of somatoform disorders by perspective
Explanation of dissociative disorders by perspective:
We all experience mood disorders. We feel happy or up when things go well for us, such as finding out that we did well on a test. We feel sad or down when things do not go well for us as when we find out that we did not do so well on a test. This is normal mood or affect. Some people, though, experience mood changes that seem inappropriate or inconsistent to the situation that they are in. These people may be experiencing mood disorders. There are two broad categories of mood disorders: major depression and bipolar disorder. Mood disorders are among the most common of all psychological disorders. In fact major depression has been referred to as the common cold of mental illness.
These symptoms must be present for at least two weeks for the diagnosis to be made. People who suffer from major depression need immediate treatment since suicide could be considered by them. Explanation of mood disorders by perspective
The negative symptoms of schizophrenia are the ones that show a reduction of normal functioning. Examples of negative symptoms include the following:
There are four types of schizophrenia: paranoid, disorganized, catatonic and undifferentiated. Paranoid schizophrenia involves strongly held delusions of persecution or grandeur. The person may act on the delusion as in a person feeling that people are plotting against them and then will act out in a defensive manner to protect themselves. The movie, A Beautiful Mind, was about John Nash and depicted his struggle with schizophrenia.
A second type of schizophrenia is disorganized schizophrenia. This type involves inappropriate behaviors including odd movements and disconnected emotional states. Word salad is common with this type. Catatonic schizophrenia involves rigid or excitable motor behavior. The patient will change from the rigid stupor to agitation. People can hold unusual and uncomfortable body positions for long periods of time. Undifferentiated schizophrenia has a mixture of symptoms. It involves thought disorders and features from the other types of schizophrenia.
Schizophrenia typically occurs in men younger than age 25 and in women between 25 and 45 years old. Both men and women are equally affected and schizophrenia is noted in all cultures and it affects about 1% of the world’s population. Explanation of schizophrenia by perspective
Personality disorders are the last group that we will look at. Personality disorders are characterized by long-standing chronic, inflexible, maladaptive patterns of perception, thought and behavior that interfere with a person’s ability to function personally or socially. This pattern emerges during adolescence. As a disorder these are hard to diagnose and it is questioned if they really exist or are a part of other disorders. Two examples of personality disorders are narcissistic personality disorder and antisocial personality disorder.
The Health Organization estimates that 400 million people worldwide suffer from psychological disorders. Depression and schizophrenia are the only disorders observed in all cultures. A U.S. government survey estimates that 15% of the population is in need of therapy with 1.9 million people per year admitted to mental hospitals in the United States. 2.4 million Americans get out-patient help each year. Although there is a large number of people having mental disorders, unfortunately there is still a stigma that prevails about mental illness. Many people who suffer from a mental disorder have to also endure being ostracized from society and made to feel shame and guilt for their illness. Some of the misconceptions that society has about mental illness include:
A last issue that we need to look at is how the law and psychology are not in synch. The laws use the terms of sanity and insanity. Insanity is a legal term that rests primarily on whether a person is aware of the consequences of their behavior and can control their behavior. The insanity defense is used if it can be proven that at the time of committing a criminal act a person either did not understand the nature of the act nor did not know it was wrong. Psychologists are brought in as expert witnesses to assess the mental state of the patient at the time of a crime. Sane people, in legal terminology, understand right from wrong and understand what can happen from violating laws and rules. They are also able to control their urges and behave in acceptable ways. Psychology looks at mentally healthy versus mentally ill people. Psychology believes that people can be mentally ill and still be sane. Problems arise when mentally ill people commit crimes and have to be judged in the legal system. The law allows for “not guilty by reason of insanity”. These people are sentenced to a mental hospital for treatment and given therapy. They can be released if they are judged not to be a threat to society. Many people are outraged by the insanity defense because they feel that it allows criminals not pay their debt to society. The other side of the issue advocates that insane people do not understand the consequences of their actions and they should not be held legally responsible and sent to jail where they cannot get the help that they need. The reality is that the insanity defense is used in only about 1% of the felony cases and is not successful in all of them. Insanity is a legal term because either you are sane or insane. That concept is not used in psychology because psychology sees degrees of disorders and not the all-or-nothing concept of the law. Some have asked that the plea be changed to guilty but insane.
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Flashcards 
The DSM has had four major revisions since its first edition in 1952. It has also had several minor revisions. The DSM-4 was published in1994 and had text revisions) in 2000. (TR stands for text revisions.) The first DSM had about 100 diagnoses to the DSM-4TR that has about 400. Can you think of reasons for the increased numbers in entries?
Discussion 5-2: After learning about the DMS’s positive and negative points, post a discussion with your view of it being used universally as a diagnostic tool. What about the labels that it puts on people? Respond to another student also. 
Five anxiety disorders are: panic attacks, generalized anxiety disorders, phobias obsessive-compulsive disorders and stress disorders. 
One example are conversion disorders where the person experiences physical complaints or loss of functioning of a major part of their body (eyes, legs etc) without any organic reason. A second one is hypochondrias, often called hypochondria which is a person’s over- preoccupation with their health and physical condition despite symptoms of any disorder. People who have this disorder have an unhealthy fear of having a serious disease and will not believe that they do not have it. 
The dissociative disorders are characterized by changes in memory, consciousness or identity due to psychological factors. Dissociative amnesia is a sudden loss of memory usually following a stressful event. It can last for hours or years and just as quickly as it came on it disappears. This type of amnesia cannot be explained biologically as in experiencing a head injury. Dissociative fugue is characterized by forgetting personal information, also accompanied by relocation with the possibility of assuming of a new identity. When the fugue is over, the person does not have memories from the fugue state. Some missing persons are victims of fugue. Depersonalization disorder is an experience of separating from the self. People who suffer from this disorder talk about being outside of their bodies and then having the experience of watching themselves. Dissociative identify disorder, formally called multiple personality disorder, is an extremely rare and very controversial disorder characterized by the existence of two or more distinct personalities within one person. Hollywood and soap operas would make us think that this disorder is common and has a quick onset and departure; however, this is not the case. A person diagnosed with dissociative identity disorder will have years of therapy ahead of them. The original personality is unaware of the other personalities and the person will experience blackouts and lapses of memory. This disorder is controversial and many psychologists would like to see it eliminated in the next DSM which is scheduled to come out in 2010 or 2011. 
Major depression will affect 8 to 18 percent of the general population in their lifetime (Boyd& Weissman, 1982). According to the DSM-4TR, major depression is diagnosed when an individual experiences at least five of the following symptoms:
Assignment 5-2 Research has found that the greatest risk of developing a major depression occurs between the ages of 15-24 and 35-44. Your age group is certainly within the risk group. Write an essay of 150-200 words explaining why depression is so prevalent in your age group and what can be done to help a friend that might be experiencing a depression. What coping mechanisms are there for your age group? Please do this in word document and upload it to assignment 5-2. 
The term narcissism was derived from the Greek mythology and was about a Greek youth whose punishment for not falling in love with the nymph; Echo fell in love with his image in pool of water. Today the disorder refers to a grandiose sense of self-importance and a preoccupation with fantasies of success and power. The narcissist needs a steady and large amount of attention and admiration and reacts strongly to criticism. They feel entitled to favors without thinking of reciprocating. The antisocial personality disorder is characterized by a long-standing pattern of irresponsible behavior that hurts others without causing any feelings of guilt. Trouble with the law and authority figures usually begins early in life and many antisocial personalities spend time incarcerated.
You are now ready to take Quiz 5.1 on disorders. 