Mental Illness/Abnormal Behavior

Mental illnesses - medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning- when thinking, mood, etc. is irrational, uncontrollable, and disruptive

Diagnostic & Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) – Fifth Edition due out in May, 2013- “Bible” of psychiatrists

DSM-IV

Standardize language and diagnosisFive Dimensions or Axis1.Clinical disorders, including major mental disorders and learning disorders2.Personality disorders and intellectual disabilities 3.Acute medical conditions and physical disorders4.Psychosocial and environmental factors contributing to the disorder5.Global Assessment of Functioning

DSM-IV

Controversies

- not reliable & valid difficult to diagnose in standard way- Rosenhan experiment

- does not show causality- cultural biases- money maker for pharmaceuticals- creates more illnesses- labels- EXCUSE for poor behavior- Thomas Szasz

How prevalent are mental illness?

Any Anxiety Disorder Any Mood Disorder

Anxiety Disorders

Anxieties are common-But becomes illness if it is:- disruptive- irrational- uncontrollable

Generalized Anxiety Disorder-pattern of frequent, constant worry and anxiety over many different activities and events- symptoms include: constant presence of worry or tension, difficulty concentrating, fatigue, irritability, sleeping problems, restlessness or feeling keyed up or “on the edge”

Chicken Little Syndrome- constant feeling of overwhelming dread!

Anxiety Disorders

Panic Disorder - repeated attacks of intense fear that something bad will occur when not expectedSymptoms include: chest pain, dizziness, feelings of dying or doom, nausea, breathing issues, numbness in hands and arms, racing hear, sweatiness, chills or hot flashes, uncontrollable trembling or shaking

Similar to a heart attack

Anxiety Disorders

Phobic Disorder - strong, irrational fear of something that poses little or no actual dangerSimple – fear of specific situation or thingAgoraphobia - fear of wide open spaces, crowds, or uncontrolled social conditions- Both marked by panic attacks when confronted with phobic situation- 2/3 of all phobias are agoraphobics

Anxiety Disorders

Obsessive-Compulsive Disorder – OCD unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions)- most common is fear of germs and need for cleanliness- rituals provide only temporary relief- not performing rituals causes greater anxiety

Anxiety Disorders

Post-traumatic Stress Disorder (PTSD) - anxiety occurring after one has seen or experienced a traumatic event that involved the threat of injury or death

- Symptoms include:flashbacks, feelings of emotional numbness, feelings of detachment, easily startled, difficulty sleeping, emotional outbursts, memory impairment, lack of concentration, sense of no future

Mood Disorders

Four types – Major Depression, Bipolar Disorder, Dysthymic Disorder, & Cyclothymic Disorder- once considered the most common form of mental illness now anxiety- most common mood disorder is…

DepressionWomen get depressed at twice the rate of men – Why??

Symptoms fall into 4 categories:Physical – weight loss, appears fatiguedBehavioral – no interest in favored activities, sleep problems, eating problems, restless, irritableCognitive – inability to think, concentrate, thoughts of suicideEmotional – feelings of worthlessness, hopelessness, helplessness, self-loathing

Mood Disorders

Speaking of suicide…Some facts- Suicide is second leading cause of death among young people 18-24- suicide cuts across all socioeconomic groups- suicides occur throughout day- women attempt suicide at higher rate than men- men succeed more

- few suicide victims leave a note- always get professional help for those with suicidal thoughts – ok to talk about their feelings!

Mood Disorders

Bipolar Disorder – once known as Manic DepressionTwo parts – manic – elevated mood – “high” and depression- Abrupt mood swings- Symptoms of manic episode include: inflated self-esteem, racing thoughts, no need for sleep, hyperactivity, feelings of invincibility, agitation, reckless behavior (incl. spending sprees, promiscuity, binge eating & drug use)

- affects about 2½% of the population- story of Patty Duke

Mood Disorders

2 low grade mood disordersDysthymic Disorder- low grade depression with less severe symptoms- chronic – longer than 2 years- able to functionCyclothymic Disorder-low grade bipolar – less severe mood swings

I lied – a fifth mood disorder – Seasonal Affective Disorder – SAD- related to seasonal conditions- depression symptoms

Personality Disorders

- conditions in which a person’s long-term (chronic) behaviors, emotions, and thoughts are very different from their culture’s expectations and cause serious problems with relationships and work

Paranoid Personality Disorder - long-term distrust and suspicion of others, but does not have a full-blown psychosis- Symptoms include: concern that other people have hidden motives, expectation that they will be exploited by others, inability to

work together with others, social isolation, detachment, hostility

Personality Disorders

Borderline Personality Disorder - long-term patterns of unstable or turbulent emotions, such as feelings about themselves and others

Symptoms include: see things in extremes (all good or all bad), fear of abandonment, feelings of emptiness and boredom, displays of inappropriate anger, impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting, intolerance of being alone, repeated crises and acts of self-injury, such as wrist cutting or overdosing, intense and unstable relationships

Personality Disorders

Narcissistic Personality Disorder - inflated sense of self-importance and an extreme preoccupation with self

1. exaggerates achievements2. preoccupied with fantasies of wealth & power3. belief in uniqueness or specialness4. requires excessive admiration5. sense of entitlement6. exploitative7. lacks empathy8. envious of others9. arrogant

Personality Disorders

Antisocial Personality Disorder - long-term pattern of manipulating, exploiting, or violating the rights of others CRIMINAL

Symptoms include:1. failure to conform to social norms break laws2. deceitfulness3. impulsive or failure to plan ahead4. aggressive5. reckless disregard for safety of others6. irresponsible – does not follow through on obligations7. lack of remorse

Dissociative Disorders

involve disruptions or breakdowns of memory, awareness, identity and/or perception

Dissociative amnesia - impairment of recall resulting from emotional or psychological trauma, not physiological- recall retrograde (old) or form anterograde (new) memories

Dissociative Disorders

Dissociative Fugue - involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity- rare- lasts for few days, but can last for months- precipitated by a stressful episode- memories are recovered

Dissociative Disorders

Dissociative Identity Disorder, aka Multiple Personality Disorder - condition in which a person displays multiple distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment

- Controversial- up to 1980 – 200 cases reported in US- 1980 to 1990 – 20,000 cases- 1985-1995 – 40,000 cases

Schizophrenia

disorder that makes it difficult to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses, and to behave normally in social situationsBREAK WITH REALITY

Symptoms – three typesPositive – excess; should not have them- hallucinations - hearing, seeing, or feeling things that are not there - delusions - false beliefs or thoughts

Schizophrenia

Negative – loss of something you should have- alogia – loss of speech- flat affect – loss of emotions & vocal tones- avolition – loss of ability to care for oneself

Disorganized – random- bizarre movements with no relations to environment- irrational thinking- no focus

Schizophrenia

Four kinds – based on types of symptoms

Paranoid - feel anxious, are more often angry or argumentative, and falsely believe that others are trying to harm them or their loved ones

- positive symptoms

Catatonic - constant state of unrest, or no movement, rigid; odd facial expressions and unresponsive to others

- negative symptoms- waxy flexibility

Disorganized - have problems thinking and expressing their ideas clearly, often exhibit childlike behavior, and frequently show little emotion

- disorganized symptoms

Undifferentiated – symptoms of more than one type of schizophrenia