Psychological Psychological Disorders: Part 2Disorders: Part 2

Music: Music: ““Mad WorldMad World””Gary JulesGary Jules

““Mad WorldMad World””Tears for Fears (original)Tears for Fears (original)

Today’s AgendaToday’s Agenda

1. Schizophrenic Disorders1. Schizophrenic Disorders A) Symptoms B) TheoriesA) Symptoms B) Theories

2. Personality Disorders2. Personality Disorders ParanoidParanoid HistrionicHistrionic NarcissisticNarcissistic Antisocial / Borderline Antisocial / Borderline Obsessive-compulsive Obsessive-compulsive DependentDependent

3. Review Quiz3. Review Quiz 4. Movie: “The New State Asylums” (chapters 1, 3, 4. Movie: “The New State Asylums” (chapters 1, 3,

and 5) available on the web and 5) available on the web http://http://www.pbs.org/wgbh/pages/frontline/shows/asylumswww.pbs.org/wgbh/pages/frontline/shows/asylums//

1.1. Schizophrenic DisordersSchizophrenic Disorders

Schizophrenia: “split mind”Schizophrenia: “split mind” A) Symptoms:A) Symptoms:

11. . DisorganizedDisorganized thinkingthinkingContent is disturbed (e.g. delusions)Content is disturbed (e.g. delusions)

Expression is bizarre (e.g. word salad)Expression is bizarre (e.g. word salad)

2. Disturbed perceptions2. Disturbed perceptionsE.g. auditory hallucinationsE.g. auditory hallucinations

3. Inappropriate emotions and actions3. Inappropriate emotions and actionsE.g. Catatonic stupor, laughing inappropriately, E.g. Catatonic stupor, laughing inappropriately, speaking to imaginary peoplespeaking to imaginary people

4. Deterioration in adaptive functioning4. Deterioration in adaptive functioning E.g. Neglect of personal hygiene, social withdrawalE.g. Neglect of personal hygiene, social withdrawal

Prisons: The New State AsylumsPrisons: The New State Asylums

Frontline Show:Frontline Show: http://www.pbs.org/wgbh/pages/frontline/shows/asylums/http://www.pbs.org/wgbh/pages/frontline/shows/asylums/ Chapters 1, 3, and 5 were shown in class Chapters 1, 3, and 5 were shown in class 2 multiple choice questions extracted from these segments will 2 multiple choice questions extracted from these segments will

be on the final be on the final

1. b) Theories of Schizophrenia 1. b) Theories of Schizophrenia • Genetic Contribution: (p. 601)Genetic Contribution: (p. 601)

1. b) Theories of Schizophrenia 1. b) Theories of Schizophrenia

• Genetic Contribution: (p. 601)Genetic Contribution: (p. 601)• But what is inherited?But what is inherited?• Excess dopamine:Excess dopamine:• Evidence: Evidence:

• Drugs that increase dopamine produce symptoms Drugs that increase dopamine produce symptoms similar to schizophreniasimilar to schizophrenia

• Anti-psychotic drugs that decrease dopamine Anti-psychotic drugs that decrease dopamine activity lessen schizophrenic symptomsactivity lessen schizophrenic symptoms

• 14.18, p. 60214.18, p. 602

Prenatal TraumaPrenatal Trauma

p. 603p. 603

Integrated Model of Integrated Model of Schizophrenia (p. 613)Schizophrenia (p. 613)

2. Personality Disorders2. Personality Disorders

Definition:Definition: Inflexible, enduring patterns of behavior that create Inflexible, enduring patterns of behavior that create

impairment in functioning or subjective distressimpairment in functioning or subjective distress DSM-IV has 3 categories:DSM-IV has 3 categories:

Cluster A: Odd-Eccentric Cluster A: Odd-Eccentric schizoid, schizotypal, paranoidschizoid, schizotypal, paranoid

Cluster B: Dramatic/Impulsive Cluster B: Dramatic/Impulsive histrionic, narcissistic, anti-social, borderlinehistrionic, narcissistic, anti-social, borderline

Cluster C: Anxious/Fearful Cluster C: Anxious/Fearful dependent, obsessive-compulsive, avoidantdependent, obsessive-compulsive, avoidant

2. Personality Disorders: 2. Personality Disorders:

Paranoid:Paranoid: Pervasive suspiciousness, mistrust of peoplePervasive suspiciousness, mistrust of people Guarded, cold, defensiveGuarded, cold, defensive Impairment in interpersonal relationshipsImpairment in interpersonal relationships

Histrionic:Histrionic: Theatrical, dramatic and expressiveTheatrical, dramatic and expressive Needs to be center of attention; Uses physical appearance to Needs to be center of attention; Uses physical appearance to

draw attention draw attention Rapidly shifting, shallow emotionsRapidly shifting, shallow emotions Somatization disorderSomatization disorder

2. Personality disorders 2. Personality disorders (cont’d) (cont’d)

Narcissistic:Narcissistic: Need for admiration/grandiose sense of self-Need for admiration/grandiose sense of self-

importanceimportance Entitlement to special treatmentEntitlement to special treatment Fantasies of unlimited successFantasies of unlimited success

Borderline:Borderline: Instability in mood (e.g. intense anger)Instability in mood (e.g. intense anger) Identity disturbance (e.g. feelings of emptiness)Identity disturbance (e.g. feelings of emptiness) Physically self-damaging acts (slashing wrists)Physically self-damaging acts (slashing wrists) Inability to be aloneInability to be alone Intense and volatile relationshipsIntense and volatile relationships

2. Personality Disorders 2. Personality Disorders (cont’d)(cont’d)

Antisocial:Antisocial: Antisocial behaviors; violate the rights of others Antisocial behaviors; violate the rights of others

without shame or regretwithout shame or regret Superficial charm but deceitful, using lies to con othersSuperficial charm but deceitful, using lies to con others Lack of anxiety and no sense of personal Lack of anxiety and no sense of personal

responsibilityresponsibility Onset before age 15Onset before age 15 Most promising cause: Most promising cause:

Biological predisposition (limbic and frontal lobe Biological predisposition (limbic and frontal lobe abnormalities)abnormalities)

Combined with neglect and abuseCombined with neglect and abuse

2. Personality Disorders (cont’d)2. Personality Disorders (cont’d)

Obsessive-compulsive:Obsessive-compulsive: Preoccupied with rules, details, organizationPreoccupied with rules, details, organization Perfectionism that interferes with task completionPerfectionism that interferes with task completion Inflexible about matters of morality, ethicsInflexible about matters of morality, ethics Excessive mental and interpersonal controlExcessive mental and interpersonal control

Dependent:Dependent: Unable to function independentlyUnable to function independently Allow others to take responsibility for major areas of Allow others to take responsibility for major areas of

their livestheir lives Lack in self-confidence/ subordinates needs to Lack in self-confidence/ subordinates needs to

those of othersthose of others

3. Review Quiz3. Review Quiz For each case presented below, select a possible diagnosis according to the For each case presented below, select a possible diagnosis according to the

following choices:following choices:

A) Social anxietyA) Social anxiety D) Hypochondriasis D) Hypochondriasis B) Obsessive Compulsive Disorder E) Somatoform DisorderB) Obsessive Compulsive Disorder E) Somatoform Disorder C) Generalized anxiety disorder F) AgoraphobiaC) Generalized anxiety disorder F) Agoraphobia

Wesley has gone in for a psychiatric assessment. He tells the clinician the he Wesley has gone in for a psychiatric assessment. He tells the clinician the he has been feeling apprehensive an edgy for the last month, but so far his has been feeling apprehensive an edgy for the last month, but so far his anxiety hasn’t interfered with his job or home life. anxiety hasn’t interfered with his job or home life.

Doris feels terrified every time she leaves her house, and avoids doing so Doris feels terrified every time she leaves her house, and avoids doing so whenever possible. whenever possible.

Kate constantly thinks about jumping in front of an oncoming car when she is Kate constantly thinks about jumping in front of an oncoming car when she is walking. The only way she seems to be able to stop these self-destructive walking. The only way she seems to be able to stop these self-destructive thoughts is to say Mother Goose nursery rhymes over and over to herself. thoughts is to say Mother Goose nursery rhymes over and over to herself.

Laura takes over 40 different vitamins and herbal remedies each day to keep Laura takes over 40 different vitamins and herbal remedies each day to keep herself in top physical health. Recently she had some severe dizziness, but her herself in top physical health. Recently she had some severe dizziness, but her family doctor assured her that is was just a minor ear infection that would family doctor assured her that is was just a minor ear infection that would clear up in a few days. Laura is concerned because she is sure the ear clear up in a few days. Laura is concerned because she is sure the ear infection is the sign of something much more serious, such as a brain tumor, infection is the sign of something much more serious, such as a brain tumor, and she has made appointments with three different specialists to have more and she has made appointments with three different specialists to have more testing done.testing done.

3. Review Quiz (cont’d)3. Review Quiz (cont’d) For each case, select the most appropriate personality style:For each case, select the most appropriate personality style:

A) Narcissistic D) Borderline A) Narcissistic D) Borderline B) Dependent E) HistrionicB) Dependent E) Histrionic C) Obsessive Compulsive F) AntisocialC) Obsessive Compulsive F) Antisocial

Sophia has always been preoccupied with schedules, lists, and trivial details. Sophia has always been preoccupied with schedules, lists, and trivial details. She plans everything sown to the last detail and becomes very upset if things She plans everything sown to the last detail and becomes very upset if things don’t work out the way she has planned. don’t work out the way she has planned.

In the past 9 months Andrew has been fired by three different employers. He In the past 9 months Andrew has been fired by three different employers. He was unreliable and often missed work, and each employer finally let him go was unreliable and often missed work, and each employer finally let him go when they found he had been stealing money and materials. Andrew feels no when they found he had been stealing money and materials. Andrew feels no remorse over his actions, but he has managed to convince each of his former remorse over his actions, but he has managed to convince each of his former employers that he is sorry for his actions, and none plan to press any charges. employers that he is sorry for his actions, and none plan to press any charges.

Ellen is self-centered, immature, and excitable. She craves attention, especially Ellen is self-centered, immature, and excitable. She craves attention, especially from men, with whom she is flirtatious and seductive. from men, with whom she is flirtatious and seductive.

Roy alternates between periods in which he remains motionless and seems Roy alternates between periods in which he remains motionless and seems oblivious to his environment, and periods of hyperactivity and frenzied oblivious to his environment, and periods of hyperactivity and frenzied excitement. He seems to be responding to voices in his head.excitement. He seems to be responding to voices in his head.

4. Movie4. Movie

See slide #4See slide #4