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Lecture 14

PSY100Y5 Lecture 14: PSY100 Psychological Disorders Lecture

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Dax Urbszat

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PSY100 Psychological Disorders Lecture • defining abnormal behaviour • diagnosis • mental disorders What is abnormal behaviour? • amy hasn’t been to work in 2 weeks, has no physical problems but has trouble getting out of bed. No appetite and has lost 10 pounds in 2 weeks, has no interest in things that she used to enjoy - we would say this is abnormal - but if he says that her mum died last week, then we wouldn’t really think it is abnormal anymore bc that’s how we might react as well - what should we be concerned about? - Give her time, and make sure this isn’t the start of some kind of depressive episode • mary masturbates in public on a regular basis, she does it so all can see - why abnormal?: bc it is not socially acceptable - maybe she is an adult actress, then it’ll be normal behaviour bc that’s what she does for a living - the point of this scenario is that we need to know the context of it, what may seem as abnormal may be normal depending on the context - we don’t decide what’s moral and abnormal based on our morality, bc who decides? • terry is in a good marriage and good career, he dresses up as a female while having sex and his wife is ok - normal: bc not anyone’s business - abnormal: paraphilia (Sexual deviant disorder) it would require that the fetish object, in this case dresses up as a female, is the only thing that can help him achieve orgasm and erection - he requires it in order to function = paraphilia - if the wife is ok with it then they don’t have a problem, but if the wife doesn’t like it and there’s distress and suffering, this is the criteria that we use to see if they need help or not. - If there is significant impairing in some area of your life, the person needs help • so when it comes to deciding what is abnormal/normal, we look at the environment, is there distress, impairment of functioning, is there increase risk in death, illness or loss of freedom • diagnosis has created a stigma bc people don’t want others to know there’s something wrong with them Anxiety vs fear • Anxiety - future-oriented (anticipated threat) - mood state (entirely aversive, feels bad physically and psychologically, we do things like drugs and procrastination to avoid this mood state) - feeling that one cannot predict or control upcoming events • fear - present-oriented - emotional alarm reaction to present danger - emergency “fight or flight” response - adaptive and useful - turned on also in the face of threats that are not there, imaginary threats Criteria for panic attack • discrete period of intense fear/discomfort in which at least 4 symptoms developed abruptly and reached a peak within 10 minutes - palpitations, pounding/racing heart - sweating - trembling/shaking - shortness of breath/smothering sensations - feeling of choking - chest pain/discomfort - nausea or abdominal distress - feeling dizzy, unsteady, faint or lightheaded - derealization or depersonalization - fear of losing control or going crazy - fear of dying - paresthesias (numbness or tingling sensations) - chills or hot flushes the DSM-IV Anxiety disorders • panic disorder with/without agoraphobia • specific phobia • social phobia • generalized anxiety disorder (GAD) • they can only think about the negative things Panic disorder • recurrent, unexpected panic attacks • and one month of concern about additional attacks • or worry about the implications of the attack or its consequences • or a significant change in behaviour related to the attacks • when they are having a panic attack they feel sick, they feel like they are gonna throw up they leave the room and they feel better • this is classical conditioning, positive reinforcement as by leaving you take away something, and net time you’ll be scared to go into class again bc you’re scared you’re gonna get another panic attack (make you think that there’s something about this class that gives u a panic attack) • people don’t seek help bc of the stigma against it, we see things that we don’t understand and we see it as a threat • can help it by sitting through it to tell your body there was nothing to worry about and it may start going away • facing the problem and education is the way to treat it • agoraphobia – fear of places where it is difficult to escape or difficult to deal with the embarrassment - places hard to escape form are usually when we have panic attacks Agoraphobia • anxiety about being in places/situations form which escaped might be difficult or embarrassing in the event of a panic attack • situations are avoided or endured with marked distress or anxiety about having a panic attack OR require the presence of a companion • typical agoraphobic situations - shopping malls - transport - supermarkets - stores - crowds - planes - escalators - being far from home “out of safe zone” Specific phobia • marked and persistent fear that is excessive or unreasonable, cued by a specific object or situation • exposure to the phobic stimulus almost invariably provokes an immediate anxiety response (e.g a panic attack) • phobic situation/object is avoided or endured with an intense anxiety and distress • phobias are common, and things that are common we tend to understand and it is less threatening hence there is not as must stigma about it • not know about such stuff is usually due to lack of education and exposure • confidence you get by overcoming the greatest fear lets you face other fears Specific phobia – types 1. animal (1. Snake 2. Spiders) 2. natural environment (e.g heights, water) 3. blood-injection-injury type 4. situational (planes, elevators, driving) 5. other (choking, vomiting) Social phobia • marked and persistent fear of social or performance situations • situations involve exposure to unfamiliar people or to possible evaluation by others • individual fears that he/she may do something humiliating or embarrassing Obsessive-compulsive and related disorders • obsessive compulsive disorder (OCD) – recurrent and persistent obsessions and/or compulsions - symptoms cause marked distress - time consuming (more than an hour a day) - interfere significantly with the persons’ normal routine - trichotillomanic and body dysmorphic disorder - almost always in prime number sets Obsessions • persistent and intrusive thoughts, impulses, images • inappropriate, cause marked anxiety or distress • person usually attempts to ignore or suppress them • or neutralize them with some other thought or action Compulsion • repetitive behaviors or mental acts • performed to prevent or reduce anxiety/distress, not to provide please or gratification Body dysmorphic disorder • preoccupation with an imagined defect in appearance, or if a slight physical anomaly is present, the person’s concern is excessive • significant distress or impairment Stressor related disorders • PTSD - being on edge all the time - triggered by a stressor - like if fireworks go off and you relive the trauma again and it causes distress and makes you worry about it all the time - treatments involve exposure • adjustment disorder • reactive adjustment disorder Mood disorders • lifetime prevalence rates of depressive disorders: - 13% men and 25% women • lifetime prevalence rates of bipolar disorders ( not a mood disorder) - you dk who you are what you are who anyone is - less than 1% for men and women - his friends brother has bipolar disorder, off his medication, was arrested for splashing around in the fountain he thought he was Abraham Lincoln he didn’t know he was in public • psychosis – psychotic beliefs, they completely lose touch with themselves and reality - post partum psychosis – a woman murdered 5 children - very dangerous and scary • 15% of people with psychosis disorders commit suicide Mood episodes 1. major depressive episode - unhappy, sad mood - loss of things you used to enjoy 2. manic episode 3. hypomanic episode 4. mixed episode 1. Major depressive episode - depressed mood - loss of interest (anhedonia) - significant weight loss/gain - insomnia or hypersomnia - psychomotor agitation or retardation - fatigue or loss of energy - worthlessness or guilt - diminished ability to concentrate, indecisive o no confidence in your decisions 2. Manic episode (diagnosis of bipolar disorder) - abnormally and persistently elevated, expansive or irritable mood - inflated self esteem and grandiosity - requiring very little sleep (hallmark of a manic episode, precursor to delusional hallucinations) - talkativeness - flight of ideas - distractibility - psychomotor agitation - buying sprees, sexual indiscretions (sex with family/a child), foolish business investments - when you confront these people, they get irritable and angry “ fuck you ill get a restraining order” they turn on you very quickly - a lot of dangerous behaviors is associated with it - potential of possible psychosis o delusions, hallucinations where you are not in touch with reality 3. Hypomanic Episode - symptoms are milder than a manic episode
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