PSYC 3140 Lecture Notes - Hand Washing, Panic Disorder, As Good As It Gets

20 views3 pages
Published on 18 Apr 2013
York University
PSYC 3140
of 3
Somatization Disorder
Recurring multiple somatic complaints with no known physical cause
Most empirical (DSMII) – least practical
Earlier versions of the DSM – criteria for diagnosis: 13/35 symptoms
Most expensive because people with this are found in emergency rooms but they pass all
medical examinations no known physical cause of symptoms
Not practical for doctors to memorize 35 symptoms
Revised DSM-IV:
4 pain symptoms in different locations
2 gastrointestinal symptoms (ex. diarrhea or vomiting)
1 sexual/genital/reproductive symptom (ex. erectile dysfunction)
1 pseudo neurological symptom (ex. numbness)
With MMPI -high 1 and 3 (54% of the clinic group) answer: chronic pain and bodily
23% of the clinical group with no peak scores (except) most likely reflects: depression
5% of the clinical group with a peak score on scale F, and other elevations, reflects:
Endorsement of any abnormalities, causing an invalid profile
Pain Clinic – MMPI Profiles
Pain disorder – chronic pain – 54%
Normal – ignoring emotional concerns – 23%
Depression – 18%
Over-endorsement of psychopathology – invalid – 5%
Dissociative Identity Disorder
Controversial Condition – “Multiple Personality Disorder
Not schizophrenia
Herschel Walker
Teased as a youngster – overweight, speech impediment
Football star – running back
Heisman trophy winner
Perhaps the most basic psychopathological symptom
Object vs. Neurotic Anxiety
Neurotic Anxiety – out of proportion to the threat
Objective Anxiety – realistic – “Only a foolish optimist would deny the dark realities of the
Basic anxiety symptoms are evident in the condition – panic disorder
Dr. Norman Endler (1931-2004)
Born and raised in Montreal
Became Chain of Department of Psychology at York University
CPA award – 1997
Person-Situation Interactional Model of Anxiety
Created the EMAS test – Endler Manifest Anxiety Scale
Disclosed his own personal battle with mental illness
Treated effectively with ECT (electro convulsive therapy)
Wrote Holiday of Darkness about his story
Coping Mechanisms
Ego defenses in psychodynamic terms
Anna Freud discussed ego defenses (not Sigmund)
Repression – most basic – not remembering painful aspects of experience – example:
women and childbirth – remember joy of baby not pain
Denial – being overly elaborate in refusal – “no, no, no
Projection – transferring feelings onto another – example: brother mad at sister, he says
she's mad at me!”
Rationalization – trying to make logical explanations for doing something
Sublimation – example: alcoholic studying people who drink – usually about work, the
most sophisticated because putting emotion/problem into constructive work
Suppression – consciously diverting thinking to something else
Main Kinds of Anxiety Disorders –p. 202
Panic Disorders with Agoraphobia
Social phobia
Generalized anxiety disorder (GAD)
Obsessive compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Case Study – Branka – Age 32
Referred for psychological assessment following motor vehicle accident
Employed as a personal support worker – ambivalent about returning to work
Lives with mother and younger siblings
Complicated personal history – survivor of a war torn country
Diagnosis: PTSD
Axis I – she avoided any kind of driving, she had nightmares, startled by loud noises like
Axis II – longstanding attachment with mom, did not like to be separated from her
Obsessive Compulsive Disorder
Obsessions – persistent thought compulsions – repetitive behaviours
Case Study: Canadian Comedian – Howie Mandel
OCD is different than worries
Work of worry (Breznitz) – healthy preparation
Obsessions – persistent, recurring, intrusive ruminations
Compulsions-- ritual behaviour – Shakespeare’s lady Macbeth – hand washing – undoing
guilt over terrible action
Jack Nicholson in “As Good As It Gets”
Different than OCPD (Obsessive Compulsive Personality Disorder)
OCD is ego-dystonic, OCPD is ego-syntonic
OCPD – perfectionistic, stubborn, miserly, rigid about rules
People with OCD are aware that things are not quite right with their thoughts/behaviours
but people with OCPD they do not recognize the behaviours as bizarre
Worries vs. Obsessions
Worries are more often seen as triggered by a specific event
Content of worries are normal every day experiences: tests, finances, relationships
Content of obsessions are contamination, sex, religion (themes of illness and harm often
….... both
Worries are mostly thoughts whereas obsessions can be thoughts and images and impulses
Worries are not seen as intrusive and as unacceptable as obsessions (more likely to be ego
Missed snake phobia video – using therapy to help woman overcome fear