Psychological Disorders Chapter 13
Imagine yourself being mentally ill in the times of the Hunters and Gatherers. How would we cure you?
Cranium; Cinco Cerros, Peru; Prehistoric; Adult female. Rectangular trephination (straight cutting, approx. 2.2 x 1.8 cm.), involving frontal - right, with no evidence. Scraped area (1.8 x 1.4 cm.) medial to trephination.
Cranium; San Damian, Peru; Prehistoric; Adult female. Unhealed trephination (straight cutting example) at bregma, resulting in aperture (approx. 3.0 x 1.7 cm.). Rectangular area (approx. 6.3 x 6.2 cm.) around trephination may show area from which scalp was reflected (color and texture of bone slightly different).
Cranium; Cinco Cerros, Peru; Prehistoric; Adult male. Large healed trephination involving frontal - left, resulting in aperture approx. 3.2 x 2.0 cm. Large healed lesion (probably trephination) left parietal (center) including sagittal suture, resulting in small aperture approx. 05 x 0.2 cm. Multiple destructive lesions with irregular edges (no evidence of new bone) on frontal, parietals, sphenoid (left, great wing) and occipital [metastatic carcinoma?]. Destruction of left side of face (barely visible in slide) probably at least partly due to this pathology. Healed fracture of left zygomatic arch.
Trephination Tools
Copper and bronze tumi knives. Left: 22.0 x 13.8 cm. Bronze. Probably from the Chimu culture, Moche Valley, north coast of Peru. A.D. 1000 to 1470.
Obsidian blades. Four prismatic obsidian blades of the type probably used in Peruvian trephinations.
Patients in steam cabinets, c 1910. American Psychiatric Association Archives
Rocking chair therapy on a female ward, c. 1913. Missouri State Archives
The Lobotomist Dr. Walter Freeman
How many of us have a psychological problem?
1 in 5
(about 44 million)
How o?en do you shower? Ever been bummed out? Ever feel that you have the power of God but just don’t know how to use it?
Abnormal Behavior
Behavior that is… deviant (atypical) maladaptive (dysfunctional) personally distressing (despair)
Theoretical Approaches Biological Approach: Medical Model disorders with biological origins
Psychological Approach experiences, thoughts, emotions, personality
Sociocultural Approach social context
Biopsychosocial Model interaction of biological, psychological and sociocultural factors
DSM-IV-TR Axes Multiaxial System
Axis I and II: Psychological Disorders Axis III: General Medical Conditions Axis IV: Psychosocial/Environmental Problems Axis V: Current Level of Functioning
Anxiety Disorders ‌uncontrollable fears that are disproportionate and disruptive generalized anxiety disorder panic disorder phobic disorder obsessive-compulsive disorder post-traumatic stress disorder
Phobic Disorder Diagnosis and Symptoms an irrational, overwhelming,
persistent fear of a particular object or situation (e.g., social phobia)
Etiology biological factors: genetic
disposition psychological factors: learned
Examples of Phobic Disorders
Social Phobias in the U.S.
Obsessive-Compulsive Disorder Diagnosis and Symptoms persistent anxiety-provoking thoughts and/or urges to perform repetitive, ritualistic behaviors to prevent or produce a situation
Etiology biological factors: genetic predisposition psychological factors: life stress
Mood Disorders …disturbance of mood that affects entire emotional state
Symptoms may include cognitive, behavioral, or physical symptoms interpersonal difficulties
Types major depressive disorder, dysthymic
disorder bipolar disorder
Bipolar Disorder Characterized by extreme mood swings Etiology strong genetic component swings in metabolic activity in cerebral
cortex levels of neurotransmitters
Suicide Prevalence over 32,000 in year 2004 one completion for every 8 to 25 attempts 3rd leading cause of death in early adolescence
Suicide Biological factors low levels of serotonin poor health
Psychological Factors mental disorders trauma (recent/immediate and highly stressful) substance abuse
Sociocultural Factors chronic economic hardship cultural and religious norms gender differences
When Someone is Threatening Suicide
Dissociative Disorders …sudden loss of memory or change in identity
Dissociation protection from extreme stress or shock problems integrating emotional memories
Types dissociative amnesia dissociative fugue dissociative identity disorder (DID)
Dissociative Identity Disorder Diagnosis and Symptoms the same individual possesses two or more distinct personalities each personality has unique memories, behaviors, and relationships only one personality is dominant at a time personality shifts occur under distress
Etiology extraordinarily severe abuse in early childhood social contagion mostly women runs in families
Schizophrenia highly disordered thought split from reality (psychotic) typically diagnosed in early adulthood
high suicide risk
Symptoms of Schizophrenia Positive Symptoms hallucinations and delusions thought disorders and disorders of movement
Negative Symptoms flat affect
Cognitive Symptoms attention difficulties and memory problems impaired ability to interpret information and make decisions
Etiology of Schizophrenia Biological Factors genetic predisposition structural brain abnormalities regulation of neurotransmitters
Psychological Factors diathesis-stress model
Sociocultural Factors influence how disorder progresses