| Dissociative Disorders : Dissociative Disorders Dissociative Disorders
conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings
Dissociative Identity Disorder
rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities
formerly called multiple personality disorder |
| Slide3 : Memories related to a
trauma
disappear. Memories related to a
trauma disappear and the person starts life all over. A person will have
several personalities
that are unique. |
| Dissociative Amnesia : Dissociative Amnesia Also known as psychogenic amnesia
Memory loss the only symptom
Often selective loss surrounding traumatic events
person still knows identity and most of their past
Can also be global
loss of identity without replacement with a new one |
| Dissociative Amnesia : Dissociative Amnesia Margie and her brother were recently victims of a robbery. Margie was not injured, but her brother was killed when he resisted the robbers. Margie was unable to recall any details from the time of the accident until four days later. |
| Dissociative Fugue : Dissociative Fugue Also known as psychogenic fugue
Global amnesia with identity replacement
leaves home
develops a new identity
apparently no recollection of former life
called a ‘fugue state’
If fugue wears off
old identity recovers
new identity is totally forgotten |
| Dissociative Fugue : Dissociative Fugue • Jay, a high school physics teacher in New York City, disappeared three days after his wife unexpectedly left him for another man. Six months later, he was discovered tending bar in Miami Beach. Calling himself Martin, he claimed to have no recollection of his past life and insisted that he had never been married. |
| Dissociative Identity Disorder : Dissociative Identity Disorder Originally known as “multiple personality disorder”
2 or more distinct personalities manifested by the same person at different times
VERY rare and controversial disorder
Examples include Sybil, Trudy Chase, Chris Sizemore (“Eve”)
Has been tried as a criminal defense |
| Dissociative Identity Disorder : Dissociative Identity Disorder Pattern typically starts prior to age 10 (childhood)
Most people with disorder are women
Most report recall of torture or sexual abuse as children and show symptoms of PTSD
|
| Dissociative Identity Disorder (DID) : Dissociative Identity Disorder (DID) Norma has frequent memory gaps and cannot account for her whereabouts during certain periods of time. While being interviewed by a clinical psychologist, she began speaking in a childlike voice. She claimed that her name was Donna and that she was only six years old. Moments later, she seemed to revert to her adult voice and had no recollection of speaking in a childlike voice or claiming that her name was Donna. |
| Causes of Dissociative Disorders? : Causes of Dissociative Disorders? Repeated, severe sexual or physical abuse
However, many abused people do not develop DID
Combine abuse with biological predisposition toward dissociation?
people with DID are easier to hypnotize than others
may begin as series of hypnotic trances to cope with abusive situations |
| The DID Controversy : The DID Controversy Some curious statistics
1930–60: 2 cases per decade in USA
1980s: 20,000 cases reported
many more cases in US than elsewhere
varies by therapist—some see none, others see a lot
Is DID the result of suggestion by therapist and acting by patient? |
| Schizophrenia : Schizophrenia Schizophrenia
literal translation “split mind”
a group of severe disorders characterized by:
disorganized and delusional thinking
disturbed perceptions
inappropriate emotions and actions |
| What is Schizophrenia? : What is Schizophrenia? Comes from Greek meaning “split” and “mind”
‘split’ refers to loss of touch with reality
not dissociative state
not ‘split personality’
Equally split between genders, males have earlier onset
18 to 25 for men
26 to 45 for women
|
| Slide15 : Schizophrenic Disorders Symptoms Disorganized Thoughts
Hallucinations
Delusions
Garbled Speech
Word Salad
Clanging |
| Symptoms of Schizophrenia : Symptoms of Schizophrenia Positive symptoms
hallucinations
delusions
Negative symptoms
absence of normal cognition or affect (e.g., flat affect, poverty of speech)
Disorganized symptoms
disorganized speech (e.g., word salad)
disorganized behaviors |
| Slide17 : Frequency of positive and negative symptoms in individuals at the time they were hospitalized for schizophrenia. Source: Based on data reported in Andreasen & Flaum, 1991. |
| Symptoms of Schizophrenia : Symptoms of Schizophrenia Chronic or process
schizophrenia is a slow-developing process; recovery is doubtful.
Acute or reactive
schizophrenia develops rapidly; recovery is much more likely. |
| Schizophrenia : Schizophrenia Delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
In a psychiatrist's waiting room two patients are having a conversation. One says to the other, "Why are you here?" The second answers, "I'm Napoleon, so the doctor told me to come here." The first is curious and asks, "How do you know that you're Napoleon?" The second responds, "God told me I was." At this point, a patient on the other side of the room shouts, "NO I DIDN'T!" |
| Symptoms of Schizophrenia : Symptoms of Schizophrenia Delusions of persecution
‘they’re out to get me’
paranoia
Delusions of grandeur
“God” complex
megalomania
Delusions of being controlled
the CIA is controlling my brain with a radio signal |
| Symptoms of Schizophrenia : Symptoms of Schizophrenia Hallucinations
hearing or seeing things that aren’t there
contributes to delusions
command hallucinations: voices giving orders
Disorganized speech
Over-inclusion—jumping from idea to idea without the benefit of logical association
Paralogic—on the surface, seems logical, but seriously flawed
e.g., Jesus was a man with a beard, I am a man with a beard, therefore I am Jesus |
| Disorganized Thinking : Disorganized Thinking Word Salad
jumping from one idea to another even within sentences.
Clang Associations
rhyming the last word of a sentence. |
| Disorganized Thinking : Disorganized Thinking |
| Symptoms of Schizophrenia : Symptoms of Schizophrenia Disorganized behavior and affect
behavior is inappropriate for the situation
e.g., wearing sweaters and overcoats on hot days
affect is inappropriately expressed
flat affect—no emotion at all in face or speech
inappropriate affect—laughing at very serious things, crying at funny things
catatonic behavior
unresponsiveness to environment, usually marked by immobility for extended periods |
| Schizophrenia : Schizophrenia |
| Schizophrenia : Schizophrenia |
| Slide29 : Chemical Factors in Schizophrenia 1. Dopamine is a neurotransmitter found in the brain. 2. Schizophrenics have very high levels of dopamine. 3. They report that they feel agitated, talk rapidly, and their thoughts are racing. 4. Some schizophrenics report that lower levels of dopamine make them feel better. |
| The Dopamine Theory : The Dopamine Theory Drugs that reduce dopamine reduce symptoms
Drugs that increase dopamine produce symptoms even in people without the disorder
Theory: Schizophrenia is caused by excess dopamine
Dopamine theory not enough; other neurotransmitters involved as well |
| Genetic Factors : Genetic Factors Genetic Factors
1 in 100 odds of any person being diagnosed with schizophrenia.
1 in 10 chance among those who have an afflicted sibling or parent.
1 in 2 chance among those who have an afflicted identical twin. |
| Schizophrenia : Schizophrenia |
| Biological Bases of Schizophrenia : Biological Bases of Schizophrenia Other congenital influences
difficult birth (e.g., oxygen deprivation)
prenatal viral infection
Brain chemistry
neurotransmitter excesses or deficits
dopamine theory |
| Other Biological Factors : Other Biological Factors Brain structure and function
enlarged cerebral ventricles and reduced neural tissue around the ventricles
PET scans show reduced frontal lobe activity
Early warning signs
nothing very reliable has been found yet
certain attention deficits can be found in children who are at risk for the disorder
Father’s age—older men are at higher risk for fathering a child with schizophrenia |
| Schizophrenia : Schizophrenia |
| Family Influences on Schizophrenia : Family Influences on Schizophrenia Family variables
parental communication that is disorganized, hard-to-follow, or highly emotional
expressed emotion
• highly critical, over-enmeshed families |
| Cultural Differences in Schizophrenia : Cultural Differences in Schizophrenia Prevalence of symptoms is similar no matter what the culture
Less industrialized countries have better rates of recovery than industrialized countries
families tend to be less critical of the patients
less use of antipsychotic medications, which may impair full recovery
think of it as transient, rather than chronic and lasting disorder |
| Summary of Schizophrenia : Summary of Schizophrenia Many biological factors seem involved
heredity
neurotransmitters
brain structure abnormalities
Family and cultural factors also important
Combined model of schizophrenia
biological predisposition combined with psychosocial stressors leads to disorder
Is schizophrenia the maladaptive coping behavior of a biologically vulnerable person? |
| Personality Disorders : Personality Disorders Personality Disorders
disorders characterized by inflexible and enduring behavior patterns that impair social functioning
usually without anxiety, depression, or delusions |
| Slide42 : Personality Disorders Borderline Personality Disorder These people have unstable and intense relationships with others. They are dependent on others and yet, sabotage those relationships. They have problems controlling their impulses; their perceptions and thoughts are distorted. |
| Borderline Personality Disorder : Borderline Personality Disorder Chronic instability of emotions, self-image, relationships
Self-destructive behaviors
Intense fear of abandonment and emptiness
Possible history of childhood physical, emotional, or sexual abuse
75% of diagnosed cases are women |
| Paranoid Personality Disorder : Paranoid Personality Disorder Pervasive mistrust and suspiciousness of others are the main characteristic
Distrustful even of close family and friends
Reluctant to form close relationships
Tend to blame others for their own shortcomings |
| Histrionic Personality Disorder : Histrionic Personality Disorder Histrionic Personality Disorder displays a shallow, attention-getting emotionality.
Histrionic individuals go to great length to gain others’ praise and reassurance. |
| Narcissistic Personality Disorder : Narcissistic Personality Disorder Narcissistic Personality Disorder exaggerate their own importance, aided by success fantasies.
They find criticism hard to accept, often reacting with rage or shame. |
| Personality Disorders : Personality Disorders Antisocial Personality Disorder
disorder in which the person (usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members
may be aggressive and ruthless or a clever con artist
These people consistently come into conflict with the law and show little or no concern, guilt, or anxiety.
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| Personality Disorders : Personality Disorders PET scans illustrate reduced activation in a murderer’s frontal cortex |
| Personality Disorders : Personality Disorders |
| Rates of Psychological Disorders : Rates of Psychological Disorders |