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Main contents of medical psychology---psychological disorders
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psychological disorders
Three standards
ICD－10: International Classification of Diseases
The ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use.
It is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records.
CCMD－3: The Diagnostic Standard of Chinese clinical mental disorders
DSM-4 : Diagnostic and Statistical Manual of Mental Disorders(DSM)
In the 1950s,
The American Psychiatric Association
a manual of clinical syndromes
clinicians use to make diagnoses.
DSM-4 and Psychological syndromes
The aim of DSM
▲To identify mental disorders on the basis of readily observable signs or symptoms to minimize idiosyncratic diagnoses.
▲DSM-4 tends to be most compatible with a medical model of psychopathology, which presumes that psychological disorders fall into discrete categories.
Multiaxial system of diagnosis
Axis 1. Describes state disorder
Axis 2. Describes trait disorders
Axis 3. lists any general medical conditions
Axis 4. reserved for psychosocial and environmental stressors
Axis 5. Rates the patient’s current level of functioning and the highest level of functioning
MOOD DISORDER
It appears to occur more frequently in the upper social classes.
Types of mood disorders:
1.Major Depressive Disorder:
characterized by depressed mood and loss of interest in pleasurable activities.
Disturbances in appetite, sleep, energy level, and concentration.
It is typically last about five months.
2.Dysthymic disorder
¡ Chronic low-level depression lasting more than 2 years, with intervals of normal moods that never last more than a few weeks or months.
3.Bipolar disorder
¡ Individuals have manic episodes and may also experience intense depression.
¡ Often experience both emotional poles,
Treatments
¡ A.Electroconvulsive therapy (ECT)
? A generalized CNS seizure by electric current
? More reliable, simpler than using chemical convulsants
? Mechanism: involve major neurotransmitter responses at the cell membrane
? Most effective (70-85%) treatment of severe depression
¡ B. Behavioral:
? Behavioral counseling: to family members/others
? Behavioral techniques: desensitization
¡ C. Social:
? Flexible use of social services
? Early involvement in alcohol treatment programS
? Help from family, employer, friends
¡ D. Psychological:
? seldom possible during acute stage
¡ Cognitive behavioral therapy
how to identify and challenge the negative thoughts. This approach is usually done in short-term therapy, and has been found to be particularly helpful for depression.
¡ Interpersonal therapy
¡ Psychodynamic therapy
¡ Group therapy
Major Depression Prevention
¡ learning how to manage stress
¡ avoiding overuse of alcohol, drugs, and caffeine
¡ exercising regularly
¡ maintaining good sleep habits
¡ Many episodes of depression are not preventable.
¡ St. John Wort is a herb suspected to heal mild depression
Anxiety disorders
The anxiety disorders do not involve a loss of contact with reality.They are aware of the illogical and self-defeating nature of certain of their behaviors.
Anxiety generated by modern life can set off the flight of fight response, the body becomes physically aroused when a person is confronted with a real physical threat or with an imagined threat, consequently, some anxious people could find themselves in a continual state of arousal.
Manifestations
Cognitively : Terrifying cognitions , a preoccupation with unknown dangers, an inability to concentrate or make decisions
Motorically: random movement: pacing, squirming, tics, lip biting jumpiness
Somatically :shallow breathing, mouth dryness, cold hands and feet， diarrhea, fainting, muscular tenseness in the head,neck,shoulders and chest.
Affectively: continually uneasy and worried about imminent danger, no matter how well things are going.
Type of anxiety disorder:
1.panic disorders
frightening episodes of apprehension and
feelings of impending doom.
2.generalized anxiety disorders
Tend to have milder anxiety-evoking thoughts dealing with .
Phobias
? A strong, persistent, and unwarranted fear of some specific object.
? Feel extremely terrible and avoid absolutely when faced their terror
? Anything can become the source of this intense fear
Social phobias:
An irrational fear of social situations
The most common forms:
Extreme fear of public speaking
Eating in restaurants
Using public restrooms
Performing in public
There is no fear when the individual engages in any of these activities in private
Simple phobias:
an extreme fear of a specific object or situation
Small animals , Height
The dark, lightning
Death, Exam
Deep water, Being mentally ill
Being in a enclosed place
Treatment of phobias
exposure
flooding
systematic desensitization
modeling therapy
Obsessive-compulsive disorders
Obsessions: a intrusive,uncontrollable and persistent thought
Compulsions: a involuntary impulse to perform a particular act repeatedly.
Treatment of obsessive-compulsive disorders
Biological treatments: leukotomy medication
Behavioral treatment: systematic desensitization
Personality Disorders
¡ Are characterized by enduring maladaptive patterns of thought, feeling, and behavior that lead to chronic disturbances in interpersonal and occupational functioning
¡ The prevalence of personality disorders in the general population is, the best estimate in the range of 10 percent.
¡
Borderline Personality Disorder
¡ Marked by extremely unstable interpersonal relationship, dramatic mood swings, an unstable sense of identity, intense fears of separation and abandonment, manipulativeness and impulsive behavior.
¡ Their representations are often simplistic and one-sided, strongly influenced by their moods and needs.
¡ Splitting their representations into all good or all bad.
¡ Extremely prone to attribute negative or malevolent intentions to other people and to expect abuse and rejection.
Antisocial Personality Disorder
It is marked by irresponsible and socially disruptive behavior in a variety of areas.
Symptoms:
stealing,
destroying property
Lack of empathy
Lack of Remorse for misdeeds
Nearly all adult antisocial personality disorders were conduct-disordered as children.
Although only 40 to 50 percent of conduct-disordered children become antisocial adults.
Antisocial individuals rarely take the initiative to seek treatment.
Dissociative disorders
1. psychogenic fugue:
is psychogenic amnesia accompanied by flight
2. psychgenic amnesia:
3. depersonalization disorder
it is characterized by feelings of unreality concerning the self and the environment
4. Multiple personality : is a dramatic disorder in which two or more relatively independent personality exist in oneindividual.
once thought to be quite rare,may actually be a relatively common but misdiagnose disorder,stress or extreme trauma
during childhood seems to be at the root of the disorder.
treatment of dissociative disorders:
alleviating the depression
behavioral approach
Eating disorder
Anorexia nervosa
n An eating disorder in which the affected individual is intensely fearful of becoming obese and engages in self -starvation
Bullimia
n An eating disorder characterized by the rapid consumption of large quantities of food， usually followed by self-induced vomiting
Schizophrenia
A group of disorders characterized by severe impairment of cognitive processes, personality disintegration, and social withdrawal.
symptoms:
® Thoughts disturbances
The most common symptoms:
lack of insight
Delusion
Inappropriate and bizarre use of language
® Problem with attention
Experience difficulty in directing their attention to a particular aspect of environment or
Focus on a particular thing
® Perceptual distortion
Hallucinations: sensory perceptions that are not directly attributable to environment stimuli
® Motoric disturbances
® Extreme activity levels
® Peculiar body movements or postures
® Strange gestures and grimaces
® Combination of these
® Affective symptoms
® inappropriate emotions: express wrong emotions or may express them inappropriately
® or a lack of emotion.
REASONS:
Heredity
® Heredity does have an influence on this group of disorders
® Heredity alone is not sufficient to cause schizophrenia, environmental factors are also involved.
Social factors:
® Negative family patterns,
® Involving parental characteristics or intrafamilial communication processes
® Correlated with schizophrenia
® Most prevalent among individuals in
® Low-status occupations
® Live in the poorest areas of large cities
® Loosely related to cultural variables
Psychological Factors in Physical Disorders
Psychophysiological disorder:
Any physical disorder that has a strong psychological basis.
Most of the psychophysiological disorders involve actual tissue damage(such as ulcer) or physiological dysfunction(as in asthma or migraine headaches).
Medical treatment is usually required in conjunction with psychotherapy.
Coronary heart disease(CHD):
Conception:a narrowing of the arteries in or to the heart, which results in the restriction or partial blockage of the flow of blood and oxygen to the heart.
Symptoms: chest pain, heart attack
Influence factors: cardiac arrest, Cigarette smoking, Physical inactivity, Obesity, Hypertension, elevated serum cholesterol.
Essential hypertension
High blood pressure with no known organic cause.can lead to heart attacks or serious circulatory problems.
Between 10 and 15 percent of the population of the united states suffers from this condition.
10 percent of all hypertension cases is there an identifiable physical cause
Emotions, and the way in which one deals with them, have also been suggested as being involved with hypertension.
Peptic ulcers
10,000 deaths each year in the united states.
One of every ten persons will be afflicted by this disorder at some point in their lives.
Treatment of psychophysilolgical disorders
consist of both medical treatment for the physical symptoms and conditions and psychological therapy to eliminate stress and anxiety.
The conversion disorders
(somatoform disorders) do involve physical symptoms(blindness, paralysis, loss of feeling), but they do not involve any physical pathology or process.
1, somatization disorder
The individual chronically complains of a number of physical symptoms that have no physical basis。
2,conversion disorder
There is significant organ impairment， without an underlying physical cause。May take the form of partial paralysis， blindness，deafness，or loss of speech of feeling
3,psychogenic pain disorder
Is characterized by severe pain that has a psychological rather than a physical basis。
Psychogenic pain occurs more frequently in women than in man.
4, hypochondriasis
Is a persistent preoccupation with one’s health and physical condition .
Hypersensitive to bodily functioning and process。A twinge in the arm might be as a sure sign of a heart condition， or a stomachache as an indication of an ulcer
5, Neurasthenia
extreme awareness of symptoms and may visit doctors often.
Is a stress-intolerance syndrome, a condition characterized by a lowered tolerance to stresst
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