PSYCH 1103 1st Edition Lecture 14 Outline of Last Lecture I. DSM-IV: 5 Axes a. Axis Ib. Axis IIc. Axis IIId. Axis IV e. Axis VII. Anxiety disordersa. Phobiab. Generalized anxiety disorderc. Panic disorder d. Obsessive-compulsive disorder III. Mood disorders a. Depression b. Dysthymiac. Bipolar disorderd. Biological factors e. Psychological factors IV. Dissociative disorders a. Definition b. Dissociative identity disorder c. Dissociative amnesia d. Dissociative fugue V. Schizophrenia Outline of Current Lecture I. Types of schizophrenia a. Paranoid type b. Catatonic type c. Disorganized schizophrenia d. Undifferentiated schizophrenia II. Explanations for schizophrenia a. Genetic factorsb. Dopamine hypothesis c. Neuroanatomy III. Personality disorders a. Axis II b. Three clusters of personality disordersIV. Treatment of psychological disorders a. Therapists b. Psychoanalysis Current LectureI. Types of schizophreniaa. Paranoid type i. Dominated by delusions1. Gradeur, persecution 2. Think people are out to get you 3. Think you will be abducted or found by the CIA ii. Often with hallucinations 1. Resulting in unpredictable behavior iii. Typically less disorganized behavioriv. And less withdrawalv. 40% of schizophrenics (within this type) b. Catatonic type i. Alternating periods of extreme withdrawal and extreme excitement ii. Remain motionless for hours, even days 1. Waxy flexibility iii. Suddenly become very animated, impulsive, even frenzied iv. 8% of schizophrenics (within this type) c. Disorganized schizophrenia i. Delusions ii. Hallucinationsiii. Neglected hygiene iv. Much disorganized behavior v. Prevalent among homeless vi. 5% of schizophrenics (within this type) d. Undifferentiated schizophrenia i. Patterns of disordered behavior that don’t fall into other types ii. 40% of schizophrenics (within this type) II. Explanations for schizophrenia a. Genetic factors i. Monozygotic vs. dizygotic twins ii. No “smoking gun” gene 1. Not a single gene responsible b. Dopamine hypothesis i. “Schizophrenia caused by excess dopamine activity” ii. Dopamine blockers help some patients 1. But not all c. Neuroanatomyi. Changes in gross anatomy of brain ii. Thompson showed significant loss of gray matter across adolescence 1. All adolescents lose some gray matter to pruning 2. But much larger loss for diagnosed individuals III. Personality disorders a. Axis II i. Dysfunctional developmental outcomes ii. Not so much severe disorders b. Three clusters of personality disorders i. Odd-eccentric: cluster A 1. Paranoid a. Suspiciousness, distrust b. Antagonism c. Social isolation d. Detachment e. Treatment is tricky, suspicion of doctors 2. Schizoid a. Indifference to others b. Social isolation c. Lack of intimacy i. Isn’t an issue to them because they don’t care3. Schizotypal a. Odd behavior and speech b. Unusual preoccupations and fears c. Magical thinking d. Have trouble with relationships i. Bothered by lack of intimacy ii. Dramatic- erratic: cluster B1. Histrionic a. Excessive emotionality b. Center of attention c. Shallow feelings d. Constant need for approval 2. Narcissistic a. Obsessive self-interest b. Excessive self-importance c. Exaggerate achievements 3. Antisocial a. Impulsive b. Irresponsible c. Lack of morality d. Spectrum from “con artists” to “sociopaths”iii. Anxious-fearful: cluster C1. Dependent a. Avoid being alone b. Fears of being abandoned c. Over reliance on others d. Passive in relationships 2. Obsessive-compulsive (personality disorder) a. Different from obsessive-compulsive disorder on Axis I b. Preoccupied with rules, orderliness, control c. Inability to discard things d. Unwillingness to show affection 3. Avoidant a. Excessive shyness b. Feelings of inadequacy c. Difficulty with intimacy d. Overestimate problems IV. Treatment of psychological disorders a. Therapists i. Psychologists 1. Ph.D. or Psy.D. in clinical or counseling psychology 2. Typically use some combination of talk, behavioral, cognitive therapy 3. Usually do not prescribe medications directly a. But often have relations with MD’s to facilitate prescriptions ii. Psychiatrists 1. MD’s with training in psychological therapies 2. Can prescribe medications iii. Others 1. Psychiatric nurse 2. Social worker3. Counselor 4. Family therapists 5. School psychologists b. Psychoanalysis i. Freud sought to treat “hysterical” symptoms 1. Hysterical in terms of inappropriate 2. Became dissatisfied with hypnosisii. Developing “talking cure” 1. Free association 2. Memories of childhood trauma and abuse iii. Meaning hidden within the content 1. Manifest contenta. What you’re actual saying2. Latent content a. What you mean to