Psych 202 Lecture April 21 2015 Antisocial Personality Disorder and Psychopathy o Both involve combination of personality traits and socially deviant behaviors but they are distinct disorders o Antisocial personality pervasive pattern of disregard for and violation of rights of others Law violations deceit impulsivity aggressiveness disregard for safety irresponsibility lack of remorse Behavior based Prevalence The Hare Psychopathy Checklist Beyond the behaviors the Personality items o Glibness superficial charm o Grandiose sense of self worth o Need for stimulation o Pathological lying lie for no reason enjoy lying o Conning manipulative able to get people to do things for them o Lack of remorse guilt don t feel very bad about what they did o Shallow affect don t experience emotions in a deep way o Callous unsympathetic lack of empathy Psychopathy o Prevalence 25 of prisoners o This categorization more focus on personality not just antisocial o A fundamental incapacity for love or friendship Karpman 1961 o Mask of Sanity Cleckley 1967 o Can t tell someone is psychopathic by looking at them Ken and Barbie killers of Canada Borderline Personality Disorder o Unstable moods o Intense and volatile interpersonal relationships o Mood instability and anger outbursts o Self mutilation or suicide threats to get attention or manipulate others o Self image fluctuates and unstable sense of self o See others as all good or all bad Histrionic Personality Disorder o Excessive need for attention o Grandiose language o Provocative dress o Exaggerated illnesses o Overly dramatic excessively flirtatious o Shallow and unstable emotions o Act as if they are onstage all the time Introduction to Mental Disorders and Treatment Nonpsychotic Disorders Overview o Discuss advantages disadvantages of diagnosis o Introduce diathesis stress explanatory perspective o Describe major categories of anxiety mood disorder and psychotic disturbances o Discuss etiology and treatment o Discuss bio pyscho social model The Value and Danger of Labels Categorization and Diagnosis o Facilitates professional communication o Leads to shorthand description implied meaning o Can stigmatize and lead to self fulfilling prophesies Mental Disorders can have many causes o Family and sociocultural factors o Cognitive behavior factors o Biological factors o The diathesis stress model integrates multiple perspectives Diathesis predisposing factors o i e genetics personality traits environment early and prolonged stressors and stressresponses resulting in emotionally and behaviorally maladaptive circuits in the brain Stress precipitating factors or triggering factors o i e stressful life events Neurotic Disorders non psychotic disorders o No delusions or hallucinations o No markedly impaired reality testing Anxiety Disorders o 1 Generalized Anxiety Disorder Excessive anxiety and worry more days than not for 6 months Person finds it difficult to control the worry Anxiety worry associated with at least 3 of the following symptoms Restlessness feeling keyed up or on edge Being easily fatigued Difficulty concentrating or mind going blank Irritability Muscle tension Sleep disturbance o 2 Panic Disorder With and without agoraphobia o 3 Phobic Disorders Agoraphobia fear of open places fear of being somewhere where you might have a panic attack and can t escape so you eventually stop going out and just stay in home or only leave with a safe person Social phobia fear of social situations i e parties public speaking Specific phobias e g elevators snakes spiders o 4 OCD Obsessions i e doorknob has lots of germs on it Compulsions i e wash hands to get rid of germs o 5 PTSD People are anxious about having negative memories about traumatic events so avoid experiences and places that might trigger a flashback Panic Disorder a disorder characterized by the sudden occurrence of multiple psychological and physiological symptoms that lead to stark terror panic attacks Video clip The Sportswriter o Panic disorder w agoraphobia o Drinks alcohol to cope with going out o Stress from work and divorce avoid situations that make him anxious OCD A Young Mother s Struggle Videoclip o Fear that someone is going to take her baby o Sets traps in her house in case someone kidnaps Jake o Knows her thoughts are irrational but can t control them o Has to look at him when stopped at a stop sign o Also has a fear of contamination washed her hands 22 times in 30 minutes o Spins in circles to make sure nobody bad is around Anxiety disorders has cognitive situational and biological components o Consider the causes of OCD The importance of learning theory avoidant learning o Link between panic disorder and agoraphobia o Causes of OCD Caudate nucleus dysfunction Caudate nucleus part of basal ganglia Basal ganglia involved in impulse suppression Theory impulses leak into consciousness and prefrontal cortex becomes overactive i e strep throat Anxiety Disorder o Focus on threatening events content o the doctor examined Emma s growth o Biological factors play role o Inhibited temperaments related to anxiety o Increased CNS activation related to panic disorder Treatments that Focus on behavior and cognition are important for anxiety disorders o Systematic desensitization o Learn how to relax and control breathing to manage dimensions of fear o Virtual treatments can reduce fear response o Create a fear hierarchy i e social phobia hierarchy Cognitive and cognitive behavioral therapy involves helping a client identify and correct and distorted thinking about self others or the world o Cognitive restructuring what s the worst thing that can happen o Mindfulness meditation teaches an individual to be fully present in each moment o Cognitive behavioral therapy a blend of cognitive and behavioral therapeutic strategies DON T BELIEVE EVERYTHING YOU THINK Treatments that focus on behavior and cognition are superior for anxiety disorders continued o SSRI s help social phobia but cognitive and behavioral methods are treatments of choice o Panic disorder treatments often combine medication and cognitive behavioral therapy CBT but relapse is less with CBT OCD is an anxiety disorder most effective treatment o Blend medication and CBT with a focus on exposure and response prevention o Less placebo effectiveness Mood Disorders Most people with generalized anxiety disorder have depression The Real World Suicide Risk and Prevention o Suicide is the 11th leading cause of death in the U S and 3 rd