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Tuesday, 16 April 2019 Week 10 Lecture – Psychological disorders What is mental wellbeing?  Stereotypes of people with mental illness?  Reality?  ¼ Anxiety and Depression in Australia  How do we define Psychopathology? The study of ‘abnormal’ behaviour  Assess through interview, medical, testing, history.  Treating mental ill individuals to work towards health wellbeing.

The 4 D’s of Psychological Disorders:  People need to meet 3 of these D’s to be diagnosed with a psychological disorder.  Early intervention & prevention.  Deviance – behaviours, thoughts, and feelings that are not in line with normal or usually accepted standards.  Distress – behaviours, thoughts, and feelings that are upsetting and cause pain, suffering, and/or sorrow. • Doesn’t care about the rights of others • Nasty people • Not necessarily distressed by their own behaviour towards others.  Dysfunction – thoughts, and feelings are disruptive to one’s regular routine or interfere with day-to-day functioning. • Can't get to work, school etc. • Can't get out of bed, don’t eat. • Someone who is genuinely not functioning. • Bipolar disorder  Danger – thoughts, and feelings may lead to harm or injury to self or others • Someone is a risk at hurting themselves or other people. • Self-harm or suicidal behaviour. Classification of Psychological Disorders:  The Diagnostic and Statistical manual of Mental Disorders (DSM), first published in 1952, is currently in its 5th edition (DSM-5).  The DSM-5 uses a life span development organization scheme to classify psychological disorders into 19 major areas.  The classification system starts with disorders usually diagnosed in childhood and ends with those usually diagnoses in older adulthood.  Includes thousands of psychological disorders. Anxiety Disorders:  Anxiety is a normal emotion and can be adaptive in many ways.  Anxiety becomes problematic when it gets in the way of doing what we need and want to do.  Super common, 1 in for 4 people experience anxiety disorders.  Anxiety that is really out of proportion.

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People exhibit their anxiety, and therefore creates potential anxiety for others through genetics and/or observation. Example: if mum is scared of spiders, as a kid they will think spiders are scary and develop fear and anxiety about spiders. Social anxiety: • people really persevere with social situations, can't physically handle the social situation they’re in. • leading up to anxious situations, people don’t eat, sleep, and develop extreme distress leading up to the event. Panic and agoraphobia • Panic disorder: people become all of a sudden overwhelmed with anxiety and become literally paralysed in the situation. • Agoraphobia: is a fear of not being able to escape, not being able to get help. • Panic attack: a person is so overwhelmed, and they need to get out of a situation immediately. A person will perceive that something is bad is going to happen when it probably won’t. Separation anxiety Generalized anxiety • Everything is anxiety provoking • Leaving the house, meeting friends etc. • Anxiety stop making people doing things. • Become crippling. Health anxiety • People worry that something is wrong and something bad is going to happen.

Obsessive-Compulsive and Related Disorders:  Obsessions are recurrent unwanted and intrusive thoughts, fears, urges, or images while compulsions are behaviours that an individual feel driven to perform in response to an obsession.  You get a thought about something and you have to follow through.  I need to act on it, so the thought goes away.  If I don’t a certain number of things or a certain thing each day, they have a perceived thought that a bad and negative thing will happen.  Teach themselves to do these routines so nothing bad happens.  Body Dysmorphic Disorder • Where someone perceives a defect/flaw in their body that no one else can see. • “my nose is too big; my acne is bad” • Obsessed, constantly checking, and asking people for reassurance. • When you look at these individuals absolutely nothing is wrong for the objective observer. • People will go to extreme such as; surgery, dermatologists, gym craze. • Quite a disturbed way of seeing your body, you see a distorted image.  Hoarding Disorder:

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This condition is characterized by difficulty getting rid of things, even when they have no financial or practical value. This often results in excessive accumulation that takes over spaces at home or work.

Depressive Disorders:  Depression is more than sadness.  Individuals diagnosed with depressive disorders may also experience changes in their appetite, difficulty concentrating, and irritability.  Fell hopeless, and helpless.  People don’t sleep or oversleep.  Easily get upset.  Major Depressive Disorder: • Suicidal behaviours can accompany major depressive disorder, and may include thoughts, plans and attempts to end one’s life. • If you or someone know expresses thoughts or plans for suicide, please seek the help of a mental health professional. Bipolar and Related Disorders:  Mania, a distinct period of high energy and increased activity, is the defining feature of disorders in this category.  The opposite of a mania is depression, marked by sad mood and loss of interest or pleasure in things.  The term bipolar describes these highs of mania and lows of depression.  Do things extremely out of character.  Need medication to stable their mood, to try and stop the swings of emotions.  Bipolar II Disorder: • Hypomania is a less intense experience of mania that features the same increased energy and activity levels without the same impairment in functioning. Schizophrenia Spectrum and Other Psychotic Disorders:  Individuals with a diagnosis in this category seem to have lost touch with reality and have a hard time thinking clearly, making good judgments, and communicating effectively.  Where people experience hallucinations and delusions.  People have no emotion on their face, quite withdrawn, speech doesn’t make sense.  People need medication to control the hallucinations.  People get more functional but will have for the rest of their life and wont full recover from.  Schizophrenia: • Most individuals diagnosed with schizophrenia have significant difficulty functioning in their daily activities and many end up homeless. Trauma and Stressor Related Disorders:  As the name of the category implies, trauma and stressor related disorders are caused by exposure to trauma and stress.

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Something traumatic must have had to happen. Their life or someone else life has been put in danger People develop a stress response as a reaction to that trauma. Adjustment Disorder • Where people are having a reaction (anxiety, depression) to a situation that is highly distressing • Very common • They’re high distressed and traumatised. • Helping people to function, to help them not feel distressed in future similar situations. Post-Traumatic Stress Disorder • Post-traumatic stress disorder (PTSD) can develop as the result of an individual experiencing or witnessing a traumatic event. • The stress of military combat makes service men and women especially vulnerable.

Eating Disorders:  Are about: Body weight, size and shape.  Stereotypes?  Reality?  Types: • Anorexia Nervosa • Bulimia Nervosa • Binge Eating Disorder Somatic Symptom and Related Disorders:  Disorders in this category are characterized by an intense focus on symptoms of physical illness or pain.  While individuals with these diagnoses may experience real symptoms of illness or injury, there is no medical explanation.  People get really fixated that there is something physically wrong with them, and there’s no evidence to support that.  Hard to treat.  Factitious Disorder: • Previously known as Munchausen syndrome, factitious disorder describes a condition in which individuals knowingly and deliberately cause themselves or others to be physically ill or injured. Elimination disorders:  Elimination disorders involved elimination of urine (enuresis) and faeces (encopresis) in places other than the toilet.  These disorders are diagnosed in potty-trained children older than 5 years.  Can be linked through trauma, such as sexual abuse because they become distressed in a certain situation and cannot control their bodily functions (muscles for bladder & bowels).  Encopresis:

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The majority of children diagnosed with encopresis have experienced chronic constipation earlier in life, which can lead to fear of pain associated with defecation.

Sleep-Wake Disorders:  Disturbances in sleep can result in daytime distress impairment, including fatigue, difficulty with cognitive focus, and declines in mood.  Insomnia • Really anxious • Struggle to fall asleep at night • Need to do certain things in order to train the brain that when you go to bed you go sleep.  Parasomnia • Engage in abnormal activity when sleeping • Sleepwalking/talking • Cooking in your sleep etc. • Need medication to sedate people when they sleep. Sexual Dysfunctions:  Sexual dysfunction is a sensitive topic, and is probably more prevalent than current estimates, due to underreporting.  Sexual problems affect both men and women, young and old.  People get uncomfortable with their body being on display, and intimacy.  Erectile functions for males related to stress and anxiety.  Life transitions, kids, tiredness from work etc.  Arousal.  Orgasm.  Pain. Gender Dysphoria:  Gender dysphoria is the experience of distress, discomfort and/or anxiety associated with a gender assignment that does not match one’s gender identity.  An individual with gender dysmorphia may express the wish to be another gender, or in the case of children, assert that they will grow up to another gender.  Horrified by their own genitals, not happy with their appearance.  Might just be a sexual preference, and something that can potentially fade over time.  Help people express their mental health issues and thoughts to their friends and family for explanation and support. Childhood Disorders:  Conduct • Naughty, difficult kids. • Acting out behaviours • Antisocial and aggressive behaviours • Difficulty following rules. • Violent in the home environment

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Can be treated -> positive parenting, help to reinforce positive rules and parenting. Could potentially lead to personality disorders.

• Autism • Autism spectrum disorder • Mild, moderate, severe -> how functional a person is • People who can’t tolerate being around others, not good socially, not good if the rules change only good with routines. • Autism children do not prefer to socialise, like being by themselves • Trying to get kids to tolerate what’s going on. • Very routine based life, rigid play. • Issues with speech, repeat a lot of things you say and how you said it. Elimination Intellectual disorders • Occur at any point in someone’s life • Someone’s cognitive capacity is reduced in some way • Example: Ability to remember things, to follow a sequence, driving a car, sense of humour. Feeding disorders • Fussy eating • Children won’t eat • Infants won’t feed • Can be due to abuse or neglect • Children with OCD, very particular with what they eat • Can have implications later in life.

Substance-related and Addictive Disorders:  Addiction is characterized by repeated and compulsive engagement in activities that bring about immediate pleasure, even when the long-term outcomes are negative.  Addictions can be substance-related or behavioural.  Become very compulsive with their attitude, and stat to fixate until they fulfil their need.  The point where they use their substances that causes harm.  Alcohol and other drugs. • Drink to excess • Drive under the influence • Drink at inappropriate times • A person cannot stop the behaviour • Example: Avoidance of anxiety, increase their mood, reduce their stress, help them sleep. • Can be hard because its social thing (drinking alcohol). • Can affect relationships  Gambling Disorder • Addicted to gambling • They get a thrill, and compulsion to partake • Financial impact.

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Neurocognitive Disorders:  Disorders in this category affect how the brain processes information.  Neurocognitive disorders are acquired, meaning that the cognitive deficit was not present at birth.  These disorders are attributable to brain injury, disease, or substance/medication use.  Brain injuries from a car accident  Substance use  Poor cognitive functioning  Alzheimer’s Disease: • Although associated with getting older, Alzheimer’s is not considered a normal part of the aging process. • Rather, it is thought to be attributable to genetic mutation in brain cells. • Brain cells starting to decline. • Causing severe brain function • Lose more of their memory and bodily functions. Personality Disorders:  A disorder of personality is an enduring pattern of characteristics, beliefs, and behaviours that are drastically different from the expectations of the individual’s society and lead to distress and impairment.  Conditions people have for their whole life.  Their perceived thoughts don’t fit society norm  People don’t function particularly well.  These are 3 categories of personality disorders listed in DSM-5: • Cluster A: odd and eccentric behaviours • Cluster B: dramatic, emotional and erratic behaviours • Cluster C: anxious and fearful behaviours  Borderline Personality Disorder: - Swings of emotions - Always drama, always things going wrong - Get clingy - Cutting, self-harm, suicidal attempts - Quite manipulative - Seek help to regulate emotions • Antisocial Personality Disorder - Serial killers - Paedophiles - Really violate the rules - Nasty people - Do not care about hurting people • Narcissistic Personality Disorder - Very self-involved - Not good listeners - Only think about themselves - Purely do things for themselves

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What causes Psychological Disorders?  The biopsychosocial model suggests that there is not one single factor or event that causes a psychological disorder.  Rather, it is the interactions of a person’s biological makeup, psychological experiences, and social environment that determine their risk for a psychological disorder.  Can be your up bring and what your exposed to  Potential link to genetics  Peers, teasing, nastiness in environments you grow up in  Experienced traumatic things and have had no resources to cope with it....