Siti Norzeerah Aiffah Binti Badron Assignment: Compare the two types of psychological disorders

Student ID : 4111017091 Introduction to Psychology Lecturer : Dr.Geshina Ayu Binti Mat Saat Faculty of Social Science

Pages Defining and Explaining Abnormal Behaviors in Medical Terms3, 4 Historical Views of Psychological Disorders. Theorical Approaches to Psychological Disorders and Explanations. The Biological Perspectives The Psychological Perspectives The Sosiocultural Perspectives The The Cognitive Perspectives 1. Mood Disorders 1.1 1.2 1.3 1.4 1.5 Depression/ Depressive disorder. Mania Disorder Bipolar Disorder Major Mood Disorder (MDD) Dysthymic Disorder (DD) Biopsychosocial Perspectives.5

Etiology Explanations of Mood Disorders. Biological Perspective Psychological perspective Sociocultural perspectives 2. Anxiety Disorders 2.1 2.2 2.3 2.4 2.5 2.6 Generalized Anxiety Panic disorder Agoraphobia Specific phobia Social phobia Obsessive-Compulsive Disorder (OCD)

Etiology Explanations of Anxiety Disorders. Biological Perspective Psychological perspective Sociocultural perspectives
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3.

Therapies for Mood Disorders and Anxiety Disorders. 3.1 Biological treatments Antidepressants drugs Tricyclics MAO inhibitors Selective Serotonin Reuptake inhibitors (SSRIs) Lithium Antianxiety drugs 3.2 Psychotherapy treatments

Defining and Explaining Abnormal Behavior in Medical Terms. In term of medical, the American Psychiatric Association (2001, 2006) defines abnormal behavior: a mental illness that effects or is manifested in a person`s brain and can affect the way individual thinks, behaves, and interacts with others. Looking at the three characteristics of abnormal behavior that patented: Deviant. Abnormal behavior often regard as not typical and unusual. Accomplished and successful people like Bill Gates and Akio Morita (founder of Sony) are among those with abnormal traits that recognized, yet we didn`t categorized them as abnormal person. We tend to regard something and someone as abnormal behavior when it deviates from what acceptable in our culture. For example, it looks okay and acceptable in Western cultures to walking around the house with shoes-on. But in much Eastern countries, having your shoes inside house are regards as insult and provoking to their cultures. This on the other hands, still didn`t called as abnormal behavior cause there`s two more characteristics to look to in considering it`s an abnormal behaviors. Maladaptive. Any abnormality of a person interferes with their ability to function effectively in daily life. Someone who believes they will embarrass themselves when going out to places will tend isolation and grounded himself in home to avoid contact with people. This belief had negatively affects his daily functioning; such as socialize
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with neighbors, walking in the park, even eating and any other thing consider as a normal behaviors. Thus any behavior that presents danger to the person itself or those around him or her are regards as maladaptive. Personal Distress Any person engaging in abnormal behavior finds it troubling, humiliating as it cause intense shame, guilt and despair to them. Moreover, even though others didn`t see what they`ve been doing, it still strike a negative perception on themselves. For example, person with bulimia disorder tend to feel shame after purged on basis that others understand them as a normal person with a normal attitude towards their eating habit, but others didnt actually realize that the truth of his or her behavior.

Theorical Approaches to Psychological Disorders and Their Explanations. Biological model Holds that psychological disorders caused by physiology malfunctions of the nervous system or brain structure, and heredity seem to play lead role. Recently, neuroscience provides exciting new insights into the nature and causes of psychological disorders. Specific areas in brain have been found to involved in disorders such as schizophrenia (Chance, Esiri, & Timothy, 2003; Yotsutsuji et al., 2003) This model also looks insight from the psychiatrics perspectives and involvement in treating patients with biological substances. From medical view, abnormalities are called mental illnesses, the afflicted individuals are patients, and treated by doctors. Psychological Model Freud and his followers popularized the psychoanalytic where regards behavior disorders as symbolic actions of unconscious internal conflicts and emphasizes the contribution of experiences, thoughts, emotions and personality experiences. Sosiocultural Model Looking up the causes and effects at the social contexts that surrounds a person life; such as gender, ethnicity, socioeconomic status, family relationships, and culture. Some disorders can be culture-related in different several places. Witchcraft is example of abnormal behavior that involved intense feeling of untouched from reality, vomiting and high tension. Biopsychosocial Model Summation of abnormal behaviors that have the summation of three previous models. Those three views add and act coherently with each
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characteristics.

Usually

referred

to

one`s

childhood

other to make an abnormal disorders. For instance; people that live in poverty areas and had been terrorized by wars have higher chances at developing abnormal disorders of anxiety others than someone who had a father that has OCD.

1.

Mood Disorders

For mood disorders sufferer, life can be seen as gloomy and sometimes quite crazy in manic situation. Mood disorders once reported to inflict roughly 9.5 percent of United States population (National Institute of Mental Health, 2008). Mood disorders can be a depression and bipolar; involves wide mood swings from deep depression to extreme euphoria and agitation in individual. It`s very important to distinguish between the clinical depression and 'normal' kind of depression that occurs and we`ve experience all the times. Even healthy psychological people get the "blues" for no apparent reason. Only when the depression tend to get more serious, lasting and well beyond typical reaction to any stressful event, then the depression can be classified as mood disorders ( American Psychologist Association, 2000). 1.1 Depression/ Depressive disorder.

Sufferers are overwhelmed with worthlessness, sadness, loss interest of activities and even show excessive guilt about something they do or experience. They unable to experience any pleasure they`ve once enjoyed such as socialize with others. They show tiredness and unenergetic, lose interest in food and sex, including insomnia. For them, thinking and concentrating can be challenging for them, even up to the point of making everyday life decision or reading newspaper (Morris, Maisto, 2005). This disorder are very common, that in fact a number of successful individuals had diagnosed with it. Among them are renowned artist Pablo Picasso, actress Drew Barrymore and actor Jim Carrey, including famed astronaut Buzz Aldrin (the second moonwalker) (King, 2010) 1.2 Mania Disorder

This disorder are characterized when a person in euphoric state or "high";

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extremely active, excessive talkative and easily distracted from any situation. People with this disorder become a grandiose- where their selfesteem is greatly inflated. In order to stand up for their self-conscience, they show symptoms of extremes; running wild, incomprehension and violent up until to point they collapse or faint. 1.3 Bipolar Disorder

Manic episodes are rarely appear, but when it found alongside extreme depression in individual, then it called bipolar disorder. Both mood alternate each other ; lasting from few days to few months, and normal mood intervening along side. It is equally prevalent in men and women, contrast to depression. 1.4 Major Mood Disorder (MDD)

For two weeks, individuals with this disorder are marked by lasting extreme of depression and depressed characteristics, such as lethargy and hopelessness. Sadly, due to the total despair many of sufferer perceived about their life, MDD can impairs daily functioning and had been the leading cause of disability in the United States (National Institute Of Mental Health, 2006) Nine of these symptoms (at least five should be present along two-weeks period) must be registered in individuals to ensure they suffer from MDD: a) Depressed mood most of the day b) Reduced interest or pleasure in all or most activities. c) Significant weight loss or gain or significant decrease or interest in appetite d) Trouble sleeping or sleeping too much during days e) Psychomotor agitation or retardation f) Fatigue or loss energy g) Feeling worthless or guilty in an excessive manner e) Problems in thinking, concentrating, or making decisions
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f) Recurrent thoughts of death and suicide g) No history of manic episodes (periods of euphoric moods). 1.5 Dysthymic Disorder (DD)

This disorder is generally more chronic and has fewer symptoms than MDD; as an adult feeling depressed mood for most days for at least two years (Coon & Mitterer, 2009;) and one year as a child or adolescent (King, 2010). If individuals diagnosed with MDD and the two-year period broken by normal mood lasting to more than two months, then they can`t be classified having DD. Two or more of these symptoms must be present: a) Poor appetite or overeating b) Sleep problems c) Low energy or fatigue d) Low self esteem e) Poor concentration or difficulty making decisions f) Feelings of hopelessness.

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Etiology Explanations of Mood Disorders. Biological Perspective Some scientists are focusing on the biology of mood changes. Where they interested in brain`s chemicals and neurotransmitters substances, especially serotonin, norepinephrine and dopamine levels to identify the cause of MD ( Craddock & Forty, 2006; Kato,2001). There`s a confident and consistent evident that genetics play an important role in development of depression (Mineka,Watson & Clark, 1998) , where specific brain structures are found involved, as noted in bipolar disorder (Badner, 2003; Katz & McGuffin,1993; Scharinger et al., 2010). Depressed individuas show lower level of brain activity in the section of prefrontal cortex that involved in generating actions (Clark, Chamberlain, & Sahakian, 2009; Friedel & others, 2009) as well as in regions where the brain associate to recognize opportunities for pleasurable experiences (Kedwell & others, 2005; Tye & Janak,2007). Individuals with major-depressive disorder appear to have too few receptors for the neurotransmitters serotonin and nonepinephrine to carry impulses (Ashgar-Ali & Braun, 2009; Cipriani & others, 2009). Other research also suggest that problem in regulating neurotransmitters called substance P might involved in depression (Norman & Burrows, 2007) as it thought to play role in psychological experience of pain. From the studies of twins, heredity also gives way to MD along generations as one of identical twins develop 67 percent chances to have MD if the other twin clinically depressed, while fraternal twins had 19 percent( Coon & Mitterer, 2009; McGuffin, Katz, Watkins, & Rutherford,1996). Psychological perspective Drawn on behavioral learning theories and cognitive theories make for MD
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shown that in recent years, research has focused on psychological etiology for the contribution of maladaptive cognitive distortions (Morris, Maisto, 2005). Behavior view on depression identified on learned helplessness, an individuals acquisition of feeling of powerlessness due exposed to provoking circumstances; such prolonged stress which beyond their control (Seligman, 1975).When they cannot control their stress,they tend to stop changing their situations, which leads to spiral of hopelessness (Becker-Weidman & others, 2009). Individuals with maladaptive cognitive distortions develop a negative selfconcept-feeling of incompetence that has little to do with reality but maintained within by a distorted and illogical perception of real events that they encounters before (Beck, 1967,1976,1984, 2002). Beck`s theory have been studied by others and they found that for instance; colleges students with negative cognitive styles perceived information in more negative terms than those who not depressed (Alloy, Abramson, & Francis, 1999; Roth & Rehm, 1980; Watkins, Vache, Verney, Matthews, & Muller, 1996). In other simpler context, Beck proposed that individuals who thinks they unworthy after encounters wrenching experiences; such as loss of parent, humiliating criticisms from teachers and severe difficulties in gaining parent or social approval have develop negative view oneself. Sociocultural perspectives Freud views of depression as a result from excessive and irrational grief over a real events, or known as a "symbolic loss" and "unsolved grief" however, is complex and not supported by current evidence ( Crook & Elliot, 1980). But the analogy he drew had became basis for linking depression to troubled relationships as depression occurs to women two to three times than in men (Culbertson, 1997; Weissman & Olfson, 1995).
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This due that woman is more relationship-oriented than men in society (Gilligan, 1982). Incidence of depression is high, too among single women who the heads of house-hold and among young married women who endures life; working at unsatisfying, dead-end jobs (Whiffen & Demidenko, 2006)

Individuals with low socioeconomic status (SES), especially people living in poverty, tend to develop depression than opposites them (Boothroyd & others, 2006). This due to cope up to their suffering and study revealed that depression did increase as a standard living and employment surroundings worsened (Lorant & others, 2007). Studies found that very high rates of depression in Native Americans group are wide spread as they live through poverty, hopelessness, and alcoholism (Teeson & Vogl, 2006).

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2. 2.1

Anxiety Disorders Generalized Anxiety Disorder

Defined by prolonged vague but intense fears that not attach to any particular object or circumstance; perhaps comes closest to everyday meaning to the term neurotic. Sufferers must experience persistent anxiety and worries for at least six months plus they unable to specify the reason for that period of anxiety (Kendler & others, 2007). They feel nervousness all the times; they tend to worry about their work, relationships, even their own health which eventually leads to fatigue, muscle tension and sleeping difficulty. The symptoms including: a) Inability to relax b) Typically complain of sweating, racing heart c) Dizziness d) Constantly feeling restless e) Hyper vigilance (constant alertness to potential threats) f) Poor concentration g) Clammy hands. 2.2 Panic disorder

Characterized by recurrent panic attacks, sudden onsets of intense terror,without warning and no specific or apparent reason; it just happens.
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Panic attacks sufferers experience chest pain, sweating, difficulty in breathing, fainting, even dying and it lasts for few minutes. These events eventually lead sufferers to overwhelming dread; the panic attacks will strike again and may persist for days or weeks. That dread will lead to two types of panic disorders; with agoraphobia and without agoraphobia. People with panic disorder with agoraphobia (fear of market places in Greek) , they feel the intense fears that panic attacks will strike in impropriate times in public places; such as supermarket or crowds cause sufferers fears to leave their home and family surrounding. Thus, they sometimes becomes a prisoner in their own homes (American Psychiatric Association,2000). While people with panic disorder without agoraphobia still socialize with other people. When panic attacks occurs, choking, feeling of unreality or chest pain cause sufferers to believe that they having heart attacks when it wasn`t, and those fears eventually driving them mad and going insane. Life getting miserable and dreadful for them in the future and most of these sufferers are women (Foot & Koszycki,2004). 2.3 Agoraphobia

People who had this fear that something extremely embarrassing to them will happen if they leave home; the word agoraphobia itself are from Greek and Latin words that literally means "fear of the marketplace". Doing something that acceptable as daily works; such as walking the pedestrian walks, being in the crowds or even across the bridge may impossible for them ( American Psychiatrics Association,2000). Leaving home that regards as sources of security are frightening for them. Recorded that about 4.2 percent of all adults suffered from this disorder(Grant et al., 2006) 2.4 Specific phobia

It is an intense, irrational, paralyzing fears of particular things that

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perhaps to be feared, but it so excessive and unreasonable when there actually no real danger (Miltner et al., 2004). In fact, these phobias are greatly impacted in sufferers that they tend to avoid routine or adaptive activities; thus interferes with their life-functioning. It can be identified on person when they encounters something that makes them vomit, running, fainting or even climbing in wild to avoid the items that provokes their phobia and disrupt their daily life. For example, afraid of spider are reasonable, but people with spider phobia (arachnophobia) may regards a picture of spider as disturbing as it crawling or biting them (Miltner et al., 2004). Having a stroll at the park with lake are very comforting for us, but those who has aquaphobia; afraid of being in or on water, for instance, may avoid going to those places. Estimates indicate that about 1 to 10 people suffer from at least one phobia and 9 percent of all adults of this disorder in the United States (National Institute of Mental Health, 2008).

2.5

Social Phobia

Refers to excessive, inappropriate fears that connected with social situations; such as writing or speaking in public tend to leads them to find a way to cope with this irrational embarrassment. It a social disorder when excessive enough to interfere with life functioning such as attends school, eating in public or simply talking with people. Those with this social disorder endure it by intense anxiety or distress and can be identified by: a) Pounding heart b) Shaking hands c) Sweating d) Diarrhea e) Mental confusion f) Blushing.

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2.6

Obsessive-Compulsive Disorder (OCD)

Obsessions are involuntary thoughts or ideas that keep recurring even after stop attemptions; compulsions are repetitive behaviors that a person feels compelled to perform. We all experience it several times in life; such as checking the door knob locked few times before heading to car or going to bed before an early flight, but people with OCD dwell on their doubts so much and they repeat their routines up to hundred times a day (Abramovitz, 2009). We all had a mild obsessions and compulsions at times, but why people with OCD are regards as anxiety-type disorders? When their irrational routines; such as cleaning the phone every 15 minutes, try to be stopped by someone else, they experience severe anxiety which makes them worried sick when they unable to perform the routine.

Etiology Explanations of Anxiety Disorders Biological perspective Psychiatrics point up to heredity, arguing that a predisposition to anxiety disorders may be inherited in generations (Eysenck, 1970; Sarason & Sarason, 1987). Studies on concordance rate (indicates the percentage of twin pairs or other pairs of relatives who exhibit the same disorder) shown that relatives share more genetic similarity in identical twins had higher concordance rates. This proved and consistent with the findings that 15%20% of infants displays an inhibited temperament, characterized by shyness, timidity and wariness (Skre, Onstad, Torgersen, & Lygren, 1993). One biological view that individuals who experience panic disorder may
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have an autonomic nervous system that prediposited to be very active (Barlow, 1988). Anxiety based on possibility it may stem from problem involving low level of GABA (Gamma aminobutyric acid) that occupied one-third of human brain, cause extreme anxiety. GABA helps control neurons from firing up and the precision of signal in brain. Psychological etiology Phobias are often learned after only one fearful event. Classical conditioning in humans by Pavlov are the best to explain this; John Watson and Rosalie Ryner proved through an experiment called "Little Albert" whereas showing infant, Albert to a lab rat and create a phobia in himself towards the rodent ( Watson & Rayner, 1920) First, they put Albert and the white rat near and Albert shows no fear towards the rodent at first. When Albert start to cuddle and play with the rat, the experimenter bang a steel of bar. Because all children afraid of loud noise, it natural to him to fear of the bang. After few of those experiments, Albert started cry and withdrew from the rodent even when the experimenter didnt strike the steel bar anymore. This is an example of how phobias develop; the irrational fears towards normal things.

Cognitive etiology. Thought and beliefs contribute to the sense of helplessness (Fiske, Wetherell, & Gatz, 2009; Smith, Calam & Bolton, 2009). Aaron Beck (1907) theory about cognitive distortions, unrelenting experience tend to lead negative thoughts and self-concept in one`s childhood and adolescence years. When a situation that resemble their wrecking and stressful event years earlier, those same feeling of incompetence may be activated, which resulting in depression.
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3. Therapies for Mood Disorders and Anxiety Disorders. 3.1 Biological treatments Clients and therapists select biological treatments for several reasons. First, therapist find that it difficult to help people with any psychotherapies as patients sometimes agitated, unresponsive and cannot contain their euphoria. Second, biological treatments used for disorders that have a strong biological component; such as in brains and heredity. Third, biological treatment used to patients who dangerous to themselves and can inflict others. Due to certain drawbacks and not cost-effective as using this kind of treatments in long term; such as addictive and nausea, psychologist now days still striving to reduce prescribing drugs therapies. Antidepressants drugs Known as drugs that regulates mood and thought to help combat depression through their effects on neurotransmitter in brain (King, 2010). There`s three main classes; Mixomine Oxidance inhibitors (MAO inhibitors) such as Nardill and Tricyclics; such as Elavil had long been prescribed by psychologist before late 1880`s. Both drugs work by increasing the concentration of the neurotransmitters serotonin and nonepinephrine (Mc Kim, 1997). Selective Serotonin Reuptake inhibitors (SSRIs) then appear in the late 1880`s. Afterwards, psychiatrist increasingly prescribing this, showed that the effectiveness of SSRIs. Tricyclics
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So called due to their three-ringed molecular structure, its works by increasing the level of neurotransmitters, especially nonepinephrine and serotonin (Lopez-Munoz & Alamo, 2009). Low serotonin levels cause negative moods and aggression and tricyclics reduce the symptoms of depression in approximately 60 to 70 percent of cases. Tricyclics usually take about two to three weeks for it to improve moods. And drawbacks for using this drug are restlessness, faintness, trembling, sleepiness and memory difficulties. MAO inhibitors MAO inhibitors thought works by blocking the enzyme monoamine oxidase that breaks down the neurotransmitters of serotonin and neropinephrine in brains (Hazell, 2009). However, due to its extremely risky to use than tricyclics had cause psychologist to limit prescribing it to patients. MAO had potential interactions with fermented foods; such as cheese, and alcoholics beverages; such as red wine, which these types of foods react with inhibitors to raise blood pressure overtime that can lead to stroke for user. Selective Serotonin Reuptake inhibitors (SSRIs) Widely used as Prozac; works by reducing the uptake of serotonin in nervous system, thus increasing amount of serotonin active in the brain. Increasing levels of neropinephrine in brain reduces their symptoms of depression and also relieves the associated symptoms of anxiety (King, 2010). Furthermore, these drugs have much fewer side effects than MAO or Tricyclics (Nemeroff & Schatzberg, 2002). Today, antidepressant drugs are not only used to treat depression, but have also shown to treating anxiety-based disorders; such as generalized anxiety disorder, panic disorder and post-traumatic disorder ( Bourin,2003; Donnelly, 2003; Shelton & Hollon, 2000).
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However, SSRI`s do not work for everyone. At least quarter of MDD patients do not respond to these drugs (Shelton & Hollon, 2000) and it produce unpleasant but not serious side effects including nausea, insomnia, headaches, and may impaired sexual functioning (Balon, 2002; Clayton, McGarvey, Abouesh, & Pinkerton, 2001). Lithium For bipolar disorder, lithium is used to treat them biological and it effective in approximately 75 percent of cases (Gnanadisen, Freeman, & Gelenberg, 2003). However, due to slow to take effects, it taken with antidepressant (Solomon, Keitner, Miller, Shea, & Keller, 1995). Truthfully, scientists and psychiatrists didn`t really know what lithium does to bipolar disorder,but study with mice indicates that it may act to stabilize the levels of specific neurotransmitters in the brain (Dixon & Hokin, 1998) Antianxiety drugs Known as tranquilizers, it quickly produces a sense of calm and reduce anxiety to make individuals less excitable (Coon & Mitterer, 2009; King, 2010) . These drugs are and can be potentially addictive and therefore best used as temporarily for symptom relief of anxiety (Lader, Tyler, & Donoghue, 2009). Benzodiazepines generally offer the greatest release for anxiety symptoms, working by binding to the receptor sites of neurotransmitters that overly active during anxiety (Poisnel & others, 2009). Commonly used prescribed of benzodiazepines are Valium, Xanax, and Librium. Benzodiazepines are relatively fast-acting; taking effects within hours, but contrary to that, it must be taken two to three weeks before patients started to feel the benefits. The side-effects of this drugs are drowsiness,
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fatigue, loss of coordination and mental slowing, (Fields, 2010) even worst cause abnormalities to infants born to mothers who took them during pregnancy (Istaphanos & Loepke, 2009). 3.2 Psychotherapy treatments 3.3 Cognitive Therapies Emphasize that thoughts are the main source of psychological problems and they attempt to change individual`s feeling and behaviours by changing cognitions. Recent study revealed that cognitive therapy is more successful in treating depression than drug therapy (Sava & others, 2009) Beck`s Cognitive Therapy. Aaron Beck developed a somewhat different of cognitive therapy to treat psychological problems, especially depression (1976, 1993). Beck assumed that depression results when people thinks illogically about themselves, their world, and the future (2005, 2006). Involves more openminded dialogues between therapist and client. In initial phases, emotions are a product of cognitions, which means people thought can lead to emotions. However, these thoughts happen so rapid and quickly that person is not even aware of them. Beck`s proposed that clients/ sufferers of depression identify their automatic thoughts and emotional reactions. This therapy gets individuals to reflect on own issues and discover the misconception on them. Logical thinking (called in simpler ways) told to be found and identify by clients themselves in their logical errors. Clients told to challenge the accuracy of these automatic thoughts they`ve perceived after an event by recognizing the logical errors in their thinking, thus reducing the depression and anxiety. These logical errors tend leads to erroneous or illogical beliefs like stated here; perceiving the world as harmful while ignoring the evidence to the
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contrary- example; a woman still feels worthless even after her friend told how attractive she is in classes and people genuinely like her, over generalizing on the basis of limited examples or events happens; such as a man seeing himself as worthless because his former girlfriend broke up with him, magnifying the importance of undesirable events-example; seeing the loss of loved one`s as the end of his or her world.

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gov/health/publications/the-numbers-count-mental-disorders-in-america/ index-shtml. Najmi, S., Riemam, B. , & Wagner, D. M. (2009) Managing unwanted intrusive thoughts in obsessive-compulsive disorder. Relative effectiveness of suppression, focused distraction, and acceptance. Behavior Research and Therapy. (In press) S Spitzer, R. L., Skodal, A. E., Gibbon, M., & Williams, J. B. W. (1981) DSM-III case book. Washington, DC : American Psychiatric Association. Sava, F. A., Yates, B. T., Lupu, V., Szentagotal, A., & David, D. (2009). Cost-effectiveness and cost-utility of cognitive therapy, rational emotive 36-52. W Wu, K. D., Aardema, F., & O`Connor, K. P. (2009). Inferential confusion, obsessive beliefs, and obsessive-compusive symptoms: A replication and extension. Journal of Anxiety Disorders. 23. 746-752. behavioral therapy, and fluoxetine (Prozac) in treating depression: A randomized clinical trial. Journal of Clinical Psychology, 65.

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