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Fundamentals of Psychology: The Brain, The Person, The World Stephen M. Kosslyn Robin S. Rosenberg Allyn & Bacon Psychological Disorders Chapter 11 Psychological Disorder The presence of a constellation of symptoms that create significant distress or impair work, school, family, relationships, or daily living Four factors Deviance (atypical) Distress Dysfunction (disability) Danger Psychological Disorders- Etiology Psychotic disorder person loses contact with reality Neurotic disorder (term seldom used now) usually distressing but that allows one to think rationally and function socially Freud saw the neurotic disorders as ways of dealing with anxiety experiences irrational ideas and distorted perceptions Intern’s Disease Upon hearing the symptoms of a disorder, the tendency for people to believe that they or someone they know shares those symptoms Only a trained professional can diagnose a psychological disorder. What is Abnormal Behavior? By the standard of statistical rarity, behavior is abnormal when it is infrequent. Dysfunctional behavior interferes with a person's ability to function in day-to-day life. What is Abnormal Behavior? The criterion of personal distress is frequently used to identify the presence of a psychological disorder. Departures from social norms are used to define deviant, and therefore abnormal behaviors; social norms, however, can change over time and vary across cultures. What is Abnormal Behavior? Insanity – is a legal ruling that an accused individual is not responsible for a crime. Contrary to the public's understanding of the insanity plea, such pleas are infrequently used and rarely successful. Explaining Abnormality THE BRAIN THE PERSON THE GROUP Diathesis-stress model Classical and operant conditioning Labels Explaining Abnormality (BRAIN) -- The medical model views abnormal behaviors as no different from illnesses and seeks to identify symptoms and prescribe medical treatments. (PERSON) – The psychodynamic model considers abnormal behavior as the result of unconscious conflicts, often dating from childhood. Explaining Abnormality (PERSON) -- The cognitive model suggests that our interpretation of events and our beliefs influence our behavior. (PERSON) -- The behavioral model views abnormal behaviors as learned through classical conditioning, operant conditioning, and modeling. (GROUP) -- The sociocultural model emphasizes the importance of social and cultural factors in the frequency, diagnosis, and conception of disorders. Explaining Abnormality Bio-psycho-social Perspective assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Labels and Abnormality Rosenhan “On being sane in insane places” 8 pseudopatients claimed to hear voices Admitted to psychiatric hospitals Stopped reporting symptoms Normal behaviors were interpreted as pathological Doctors rarely responded to questions Many real patients were not fooled Categorizing Disorders Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-R) -Provides rules for diagnosing psychological disorders that have increased reliability. Axis I: clinical disorders Axis II: personality disorders and mental retardation Axis III: general medical conditions Axis IV: psychosocial and environmental problems Axis V: global assessment of functioning Classifying and Counting Psychological Disorders Phobias, alcohol and drug abuse or dependence, and major depressive disorder are among the most common psychological disorders. Classifying and Counting Psychological Disorders Many people suffer from more than one psychological disorder (co-morbidity). Mood Disorders Mood Disorders Depression characterized by emotional extremes The symptoms of include sadness, reduced pleasure and energy levels, feelings of guilt, sleep disturbances, and suicidal thinking. Mood Disorders Major depressive disorder A mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities Lifetime prevalence Women 20% Men 12% Dysthymia A mood disorder similar to major depression, but is less severe and more chronic (long-lasting) in nature Lifetime prevalence 6% Mood Disorders Suicide Is often associated with depression, is one of the leading causes of death in the United States. Attempted by 30% of depressed people The risk factors Include being male, being unmarried, and being depressed. Mood Disorders Bipolar disorder occurs when a person’s moods swings between depression and mania. Formerly called manic depression Lifetime prevalence 1% The symptoms of mania include euphoria, increased energy, poor judgment, impulsivity, insomnia, decreased sleep, and self aggrandizement. Mania Manic episode Prodromal phase Often cycles with depression Explaining Mood Disorders THE BRAIN THE PERSON Hereditary factors Often runs in families Lower levels of serotonin and norepinephrine Frontal lobe Increased activity Amygdala Attributional style – How the person interprets their surroundings. Learned helplessness – typified by when someone doesn’t feel in control the outcome of their situation. THE GROUP Diminished social support network Explaining Mood Disorders PET scans show that brain energy consumption rises and falls with emotional swings Explaining Mood Disorders Altering any one component of the chemistry-cognition-mood circuit can alter the others Mood Disorders The vicious cycle of depression can be broken at any point Anxiety Disorders Are characterized by distressing, persistent anxiety or maladaptive behaviors that attempt to reduce anxiety Anxiety Disorders Generalized Anxiety Disorder Phobia The person is typically tense, apprehensive, and in a state of autonomic nervous system arousal persistent, irrational fear of a specific object or situation The most frequently diagnosed phobia is agoraphobia Anxiety Disorders Panic disorder Frequent panic attacks (which resemble heart attacks) marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation are the main symptom of panic disorder. It is also characterized by Biological and cognitive explanations for this disorder have been proposed. Lifetime prevalence 3% Anxiety Disorders Phobias Social phobia Lifetime prevalence 13% Specific phobia Animal fears Blood-injection-injury fears Natural environment fears Situation fears Miscellaneous fears Lifetime prevalence 10% Anxiety Disorders Obsessive-Compulsive Disorder (OCD) Obsessions Are senseless thoughts, images, or impulses that occur repeatedly; they are often accompanied by Compulsions which are irresistible, repetitive acts, such as: Checking Washing Ordering Lifetime prevalence 2% Anxiety Disorders PET Scan of brain of person with Obsessive/ Compulsive disorder High metabolic activity (red) in frontal lobe areas involved with directing attention Stress Disorders Posttraumatic Stress Disorder (PTSD) Traumatic event Symptoms Re-experience event Avoidance and emotional numbing Heightened arousal Lifetime prevalence 8% (among Americans) Prevalence strongly affected by environment Violence Disasters Stress Disorders Somatoform disorders involve the presentation of physical symptoms that have no known medical causes, but psychological factors are involved. Among these disorders are: hypochondriasis, somatization disorder, and conversion disorder. Stress Disorders Dissociative disorders involve disruptions in some function of the mind. Dissociative amnesia occurs when memories cannot be recalled; in dissociative fugue, memory loss is accompanied by travel. Dissociative identity disorder is characterized by the presence of two or more personalities in the same individual. Formally known as multiple personality disorder Schizophrenia Positive symptoms Delusions Hallucinations Disordered behavior Disorganized speech Negative symptoms Flat affect Alogia Avolition Schizophrenia Four subtypes Paranoid Disorganized Catatonic Undifferentiated or Residual Explaining Schizophrenia THE BRAIN Hereditary Schizophrenia tends to run in families. The risk of developing the disorder increases with the degree of genetic relatedness between an individual and a family member who has schizophrenia. Ventricle size Dopamine, a neurotransmitter, seems to be involved in the development of schizophrenia Explaining Schizophrenia THE PERSON High reactivity to stress Misinterpretation of the environment Emotional dampening THE GROUP High expressed emotion Social selection and social causation Hostile family interactions and communications Extreme levels of stress Explaining Schizophrenia A widely accepted explanation among psychologists and physicians is: A predisposition that may be inherited, with the actual development of the disorder requiring the presence of other factors including exposure to high levels of stress. Eating Disorders Anorexia nervosa Bulimia nervosa Factors Genetic predisposition Gender Cultural factors Lifetime prevalence 0.5%-4% Personality Disorders Personality disorders are long-standing dysfunctional patterns of behavior. Categorizations of Personality Disorders Dramatic Types Antisocial personality disorder Borderline personality disorder Narcissistic personality disorder Histrionic personality disorder Anxious Types Dependent personality disorder Avoidant personality disorder Obsessive-compulsive personality disorder Odd Types Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder