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Chapter 11: Psychological Disorders Copyright © 2005 Allyn & Bacon Psychological Disorder The presence of a constellation of symptoms that create significant distress or impair work, school, family, relationships, or daily living Symptoms Cognitive Emotional Behavioral Psychological Disorders Four factors Deviance (atypical) Distress Dysfunction (disability) Danger 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 medical model views abnormal behaviors as no different from illnesses and seeks to identify symptoms and prescribe medical treatments. The psychodynamic model considers abnormal behavior as the result of unconscious conflicts, often dating from childhood. Explaining Abnormality The humanistic model suggest that inappropriate thoughts, behaviors, and emotions can be the result of conditions of worth and if our ideal self becomes mismatched with our real self. The cognitive model suggests that our interpretation of events and our beliefs influence our behavior. The behavioral model views abnormal behaviors as learned through classical conditioning, operant conditioning, and modeling. The sociocultural model emphasizes the importance of social and cultural factors in the frequency, diagnosis, and conception of disorders. Explaining Abnormality Biological (Evolution, individual genes, brain structures and chemistry) Sociocultural (Roles, expectations, definition of normality and disorder) Bio-psycho-social Perspective Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Has become the prevailing explanation among most psychologists. 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-IVTR) - 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. 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 Hereditary factors Lower levels of serotonin and norepinephrine Frontal lobe Increased activity Amygdala The person Often runs in families 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 Anxiety Disorders Anxiety Disorders – Are characterized by distressing, persistent anxiety or maladaptive behaviors that attempt to reduce anxiety Anxiety Disorders Generalized Anxiety Disorder The person is typically tense, apprehensive, and in a state of autonomic nervous system arousal Phobia 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 Obsessive-Compulsive Disorder (OCD) Obsessions Are senseless thoughts, images, or impulses that occur repeatedly; they are often accompanied by Compulsions Are irresistible, repetitive acts that are often performed to reduce the anxiety caused by the obsessions. Compulsions include: Checking Washing Ordering Lifetime prevalence 2% Anxiety 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 Possible Genetic Predisposition Schizophrenia Is a type of psychosis Person has a break with reality May experience positive symptoms (e.g., delusions, hallucinations, disorganization) May experience negative symptoms (e.g., extreme withdrawal, flat affect, alogia, or avolition) Four subtypes Paranoid Disorganized Catatonic Undifferentiated __________________ Residual 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 Should not be confused with schizophrenia 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 The Dopamine Hypothesis This neurotransmitter, seems to be involved in the development of schizophrenia 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. Diathesis-Stress Model 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 Personality Disorders Anxious Types Dependent personality disorder Avoidant personality disorder Obsessive-compulsive personality disorder Odd Types Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder