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Chapter 14
Psychological Disorders – 8th Edition
Abnormal Behavior
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Historical aspects of mental
disorders – F 14.1
 The medical model
 What is abnormal behavior?
– 3 criteria – F 14.2
• Deviant
• Maladaptive
• Causing personal distress
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A continuum of
normal/abnormal
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Prevalence, Causes, and Course
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Epidemiology
Prevalence - % of population that displays the
disorder during a specific period
Lifetime prevalence – F 14.5
Diagnosis
Etiology – causes
Prognosis
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Psychodiagnosis: The Classification
of Disorders
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American Psychiatric Association – published
first taxonomy in 1952
Diagnostic and Statistical Manual of Mental
Disorders – 4th ed. (DSM - IV)
Multiaxial system
5 axes or dimensions – F 14.3
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Axis I – Clinical Syndromes
Axis II – Personality Disorders or Mental Retardation
Axis III – General Medical Conditions
Axis IV – Psychosocial and Environmental Problems
Axis V – Global Assessment of Functioning
Example Figure 14.4
DSM V – to be published in 2011-12
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Figure
14.3
– DSM-IV
Fig. 14-3,
p. 555
overview
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The DSM multiaxial system
Figure 14.4 –
Example multiaxial
evaluation
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Axis I Clinical Syndromes and Axis II
Personality Disorders
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Anxiety Disorders – p. 583
Somatoform Disorders – p. 586
Dissociative Disorders – p. 589
Mood Disorders – p. 590
Schizophrenic Disorders – p. 598
Eating Disorders – p. 613
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Axis II – Personality Disorders – p. 604
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Clinical Syndromes: Anxiety
Disorders
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Generalized anxiety disorder
– “free-floating anxiety”
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Phobic disorder
– Specific focus of fear
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Panic disorder and agoraphobia (definition issue
– p. 582)
– Physical symptoms of anxiety/leading to agoraphobia
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Obsessive compulsive disorder
– Obsessions
– Compulsions
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Etiology of Anxiety Disorders
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Biological factors – F 14.6
– Genetic predisposition, anxiety sensitivity
– GABA circuits in the brain
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Conditioning and learning
– Acquired through classical conditioning or observational
learning – F 14.7
– Maintained through operant conditioning
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Cognitive factors
– Judgments of perceived threat – F 14.8
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Personality
– Neuroticism
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Stress – F 14.9
– A precipitator
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Clinical Syndromes: Somatoform
Disorders
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Somatization Disorder
Conversion Disorder – Figure 14.10
Hypochondriasis
– Etiology
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Reactive autonomic nervous system
Personality factors
Cognitive factors
The sick role
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Clinical Syndromes: Dissociative
Disorders
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Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
– Etiology
• severe emotional trauma during childhood
– Controversy
• Media creation?
• Sybil
• Repressed memories
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Clinical Syndromes: Mood Disorders
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Figure 14.11 and Table 14.1
Major depressive disorder
– Dysthymic disorder
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Bipolar disorder (manic-depressive disorder)
– Cyclothymic disorder
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Etiology
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Age of onset – F 14.12
Genetic vulnerability – F 14.14
Neurochemical factors
Cognitive factors – negative thinking – F 14.15, F 14.16
Interpersonal roots
Precipitating stress
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XX 14.14
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XX 14.16
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XX 14.17
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Clinical Syndromes: Schizophrenia
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General symptoms
– Delusions and irrational thought
– Deterioration of adaptive behavior avolition
– Hallucinations – any modality but
usually auditory
– Disturbed emotions – 66%
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Prognostic factor
– Gradual onset
– Sudden onset
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Subtyping of Schizophrenia
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4 subtypes
– Paranoid type – most
common subtype - John
Nash
– Catatonic type
– Disorganized type
– Undifferentiated type
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New model for classification
– Positive vs. negative
symptoms
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Etiology of Schizophrenia
Genetic vulnerability – F 14.18
 Neurochemical factors – Dopamine hypothesis – F
14.19
 Structural abnormalities of the brain – prefrontal lobe
and ventricles – F 14.20
 The neurodevelopmental hypothesis – F 14.21
 Expressed emotion – F 14.22
 Precipitating stress – stress-vulnerability model –
Slide 33
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Figure 14.18 – Genetic vulnerability schizophrenia
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Figure 14.19 The dopamine hypothesis as an explanation for schizophrenia
Neurological Changes in Schizophrenia
Figure 14.20
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Figure 14.21 – Neurodevelopment hypothesis of schizophrenia
Figure 14.22 –
Expressed emotion
and relapse rates in
schizophrenia
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Slide 33 – The stress-vulnerability model of schizophrenia
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Personality Disorders
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Table 14.2 – description and male/female
percents
Anxious-fearful cluster
– Avoidant, dependent, obsessive-compulsive
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Dramatic-impulsive cluster
– Histrionic, narcissistic, borderline, antisocial
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Odd-eccentric cluster
– Schizoid, schizotypal, paranoid
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Etiology
– Genetic predispositions, inadequate socialization in
dysfunctional families
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Prognosis
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Psychological Disorders and the Law
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Insanity
– M’naghten rule
– The insanity defense – Figure 14.23 – perception versus
actual cases
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Involuntary commitment – varies by states
– danger to self
– danger to others
– in need of treatment
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Culture and pathology – p. 610 - 611
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XXX 14.23
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John Hinkley, Jr. – assassination attempt of
President Reagan in 1981
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Eating Disorders – p. 613-615
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Issues of weight – slide 41
Anorexia nervosa
– Criteria and subtypes: restrictive and binge/purge
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Bulimia nervosa
Binge eating
History and prevalence
– Age onset – Figure 14.25
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Etiology
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Genetics
Personality – perfectionism
Cultural issues - “perfect” body type and digital photograph
Family role
Cognitive factors
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Figure 14.25 - Age of anorexia nervous in the United States – Lucas et al.
(1991)
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XXXXX Slide 41
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