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Chapter # 14: Abnormal Psych Medical Model Rosenhan Study DSM – IV DSM – IV-TR and V-- Axis I, II, III, IV, V criteria for determining disordered behavior -focus on brain chemistry, esp. in regard to serotonin and norepinephine -correlation b/t lower than normal activity levels of those neurotransmitters and presence of depression -1970s visited diff mental institutions and reported they were hearing voices -all admitted with a preliminary diagnosis of schizophrenia -once inside institution , pseudopatients returned to normal behavior -patients for 3 weeks but no staff ever “caught on” they were healthy -several actual patients expressed doubt about pseudopatients’ mental illness but it seems that label to a person influences how each of his subsequent behaviors is perceived -patients released, told that condition was “in remission”, labels stick -American Psychiatric Association’s handbook for identification and classification of behavioral abnormalities -contains detailed descriptions of every psychological affliction -Thomas Szasz says book provides labels for behaviors that are not disorders; book causes as many problems as it solves: people feel compelled to live up to expectations that accompany disease -used to classify behaviors across 5 dimensions or axis Axis I: major disorders, schizophrenia, delirium and dementia, states of perceptual and cognitive disruption; eating and sleeping disorders Axis II: personality disorders, avoidant and dependent personalities Axis III: physical disorders that impact behavior; not limited to disorders in brain Axis IV: asses level of psychological stress person is experiencing due to factors evaluated by first three axes Axis V: represents overall assessment of person’s level of functioning -atypical: unusual, most people don’t do it -disturbing: makes others feel uncomfortable -maladaptive: extremes of mood are pervasive and damage healthy functioning -unjustifiable: irrational, indefensible Chapter # 14: Abnormal Psych Phobia Specific Phobia Social Phobia Agoraphobia Obsessive Compulsive Disorder (OCD) Post-traumatic stress disorder (PTSD Generalized anxiety disorder (”free-floating anxiety”) Panic Attacks Delusions Hallucinations “Word Salad” Disorganized Schizophrenia Catatonic Schizophrenia -persistent irrational fears of common events or objects -fear triggered by specific thing or object -intense fear associated w/ public setting -fear of being in open spaces or public places or other places from which escape is perceived to be difficult -anxiety disorder -involuntary, persistent, undesirable obsessions one feels driven to carry out; repetitive behaviors that are time consuming and maladaptive -sufferer recognizes that obsessions/compulsions are irrational or maladaptive and does not want to have them but cannot control them -caused by exposure to trauma (ex: war or violence) which leads to recurring thoughts and anxiety linked to trauma -decreased ability to function, detachment from reality -restlessness, irritability, sleep impairment, loss of concentration, nightmares, flashbacks -marked by ongoing tension, apprehension, and nervousness that does not seem to be linked to any specific trigger or stimulus -individual feels overwhelming sense of panic, fear, and desire to escape -lasts a few minutes, debilitating -sweating, increased heart rate, paralyzed with fright -false beliefs -seeing, hearing, or sensing something that doesn’t actually exist -symptom of schizophrenia -jumbled thinking -victim’s speech is loosely connected and words can be thrown together in odd, nonsensical ways -symptoms: cognitive and emotional -speech and thought are confused and emotions can be highly childlike or inappropriate -flattened effect in which the victim demonstrates no emotion or response and may even “freeze” in odd, contorted positions -marked by stupor and rigid body Ex. by specific animals, heights or enclosed spaces ex. fear of public speaking -ex: washing hands -ex: paranoid, believe that “Law enforcement officials have me under constant surveillance” Chapter # 14: Abnormal Psych Positive and Negative Symptoms Delusions of grandeur Persecutorial Delusions Echolalia & Echophraxia Paranoid Schizophrenia Undifferentiated Schizophrenia Dopamine Hypothesis Manic Disorder Dysthymia & Cyclothymia -positive symptoms: sufferer HAS what a healthy person does NOT have -negative symptoms: refer to something sufferer LACKS that a healthy person has ( + ex: hallucinations, false beliefs) -fake belief that one has fame or power Ex. “I’m Napoleon” -feelings of being persecuted Echolalia – associated with schizophrenia; repetition of words Echopraxia – associated with schizophrenia; a person mimics behaviors, gestures, or postures of another -marked by chronic sense of being observed and persecuted -delusions -“wastebasket” category -schizophrenia that does not fit into other subtypes -lack of dopamine: Parkinson’s disease -too much of dopamine: schizophrenia -characterized by extreme talkativeness, increased self esteem, excessive pleasure seeking, and lack of sleep -rare Dysthymic disorder– lower form of depression Cyclothymic disorder—lower form of bipolar Bipolar Disorder -characterized by sudden shifts in mood, deep depression and listlessness to extreme euphoria, optimism, and energy -3 types: severe depression with manic episodes, primarily manic (rare), or normal to manic to depressive Learned Helplessness -the feeling of futility and passive resignation that results from inability to avoid repeated aversive events; associated w/ depression Chapter # 14: Abnormal Psych Serotonin and Norepinephrine Sleep Disturbances Dissociative Amnesia Dissociative Fugue Dissociative Identity Disorder Conversion Disorder -serotonin: arousal, sleep, pain sensitivity, mood and hunger relation -norepinephine: secreted by adrenal glands when organism is under stress and aroused by fight or flight -insomnia -hypersomnia -narcolepsy -sleep apnea -sleep walking/somnambulism -night terrors -somnilloquy -characterized by large scale memory loss for events or one’s identity -sudden in onset and recovery -associated with injury or highly traumatic incident -“traveling amnesia” -marked by amnesia and physical relocation -complete loss of identity followed by assumption of a new identity - aka: multiple personality disorder -rare condition involving existence of 2+ separate personalities housed in one body -identities may or may not be aware of each other -sufferer is essentially converting psychological stress to physical symptoms Hypochondriasis -involves a preoccupation with the fear that one has an illness even in the Somatization Disorder Autism AD/HD Paranoid Personality Disorder face of medical evidence to the contrary -imagines symptoms and seeks treatment -psychological disorders characterized by physical manifestations -“pervasive developmental disorder” -characterized by lack of appropriate social responsiveness -more common among boys -characterized by impulsivity and limited ability to focus on tasks -extreme distrust and suspicion of others -ex: soldier who becomes paralyzed under stress of battle and cannot move even though there is no organic problem Chapter # 14: Abnormal Psych Schizoid Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder -poor capacity for forming social relationships -shy, withdrawn behavior -considered “cold” -more common in males -individual who is rebellious, deceitful, manipulative, often hurtful with no sense of remorse or empathy -disregard for rights or interest of others -“sociopath” or “psychopath” -instability -marked by sudden and intense rage, deep insecurity and fear of abandonment, general instability in relationships and emotional interaction -marked by an insatiable need and search for attention and a tendency toward highly emotional behavior -characterized by self-preoccupation and the need for others to focus on oneself -exaggerated sense of one’s own value and importance -excessively sensitive to potential rejection, humiliation -desires acceptance but is socially withdrawn -excessively lacking in self-confidence -subordinates own needs -allows others to make all decisions -more common in females