Download Theories of personality

chapter 11
Psychological disorders
chapter 11
Overview
Defining and diagnosing disorder
Anxiety disorders
Mood disorders
Personality disorders
Drug abuse and addiction
Dissociative identity disorder
Schizophrenia
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Dilemmas of definition
Possible models for defining disorders
As the violation of cultural standards
As emotional distress
As behavior harmful to oneself or others
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Mental disorder
Any behavior or emotional
state that causes a person to
suffer, is self-destructive;
seriously impairs the
person’s ability to work or
get along with others; or
endangers others or the
community
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Your turn
Psychopaths are often happy, functional people, but
they manipulate and harm others without
conscience. On what basis are psychopaths said to
have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along
with others;
(3) or endangers others or the community.
chapter 11
Your turn
Psychopaths are often happy, functional people, but
they manipulate and harm others without
conscience. On what basis are psychopaths said to
have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along
with others;
(3) or endangers others or the community.
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Diagnostic and Statistical Manual
Axis I: Primary clinical problem
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Social and environmental
stressors
Axis V: Global assessment of overall
functioning
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Explosion of mental
disorders
Supporters of new
categories answer that it
is important to
distinguish disorders
precisely.
Critics point to
economics: diagnoses are
needed for insurance
reasons for therapists to
be compensated.
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Concerns about
diagnostic system
The danger of over-diagnosis
The power of diagnostic labels
Confusion of serious mental disorders
with normal problems
The illusion of objectivity and
universality
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Advantages of the DSM
When the manual is used correctly and
diagnoses are made with valid objective
tests, the DSM improves the reliability of
and agreement between clinicians.
The DSM-IV included for the first time a
list of culture-bound syndromes.
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Projective tests
Projective tests
Psychological tests used to
infer a person’s motives,
conflicts, and unconscious
dynamics on the basis of the
person’s interpretation of
ambiguous stimuli
Rorschach inkblot test
A projective personality test
that asks respondents to
interpret abstract,
symmetrical inkblots
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Objective tests
Inventories
Standardized objective questionnaires requiring written
responses
Typically include scales on which people are asked to rate
themselves
MMPI
Most widely used personality instrument
Clinical and employment settings
Measures aspects of personality that, if extreme, suggest
a problem
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Generalized anxiety
disorder
Continuous state of anxiety
marked by feelings of worry and
dread, apprehension, difficulties
in concentration, and signs of
motor tension
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Posttraumatic stress
disorder
An anxiety disorder in which a person who
has experienced a traumatic or lifethreatening event has symptoms such as
psychic numbing, reliving the trauma, and
increased physiological arousal
Diagnosed only if symptoms persist for six
months or longer
May immediately follow event or occur later
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Panic disorder
An anxiety disorder
in which a person
experiences
recurring panic
attacks
Panic attack: a feeling of
impending doom or death,
accompanied by physiological
symptoms such as rapid
breathing and dizziness
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Fears and phobias
Phobia
An exaggerated, unrealistic fear of a specific situation,
activity, or object
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Agoraphobia
A set of phobias, often set off by a
panic attack, involving the basic
fear of being away from a safe
place or person.
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Obsessive-compulsive
disorder
An anxiety disorder in which a person
feels trapped in repetitive, persistent
thoughts (obsessions) and repetitive,
ritualized behaviors (compulsions)
designed to reduce anxiety
Person understands that the ritual
behavior is senseless but guilt mounts
if the behavior is not performed.
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Your turn
If you have the persistent thought that gremlins are
sabotaging any airplane you are on or will be on,
then you have a _____. If you cannot stop asking
for more water during flights, then you have a
_____.
1.
2.
3.
4.
Obsession; compulsion
Compulsion; obsession
Phobia; obsession
Plane ticket; pet camel
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Your turn
If you have the persistent thought that gremlins are
sabotaging any airplane you are on or will be on,
then you have a _____. If you cannot stop asking
for more water during flights, then you have a
_____.
1.
2.
3.
4.
Obsession; compulsion
Compulsion; obsession
Phobia; obsession
Plane ticket; pet camel
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Depression
Major depression
A mood disorder involving disturbances in
emotion (excessive sadness), behavior (loss of
interest in one’s usual activities), cognition
(thoughts of hopelessness), and body function
(fatigue and loss of appetite)
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Symptoms of
depression
Depressed mood
Reduced interest in almost all activities
Significant weight gain or loss
Sleeping too much or too little
Fatigue
Feelings of worthlessness or guilt
Reduced ability to think, concentrate
Recurrent thoughts of death
DSM IV requires 5 of these
within the past 2 weeks
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Bipolar disorder
A mood disorder in which episodes of
depression and mania (excessive
euphoria) occur.
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Biological theories of
depression
Studies of adopted children support genetic
explanations of depression
5-HTT is a gene that is present in either a
long or short form.
17% of individuals with the long form become severely
depressed.
43% of individuals with 2 copies of the short form become
depressed.
Genetics may also influence levels of
serotonin and other neurotransmitters.
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Life experiences and
circumstances
Social explanations emphasize the
stressful circumstances in people’s
lives.
Loss of or problems with important relationships
Psychologists investigating sex differences in depression
have ruled out hormones and genetics and are now
investigating life circumstances. Women are less
satisfied with work and family and more likely to live in
poverty.
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Cognitive habits
Cognitive explanations
emphasize habits of
thinking and ways of
interpreting events.
Depressed people
believe their situation is
permanent,
uncontrollable.
Rumination
Brooding about negative aspects
of one’s life
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Problem personalities
Personality disorder
Rigid, maladaptive patterns that cause personal distress or an inability to get
along with others
Paranoid personality disorder
Characterized by habitually unreasonable and excessive suspiciousness and
jealousy
Narcissistic personality disorder
Characterized by an exaggerated sense of self-importance and self-absorption
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Criminals and psychopaths
Antisocial personality disorder
Characterized by a lifelong pattern of irresponsible,
antisocial behavior such as lawbreaking, violence, and
other impulsive, restless acts
Psychopathy
Characterized by a lack of remorse, empathy, anxiety,
and other social emotions; the use of deceit and
manipulation, and impulsive thrill seeking
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Causes of APD and
psychopathy
Abnormalities in
the central
nervous system
Impaired frontallobe functioning
Genetic influences
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Biology and addiction
The biological model holds that
addiction is due primarily to a person’s
biochemistry, metabolism, and genetic
predisposition.
More evidence comes from twin studies.
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The addicted brain
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Learning, culture, and
addiction
Addiction patterns vary according to cultural
practices and the social environment.
Policies of total abstinence tend to increase
addiction rates rather than reduce them.
Not all addicts have withdrawal symptoms
when they stop taking a drug.
Addiction depends on both the drug and the
reason for taking it.
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Dissociative identity
disorder
A controversial disorder marked by the
appearance within one person of two or
more distinct personalities, each with its
own name and traits
Commonly known as Multiple Personality Disorder
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The MPD controversy
First view
MPD is common but often unrecognized as such.
Starts in childhood as a means of coping
Trauma produced a mental splitting.
Second view
Created through pressure and suggestion by clinicians
Handfuls to ten thousand since 1980
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Sociocognitive explanation
MPD is an extreme form of our ability to
present many aspects of our personalities to
others.
MPD is a socially acceptable way for some
troubled people to make sense of their
problems.
Therapists looking for MPD may reward
patients with attention and praise for
revealing more and more personalities.
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Symptoms of
schizophrenia
Bizarre delusions
Hallucinations and heightened sensory
awareness
Disorganized, incoherent speech
Grossly disorganized and inappropriate
behavior
Impaired cognitive abilities
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Delusions and
hallucinations
Delusions
False beliefs that often accompany schizophrenia
and other psychotic disorders
Hallucinations
Sensory experiences that occur in the absence of
actual stimulation
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Genetic vulnerability
The risk of
developing
schizophrenia
increases as the
genetic
relatedness with a
diagnosed
schizophrenic
increases.
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Structural brain
abnormalities
Several abnormalities exist, especially
when disease has primarily negative
symptoms.
Decreased brain weight
Decreased volume in temporal lobe or hippocampus
Enlargement of ventricles
About 25% do not have these
observable brain deficiencies.
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Neurotransmitter
abnormalities
Include serotonin, glutamate, dopamine
Many schizophrenics have high levels of
brain activity in areas served by
dopamine, and greater numbers of
dopamine receptors.
Similar abnormalities are found in
depression and alcoholism.
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Prenatal or birth
complications
Damage to the fetal brain
increases chances of
schizophrenia and other mental
disorders.
May occur as a function of maternal
malnutrition or illness
May also occur if brain injury or oxygen
deprivation occurs at birth
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Adolescent abnormalities
in brain development
Normal pruning of excessive
synapses in the brain occurs
during adolescence.
In schizophrenics, a greater
number of synapses are pruned
away.
May explain why first episode occurs in
adolescence or early adulthood