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Psychological disorders Psychopathology Abnormal psychology Chapter 14 Medical model • Disease based • Diagnosis= distinguish from other diseases • Etiology= cause • Prognosis= probable outcome Figure 14.1 Historical conceptions of mental illness • Demonic possession • Evil spirits • Inhumane treatment Myths 1.No cure 2.Violent and dangerous 3.Bizzarre Historical treatment of people with mental illness • Philippe Pinel • Dorothea Dix Thomas Szaz 1.Criticized use of medical model 2.“Problems in living” Defining abnormal behavior 1.Maladaptive 2.Unjustifiable 3.Distressing 4.Atypical Concept check 14.1 Applying the criteria of Abnormal behavior David Rosenhan Describe his study… David Rosenhan 1. Claimed they “heard voices” and admitted to mental hospital 2. Staff identified their behavior as symptomatic 3. Controversy over findings Diagnosis 1.Classification or taxonomy 2.Dangers in labeling DSM-IV-TR 1.Diagnostic and Statistical Manual of Mental Disorders 2.Version IV-Text Revised DSM-IV-TR 1.American Psychiatric Association 2.Prototypical model 3.No CAUSE 4.No TREATMENT DSM-IV-TR 1. Axis 1: Clinical disorders 2. Axis 2: Personality disorders and mental retardation 3. Axis 3: General medical conditions 4. Axis 4: Psychosocial and environmental problems 5. Axis 5: Global assessment of functioning DSM-IV-TR 1. 2. 3. 4. 5. Axis 1: Cool Axis 2: People Axis 3: Get Axis 4: P Axis 5: G’s DSM-IV-TR You need to know the 5 axial system!!! You love love love page 565 Prevalence • Epidemiology- study of prevalence • Prevalence- % of population with the disorder Clinical syndromes (Axis I) 1. Childhood disorders 2. Organic mental disorders 3. Substance related 4. Schizophrenia and other psychotic disorders 5. Mood disorders Clinical syndromes (Axis I) 6. Anxiety disorders 7. Somatoform disorders 8. Dissociative disorders 9. Sexual and gender-identity 10.Eating disorders Anxiety Disorders 1. 2. 3. 4. 5. Generalized anxiety disorders Phobia Panic Agoraphobia or social phobia Obsessive-compulsive disorder 6. Post traumatic stress disorder Etiology of Anxiety Disorders Remember anxiety disorders are different Understand the etiology for each one Etiology of Anxiety Disorders 1. Biological 2. Conditioning and learning 3. Cognitive factors 4. Stress Anxiety Disorders Make a DSM-IV-TR multiaxial diagnosis Case study activity Somatoform Disorders • Soma= body • Physical ailments that cannot be explained by organic conditions Somatoform Disorders 1. Somatization diverse complaints 2. Conversion loss of one system “La belle indifference” 3. Hypochondriasis Conversion Etiology of Somatoform Disorders 1. Defense mechanisms 2. Personality – Histrionic and Narcissitic 3. Cognitive 4. Sick role • Reinforcement • What are the benefits? Concept check 14.2 Distinguishing anxiety and somatoform disorders Dissociative disorders • Lose contact with identity or memory 1. Amnesia 2. Fugue 3. Dissociative Identity Disorder (DID) Dissociative amnesia • Remember not due to neurological impairment! • Retrograde (old memories) • Anterograde amnesia – new memories – hippocampus Dissociative fugue • • • • Usually a traumatic event Lose memory of identity Leave their home Bourne Identity DID • Dissociative Identity Disorder • Used to be Multiple Personality Disorder • Not schizophrenia DID • Be careful of what you see on TV and Movies • Not everything is accurate! Etiology of DID • Relatively little understanding • Excessive stress • Positive correlation with childhood abuse Mood disorders • Affect= emotions 1. Major depressive disorder 2. Dysthmic disorder 3. Double depression Mood disorders 4. Bipolar 5. Cyclothmia 6. Bipolar II 7. Seasonal affective disorder (SADS) 8. Postpartum depression Etiology of Mood disorders 1. Genetic vulnerability 2. Neurochemical factors 3. Cognitive factors 4. Interpersonal roots 5. Stress Etiology of Major depressive disorder 1. Not bipolar disorder 2. Neurochemical • Serotonin • Norephinephrine 3. Cognitive Cognitive etiology of Major Depressive Disorder • Learned helplessness • Pessimistic explanatory style • Hopelessness • Ruminate Depression Researchers • • • • Aaron Beck Martin Seligman Susan Nolen-Hoeksema Alloy and Abramson Featured Study Does negative thinking CAUSE depression? Featured Study What was the • Independent variable • Dependent variable Featured Study • Independent variable cognitive style • Dependent variable depression Featured Study • Independent variable was not manipulated • Quasi-experimental design Schizophrenic disorders • Delusions • Hallucinations • Deterioration of adaptive behavior • Disturbed emotion Schizophrenic disorders • Delusions – False beliefs – “I am superman” • Hallucinations – False sensory perceptions – “I see superman” Schizophrenic Subtypes 1. Paranoid type 2. Catatonic type 3. Disorganized 4. Undifferentiated 5. Residual Andreasen’s alternative approach 1. Positive symptoms • Hallucinations • Delusions 2. Negative symptoms • Flat emotions • Withdrawal or apathy • Lack of speech Etiology of Schizophrenia 1. Genetic vulnerability 2. Neurochemical 3. Structural abnormailities 4. Neurodevelopmental 5. Expressed emotion 6. Stress Concept check 14.3 Distinguishng schizophrenic and mood disorders Personality disorders Extreme, inflexibly personality traits that cause distress or impairment in functioning Personality disorders Categories 1. Anxious/Fearful 2. Odd/Eccentric 3. Dramatic/Impulsive Personality disorders 1. Anxious/Fearful a) Avoidant b) Dependent c) Obsessive-compulsive 2. Schizoid 3. Schizotypal 4. Paranoid Personality disorders 2. Odd/Eccentric a) Schizoid b) Schizotypal c) Paranoid d) Schizoaffective (not in book) Personality disorders 3. Dramatic/Impulsive a)Histrionic b)Narcissistic c)Borderline d)Antisocial Antisocial personality disorder • Impulsive, callous, manipulative, aggressive, irresponsible, no remorse • Often involved in crime Antisocial personality disorder • Used to be called sociopath • Hannibal Lecter, Ted Bundy • Etiology: – Physiological, slow to condition – Environmental factors Psychological Disorders and the Law • Insanity plea • Involuntary commitment (Baker act) Culture and pathology • Cultural variation • Culture-bound disorders – Koro: fear of penis withdrawing into abdomen – Windigo: fear of becoming a cannibal Stress-vulnerability model • • • • Diathesis stress model Multiple causation Interaction of factors Figure 14.23, page 597 Eating disorders • Anorexia nervosa • Bulimia nervosa – Binge – purge Etiology of Eating disorders 1. Genetic vulnerability 2. Personality 3. Cultural values 4. Family 5. Cognitive factors Critical thinking 1. Representative heuristic 2. Availability heuristic 3. Cumulative probability 4. Conjunctive probability