Download lecture ch 15

Psychological
Disorders Chapter 15
Abnormal Behaviour Example
• Two weeks ago, a man jumped
from a 401 overpass after
throwing his 5 year old daughter
off. He died and she is still in
guarded condition in the
hospital. He left a suicide note
that seemed to indicate that he
wanted to punish his wife.
• What would cause someone to
take such a drastic act?
What Is Abnormal Behaviour?
Abnormal behaviour is characterized as
(a) not typical
(b) socially unacceptable
(c) distressing
(d) maladaptive
(e) result of disorganized
cognition
Perspectives on Abnormality
• Model:
• Abnormal psychology:
Models of Abnormal
Behaviour
The Medical-Biological Model
• focuses on the physiological
conditions that initiate and
underlie abnormal behaviour
• Many terms used in abnormal
psychology borrowed from
medical field
• Diagnose, treat, cure with
emphasis on drugs and
hospitalization
The Psychodynamic Model
• rooted in Freud’s theory of
personality
• assumes psychological
disorders result from anxiety
produced by unresolved
conflicts outside a person’s
awareness
The Humanistic Model
• focuses on individual uniqueness
and decision making
• Maladjustment occurs when a
person’s needs are not met
The Behavioural Model
• Abnormal behaviour is
learned through selective
reinforcement and
punishment
The Cognitive Model
• Human beings engage in
both prosocial and
maladjusted behaviours
because of their thoughts
The Sociocultural Model
• Maladjustment occurs
within and because of
a context
• Frequency and type of
disorders varies across
cultures
The Evolutionary Model
• humans evolved in a
specific environment
• Maladjustments may be
expressions of behaviour that
would once have been
normal in evolutionary history
Which Model Is Best?
• Some psychologists use
only one model to
analyze all behaviour
problems
• Others may take an
eclectic approach
Diagnosis: DSM
Diagnosing Psychopathology:
The DSM
Diagnostic and Statistical Manual
of Mental Disorders (DSM)
Diagnosing Psychopathology
GOALS of DSM
Table 15.1 Major Classifications of the Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition (TR)
Diagnosising Psychopathology
Criticisms:
- Potential biases
- Symptom focus rather
than etiology
- Too complex
- Medical model focus
- Reliability
- Pathologize everyday
behaviour
Anxiety Disorders
Defining Anxiety
• Anxiety :
a generalized feeling of
fear and apprehension
that may be related to a
particular situation or
object often
accompanied by
increased physiological
arousal
Generalized Anxiety Disorder
Diagnostic Criteria:
• Excessive anxiety and worry for at least 6 months
• Difficult to control the worry
• At least three of the following: restlessness, fatigue, difficulty
concentrating, irritability, muscle tension, sleep disturbance
• Focus of anxiety is NOT associated with other anxiety disorders
• Symptoms cause clinically significant distress
• Not due to direct effects of substance abuse or medical
condition
Generalized Anxiety Disorder
• Prevalence
• Risk factors
• Comorbidity
Phobic Disorders
• Phobic disorders :
• Three main Types
Agoraphobia
• Excessive fear and avoidance
of being alone in a place
from which escape may be
difficult or embarrassing
• Accompanied by panic
attacks
• More common in females
than males (5.8% : 2.8%)
• Often brought on by
interpersonal stress
Social Phobia
• Excessive fear and
avoidance of situations
where one might be
scrutinized by others
• Fear of acting in a way that
may lead to humiliation or
embarrassment
• Affects males and females
equally
• Identified in all cultures
Specific Phobias
• Irrational and persistent fear and
avoidance of a particular object or
situation
• 5 – 12% of the population has one or
more specific phobias
• Categories of specific phobias:
Obsessive-Compulsive Disorder
• Persistent, uncontrollable
thoughts and irrational
beliefs that cause
compulsive rituals that
interfere with daily life
– Obsessions =
– Compulsions =
Obsessive-Compulsive Disorder
• 80% of cases report both
obsessions and compulsions
• Compulsions are used to
combat anxiety associated with
obsessions
• 2% of the population (males =
females)
• Neurological mechanisms
identified (frontal lobe and
amygdala)
Mood Disorders
Depressive Disorders
• Depressive disorders
• Major depressive
disorder
Symptoms of Major Depressive
Disorder
• Poor appetite
• Insomnia
• Weight loss
• Loss of energy
• Feelings of
worthlessness and
guilt
• Inability to
concentrate
Major Depressive Disorder:
Onset and Duration
• Onset
– usually prior to age 40
• Duration
– days, weeks, or months
– Single episode or
recurring episodes
Major Depressive Disorder:
Prevalence
• Major depressive
disorder affects
about 1.3 million
Canadians each
year
• Women are twice as
likely as men to be
diagnosed
Major Depressive Disorder: Clinical
Evaluation
• Diagnosis of depression
(or any other mental
disorder) should involve a
complete clinical
evaluation:
• A physical examination
• A psychiatric history
• A mental status
examination
Causes of Major Depressive
Disorder
Biological Theories:
e.g. Monoamine theory
Learning and Cognitive
Theories
• Learning and thoughts underlie
depression
• Lewinsohn:
• Beck:
Figure 15.2 Lewinsohn’s View of Depression
Learned Helplessness
• The behaviour of giving up or not
responding exhibited by people
and animals exposed to negative
consequences over which the feel
they have no control
• Seligman suggests that people’s
beliefs about the causes of failure
determines whether they will
become depressed
The Biopsychosocial Model
Diathesis-stress model
• Combination of factors lead to
vulnerability
• Vulnerability: person’s
diminished ability to deal with
life events
• Increased vulnerability means
less stress is needed to initiate
depression
Bipolar Disorder
• originally known as manicdepressive disorder
• People with the disorder
experience behaviour varying
between two extremes
Bipolar Disorder
• Manic Phase:
• Depressed Phase:
MEDIA DEPICTION OF DEPRESSION
Dissociative Disorders
Dissociative Disorders
• Dissociative disorders are
characterized by a sudden,
temporary, alteration in
consciousness, identity,
behaviour, and/or memory
Dissociative Disorders
Dissociative Disorders include:
• Dissociative amnesia –
• Dissociative identity disorder
-
MEDIA DEPICTION OF DID
Schizophrenia
Schizophrenia
• Schizophrenic disorders –
• Psychosis –
Essential Characteristics of
Schizophrenic Disorders
• People who suffer from schizophrenia can
have significantly different symptoms, yet
still be given the same label
• Schizophrenia is a group or class of
disorders and each case is identified
according to some kind of basic
disturbance in one of the following areas:
language, thought, perception, affect
(emotions), and behaviour
Essential Characteristics of
Schizophrenic Disorders
• Positive symptoms –
• Negative symptoms -
Schizophrenia: Language and
Thought Disturbances
• Difficulty maintaining logical thought and
coherent conversation
• Word Salad –
• Neologism –
Delusions - mistaken beliefs maintained in spite of
strong evidence to the contrary. Three common
delusions include:
 Thought broadcasting
 Thought insertion
 Thought withdrawal
Schizophrenia: Perceptual
Disturbances
• The senses of people with
schizophrenia may either be
enhanced or blunted
• Sensory stimulation is jumbled and
distorted
• Hallucinations –
• Auditory hallucinations are most
common
Schizophrenia: Emotional
Disturbances
• inappropriate affect –
• ambivalent affect –
• flat affect –
Schizophrenia: Behavioural
Disturbances
• Disturbances in behaviour
may take the form of
unusual actions that have
special meaning
• The abnormal behaviours
of individuals with
schizophrenia are often
related to disturbances in
their perceptions,
thoughts and feelings
Five Types of Schizophrenia
• Paranoid -
• Catatonic - two subtypes:
• Excited type • Withdrawn type • Disorganized - characterized by severely disturbed
thought processes, incoherence, disorganized
behaviour, and inappropriate affect
Five Types of Schizophrenia
(cont’d)
• Residual -
• Undifferentiated –
Causes of Schizophrenia
• Diathesis-stress model of
schizophrenia -
Causes of Schizophrenia
Biological Factors:
• Genetics • Neurotransmitters –
• Brain Function –
Psychosocial (Environmental) Factors:
Nature and Nurture
• The development of
schizophrenia does not
occur through a simple
mechanism
• Both biology and
environment are involved
• Vulnerability is a
diminished ability to deal
with demanding life
events
MEDIA DEPICTION OF
SCHIZOPHRENIA
Personality Disorders
Personality Disorders
• Axis II of the DSM
classification system
• Personality disorders –
psychological disorders
characterized by
inflexible and longstanding maladaptive
behaviours that typically
cause stress and/or
social or occupational
problems
Personality Disorders: Clusters
• Three broad classes:
A) odd or eccentric –
B) dramatic, emotional, or erratic –
C) anxious or fearful –