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Psychological Disorders Chapter 15 Copyright © 2005 Pearson Education Inc What Is Abnormal Behaviour?  Abnormal behaviour is characterized as not typical, socially unacceptable, distressing to the person who exhibits it or to the person’s friends and family, maladaptive, and the result of disorganized conditions 15-2 Copyright © 2005 Pearson Education Inc Perspectives on Abnormality  Practitioners turn to models to explain the causes of abnormal behaviour  A model is an analogy that helps discover relationships among data  Models of maladjustment form the basis of abnormal psychology, the field of psychology concerned with assessment, treatment and prevention 15-3 Copyright © 2005 Pearson Education Inc The Medical-Biological Model  The medical-biological model focuses on the physiological conditions that initiate and underlie abnormal behaviour 15-4 Copyright © 2005 Pearson Education Inc The Psychodynamic Model  The psychodynamic model is rooted in Freud’s theory of personality  It assumes psychological disorders result from anxiety produced by unresolved conflicts outside a person’s awareness 15-5 Copyright © 2005 Pearson Education Inc The Humanistic Model  The humanistic model focuses on individual uniqueness and decision making  Maladjustment occurs when a person’s needs are not met 15-6 Copyright © 2005 Pearson Education Inc The Behavioural Model  The behavioural model states that abnormal behaviour is learned through selective reinforcement and punishment 15-7 Copyright © 2005 Pearson Education Inc The Cognitive Model  The cognitive model asserts that human beings engage in both prosocial and maladjusted behaviours because of their thoughts 15-8 Copyright © 2005 Pearson Education Inc The Sociocultural Model  According to the sociocultural model, maladjustment occurs within and because of a context 15-9 Copyright © 2005 Pearson Education Inc The Evolutionary Model  The evolutionary model says humans evolved in a specific environment  Maladjustments may be expressions of behaviour that would once have been normal in evolutionary history 15-10 Copyright © 2005 Pearson Education Inc Which Model Is Best?  Some psychologists use only one model to analyze all behaviour problems  Others may take an eclectic approach 15-11 Copyright © 2005 Pearson Education Inc Diagnosing Psychopathology: The DSM  The American Psychiatric Association has devised a system for diagnosing maladjusted behaviour, the Diagnostic and Statistical Manual of Mental Disorders (DSM) 15-12 Copyright © 2005 Pearson Education Inc Table 15.1 Major Classifications of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (TR) 15-13 Copyright © 2005 Pearson Education Inc Diversity and Diagnoses  DSM instructs clinicians to become more sensitive to issues of diversity and examples of syndromes specific to various cultures  Research shows that the likelihood of a specific diagnosis is related to ethnicity and culture 15-14 Copyright © 2005 Pearson Education Inc Defining Anxiety  Anxiety is a generalized feeling of fear and apprehension that may be related to a particular situation or object often accompanied by increased physiological arousal  Karen Horney considered anxiety a motivating force while Freud saw anxiety as the result of conflict between the id, ego and superego 15-15 Copyright © 2005 Pearson Education Inc Generalized Anxiety Disorder  A person with generalized anxiety disorder feels almost continuous anxiety for six months, increased activity of the autonomic nervous system, difficulty concentrating, and fatigue 15-16 Copyright © 2005 Pearson Education Inc Phobic Disorders  Phobic disorder is an excessive irrational fear and avoidance of specific objects or situations  People with phobic disorders exhibit avoidance and escape behaviours 15-17 Copyright © 2005 Pearson Education Inc Agoraphobia  Agoraphobia involves a marked fear and avoidance of being alone in a place from which escape may be difficult or embarrassing  Symptoms include hyperventilation, extreme tension, and cognitive disorganization 15-18 Copyright © 2005 Pearson Education Inc Social Phobia  Social phobia is anxiety involving a fear of and a desire to avoid situations where one might be scrutinized by others 15-19 Copyright © 2005 Pearson Education Inc Specific Phobias  A specific phobia involves irrational and persistent fear of a particular object or situation 15-20 Copyright © 2005 Pearson Education Inc Obsessive-Compulsive Disorder  Obsessive-compulsive disorder involves persistent, uncontrollable thoughts and irrational beliefs that cause compulsive rituals that interfere with daily life 15-21 Copyright © 2005 Pearson Education Inc Depressive Disorders  In depressive disorders, people show extreme and persistent sadness  Major depressive disorder is characterized by loss of interest in almost all of life’s usual activities 15-22 Copyright © 2005 Pearson Education Inc Symptoms of Major Depressive Disorder  Symptoms of major depressive disorder include:  Poor appetite  Insomnia  Weight loss  Loss of energy  Feelings of worthlessness and guilt  Inability to concentrate 15-23 Copyright © 2005 Pearson Education Inc Major Depressive Disorder: Onset and Duration  Most people who experience major depressive disorder undergo the first episode prior to age 40  Symptoms are readily apparent and may last for days, weeks, or months  Episodes of major depression may occur once or many times 15-24 Copyright © 2005 Pearson Education Inc Major Depressive Disorder: Prevalence  Major depressive disorder affects about 1.3 million Canadians each year  Women are twice as likely to be diagnosed and express their feelings openly 15-25 Copyright © 2005 Pearson Education Inc 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 15-26 Copyright © 2005 Pearson Education Inc Causes of Major Depressive Disorder  Biological theories imply both genetics and neurotransmitters may underlie depression  Monoamine theory suggests that depression results from deficiencies of monoamines or inefficient receptors 15-27 Copyright © 2005 Pearson Education Inc Learning and Cognitive Theories  Lewinsohn feels that people who fail to receive reinforcement are deprived of pleasure  Beck says depressed people have negative views of themselves, the environment and the future 15-28 Copyright © 2005 Pearson Education Inc Figure 15.2 Lewinsohn’s View of Depression 15-29 Copyright © 2005 Pearson Education Inc Learned Helplessness  Learned helplessness is 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 15-30 Copyright © 2005 Pearson Education Inc The Biopsychosocial Model is a person’s diminished ability to deal with life events  The more vulnerable the person, the less stress or anxiety is needed to initiate depression  The link between vulnerability and stress is called diathesis-stress model  Vulnerability 15-31 Copyright © 2005 Pearson Education Inc Bipolar Disorder  Bipolar disorder was originally known as manic-depressive disorder  People with the disorder experience behaviour varying between two extremes 15-32 Copyright © 2005 Pearson Education Inc Bipolar Disorder  The manic phase involves rapid speech, inflated self-esteem, impulsiveness, euphoria, and decreased need for sleep  In the depressed phase, the person is moody and sad, with feelings of hopelessness 15-33 Copyright © 2005 Pearson Education Inc Dissociative Disorders  Dissociative disorders are characterized by a sudden, temporary, alteration in consciousness, identity, behaviour, and/or memory 15-34 Copyright © 2005 Pearson Education Inc Dissociative Amnesia  Dissociative amnesia involves a sudden and extensive inability to recall important personal information 15-35 Copyright © 2005 Pearson Education Inc Dissociative Identity Disorder  Dissociative identity disorder is more commonly known as multiple personality and involves the existence within an individual of two more distinct personalities each dominant at different times 15-36 Copyright © 2005 Pearson Education Inc Schizophrenia  Schizophrenic disorders involve a lack of reality testing, and deterioration of social and cognitive functioning  People with schizophrenia match the definition of psychotic with gross impairment of reality testing and inability to meet the demands of life 15-37 Copyright © 2005 Pearson Education Inc Essential Characteristics of Schizophrenic Disorders  Schizophrenia is characterized by “positive” and “negative” symptoms  Positive symptoms are symptoms people with schizophrenia experience, but normal people do not  Negative symptoms are behaviours that occur normally, but do not in schizophrenics 15-38 Copyright © 2005 Pearson Education Inc Schizophrenia: Thought Disorders  One of the first signs of schizophrenia is difficulty maintaining logical thought and coherent conversation  The person may show disordered thinking and impaired memory  People with schizophrenia may also suffer delusions (incorrect beliefs) 15-39 Copyright © 2005 Pearson Education Inc Schizophrenia: Perceptual Disorders  Another sign of schizophrenia is hallucinations  Compelling perceptual experiences without any actual physical stimulation  Auditory hallucinations are most common 15-40 Copyright © 2005 Pearson Education Inc Schizophrenia: Emotional Disorders  A striking characteristic of schizophrenia is inappropriate affect  Emotional responses not appropriate in the circumstances 15-41 Copyright © 2005 Pearson Education Inc Emotional Disorders  Some people with schizophrenia show no emotions, what is referred to as constricted or flat affect  Another characteristic is ambivalent affect or the showing a wide range of emotions in a brief period 15-42 Copyright © 2005 Pearson Education Inc Paranoid Type  People with paranoid type schizophrenia may seem normal  However, their thoughts are characterized by delusions and hallucinations often organized around a theme 15-43 Copyright © 2005 Pearson Education Inc Catatonic Type  Catatonic • • type of schizophrenia has two subtypes: The excited type shows excessive activity Withdrawn catatonic schizophrenics appear stuporous 15-44 Copyright © 2005 Pearson Education Inc Disorganized Type  The disorganized type of schizophrenia is characterized by severely disturbed thought processes, incoherence, disorganized behaviour, and inappropriate affect 15-45 Copyright © 2005 Pearson Education Inc Residual Type  People who have the residual type of schizophrenia show symptoms of schizophrenia but remain in touch with reality 15-46 Copyright © 2005 Pearson Education Inc Undifferentiated Type  Some people exhibit all essential features of schizophrenia but do not fit neatly into one of the categories covered so far  These individuals are said to have the undifferentiated type of schizophrenia 15-47 Copyright © 2005 Pearson Education Inc Causes of Schizophrenia  Most theorists adopt a diathesis-stress model to explain the cause of schizophrenia  This asserts that a genetic or biological vulnerability underlies schizophrenia  Life stress interacts with vulnerability to produce schizophrenia 15-48 Copyright © 2005 Pearson Education Inc Biological Evidence  Biological factors may predispose a person to develop schizophrenia  Schizophrenia does “run in families”  Estimates of the degree to which two or more individuals share a trait are called concordance rates  Concordance for schizophrenia for identical twins is about 48% 15-49 Copyright © 2005 Pearson Education Inc Environmental Factors  Behavioural theories of schizophrenia are based on traditional learning principles  Parents sometimes confuse their children or have difficulty communicating effectively or offer children inconsistent messages 15-50 Copyright © 2005 Pearson Education Inc 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 15-51 Copyright © 2005 Pearson Education Inc Personality Disorders  Axis II includes personality disorders that applies to people with long-standing, inflexible, maladaptive behaviours that typically cause stress and social or occupational difficulties 15-52 Copyright © 2005 Pearson Education Inc Paranoid Personality Disorder  People with paranoid personality disorder show odd or eccentric behaviour 15-53 Copyright © 2005 Pearson Education Inc Borderline Personality Disorder  Borderline personality disorder individuals have trouble with relationships 15-54 Copyright © 2005 Pearson Education Inc Histrionic Personality Disorder  Histrionic personality disorder individuals seek attention by exaggerating situations in their lives 15-55 Copyright © 2005 Pearson Education Inc Narcissistic Personality Disorder  Narcissistic personality disorder individuals have an exaggerated sense of self-importance 15-56 Copyright © 2005 Pearson Education Inc Antisocial Personality Disorder  People with antisocial personality disorder are self-centred and irresponsible, and violate the rights of others 15-57 Copyright © 2005 Pearson Education Inc Dependent Personality Disorder  Dependent personality disorder involves fearful and anxious behaviour  People with dependent personality disorder are submissive and clinging 15-58 Copyright © 2005 Pearson Education Inc Are People with Mental Disorders Violent?  Most people who have mental disorders are not violent  Likewise, most people who commit violence do not have a mental disorder  However, some mental disorders are associated with a greater likelihood of committing violent acts 15-59 Copyright © 2005 Pearson Education Inc Diagnoses Associated with Violence  In general, the more serious disorders carry a greater risk for violence  People who have delusions may be at specific risk  In the manic phase of bipolar disorder, people can be impatient and easily angered 15-60 Copyright © 2005 Pearson Education Inc The Insanity Plea  Insanity refers to a condition that excuses people from responsibility  Legally, a person cannot be held responsible for a crime if, at the time of the crime, the person lacked the capacity to distinguish right from wrong, or to obey the law 15-61 Copyright © 2005 Pearson Education Inc The Insanity Plea  Most people overestimate how often the insanity plea is made  Only about 1% of felony defendants us an insanity defense  Even when successful, the defendant seldom leaves the courtroom a free person 15-62 Copyright © 2005 Pearson Education Inc Suicide  People with mental disorders are more likely to be a danger to themselves  Attempters try to commit suicide, but are unsuccessful  Completers succeed in taking their lives 15-63 Copyright © 2005 Pearson Education Inc Violence as a Risk for Developing Mental Disorders  Only a few mental disorders increase the likelihood a person will be violent  Being the target of violence increases the risk for many disorders  The experience of violence has the greatest potential for harm on children 15-64 Copyright © 2005 Pearson Education Inc Child Abuse  Child abuse is the physical, emotional, or sexual mistreatment of a child  Victims of abuse and neglect are at greater risk of mood disorders and antisocial personality disorders, PTSD, depression, suicide, and sexual disorders  Child abusers usually do not have any diagnosable mental disorder 15-65 Copyright © 2005 Pearson Education Inc Intimate Partner Violence  Intimate partner violence is also known as spouse abuse and domestic violence  Women are more likely to be the victim  Partner violence is more likely in couples and societies in which gender roles are rigid and women have little power 15-66 Copyright © 2005 Pearson Education Inc Rape  Rape is forcible sexual assault on an unwilling partner  Date rape, or acquaintance rape is more common than rape by a stranger 15-67 Copyright © 2005 Pearson Education Inc