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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