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Download Ch. 16 Psychological Disorders
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What is abnormal behavior? What is meant by a psychological disorder? A “harmful dysfunction” judged to be: Atypical – outside of norms Disturbing - varies with time and culture Maladaptive Harmful Unjustifiable Defining abnormality › Subjective discomfort › Statistical definitions › Social non-conformity › Situational context › Cultural relativity (all definitions of abnormality are relative) › It is generally agreed that behavior must interfere with normal activities and cause distress to be abnormal; behavior must be “maladaptive,” not meeting demands of day to day life (e.g., danger to self and/or others) Psychopathology: the scientific study of mental, emotional, and behavioral disorders, e.g. › An inability to behave in ways that foster the well-being of the individual and, ultimately, society › Good “mental health” implies getting what you want to be socially acceptable. Mental health problems are extensive › 1 in 100 will require hospitalization › In any given week, 13% of Americans experience an anxiety-related disorder. DSM-IV › American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, 1994). Presently distributed as DSM-IVR (revised 2000) › Widely used system for classifying psychological disorders. Seventeen major categories, 5 axes Disorders usually diagnosed in infancy, childhood, or adolescence. › ADD, mental retardation, stuttering, etc.. Delirium, dementia, and other cognitive disorders. › Memory and thought distortion as a result of brain damage (Alzheimer’s Disease) Substance related disorders › Alcohol and drugs Psychotic disorders › characterized by a retreat from reality, by hallucinations and delusions, and by social withdrawal; psychotic person cannot tell fantasy from hallucination from reality [e.g., schizophrenia (probably a disorder of the frontal cortex); delusional disorders; severe mood disorders. Mood Disorders › disturbances in affect or emotion (e.g., manic or depressed in “manic-depressive” or “bi-polar” disorder); may include psychotic symptoms Anxiety Disorders › panic, phobias, or generalized anxiety [neurosis; chronic and persistent anxiety; post-traumatic stress disorder (PTSD: anxiety existing after a distressing or traumatic event); obsessive (thoughts)-compulsive (acts) disorder (OCD)] Somatoform Disorders › physical symptoms that mimic physical disease or injury for which there is no apparent cause (e.g., hypochondriasis; conversion reactions) Dissociative Disorders › sudden amnesia; multiple personality; depersonalization Sexual and Gender-Identity Disorders › gender identity disorder; paraphilias [exhibitionism, fetishism, voyeurism; also, sexual dysfunction (N.B. rape a crime not a sexual disorder; homosexuality no longer considered a sexual disorder)] Eating Disorders › Anorexia nervosa, bulimia nervosa Sleeping Disorders › Insomnia, sleepwalking, narcolepsy Impulse Control Disorder › Tendency to act on impulses, such as gamble excessively or steal Axis I – used to classify current symptoms; Range from disorders that are first evident during Infancy, childhood, or adolescents to substance-abuse disorders to schizophrenia. Axis II – describes developmental disorders and long-standing personality disorders, such as compulsiveness, over-dependency, or aggressiveness; language disorders, reading or writing difficulties, autism, or speech problems. Axis III – describes physical disorders or general medical conditions that are relevant to understanding or caring for a person; brain damage, chemical imbalance that causes a disorder in Axis I. Axis IV – measurement of current stress level at which the person is functioning. Stress is rated on events that have occurred within the past year. Axis V – highest level of adaptive functioning present within the past year. Adaptive functioning means › Social relation- quality of relationship with friends and family. › Operational functioning- how you function as a worker, student, or homemaker and the quality of work you accomplish. › Use of leisure time- recreational activities or hobbies and the amount of involvement and pleasure a person has from them. Anxiety – vague, generalized apprehension or feeling one is in danger. Any disorder in which anxiety is a characteristic feature or avoidance of anxiety motivates abnormal behavior Generalized Anxiety Disorder Panic Disorder Specific Phobia Social phobia Obsessive-Compulsive Disorder (OCD) Post-traumatic stress disorder (PTSD) v. acute stress disorder Phobia – intense and irrational fear of a particular object or situation. Panic disorder – an extreme anxiety that manifests itself in the form of panic attacks. Symptoms include sense of smothering, choking, or difficulty breathing; faintness or dizziness; nausea; and chest pains. Obsessive-Compulsive Disorder (OCD) – acute anxiety that cause a person to think the same thoughts over and over again. Examples?? Why do people develop OCD? › Possibly used as a diversion from real fears and help reduce anxiety. Conditioning Feelings of not being in control Genetic predisposition to some anxiety disorders Displacement or repression of unacceptable thoughts or impulses Societal or social pressures Post-traumatic stress disorder – victims of traumatic events who experience the original event in the form of flashbacks or dreams. Examples?? Physical symptoms without any physical cause. Person experiences symptoms as real › Somatization disorder › Hypochondriasis › Conversion disorder (hysteria) La belle indifference › Factitious disorders › Body dysmorphic disorder http://www.youtube.com/watch?v=iAuc2xAM7-8 Freud › Symptoms related to traumatic experience in the past Cognitive-Social › Ways in which the behavior is being rewarded Biological perspective › Real physical illnesses that may be misdiagnosed or overlooked Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings Dissociative Identity Disorder (formerly MPD) Dissociative amnesia › Anterograde v. retrograde › Malingering Dissociative fugue Depersonalization disorder May involve unconscious processes Memory impairments may also include biological factors such as normal aging and Alzheimer’s disease Common with use of some drugs such as LSD Trauma may also be involved A group of severe disorders characterized by disorganized and delusional thinking delusions of reference/persecution/grandeur disturbed perceptions/hallucinations (auditory) and disorganized thought inappropriate emotions and actions blunting/flat or inappropriate affect Paranoid Disorganized (hebephrenic) Undifferentiated Residual Catatonic › Wavy flexibility and mutism Biological predisposition Twin studies show genetic link Excessive levels of dopamine lead to symptoms Abnormalities of brain structures Abnormal patterns of connections between brain cells May involve family relationships and social class Environmental triggers Disorders characterized by inflexible and enduring behavior patterns that impair social functioning (inflexible and maladaptive) Antisocial personality disorder Dependent personality disorder Histrionic personality disorder Borderline personality disorder Schizoid personality disorder Narcissistic personality disorder Passive-aggressive personality disorder Avoidant personality disorder Paranoid personality disorder Combination of biological predisposition, adverse psychological experiences, and an unhealthy social environment Also possible link to damaged frontal lobe during infancy Emotional deprivation during childhood may lead to antisocial tendencies Major Depressive disorder – severe form of lowered mood in which a person experiences feelings of worthlessness and diminished pleasure or interest in many activities. Seasonal Affective Disorder (SAD) More that 30,000 Americans a year end their lives due to depression. Personality disorders: inflexible ways of dealing with others and one’s environment. Anti-social personality: irresponsible, shallow emotions, and lack of conscience. Antisocial › Patterns of disregard and violating the rights of others without feeling remorse. Dependent › Patterns of submissiveness and excessive need to be taken care of. Histrionic › Excessive emotion; constantly seeking attention Obsessive-Compulsive › Intense interest in being orderly; having control, and achieving perfection Paranoid › Distrusts others; perceives others as having evil motives. Schizotypal › Feeling of intense discomfort in close relationships; distorted thinking and eccentric behavior. Psychological dependence: use of a drug to such an extent that a person feels nervous of anxious without it. › Alcohol › Nicotine › caffeine Addiction: pattern of drug abuse characterized by an overwhelming and compulsive desire to obtain and use the drug. Tolerance: physical adaptation to a drug so that a person needs an increased amount in order to produce the original effect. Withdrawal: state of physical and physiological upset during which the body and mind revolt against the absence of the drug. › › › › › › Nausea Shakes Hallucinations Migraines Convulsions Death Most severe drug addiction in the United States. http://www.sadd.org/s tats.htm#underage Alcohol can cause psychological dependence, tolerance, and addiction. Alcoholism develops from both environmental and genetic factors. A person’s risk of becoming an alcoholic is three to four times higher if a family member is an alcoholic. Step 1: Get help through delirium tremens (violent withdrawal) Step Two: Get treatment › Alcoholics Anonymous (AA) › Drug therapy › Psychotherapy › Hypnosis