Chapter 14. Psychological Disorders 8 th Edition

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1 Chapter 14 Psychological Disorders 8 th Edition

2 Abnormal Behavior Historical aspects of mental disorders F 14.1 The medical model What is abnormal behavior? 3 criteria F 14.2 Deviant Maladaptive Causing personal distress A continuum of normal/abnormal

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4 Prevalence, Causes, and Course Epidemiology Prevalence - % of population that displays the disorder during a specific period Lifetime prevalence F 14.5 Diagnosis Etiology causes Prognosis

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6 Psychodiagnosis: The Classification of Disorders American Psychiatric Association published first taxonomy in 1952 Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM - IV) Multiaxial system 5 axes or dimensions F 14.3 Axis I Clinical Syndromes Axis II Personality Disorders or Mental Retardation Axis III General Medical Conditions Axis IV Psychosocial and Environmental Problems Axis V Global Assessment of Functioning Example Figure 14.4 DSM V to be published in

7 Fig. 14-3, p. 555 Figure 14.3 DSM-IV overview

8 The DSM multiaxial system Figure 14.4 Example multiaxial evaluation

9 Axis I Clinical Syndromes and Axis II Personality Disorders Anxiety Disorders p. 583 Somatoform Disorders p. 586 Dissociative Disorders p. 589 Mood Disorders p. 590 Schizophrenic Disorders p. 598 Eating Disorders p. 613 Axis II Personality Disorders p. 604

10 Clinical Syndromes: Anxiety Disorders Generalized anxiety disorder free-floating anxiety Phobic disorder Specific focus of fear Panic disorder and agoraphobia (definition issue p. 582) Physical symptoms of anxiety/leading to agoraphobia Obsessive compulsive disorder Obsessions Compulsions

11 Etiology of Anxiety Disorders Biological factors F 14.6 Genetic predisposition, anxiety sensitivity GABA circuits in the brain Conditioning and learning Acquired through classical conditioning or observational learning F 14.7 Maintained through operant conditioning Cognitive factors Judgments of perceived threat F 14.8 Personality Neuroticism Stress F 14.9 A precipitator

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13

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15 Clinical Syndromes: Somatoform Disorders Somatization Disorder Conversion Disorder Figure Hypochondriasis Etiology Reactive autonomic nervous system Personality factors Cognitive factors The sick role

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17 Clinical Syndromes: Dissociative Disorders Dissociative amnesia Dissociative fugue Dissociative identity disorder Etiology severe emotional trauma during childhood Controversy Media creation? Sybil Repressed memories

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19 Clinical Syndromes: Mood Disorders Figure and Table 14.1 Major depressive disorder Dysthymic disorder Bipolar disorder (manic-depressive disorder) Cyclothymic disorder Etiology Age of onset F Genetic vulnerability F Neurochemical factors Cognitive factors negative thinking F 14.15, F Interpersonal roots Precipitating stress

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21

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23 XX 14.14

24 XX 14.16

25 XX 14.17

26 Clinical Syndromes: Schizophrenia General symptoms Delusions and irrational thought Deterioration of adaptive behavior - avolition Hallucinations any modality but usually auditory Disturbed emotions 66% Prognostic factor Gradual onset Sudden onset

27 Subtyping of Schizophrenia 4 subtypes Paranoid type most common subtype - John Nash Catatonic type Disorganized type Undifferentiated type New model for classification Positive vs. negative symptoms

28 Etiology of Schizophrenia Genetic vulnerability F Neurochemical factors Dopamine hypothesis F Structural abnormalities of the brain prefrontal lobe and ventricles F The neurodevelopmental hypothesis F Expressed emotion F Precipitating stress stress-vulnerability model Slide 33

29 Figure Genetic vulnerability - schizophrenia

30 Figure The dopamine hypothesis as an explanation for schizophrenia

31 Neurological Changes in Schizophrenia XXXX Figure 14.20

32 Figure Neurodevelopment hypothesis of schizophrenia Figure Expressed emotion and relapse rates in schizophrenia

33 Slide 33 The stress-vulnerability model of schizophrenia

34 Personality Disorders Table 14.2 description and male/female percents Anxious-fearful cluster Avoidant, dependent, obsessive-compulsive Dramatic-impulsive cluster Histrionic, narcissistic, borderline, antisocial Odd-eccentric cluster Schizoid, schizotypal, paranoid Etiology Genetic predispositions, inadequate socialization in dysfunctional families Prognosis

35

36 Psychological Disorders and the Law Insanity M naghten rule The insanity defense Figure perception versus actual cases Involuntary commitment varies by states danger to self danger to others in need of treatment Culture and pathology p

37 XXX 14.23

38 John Hinkley, Jr. assassination attempt of President Reagan in 1981

39 Eating Disorders p Issues of weight slide 41 Anorexia nervosa Criteria and subtypes: restrictive and binge/purge Bulimia nervosa Binge eating History and prevalence Age onset Figure Etiology Genetics Personality perfectionism Cultural issues - perfect body type and digital photograph Family role Cognitive factors

40 Figure Age of anorexia nervous in the United States Lucas et al. (1991)

41 XXXXX Slide 41

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