Psychological Disorders: More Than Everyday Problems 14 /
Psychological Disorder(p.630) The presence of a constellation of symptoms that create significant distress; impair work, school, family, relationships, or daily living; or lead to significant risk or harm Symptoms Cognitive Emotional Behavioral
Defining Abnormality Distress --- Impairment or disability --- Danger Cultural and social influences(p.631) A behavior that is bizarre or inappropriate in one Context may be entirely appropriate in another
Normal VS Abnormal Statistical deviation( Violation of cultural standards Maladaptive behavior Emotional distress Impaired judgment & lack of control
Explaining Abnormality Biopsychosocial model (p.632) The Brain Genes Neurotransmitters Brain Structure and Function Diathesis (of the Diathesis-Stress Model) predisposition to a state or condition (p.633)
Explaining Abnormality The Person Classical and Operant Conditioning Cognitive Biases Emotions
Explaining Abnormality The Group Culture Conception of Disorders Social labeling creates disorders? / Social factors can lead to diagnostic bias
Labels and Abnormality Rosenhan(1973): On being sane in insane places 8 pseudopatients claimed to hear voices Admitted to psychiatric hospitals Stopped reporting symptoms Normal behaviors were interpreted as pathological Doctors rarely responded to questions Many real patients were not fooled
Categorizing Disorders (p.635) Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV1994;DSM-IV-TR2000) Axis I: clinical disorders Axis II: personality disorders and mental retardation Axis III: general medical conditions Axis IV: psychosocial and environmental problems Axis V: global assessment of functioning
Disadvantages and Advantages of thedsm (p.636) Disadvantages created a psychological or psychiatric disorder for a medical problem sleep apnea Not provide a discrete boundary separating abnormality from normality Some of the disorders are not clearly distinct from one another Advantages Theoretically neutral It strives to create standards that can be used to ensure reliability in diagnosis
Consciousness: clear; confuse; stupor Appearance: neat; unkempt; inappropriate Attention: concentrated; distractible; not detectable Attitude: cooperative; hostile; over polite Affect: apathy; anxiety ;ambivalence Speech: incoherence; irrelevance; Behavior: bizarre (queer); hyperactivity;hypoactivity Thought: process---block; content---delusion Perception: hallucination--- auditory(ah) visual(vh)
Drive ( eating; drinking; sleeping. Somatic complaint : headache JOMAC Judgment Orientation Memory Abstract thinking Calculation
Mood Disorders (p.638) Persistent or episodic disturbances in emotion that interfere with normal functioning in at least one realm of life Major depressive disorder (MDD) At least 2 weeks of depressive mood or loss interests Affect (mood) Behavior (actions) Cognition (thoughts) More common in women Most common psychological disorder in the States
Mood Disorders MDD (p.639) MDD (p.639) Dysthymia Depressive mood (at least 2yrs), 2 ;Lifetime prevalence 6% Suicide Attempted by 30% of depressed people (p.641)
Mood Disorders Bipolar disorder p.642 Mania Hypomania Manic episode Prodromal phase Often cycles with depression Formerly called manic depression Lifetime prevalence 1%
Explaining Mood Disorders The brain Hereditary factors Frontal lobe Amygdala The person Beck s negative triad(p.644) Learned helplessness Attributional style The group Life stressors Lack of social reinforcement
Anxiety Disorders Generalized anxiety disorder (p.648) 4 : panic disorder ; phobia ; obsessive-compulsive D ; PTSD Panic disorder Panic attacks Agoraphobia Locus coeruleus (a small group of cells deep in brain stem---alarm system to trigger increase HR..) Anxiety sensitivity Lifetime prevalence 3%
Anxiety Disorders Phobias ---an exaggerated fear of an object Social phobia / Lifetime prevalence 13% Specific phobia (p.651) Animal fears Blood-injection-injury fears Natural environment fears Situation fears Miscellaneous fears Lifetime prevalence 10%
Anxiety Disorders (p.653) Obsessive-compulsive disorder (OCD) Obsession Compulsion Checking Washing Ordering counting Lifetime prevalence 2-3% Caudate nucleus /
Anxiety Disorders Posttraumatic stress disorder (PTSD) / (p.655) Traumatic event Fear and helplessness Symptoms Re-experience event Avoidance and emotional numbing Heightened arousal Lifetime prevalence 8% (among Americans) Genetic predisposition
Schizophrenia Positive symptoms Negative symptoms (p.660) Delusions Flat affect Hallucinations Alogia Disordered behavior Avolition Disorganized speech L i f e t i m e p r e v a l e n c e 1 %
Schizophrenia Four subtypes (p.661) Paranoid Disorganized Catatonic / Undifferentiated
Explaining Schizophrenia Biopsychosocial Model The brain Hereditary Ventricle size Stress-related hormones The dopamine hypothesis The person Emotional dampening The group High expressed emotion HEE (p.665) (critical, hostile, overinvolved) Social selection /social drift and social causation
Dissociative Disorders (p.668) Symptoms Identity confusion Identity alteration Derealization Depersonalization Amnesia Dissociative amnesia Dissociative fugue Dissociative identity disorder
Eating Disorders (p.670) Anorexia nervosa Body image distortion Bulimia nervosa Factors Genetic predisposition Gender Cultural factors Lifetime prevalence 0.5-4%
Eating Disorders
Personality Disorders (p.676) Antisocial personality disorder (p.677) 1-2% of Americans diagnosed App. 60% of men in U.S. prisons have it Heredity and the environment Impulse and anger control
Personality Disorders Other personality disorders (p.676) Avoidant personality disorder Borderline personality disorder Dependent personality disorder Histrionic personality disorder Narcissistic personality disorder Obsessive-compulsive personality disorder Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder