Chapter 14 Psychological Disorders 8 th Edition
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
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
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 2011-12
Fig. 14-3, p. 555 Figure 14.3 DSM-IV overview
The DSM multiaxial system Figure 14.4 Example multiaxial evaluation
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
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
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
Clinical Syndromes: Somatoform Disorders Somatization Disorder Conversion Disorder Figure 14.10 Hypochondriasis Etiology Reactive autonomic nervous system Personality factors Cognitive factors The sick role
Clinical Syndromes: Dissociative Disorders Dissociative amnesia Dissociative fugue Dissociative identity disorder Etiology severe emotional trauma during childhood Controversy Media creation? Sybil Repressed memories
Clinical Syndromes: Mood Disorders Figure 14.11 and Table 14.1 Major depressive disorder Dysthymic disorder Bipolar disorder (manic-depressive disorder) Cyclothymic disorder Etiology Age of onset F 14.12 Genetic vulnerability F 14.14 Neurochemical factors Cognitive factors negative thinking F 14.15, F 14.16 Interpersonal roots Precipitating stress
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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
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
Etiology of Schizophrenia Genetic vulnerability F 14.18 Neurochemical factors Dopamine hypothesis F 14.19 Structural abnormalities of the brain prefrontal lobe and ventricles F 14.20 The neurodevelopmental hypothesis F 14.21 Expressed emotion F 14.22 Precipitating stress stress-vulnerability model Slide 33
Figure 14.18 Genetic vulnerability - schizophrenia
Figure 14.19 The dopamine hypothesis as an explanation for schizophrenia
Neurological Changes in Schizophrenia XXXX Figure 14.20
Figure 14.21 Neurodevelopment hypothesis of schizophrenia Figure 14.22 Expressed emotion and relapse rates in schizophrenia
Slide 33 The stress-vulnerability model of schizophrenia
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
Psychological Disorders and the Law Insanity M naghten rule The insanity defense Figure 14.23 perception versus actual cases Involuntary commitment varies by states danger to self danger to others in need of treatment Culture and pathology p. 610-611
XXX 14.23
John Hinkley, Jr. assassination attempt of President Reagan in 1981
Eating Disorders p. 613-615 Issues of weight slide 41 Anorexia nervosa Criteria and subtypes: restrictive and binge/purge Bulimia nervosa Binge eating History and prevalence Age onset Figure 14.25 Etiology Genetics Personality perfectionism Cultural issues - perfect body type and digital photograph Family role Cognitive factors
Figure 14.25 - Age of anorexia nervous in the United States Lucas et al. (1991)
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