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 oneContext 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 + , - . / 0� Brain Structure and Function 1 2 3 4 5 6 7� Diathesis (of the Diathesis-Stress Model)

predisposition� � � � to a state or condition (p.633)

Explaining Abnormality��� �

� The Person� �

� Classical and Operant Conditioning8 9 5 : � ; <

� Cognitive Biases = > ? @� Emotions

� The Group � Culture � Conception of Disorders! " � � � � & A B

� Social labeling creates disorders?$ % C D / E F G H I J � �

� Social factors can lead to diagnostic bias$ % * K L . M N O J ? @

Explaining Abnormality��� �

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, 4th 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 lifeP Q R I S T U V W X Y Z [ 6 7

� 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),a , b Y c2 d ^ _ ` e ;Lifetime prevalence 6%

� Suicide � �

� Attempted by 30% of depressed people� f g � h & i j (p.641)

Mood Disorders����

� Bipolar disorder�� � � � � � � �p.642� Maniak `

� Hypomania. /� Manic episode / 0 1 2� Prodromal phase 3 4 5

� Often cycles with depression� Formerly called manic depression l m n k _ `� Lifetime prevalence 1% o p q r s

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 disordert u v ` (p.648)� 4 6 7 8 0 : panic disorder9 : 0 ; phobia; < 0 ;

obsessive-compulsive D= > 0 ; PTSD? @ A 0 B C� Panic disorderw x `

� Panic attacks� Agoraphobia < D 0� 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$ y / $ % z { `� Lifetime prevalence 13%

� Specific phobia| } � ~ z { ` (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 = > -E� Compulsion= > � �

� Checking� Washing� Ordering� counting

� Lifetime prevalence 2-3%� Caudate nucleus F G H I J / F G K

Anxiety Disorders �� Posttraumatic stress disorder (PTSD) � � � �� � � / � � � � � ` � � (p.655)� Traumatic event� Fear and helplessness� Symptoms 0 L

� Re-experience event� Avoidance and emotional numbing� Heightened arousal

� Lifetime prevalence 8% (among Americans)� Genetic predisposition M N � O � �

Schizophrenia��� �� Positive symptomsP Q 0 L (p.660)� Delusions R S� Hallucinations T U� Disordered behaviorV W � �

� Disorganized speechX Y Z [ �

� Negative symptoms\ Q 0 L

� Flat affect�� ] ^� Alogia Z _ X Y� Avolition Z -̀ �

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 � 7 � � �

Explaining Schizophrenia� Biopsychosocial Model # �$ �% & ' (� The brain� Hereditary��

� Ventricle size� Stress-related hormones� The dopamine hypothesis � � � � �

� The person� Emotional dampening�

� The group� High expressed emotionHEE�(p.665)

� � � � � � (critical, hostile, overinvolved)� Social selection /social drift � � � � � and social causation

Dissociative Disorders���(p.668)

� Symptoms 0 L� Identity confusion) * + , - .� Identity alteration) * + , / 0� Derealization1 2 3 4� Depersonalization1 ) * 4� Amnesia1 5

� Dissociative amnesiaa b Q V c 0� Dissociative fugue a b Q d e 0� Dissociative identity disorder a b Q f g �h � �ij � k l � � m

Eating Disorders � ��(p.670)

� Anorexia nervosa � � `� Body image distortionn o p & q r

� Bulimia nervosa� � `� Factors * K

� Genetic predisposition� Gender� Cultural factors

� Lifetime prevalence 0.5-4%

Eating Disorders� � � �

Personality Disorders � � � � (p.676)

� Antisocial personality disorders � � � � � (p.677)

� 1-2% of Americans diagnosed� App. 60% of men in U.S. prisons have it� Heredity and the environmentM N � ! "� Impulse and anger controlt u � v w x y z

Personality Disorders � ��

� Other personality disorders (p.676)� Avoidant personality disorder6 7 8 9 : ; <� Borderline personality disorder= > 8 9 : ; <� Dependent personality disorder? @ 8 9 : ; <� Histrionic personality disorderA B 8 9 : ; <� Narcissistic personality disorder) C 8 9 : ; <� Obsessive-compulsive personality disorderD E 8 9 : ; <� Paranoid personality disorderF G 8 9 : ; <� Schizoid personality disorderH I J 8 9 : ; <� Schizotypal personality disorderI J K 8 9 : ; <