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 : ; <