module 65 introduction to psychological...
TRANSCRIPT
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ABNORMAL PSYCHOLOGY
MODULE 65 INTRODUCTION TO PSYCHOLOGICAL DISORDERS MODULE 66 ANXIETY DISORDERS, OBSESSIVE COMPULSIVE DISORDER, AND POST TRAUMATIC DISORDER MODULE 67 MOOD DISORDERS MODULE 68 SCHIZOPHRENIA MODULE 69 OTHER DISORDERS
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• What is NORMAL anyway?
• What is ABNORMAL? How do you know when a person has gone off the edge or is “crazy?” What are some examples?
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L E T ’ S S TA R T W I T H T H E S E Q U E S T I O N S :
• How should we define psychological disorders?
• How should we understand disorders? How do underlying biological factors contribute to disorders? How do troubling environments influence our well-being? And how do these effects of nature and nurture interact?
• How should we classify psychological disorders? And can we do so in a way that allows us to help people without stigmatizing them with labels?
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P S Y C H O L O G I C A L D I S O R D E R
a syndrome marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.
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D E F I N I N G A B N O R M A L B E H AV I O R
IMPORTANT: we all do abnormal things once in awhile. If someone saw what you did in private, they’d probably think you were crazy, but true problems are defined as follows…
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S C E N A R I O T O F O L L O W :
Every morning, a woman who lives in a Boston suburb asks her husband to bring in the morning newspaper, which the carrier throws just inside their fence. She does this because she is terribly afraid of encountering a poisonous snake. Her husband, concerned about her behavior, repeatedly tells her that there are no poisonous snakes living in their town. Nevertheless, she is afraid to leave the house.
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P S Y C H O L O G I C A L D I S O R D E R C R I T E R I A
*A psychological disorder is any behavior that is considered maladaptive, unjustifiable, disturbing, and atypical.
Maladaptive
• “destructive to oneself or others”
• example: woman whose fear of snakes prevented her from leaving her home
Unjustifiable
• “without a rational basis”
• example: it is not rational to refuse to leave your home to avoid a snakebite in an area that has no poisonous snakes
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Disturbing
• “troublesome to other people”
• example: the woman’s fear of snakes disturbs at least her husband, who worries about her
Atypical
• “so different that they violate a norm”
• example: the woman who can’t leave her suburban home because of her fear of nonexistent snakes is definitely behaving different;y from almost all people in her culture
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CAUSES OF ABNORMAL BEHAVIOR (DIFFERENT PERSPECTIVES)
▸ Behavior: maladaptive responses learned through reinforcement of the wrong kinds of behaviors.
▸ Psychoanalytic: results from internal conflicts in the unconscious stemming from early childhood traumas.
▸ Humanistic: results from conditions society places on the individual
▸ Evolutionary: harmful evolutionary dysfunctions that occur when evolved psychological mechanisms do not perform their naturally selected functions effectively.
▸ Biological: neurochemical or hormonal imbalances, genetic predispositions, damage to brain.
▸ Cognitive: irrational and illogical perceptions
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II. HISTORY OF PSYCHOPATHOLOGY:
▸ Was mental illness always viewed as it is today?
a. Hippocrates: symptoms of mental illness was due to an imbalance of four bodily fluids: blood, yellow bile, black bile, phlegm.
b. Middle Ages: (Medieval Church)- psychopathology was caused by the devil.
c. Phillipe Pinel: 1745-1826) Led a reform in the treatment of psychological disorders, stated that psychological disorders are due to a biological abnormality and therefore these patients should be treated with care, instead of the harsh treatments that were the norm..
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III. MEDICAL MODEL VS BIOPSYCHOSOCIAL MODEL:
▸ Explaining Psychological Disorders
Medical Model:
the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and in most cases, cured, often through treatment in a hospital.
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B I O P S Y C H O S O C I A L M O D E L
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III. MEDICAL MODEL VS BIOPSYCHOSOCIAL MODEL:
▸ Medical Model- According to Pinel…
▸ Mental illness is due to biological causes.
▸ Nature not nurture.
▸ Treatments: use of medication to treat mental illness.
▸ Terms: Psychopathology, Etiology, Prognosis
▸ Biopsychosocial Model (Bio+Psycho+Social) :
▸ Mental illness is due to nature and nurture.
▸ Treatments may consists of medication, however Psychologists would look at how negative thought patterns and social influences factor into the equation.
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I V. D S M - 5
1. describe the disorder
2. predict the future course of the disorder
3. treat the disorder appropriately
4. provide a springboard for research into the disorder’s cause
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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)
▸ The DSM-5 classifies all psychological disorders by their symptoms
▸ Lots of changes!
▸ a. Basic Features:
▸ In 1952, the American Psychiatric Association agreed upon a system for classifying abnormal symptoms.
▸ For a person to be diagnosed with a particular disorder a person must meet the Diagnostic Criteria of the DSM-V.
▸ Identifies prevalence, course, gender, cultural features, symptoms, etc… Basically everything but treatment.
▸ In multi-axial diagnosis, professionals look at the entire person, not just their “abnormal” behavior.
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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)
▸ b. Changes in the DSM-5:
▸ Autism and Asperger syndrome are combined into the Autism spectrum disorder.
▸ Mental retardation becomes an intellectual disability.
▸ New categories include hoarding disorder and binge eating disorder.
▸ OCD and PTSD are no longer anxiety diagnosis.
▸ Axis I, II, and III, are no longer used for diagnosis.
▸ There are no more subtypes for diagnosis of schizophrenia (paranoid, disorganized, catatonic, undifferentiated). All that is needed for a diagnosis is to have one of three positive symptoms namely delusions, hallucinations, or disorganized speech.
▸ Fugue is no longer used but is not dissociative amnesia.
▸ For substance abuse disorder, there is no longer a difference between abuse vs dependence.
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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)
▸ c. Strengths:
▸ Pretty reliable
▸ Used for insurance purposes
▸ d. Weaknesses:
▸ Too vague (many people fit the criteria)
▸ i.e. ADHD
▸ Leads to the development of stigmas:
▸ i.e. Presidential election of 1972
▸ Labeling (David Rosenhan study)
▸ i.e. Eight Stanford students check themselves into a mental institution claiming they were having auditory hallucinations, all eight admitted.
▸ As soon as they were admitted, all eight students acted normal. Regular behaviors were considered abnormal. It took students 19 days to be let out.
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IV. DSM-5(DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)
▸ e. Evaluation and Criticism of the DSM-5:
▸ Criticized for being too detailed and extensive.
▸ i.e. Temper tantrums and bereavement.
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V. ANXIETY DISORDERS
▸ a. Generalized Anxiety Disorder:
▸ A constant, low-level, free floating anxiety without any external cause. Such a person feels nervous and out of sorts.
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V. ANXIETY DISORDERS
▸ b. Panic Disorder:
▸ A disturbance marked by panic attacks that have no obvious connection with events in the person’s present experience.
▸ Constant worry about another panic attack can complicate problems.
▸ Symptoms include: Palpitations, increased heart rate, trembling, dizziness, hands become clammy and sweaty.
▸ PET scans of the amygdala and hypothalamus show abnormal activity in patients w/ panic.
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V. ANXIETY DISORDERS
▸ c. Agoraphobia:
▸ Fear of open places. Often people with panic develop symptoms of agoraphobia.
▸ Panic and Agoraphobia affect about 2% of the population.
▸ d. Phobias:
▸ Fear of specific object, activity, or situation. Common ones include: Social phobias, Specific phobia, Acrophobia, and Claustrophobia.
▸ Preparedness hypothesis, heredity, and learning are often the cause of phobias.
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VI. OBSESSIVE COMPULSIVE DISORDERS (OCD)
▸ Disorder that affects thoughts and actions
▸ Compelled to do the same pointless routine over and over and over again.
▸ Have irrational ideas of germs, or being hurt.
▸ Traps people in endless cycles of repetitive thoughts (obsessions) and behaviors (compulsions).
▸ These behaviors are prompted by unwanted ideas, images and impulses.
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VII. POST TRAUMATIC STRESS DISORDER (PTSD)
▸ Mental Disorder that follows experiencing or seeing a traumatic event.
▸ Reaction to a psychologically traumatic event that is outside the range of usual human experience
▸ Usually will have constant frightening thoughts.
▸ They don’t respond to people, lost of interest in life, sleepiness, lack of motivation, night terrors
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VIII. MOOD DISORDERS
▸ a. Major Depression:
▸ depression lasting at least two weeks. Symptoms include: depressed mood, diminished interest in activities, weight loss, insomnia, fatigue, feeling of worthlessness, recurrent thoughts of death.
▸ b. Dysthymia:
▸ depressed mood for more days than not. Moderate depression.
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VIII. MOOD DISORDERS
▸ c. Seasonal Affective Disorder:
▸ form of depression caused by sunlight deprivation.
▸ Caused by the light-sensitive hormone Melatonin. Therapy consists of exposing patients to bright artificial light.
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VIII. MOOD DISORDERS▸ d. Bi-polar Disorder:
▸ mania and depression.
▸ In the manic state, symptoms include:
▸ grandiosity
▸ decreased need for sleep
▸ pressured speech
▸ flight of ideas
▸ distractibility
▸ increase in goal directed behavior
▸ excessive involvement in pleasurable activities that have a high potential for painful consequences.
*Must meet criteria for major depressive episode
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VIII. MOOD DISORDERS▸ e. Classifications of Bi-polar Disorder:
▸ Mania- severe mania
▸ Hypomania- same symptoms, less severe.
▸ Bipolar I- severe mania and depression. Might be accompanied with psychotic symptoms.
▸ Bipolar II- less severe mania and depression.
▸ Cyclothymic Disorder- less severe mania and depression, more long-term.
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VIII. MOOD DISORDERS▸ f. Facts about Depression:
▸ Cross-cultural studies: most prevalent disorder in the world and in women.
▸ Martin Seligman “Common Cold of Abnormal Behavior.”
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VIII. MOOD DISORDERS▸ g. Causes of Depression:
▸ Genetics
▸ Neurotransmitters: Serotonin, Norepinephrine, and Dopamine
▸ Lower brain wave activity in left frontal lobe
▸ Viral infections
▸ Traumatic events
▸ Learned Helplessness (Martin Seligman)
▸ Cultural Pressures
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IX. SCHIZOPHRENIA
▸ a. Schizophrenia:
▸ a psychotic disorder involving distortions in thoughts, perceptions, and or emotions. Schizophrenia means “split mind.”
▸ Prevalence: 1%
▸ Course: Men before 25, Women 25-45 years of age
▸ 40% of all patient admissions to public hospitals
▸ 1/3 of patients will never get better despite treatment.
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IX. SCHIZOPHRENIA
▸ b. Symptoms of Schizophrenia
▸ Positive- refer to active processes because they add to a person’s life. Examples include: hallucinations, delusions, and disorganized thoughts.
▸ Negative- passive processes because they subtract from a person’s life. Examples include: lack of speech and flat affect.
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IX. SCHIZOPHRENIA
▸ c. Causes of Schizophrenia
▸ Methamphetamines- cause hallucinations and delusions.
▸ Dopamine Hypothesis- too much of the neurotransmitter causes Schizophrenia.
▸ Strong Genetic Link- 48% concordance rate of identical twins.
▸ Diathesis-Stress Hypothesis— genetic factors put the individual at risk, while environmental stress factors transform this into a schizophrenic disorder.
▸ E.G. homeless
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IX. SCHIZOPHRENIA
▸ c. Causes of Schizophrenia (continued)
▸ Enlarged ventricles
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X. DISSOCIATIVE DISORDERS:
▸ a. Dissociative Amnesia (Fugue):
▸ a psychologically induced loss of memory for personal information, such as one’s identity or residence.
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X. DISSOCIATIVE DISORDERS:
▸ b. Depersonalization Disorder:
▸ an abnormality involving the sensation that mind and body have separated, as in an out of body experience.
▸ c. Dissociative Identity Disorder:
▸ a condition in which an individual displays multiple identities, or personalities. Also known as multiple personality disorder.
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XI. CHILDHOOD DISORDERS
▸ a. Autism:
▸ a disorder marked by disabilities in language, social interaction, and the ability to understand another person’s state of mind. Prevalence: 1 in 500.
▸ Autistic children lack a theory of mind.
▸ Difficulty in social relationships and language lead to social isolation.
▸ Repetitive behaviors are also evident.
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Theory of Mind Problem
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XI. CHILDHOOD DISORDERS
▸ b. ADHD:
▸ a disorder involving inattention, hyperactivity, and impulsivity.
▸ Prevalence: 3-5%
▸ Overdiagnosis is a problem
▸ Occurs in more boys than girls
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XII. EATING DISORDERS
▸ a. Anorexia Nervosa:
▸ persistent loss of appetite
▸ Prevalence higher in western cultures
▸ Women mostly affected
▸ b. Bulimia Nervosa:
▸ binge and purge syndrome through self-induced vomiting and use of laxatives.
Eating Disorders are associated with other forms of psychopathology
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XIII. SOMATOFORM DISORDERS
▸ a. Conversion Disorder:
▸ paralysis, weakness, or loss of sensation- with no discernible cause. Used to be known as “hysteria.”
▸ b. Hypochondriasis:
▸ involves excessive concern about health and disease
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XIV. PERSONALITY DISORDERS
▸ a. Paranoid Personality Disorder:
▸ a pattern of distrust and suspiciousness.
▸ b. Schizoid Personality Disorder:
▸ a pattern of detachment from social relationships and a restricted range of emotional expression.
▸ c. Schizotypal Personality Disorder:
▸ a pattern of acute discomfort in close relationships, cognitive or perceptual distortions.
▸ d. Anti-social Personality Disorder:
▸ a pattern of disregard for, and violation of, the rights of others.
▸ e. Borderline Personality Disorder:
▸ a pattern of instability in interpersonal relationships, self image, and marked impulsiivity.
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XIV. PERSONALITY DISORDERS (CONTINUED)
▸ f. Histrionic Personality Disorder:
▸ a pattern of excessive emotionality and attention seeking.
▸ g. Narcissistic Personality Disorder:
▸ a pattern of grandiosity, need for admiration, and lack of empathy.
▸ h. Avoidant Personality Disorder:
▸ a pattern of social inhibition, feeling of inadequacy, and hypersensitivity to negative evaluation.
▸ i. Dependent Personality Disorder:
▸ a pattern of submissive and clinging behavior related to an excessive need to be taken care of.
▸ j. Obsessive-Compulsive Personality Disorder:
▸ a pattern of preoccupation with orderliness, perfectionism, and control.
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XV. INSANITY
▸ a. M’Naughten Case (1843)
▸ not guilty of reason of insanity. Insanity is a legal term, not a psychological one.
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XVI. MENTAL ILLNESS IS JUST A MYTH
▸ a. Thomas Szasz
▸ symptoms of mental illness seen as a way to repress people who violate social norms.
▸ Only medical labels used to justify their repression.