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Chapter 14 - Psychological Disorders.docx

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Dax Urbszat

Chapter 14 – Psychological Disorders Medical model applied to abnormal behaviour: proposes that it is useful to think of abnormal behaviour as a disease  Disease analogy is only an analogy, but it`s useful  Szasz has argued that minds can`t be sick, abnormal behaviour is not an illness  Diagnosis: distinguishing one illness from another  Etiology: apparent causation and developmental history of an illness  Prognosis: forecast about the probable course of an illness Criteria for Abnormal Behaviour  It`s all relative and subjective, normality and abnormality exist on a continuum  Variety of Criteria:  1.Deviance for the norms of society  2. Maladaptive behaviour: everyday adaptive behaviour is impaired, interfere with social or occupational functioning  3. Personal distress: individual’s report of great personal distress (depression or anxiety disorders)  People judged to have psychological disorder only when their behaviour becomes extremely deviant, maladaptive, or distressing Stereotypes of Psychological Disorders:  1. Psychological disorders are incurable (false: even the most severe psycholocial disorders can be treated successfully)  2. People with psychological disorders are often violent and dangerous  3. People with psychological disorders behave in bizarre ways and are very different from normal people (false: only true in small minority, involving severe disorders)  David Rosenhan sent normal “pseudopatients” who were normal in every way just reported hearing voices, and they were all admitted for an average of 19 days! Psychodiagnosis:  Diagnostic and Statistical Manual of Mental Disorders (DSM)  4 revisions of DSM, DSMIII was a major advance, introduced multiaxial system  Axis I: most types of disorders go on this axis, gender-identity, eating disorders, somatoform disorders, mood, anxiety, schizophrenia, substance-related disorders  AxisII: long-running personality disorders or mental retardations  AxisIII: physical disorders and general medical conditions  AxisIV: psychological and environmental problems, types of stress experienced  AxisV: global assessment of functioning, individuals current level of adaptive functioning (in social and occupational behaviour) Prevalence of Psychological Disorders  Lifetime prevalence: percentage of people who endure a specific disorder at any time in their lives  Roughly one-third of the population have had psychological disorders at some point in their lives Anxiety Disorders: feelings of excessive apprehension and anxiety , five types, not mutually exclusive  Generalized anxiety disorder (free floating anxiety): chronic high level of anxiety that is not tied to any specific threat o Physical symptoms such as trembling, muscle tension, diarrhea, dizziness, faintness, sweating, and heart palpitations  Phobic Disorders: persistent and irrational fear of an object or situation that presents no realistic danger o Common phobias are claustrophobia, brontophobia (fear of storms), hydrophobia, animal and insect phobias  Panic Disorder and Agoraphobia: recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly  Panic attacks leads to agoraphobia: afraid to leave home, fear of open public places  Agoraphobia is mainly a complication of panic disorder  Panic disorder people are mostly female (67%) Obsessive Compulsive Disorder (note: not Obsessive Compulsive personality disorder)  Obsession: thoughts that repeatedly intrude on one’s consciousness in a distressing way  Compulsions: actions that one feels forced to carry out  Obsessive-Compulsive Disorder: persistent, uncontrollable intrusions of unwanted thoughts and urges to engage in senseless rituals  E.g. Howie Mandel, deal or no deal  Four factors underlie the symptoms: obsessions and checking, symmetry and order, cleanliness and washing, and hoarding Post-Traumatic Stress Disorder  Elicited by rape, assult, sever automobile accident or natural disaster, or witnessing someone’s death  7% of people have suffered from PTSD, higher in women  Symptoms: re-experiencing the traumatic event in form of nightmares and flashbacks, emotional numbing, alienation, elevated levels of vulnerability, arousal, anxiety, anger, and guilt  Vulnerability to PTSD elevated in those who have intense emotional reactions during or immediately after the traumatic event  Severity and frequency declines over years, recovery gradual, sometimes never fully recover Etiology of Anxiety Disorders  Biological factors: o Look at concordance rate: percentage of twin pairs or other pairs of relatives who exhibit the same disorder o There is a moderate genetic predisposition to anxiety disorders o Anxiety sensitivity: highly sensitive to internal physiological symptoms of anxiety and overreact with fear  leads to vicious cycle, anxiety leads to more anxiety o Drugs that reduce excessive anxiety appear to alter neurotransmitter activity at GABA synapses  Conditioning and Learning: fear acquired through classical conditioning, person starts avoiding the stimulus  negatively reinforce the avoidance response cuz it reduces anxiety, operant conditioning  Preparedness: people are biologically prepared by their evolutionary history to acquire some fears much more easily than others  Observational learning can also lead to phobias  Cognitive Factors: certain styles of thinking make some people particularly vulnerable to anxiety disorders, people who think negatively basically  Stress: high stress often helps the onset of anxiety disorders Somatoform Disorders: physical ailments that cannot be fully explained by organic conditions and are largely due to psychological factors  Somatization Disorder: diverse physical complaints that appear to be psychological in origin o Diverse physical complaints in various organ systems  Conversion Disorder: significant loss of physical function (with no apparent organic basis) usually in a single organ system o Glove anaesthesia : lose feeling of one hand, inconsistent with known facts of neurological organization Hypochondriasis: excessive pre-occupation with health concerns and incessant worry about developing physical illnesses o Frequently appears alongside anxiety disorders and depression e.g. OCD Etiology of Somatoform Disorders  Genetic factors DO NOT appear to make much of a contribution to the development of Somatofrom Disorders  Personality Factors: people with histrionic personality (develop somatoform disorders more readily o Histrionic people tend to be self-centred, suggestible, excitable, highly emotional, and overly dramatic o Thrive on the attention they get when they become ill  Cognitive Factors also make people who draw catastrophic conclusions about minor bodily complaints more susceptible to somatoform disorders  The sick role: some people grow fond of the role associated with being sick, complaints are reinforced by benefits (like attention and sympathy) of being sick Dissociate Disorders: people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity  Dissociative Amnesia and Fugue o Dissociative Amnesia: sudden loss of memory of important personal info that is too extensive to be due to normal forgetting o Dissociative Fugue: lose memory of entire life, along with their sense of personal identity, but remember matters unrelated to their identity  Dissociative Identity Disorder (Multiple Personality Disorder): coexistence in one person of two or more largely complete, usually very different personalities o Personalities unaware of each other, experiences of a specific personality are recalled only by that personality and not by the others Etiology of Dissociative Disorders:  Some believe that DID people are intentionally role playing to use mental illness as a face-saving excuse for their personal failings  Others maintain that most cases of dissociative identity disorder are rooted in severe emotional trauma that occurred during childhood Mood Disorders: emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, social and thought processes  Mood disorders tend to be episodic  Two types of mood disorders: o unipolar disorder : experience emothional extremes at ust one end of the mood continuum, troubled by depression o Bipolar disorders: emotional extremes at both ends of the mood continuum, go through periods of both depression and mania Major Depressive Disorder: persistent feelings of sadness and despair and a loss of interest in previous sources of pleasure  Alteration in sleep patterns and appetite, lack of energy, talk slowly, low self-esteem,  Majority of cases emerge before age 40, average duration of depressive episodes is five months  Probability of reoccurrence increases as the time from the first occurrence increases  Dysthymic disorder: chronic depression that is insufficient in severity to justify diagnosis of a major depressive episode  Depression is increasing, more in women,  Tendency to dwell on one’s difficulties elevates vulnerability to depression Bipolar Disorder (manic-depressive):  One or more manic episodes as well as periods  Mood becomes elevated to the point of euphoria, high self-esteem, energy, mind-racing, hyperactive, talking rapidly, impaired judgment, sexually reckless  Cyclothymic disorder: chronic but relatively mild symptoms of bipolar disturbance  Manic states addictive  Bipolar disorders less common than unipolar disorders, seen equally in males and females Diversity in Mood disorders  Seasonal affective disorder: a type of depression that follows a seasonal pattern o Onset related to melatonin production and circadian rhythms o Phototherapy  Postpartum depression: occurs after childbirth o Higher in immigrant women Mood disorders and Suicide  Suicide one of three leading causes of death of people between ages 15 and 34  Suicide lower in immigrants and Canadian born  Women attempt suicide more
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