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Chapter 16 Psych Text Book.docx

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Psychology 1000
Terry Biggs

Chapter 16: Psychological Disorders WHAT IS ABNORMAL? - distress, dysfunction and deviance govern views on abnormality - distressed is not a significant means to classify abnormality – some may be anxious, depressed, dissatisfied about themselves/life event – no control over reactions – however some mental patients may be so far from reality they experience no distress - dysfunctional – for individual or society o interfering with ability to work or hold satisfying relationships with others - deviance – violation of the unstated norms of society, especially if violations make others uncomfortable and cannot be attributed to environmental causes - Definition: Abnormal Behaviour: behaviour that is personally distressing , personally dysfunctional and/or so culturally deviant that other people judge it to be inappropriate or maladaptive. HISTORICAL PERSPECTIVES ON DEVIANT BEHAVIOUR: - To rid the “evil spirit” from the body a trephination was performed – chiseling a hole 2cm in diameter into the skull – typically killed the person - Medieval Europe – disturbed people either involuntarily was possessed by the devil or voluntarily made a pact with the dark forces - Killing of “witches” – justified – used diagnostic tests e.g. tie a women’s hands and feet together and throw her into a lake – if she sank and drowned she was pure, if her “impurities” floated – executed - Hippocrates- Greek Physician – 5 century B.C suggested mental illness was disease just like physical disorders – site of mental illness was the brain - Today, vulnerability-stress model: every person has some degree of vulnerability to a psychological disorder. o Biological basis: genotype, NT over-under use, hormonal factor, hair trigger ANS o Personality Factors o Environmental Factors DIAGNOSING PSYCHOLOGICAL DISORDERS: - DM-IV-TR most commonly used: o 5 dimensions: o axis I – primary clinical symptoms o axis II – long standing personality or development disorders o axis III – physical conditions o axis IV – intensity of environmental stressors o axis V – person’s coping resources LEGAL CONSEQUENCES: - Competency – refers to the defendant’s state of mind during the trial - Insanity – mind frame during the crime ANXIETY DISORDERS: - 4 components: o Subjective-Emotional – feelings of tension and apprehension o Cognitive – subjective feelings of apprehension, impending danger, inability to cope o Physiological – increased HR and BP, nausea, dry mouth, diarrhea, frequent urination o Behavioural – avoidance of certain situations, and impaired task performance PHOBIC DISORDER: - Phobia: strong irrational fear of objects or situations - Many develop during childhood, adolescence and early adulthood - Once developed – they seldom go away GENERALIZED ANXIETY DISORDER: - Chronic state of diffuse, or “free-floating” anxiety not linked to any specific situation or object PANIC DISORDER: - sudden and unpredictable, much more intense - not uncommon for victim to feel as if they are dying OBSESSIVE-COMPULSIVE DISORDER (OCD) - obsessions: repetitive and unwelcomed thoughts entering conscious – difficult to dismiss - compulsions: repetitive behavioural responses – often in response to obsessive thoughts and function to reduce anxiety CAUSAL FACTORS IN ANXIETY DISORDERS: BIOLOGICAL FACTORS: - genetics play a role in vulnerability o concordance rate for identical vs. fraternal twins is 40% vs 4% in anxiety disorders - David Barlow – ANS overreacts to perceived threat creating high levels of physiological arousal - Hereditary factors  overreactivity in NT systems involved in emotional responses - GABA – inhibitory neurotransmitter – low levels  highly reactive NS that quickly produce anxiety responses - Serotonin may also be involved in anxiety disorders PSYCHOLOGICAL FACTORS: Psychodynamic theories: - neurotic anxiety: unacceptable impulses threated to overwhelm the ego’s defences and explode into action - Freud believed: o In Phobic disorders – neurotic anxiety is displaced onto external stimulus with symbolic significance in relation to underlying conflict o Obsession – related to, but less terrifying than underlying impulse o Compulsion- way of taking back/undoing one’s unacceptable urge o Anxiety and panic attacks occur when one’s defence’s aren’t strong enough to control or contain anxiety, but not strong enough to hide them either Cognitive Factors: - cognitive theorists stress the role of maladaptive thought patterns and beliefs in anxiety disorders - disordered people catastrophize their demands and magnify them into threats – think the worst will happen to them and feel powerless to cope Anxiety as a Learned Response: - behavioural perspective: anxiety disorders result from emotional conditioning - some fears are acquired through traumatic events, others through observational learning or biological dispositions and cognitive factors - operant conditioning – behaviours that reduce anxiety (compulsions, phobic avoidance..) are strengthened through negative reinforcement Sociocultural Factors: - Koro – Southeast Asia – man fears his penis will retract into abdomen and kill him - Taijin Kyofushu – Japan – pathologically fearful of offending others (odour, blushing, staring, blemish or improper facial expression) - Windigo – North American Indian – fear of being possessed by monsters that will turn them into homicidal cannibals EATING DISORDERS: - Anorexia Nervosa – intense fear of being fat and severely restrict diet to point of starvation - Bulimia Nervosa – binge and purge MOOD (AFFECTIVE) DISORDERS: - anxiety and mood disorders have a high comorbidity - about half of all depressed people have an anxiety disorder DEPRESSION: - 16.6% American’s suffer major depression in lifetime - clinical depression – intensity, duration and frequency of depressive symptoms are out of proportion to the person’s life situation - dysthymia – less dramatic effects – more chronic and long lasting - three types of symptoms: o cognitive –  difficulty concentrating and making decisions  believe they are inferior, incompetent, and inadequate  self blaming for set backs  expect failure  view future with pessimism and hopelessness o motivational  inability to begin or perform behaviours that might cause pleasure or accomplishment o somatic (physical)  loss of weight and appetite  sleep disturbances – insomnia  fatigue and weakness  lose sexual desire BIPOLAR: - periods of interchanging depression and mania PREVALANCE AND COURSE OF MOOD DISORDERS: - depression is on the rise in younger age groups: especially 15-19 years - women are 2x as likely to develop unipolar depression - women suffer first depression episode in 20s, men in 40s - 50% of people who suffer depression will have it recur, 40% wont recur, 10% will never recover CASUAL FACTORS IN MOOD DISORDERS BIOLOGICAL FACTORS: - genetic and neurochemical factors linked to depression - depression is predicted by high behavioural inhibition system (neuroticism) and low behavioural activation system (extraversion) - mania is linked to high reward-oriented behavioural activation system - depression: low activity in serotonin, norepinephrine and dopamine – produce reward and pleasure PSYCHOLOGICAL FACTORS: Personality-based vulnerability: - Abraham and Freud – early traumatic losses/rejections create vulnerability for later depression by triggering a grieving and rage process that becomes part of that person’s personality - Subsequent losses reactivate the original loss  reaction to current event and unresolved past event - To explain the increase in depression in people born after 1960 – Seligman suggests the “me” generation define their self worth in terms of individual attainment and have less commitment to family, religion, and the common good they are more likely to strongly react to failure, view negative events as a reflection of own inadequacies and experience a sense of meaninglessness Cognitive Process: - Beck – depressed people believe they are defective, worthless and inadequate – believe negative things will continue to happen to them because of their defects - Depressive cognitive triad – concerns: the world, oneself, and the future  pops into consciousness automatically – many report they cannot control negative thoughts or emotions - Beck – “Depressive Attributional Pattern” – depressed people attribute success to external sources and failures to themselves (opposite to most people) - Learned Helplessness Theory – expect bad things to occur with nothing they can do to cope or prevent them o Personal, stable, global Sociocultural Factors: - Hong Kong and Taiwan have far lower depression rate than Western culture – strong family connections and other groups help to reduce the negative impact of a loss, strong social support SOMATOFORM DISORDERS: - involve physical complaints or disabilities that suggest a medical problem, but have no known biological cause and are not produced voluntarily by the person - Hypochondriasis – any physical symptom and a person believes they have a serious illness - Pain disorder – intense pain that is either out of proportion to whatever medical condition they have or for which no physical basis can be found - Conversion Disorder – serious neurological symptoms (e.g. paralysis, loss of sensation, blindness) suddenly occur – sensory and motor pathways in the brain are all still intact. o People often exhibit la belle indifference – strange lack of concern to symptoms and implications o Relatively rare, 3/1000 North Americans at peace time, increases during war - Tend to run in families – not sure if it is genetic or environmental learning and social reinforcement DISSOCIATIVE DISORDERS: - breakdown of integration of unity, coherence and facets of self to form a consistent personality result
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