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CHAPTER 14.doc

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Lawrence Murphy

CHAPTER 14: Psychological Disorders Medical Model: proposes that it is useful to think of abnormal behaviour as a disease  18 and 19 century th - before this, it was believed that abnormal behaviour was based on superstition - the medical model allowed victims to be viewed with more sympathy and less hatred and fear - Recently… Thomas Szasz o Argued that abnormal behaviour usually involves a deviation form social norms rather than an illness Medical concepts proven valuable in the treatment and study of abnormality: - Diagnosis- distinguishing one illness from another - Etiology- the apparent causation and developmental history of an illness - Prognosis- the forecast about the probable course of an illness Criteria of Abnormal Behaviour: Diagnosis of psychological disorders involve judgment about what represents normal or abnormal behaviour - However, judgments about mental illness reflect prevailing cultural, social and political trends - People can be divided into 2 distinct groups: those who are normal and those who are not - Normality and abnormality exist on a continuum Deviance: behaviour deviates from what their society considers acceptable - normality varies - when people violate cultural norms, they may be labeled mentally ill Maladaptive Behaviour: everyday adaptive behaviour is impaired - key criterion for diagnosis of drug/substance use disorders Personal Distress: individuals report of great personal distress - criterion met for depression or anxiety disorders Stereotypes of Psychological Disorders: - they are incurable - people with psychological disorders are often violent and dangerous - people with psychological disorders behave in bizarre ways and are very different from normal people Psychodiagnosis: The Classification of Disorders 1952: The American Psychiatric Association unveiled  Diagnostic and Statistical Manual of Mental Disorders (DSM) - 100 disorders described 1968: DSM II was published, but diagnostic guidelines were still pretty sketchy 1980: DSM III represented a major advance - introduced a new multi-axial system of classification - diagnosis material was made more explicit, concrete and detailed 1994 (Current): DSM IV used intervening research to refine the criteria used previously Multi-axial Evaluation: recognizes the importance of information - Axes: dimensions used to separate judgments of individuals. There are 5 axes… Axis I: (Clinical Syndromes) Diagnosis; clinicians record most types of disorders Axis II: (Personality Disorders or Mental Retardation) Diagnosis; used to list long-running personality disorders (The following are used to record supplemental information) Axis III: (General Medical Conditions) physical disorders are listed Axis IV: (Psychological Environmental Problems) clinician makes notations regarding the types of stress experiences by the individual in the past year Axis V: (Global Assessment of Functioning) estimates are made of the individual’s current level of adaptive functioning and highest level of functioning the past year Epidemiology: the study of the distribution of mental or physical disorders in a population Prevalence- refers to the percentage of population that exhibits a disorder during a specified time period - lifetime prevalence: the percentage of the people who endure a specific disorder at any time in their lives ANXIETY DISORDERS Anxiety Disorders- are marked by feelings of excessive apprehension and anxiety 5 Principle Types of Anxiety Disorders… (Are not mutually exclusive) 1. Generalized Anxiety- disorder is marked by a chronic, high level of anxiety that is not tied to any specific threat - “free floating anxiety”  non-specific - worry about minor matters related to family, finances, work and personal illness 2. Phobic Disorder- when an individual’s troublesome anxiety is marked by a specific focus or persistent and irrational fear of an object or situation that presents no realistic danger - fears (phobias) seriously interfere with their every day behaviour 3. Panic Disorder and Agoraphobia- characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly - Agoraphobia- a condition created by the concern about exhibiting panic in public, which leads to people being afraid of leaving the home 4. Obsessive-Compulsive Disorder (OCD) - persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) - Obsession: thoughts that repeatedly intrude on one’s consciousness in a distressing way - Compulsions: actions that one feels forced to carry out (stereotypic rituals) 5. Post-Traumatic Stress Disorder (PTSD) – disturbed behaviour that is attributed to a major stressful event but that emerges after the stress is over - often elicited by any or a variety of traumatic events - Symptoms: re-experiencing the event in nightmares or flashbacks, problems in social relations Etiology: Like most psychological disorders, anxiety develops out of complicated interactions among a variety of biological and psychological factors (Biological Factors) Concordance rate- indicates the percentage of twin pairs or other pairs of relatives who exhibit the same disorder - twin and family studies suggest that there is a moderate genetic predisposition to anxiety disorders Anxiety Sensitivity- people are highly sensitive to the internal physiological symptoms of anxiety and are prone to overreact with fear when they experience these symptoms (Conditioning and Learning) Many anxiety responses may be acquired through classical conditioning and maintained through operant conditioning - Classical Conditioning: Fear is acquired - Operant Conditioning: Avoidance response is re-enforced because it is followed by a reduction in anxiety Preparedness (Martin Seligman): suggests that people are biologically prepared by their evolutionary history to acquire some fears much more easily than others Observational Learning can lead to the development of conditioned fears  ex. parents pass anxieties on to their children (Cognitive Factors) Certain styles of thinking make some people vulnerable to anxiety disorders. They suffer from anxiety because they tend to… a. misinterpret harmless situations as threatening b. focus excessive attention on perceived threats c. selectively recall information that seems threatening SOMATOFORM DISORDERS Somatoform Disorders- are physical ailments that cannot be fully explained by organic conditions and are largely due to psychological factors Psycho-somatic diseases- involve genuine physical ailments caused in part by psychological factors, especially reactions to stress (recorded in Axis III) 3 Types of Somatoform Disorders… 1. Somatization Disorder: marked by a history of diverse physical complaints that appear to be psychological in origin 2. Conversion Disorder: characterized by a significant loss of physical function (with apparent organic basis), usually in a single organ system 3. Hypochondriasis- is characterized by excessive preoccupation with health concerns and incessant worry about developing physical illnesses - constantly monitor their physical condition - frequently assume that the physician is incompetent and they go shopping for another doctor Etiology: disorders are largely a function of personality and cognitive factors (Personality Factors) Histrionic personality tends to be self-centered, suggestible, excitable, high emotional and overly dramatic (Cognitive Factors) Focus excessive attention on their internal physiological processes and amplify normal bodily sensations into symptoms of distress, which lead them to pursue unnecessary medical treatment - Complaints about physical symptoms may be reinforced by indirect benefits derived from their illness… o avoid having to confront to life’s challenges o provide a convenient excuse when people fail o attention from others DISSOCIATIVE DISORDERS Dissociative Disorders- when people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity 3 Dissociative Syndromes are… 1. Dissociative Amnesia: is a sudden loss of memory for important personal information that is too extensive to be due to normal forgetting  may occur for a single traumatic event and Fatigue: 2. Dissociative Fatigue- people lose their memory for their entire lives along with their sense of personal identity 3. Dissociative Identity Disorder (DID): involves coexistence in one person of two or more largely complete, and usually very different, personalities. “Multiple personality Disorder” - the divergences in behaviour go far beyond those that people normally display in adapting to different roles in life - “multiple personalities” feel that they have more than one identity  mistakeningly called schizophrenia Etiology: The causes of dissociative identity disorders are particularly obscure - some people believe that people with DID are engaging in intentional role-playing to use an exotic mental illness as a face-saving excuse for their personal feelings - these disorders may be rooted in emotional trauma that occurred during childhood MOOD DISORDERS Mood Disorders- marked by emotional disturbances of varied kin
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