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Psych 1000 - Chapter 16 Notes.docx

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Psychology 1000
Terry Biggs

Chapter 16 Notes - There are several possibilities of measures that can be used to judge what is normal o The personal values of a given diagnostatician o The expectations of the culture in which a person currently lives o The expectations of a person’s culture of origin o General assumptions about human nature o Statistical deviation from the norm o Harmfulness, suffering, and impairment - Abnormal behavior – behavior that is personally distressing, personally dysfunctional, and/or so culturally deviant that other people just it to be inappropriate or maladaptive - Historical Perspectives o The demonological view – abnormal behavior is caused by supernatural forces o Early biological view – mental illnesses are diseases like physical illness that affect that brain o Emil Kraepelin – earliest known psychological laboratory  Tried to induce mild mental disorder in experimental setting using alcohol, fatigue and hunger  As subjects became more impaired or deprived there was an increase in responses to a word association task that bore little or no relationship to the stimulus words  Most important contribution was to try to classify mental disorders into a descriptive system  Based upon notion that If mental disorders could be as accurately diagnosed as physical ones then they could be cured as precisely  Two major categories of disorders  Manic-depressive psychosis o Periodic alterations of extreme nervous activity and deeply depressed moods  Dementia praecox o Subsumed many disorders on the basis of similarity of symptoms o Believed to be the result of organic brain damage, generally resulting in incurable insanity - Vulnerability-stress model – each of us has some degree of vulnerability for developing a psychological disorder, given sufficient distress o It can have a biological basis or stem from personality or environment factors - Psychoses – serious pathological conditions in which a person’s ability to relate to what most people accept as reality is badly impaired o Organic – senile dementia, Alzheimer’s or any disorder known to result from deterioration of brain tissue o Functional – those for which no organic cause can be isolated - Diagnosing Psychological Disorders o To be reliable a classification system must meet standards of  Reliability – clinicians using the system show high levels of agreement in their diagnostic decisions  Validity – the diagnostic categories should accurately capture the essential features of the various disorders o The DSM-IV-TR is the most widely used diagnostic classification system in North America  It has 5 dimensions called axes that take both the person and the life situation into account  Axis I – primary clinical symptoms  Axis II – personality or developmental disorders  Axis III – physical conditions  Axis IV – intensity of environmental stressors  Axis V – recent adaptive functionings  It is a categorical system  Criteria are so specifically labeled that often times people don’t fit neatly into the categories, and people may be completely different but receive the same diagnosis. Also, it doesn’t provide a way of capturing the severity of the disorder  An alternative is to use a dimensional system in which behaviors are related along a severity measure going form adaptive conscientious to severely disordered o Social and Personal Implications  The problem is that once a diagnostic label is attached to a person, it becomes too easy to accept the label as an accurate description of the person rather than of the behavior o Legal Consequences  Competency – a defendant’s state of mind at the time of a judicial hearing (not at the time of a crime)  Insanity – relates to the presumed state of mind of the defendant at the time the crime was committed o Sometimes when people read descriptions of disorders, they often see some of those symptoms or characteristics in themselves, but that does not necessarily mean that they have a disorder - Anxiety Disorders – when the frequency and intensity of anxiety responses are out of proportion to the situation that trigger them, and the anxiety interferes with daily life o Anxiety responses have 4 components  A subjective-emotional component including feelings of tension and apprehension  A cognitive component including subjective feelings of apprehension, a sense of impending danger, and an inability to cope  Physiological responses including increased heart rate and blood pressure, muscle tension, rapid breathing, etc.  Behavioral responses such as avoidance of certain situations and impaired task performance o Phobic Disorder  Phobias – strong and irrational dears of certain objects or situations  Agoraphobia – a fear of open an public places  Social phobias – excessive fear of situations in which a person might be evaluated and possibly embarrassed  Specific phobias – things such as dogs, snakes, spiders, water, etc.  Many social phobias evolve out of extreme shyness during childhood o Generalized Anxiety Disorder – a chronic state of diffused, or free- floating anxiety that is not attached to specific situations or objects o Panic Disorder – occurs suddenly and unpredictable and is much more intense  In most cases panic attacks occur out of the blue and in the absence of any identifiable stimulus  Formal diagnosis of a panic disorder requires recurrent attacks that do not seem tied to environmental stimuli, followed by psychological or behavioral problems o Obsessive-Compulsive Disorder – an anxiety disorder characterized by persistent and unwanted thoughts and compulsive behaviors  Usually have a cognitive and a behavioral component  Obsessions – repetitive and unwelcome thoughts, images, or impulses that invade consciousness, are often abhorrent to the person, and are very difficult to dismiss or control  Compulsions – repetitive behavioral responses that can be resisted only with great difficulty - Causal Factors in Anxiety Disorders o Biological factors  Genetic factors may create a vulnerability to anxiety disorders  This may be because of the autonomic nervous system which overreacts to a perceive threat, creating high levels of physiological arousal  Hereditary factors may cause over reactivity of neurotransmitter systems involved in emotional responses  Other evidence suggest that trauma-produced over activity in the emotional systems of the right hemisphere may produce vulnerability to PTSF  Some researchers believe that abnormally low levels of inhibitory GABA activity in the arousal areas may cause some people to have highly reactive nervous systems that quickly produce anxiety responses in response to stressors. These people may also become more susceptible to phobias  Biological preparedness makes It easier for us to learn to fear certain “primal” stimuli o Psychological Factors  Psychodynamic theories  Neurotic anxiety – when unacceptable impulses threaten to overwhelm the ego’s defenses and explode into action  How the ego’s defense mechanism deal with neurotic anxiety determines the form of the anxiety disorder  Obsessions and compulsions can also be a way of handling anxiety  Anxiety disorder symptoms are symbolic expressions of underlying conflicts  Cognitive factors  Stress the role of maladaptive though patterns and beliefs  There is a tendency to magnify the degree of threat and danger  In the case of panic disorder, sometimes people misinterpret normal anxiety systems in ways that can evoke panic  Anxiety as a learned response  Anxiety disorders result from emotional conditioning possibly because of a traumatic experience that produced a classically conditioned fear response  Phobias can also be acquired through observational learning  Biological disposition and cognitive factors help to determine whether a person develops a phobia by observing a traumatic event  Once anxiety is learned, it may be triggered either by cues from the environment or by internal cues  Behaviors that are successful in reducing anxiety, such as compulsions or phobic avoidance responses, are strengthened through a process of negative reinforcement o Sociocultural Factors  Culture-bound disorders – behavior disorders whose specific forms are restricted to one particular cultural context - Eating Disorders o Can be considered as a culture-bound disorder o Anorexia nervosa – an intense fear of being fat and severely restricting food intake to the point of self-starvations  Anorexia causes menstruation to stop, strains the hear, produces bone loss, and increases the risk of death o Bulimia nervosa – overly concerned with becoming aft, but instead of self-starvation they binge eat and then purge the food, usually by inducing vomiting or using laxatives  This can cause severe gastric problems, and badly eroded teeth o Causes of anorexia and bulimia  A combination of biological, environment and psychological factors  More common in industrialized cultures in which beauty is equated with thinness  A cultural emphasis on viewing one’s body as an object contributes to eating disorders  Personality may also be a contributing factor, anorexics are often perfectionists  Bulimics tend to be depressed and anxious, exhibit low impulse control, and seem to lack a stable sense of personal identity and self-sufficiency  Genetic factors may create a predisposition toward eating disorders  May be cause by abnormal serotonin and other body chemical levels  Physiological changes initially are a response to abnormal eating but they can perpetuate eating and digestive irregularities - Mood (Affective) Disorders – emotion-based disorders that involve depression and mania (excessive excitement) o Most frequently exhibited psychological disorders o Depression  Clinical depression – the frequency, intensity, and duration of depressive symptoms are out of proportion to the person’s life situation  Major depression – leaves a person unable to function effectively in their lives  Dysthymia – a less intense form of depression that has less dramatic effects on personal and occupational functioning but it is a more chronic and long-lasting form of misery  There are four types of symptoms of depression  Emotional symptoms including sadness, hopelessness, anxiety, misery, and inability to enjoy  Cognitive symptoms including negative cognitions about self, world, and future  Motivational symptoms including loss of interest and drive and difficulty starting anything  Somatic (physical) symptoms including loss of appetite and energy, sleep difficulties and weight changes  The negative mood state is the core feature of depression o Bipolar Disorder – depression alternates with periods of mania in recurrent cycles, a state of highly excited mood and behavior that is quite the opposite of depression  Manic people can become very irritable or aggressive when their momentary goals are frustrated in any way  In a manic state speech is often rapid or pressured  The manic phase is approximately 3 months while the depressive phase is up to 9 months long o Prevalence and Course of Mood Disorders  The odds of having depression at one point in your life is 1 in 5  Depression is on the rise in young groups  The prevalence of depressive disorders is similar among socioeconomic and ethnic groups but women are twice as likely to suffer unipolar depression than men. This may be because of genetic factors, biochemical differences in the nervous system, or the monthly premenstrual depression that many women experience could increase vulnerability to depressive disorders  Depression usually dissipates with time - Causal Factors in Mood Disorders o Biological Factors  Both genetic and neurochemical factors have been linked to depression  It is likely that there is an inherited predisposition to develop a depressive disorder, five certain kinds of environmental factors such as significant losses and low social support  Two genetically based temperament systems: neuroticism and extraversion are heavily involved in the development of mood disorders  One influential hoy holds that depression is a disorder of motivation cause by under activity in a family of neurotransmitters that include norepinephrine, dopamine, and serotonin which play an important role in rewards and pleasure  Bipolar disorder seems to have a stronger genetic basis than unipolar depression o Psychological Factors  Personality-based vulnerability  Psychoanalysts believe that early traumatic losses or rejections create vulnerability for later depression by triggering a grieving and rage process that becomes part of the person’s personality  Subsequent losses and rejection reactivate the original loss and cause a reaction not only to the current event, but also to the unresolved loss from the past  In the “me” generation because people define their self- worth in terms of individual attainment and have lesser commitment to traditional values of family, religion, and the common good, they are likely to react much more strong to failure, to view negative events as reflecting their own inadequacies and to experience a sense of meaninglessness  Cognitive processes  Depressive cognitive triad – negative thoughts concerning the world, oneself, and the future that people with depression can’t control or suppress  Depressive attributional pattern – taking no credit for success but blaming oneself for failures and this maintains depressed people’s low self-esteem and their belief that they are worthless failures  Low self-esteem is a significant risk factor for later depression  Learned helplessness theory – holds that depression occurs when people expect that bad events will occur and that there is nothing they can do to prevent or cope with them. It also holds that chronic and intense depression occurs as the result of negative attributions of failure that are personal, stable, and global  Learning and Environmental Factors  Depression is usually triggered by a loss, some other punishing event, or by a drastic decrease in the amount of positive reinforcement that the person receives from his or her environment  As the depression takes over, people stop doing the behaviors that previously gave them reinforcement  Depressed people tend to generate additional negative life events through their negative moods, pessimism and reduced functioning  They also tend to make those who come into contact with them feel anxious, depressed, and hostile o Sociocultural Factors  The prevalence, symptom pattern and causes of depression vary across cultures - 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 o Hypochondriasis – when people become unduly alarmed about any physical symptom they detected and are convinced that they have or are about to have a serious illness o Pain disorder – people who experience intense pain that either is out of proportion to whatever medical condition they have or for which no physical basis can be found o Somatoform disorders differ from psychophysiological disorders in which psychological factors cause or contribute to a real medical condition such as an ulcer or asthma o Conversion disorder – serious neurological symptoms, such as paralysis, loss of sensation or blindness suddenly occurs, even though sensory and motor pathways are intact  People with conversion disorder often exhibit la belle indifference, or indifference about their symptom and its implications  Conversion disorders are relatively rare, but occur more frequently under wartime conditions o A predisposition to somatoform disorders may involve a combination of biological and psychological vulnerabilities o Somatoform disorders tend to run in the family - Dissociative Disorders – involve a breakdown of normal integration of the many facets of self, resulting in significant alterations in memory or identity o Psychogenic amnesia – a person responds to a stressful event with extensive but selective memory loss o Psychogenic fugue – a person loses all sense of personal identity, gives up his or her customary life, wanders to a new location, and establishes a new identity. The fugue is caused by a highly stressful event or trauma o Dissociative Identity Disorder (DID) – two or more separate personalities coexist in the same person. A primary or host personality appears more often than the alters but each personality has its own integrated set of memories and behaviors. There can be dramatic differences between personalities o What causes dissociative identity disorder  Putnam’s trauma-dissociation theory says that the development of new personalities occurs in response to severe stress that often began in early childhood. People create an alternate identity to detach themselves from the trauma, to transfer what is happening to someone else who can handle it, and to blunt the pain  Some people suggest that multiple personalities result from role immersion and therapist suggestion - Schizophrenia – a psychotic disorder that involves sever disturbances in thinking, speech, perception, emotion, and behavior o Characteristics of schizophrenia  Delusions – false beliefs that are sustained in the f
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