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Boston University
Psychological & Brain Sciences
CAS PS 101
Barry Grant

PsychologicalDisorders Friday, November 30, 2012 9:04 AM What is normal?What is abnormal? In determining what is "normal" we think of "deviance" (deviation) Chronic, daily thoughts, impairs person's everydaylife/behavior (dysfunction/impaired/maladaptive),ultimately causes personal distress APA Code of Ethics • Principle A: Beneficence & Non-maleficence ○ Do no harm ○ Safeguard the welfare and rights ○ Guard against misuse of their influence • Principle B: Fidelity & Responsibility ○ Psychologistsestablish relationships of trust with those with whom they work ○ Psychologistsconsult with, refer to, or cooperatewith other professionalsand institutions ○ Responsibility:sense of obligation to give back without reward • Principle C: Integrity ○ Psychologistsseek to promote accuracy, honesty and truthfulness in the practice of psychology • Principle D: Justice ○ Psychologistsrecognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology • Principle E: Respect for People's Rights & Dignity ○ Psychologistsrespect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination ○ Psychologistsare aware of and respect cultural, individual and role differences, including…  Social economicstatus  Age  Race/ethnicity ---- basically everyoneis a unique case Abnormal Behavior Deviance,Personal Distress, and Maladaptive Behavior 50% of us will experience the symptomsof a disorder at some point in our lives 20% of people in the US, are diagnosed with some sufferable outcome Maladaptive Behavior=psychologicaldysfunction: cognitive,behavioral, and emotionalbreakdown Classifying • DWM-IV ○ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised ○ Detailed lists of observable behaviors that must be present for a diagnosis to be made- very inclusive • Clinical Description ○ Represents the unique combination of:  Behaviors  Thoughts  Feelings that make up a specific disorder ○ Presenting problem  Why the person came to the clinic… ...patient "presents" with a specific outcome ○ Prevalence  How many people in a population have the disorder?  How many people in a population have the disorder? ○ Incidence  How many 'new' cases occur in a specific time period? ○ Course:  Chronic Ex. The commoncold: acute onset,  Episodic time-limitedcourse  Time-limited ○ Onset: influenced by vulnerability factors and stressors/exacerbatingevents  Acute: occur suddenly  Insidious: over a long period of time ○ Prognosis Vulnerability factors Stressors •Genetic factors •Economicadversity --> Psychologicaldisorders •Biologicalcharacteristics •Environmentaltrauma •Psychologicaltraits •Interpersonal stresses or losses •Previouslearning history •Occupational setbacks or demands •Low social support Current vulnerability Currently experienced stress Developmental Psychopathology • Behavior and experiences in childhood relevant in adult disorders • Age-related variations in susceptibility • Psychiatric illnesses are medicalconditions influenced by multiple etiologicalfactors ○ Just as complex as our physical problems DSM Classificationof Disorders • Axis 1: clinical syndromes ○ Cognitive, mood, eating disorders, depression ○ Often first diagnosed in infancy, childhood, adolescence • Axis 2: personality disorders or mental retardation (mental disability) ○ Personality Traits  Enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts ○ Personality Disorder  Enduring patterns of: □ Inflexibility and pervasiveacross broad range of personal and social situations □ Leads to clinically significant distress or impairment □ Is stable and of long duration...onset adolescence/earlyadulthood  Can be clustered □ Cluster A: "odd" or "eccentric"  Paranoid □ Cluster B: "dramatic", "emotional",or "erratic"  Antisocial  Borderline  Histrionic  Narcissistic □ Cluster C: "anxious" or "fearful"  Avoidant  Dependent  Obsessive-compulsive  Prevalence of personality disorders ~1%-2% in the general population  Prevalence of personality disorders ~1%-2% in the general population  High comorbidity among personality disorders □ Ie. Narcissistic 35.9% likelihood of paranoid  Males have a higher prevalence than females • Axis 3: general medical conditions ○ Can be related to mental/psychologicaloutcome ○ Diseases that cover every organ system (11 different organ systems) • Axis 4: psychosocialand environmentalproblems ○ Problemswith primary social support (marriage, abuse situation, recent death in the family) ○ Social environment(live alone?) ○ Education, homelessness,profession/occupation,lack of healthcare • Axis 5: global assessment of functioning (GAF) scale ○ A physician's overall assessment of your functioning Paranoid • A pattern of distrust and suspiciousness such that others' motivesare interpreted as malevolent indicated by 4 or more of the following: ○ Suspects that others are exploiting, harming, or deceiving ○ Preoccupied with unjustified doubts about the loyalty or trustworthiness of friends  Why are you being nice to me? What does that mean? ○ Reluctant to confide in others  Sharing information to the point where the informationcould be used against you ○ Reads hidden demeaning/threateningmeanings into benign remarks/events  Complimentsare often misinterpreted ○ Persistentlybears grudges  Not willing to forgive insults ○ Perceivesattacks on their character or reputation  Counterattackand react ○ Recurrent suspicious regarding fidelity of spouse/partner  Suspicions are somewhatunjustified, gathering circumstantial evidence Antisocial • Patternof disregard for, and violationof, the rights of others indicated by 3 or more of the following: ○ Failure to conform to social norms  With respect to lawful behavior (destroying property, harassing others, stealing property)  Repeating acts that are grounds for arrest ○ Deceitfulness(lying, conning, aliases)  For personal profit or pleasure (to obtain money, sex, power, etc) ○ Impulsivity  Make decisions on the spur of the moment,little forethought ○ Irritability and aggressiveness  Indicated by the amount of physical fights and assaults ○ Reckless disregard for safety of self/others  Reckless driving (speeding, driving while intoxicated)  Engaging in risky sexual behavior, substance abuse  Lack of care for your child ○ Consistent irresponsibility  Failure to meet financial obligations, work/professionallife ○ Lack of remorse  Rationalizing
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