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Chapter 14

PSYC 100 Ch. 14 Textbook Notes.docx

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PSYC 100
Samuel Reed

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CHAPTER 14: PSYCHOLOGICAL DISORDER A) ABNORMAL BEHAVIOR: MYTHS, REALITIES AND CONTROVERSIES A.1) The Medical Model Applied to Abnormal Behavior - Medical model: proposed to think abnormal behavior as a disease > similar terms: mental illness, psychological disorder, psychopathology th - Before 18 century > conceptions of abnormal behavior is based on superstition (possessed by demons, witches in league with the devil, God’s punishment) > treatment: chants, ritual, exorcisms > if the behavior is threatening: chains, dungeons, tortures and death So, where does the insane asylum fits? - being labelled as psychotic, schizophrenic, mentally ill carry a social stigma > patients are usually viewed as erratic, dangerous, incompetent, inferior Medical concepts: - diagnosis: distinguishing one illness from another - etiology: causation and developmental history of an illness - prognosis: forecast about the probable cause of an illness A.2) Criteria of Abnormal Behavior (3) -Criteria for the basis of diagnosis: 1) Deviance: behavior deviates from what society consider as acceptable 2) Maladaptive behavior: everyday adaptive behavior is impaired 3) Personal distress: criteria met by people who are troubled by depression anxiety disorder when they start telling friends, family - Normality and abnormality exist on a continuum > abnormality only applies to people with severe symptoms A.3) Stereotypes of Psychological Disorders 1) Psychological disorders are incurable > through treatment, they are cured 2) People with psychological disorders are often violent and dangerous > incidents involving the violence of mentally ill tend to command attention from the media 3) People with psychological disorders behave in bizarre ways and are very different from normal people > only true to small minority > even health professionals may have difficulty distinguishing normality from abnormality A.3) Psychodiagnosis: The Classification of Disorders Overview of Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic system - Diagnosis of disorders: Axis I,II > axis II: list long-running personality disorders or intellectual disability - remaining axis is used to record supplemental information - Axis III (General Medical Conditions) : records patients’ psychological disorder - Axis IV (Psychosocial and Environmental Problem): notations are made regarding the types of stress experienced in the previous year - Axis V (Global Assessment of Functioning): estimates are made of the individual’s current level of adaptive functioning and of the individuals’ highest level of functioning - comorbidity: the existence of 2 or more disorders A.4) The Prevalence of Psychological Disorders - Epidemiology: distribution of physical and mental disorders in a population -Prevalence: percentage of population that exhibits a disorder during a specified time period B) ANXIETY DISORDERS (5) - marked by feelings excessive apprehension and anxiety - 5 types: generalized anxiety disorder, phobic disorder, panic disorder and agrophobia, obsessive-compulsive disorder and post-traumatic stress disorder B.1) Generalized Anxiety Disorder - chronic high-level of anxiety that is not tied to any specific threat (free-floating anxiety) - accompanied by: physical symptoms such as trembling, muscle tension, diarrhea, dizziness, faintness, sweating and heart palpitations. B.2) Phobic Disorder (Phobia) - persistent irrational fear of an object or situation that presents no realistic danger - people are said to have a phobic disorder only when their fears seriously interfere with their everyday behavior > reactions accompanied by: physical symptoms of anxiety such as trembling and palpitation - people troubled by phobia generally realize that their fear is irrational but they still unable to calm themselves when encounter with a phobic object B.3) Panic Disorder and Agoraphobia - recurring attack of overwhelming anxiety that occurs suddenly and unexpectedly - which leads to agoraphobia: fear of going out to public places B.4) Obsessive-Compulsion Disorder (OCD) - Obsession: thoughts that repetitively intrude one’s consciousness in a distressing way - Compulsive: action that one feels forced to carry out (ritual) - OCD: persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsion). > patients may feel that they have lost their mind > they commit in stereotyped rituals that temporarily relieve anxiety - 4 factors underlying the symptom: 1)obsessions and checking, 2) symmetry and order, 3)cleanliness and 4) washing and hoarding < can use this to identify people with OCD B.5) Post Traumatic Stress Disorder (PTSD) - occurs after the aftermath of an incident or incidents that involve a very big impact - prevalent in the society more than anticipated and higher among women - Symptoms: re-experiencing the traumatic event in the form of nightmares and flashbacks, emotional numbing, alienation, problems in social relationships, an increased sense of vulnerability and elevated levels of arousal anxiety, anxiety, anger and guilt. B.6) Etiology of Anxiety Disorders (4) B.6.1) Biological Factors - concordance rate: percentage of twin pairs or other pairs or relatives who exhibit the same disorder - there’s a moderate genetic predisposition - anxiety sensitivity may make people vulnerable to anxiety disorders - link between anxiety disorders and neurochemical activity in the brain > therapeutic drugs reduce excessive anxiety appear to alter neurotransmitter activity at GABA synapses > disturbances in the neural circuits using GABA may play a role in some types of anxiety disorders B.6.2) Conditioning and Learning - Martin Seligman’s concept of preparedness: people are biologically prepared by their evolutionary history to acquire some fears much more easily than others - phobic fears can be acquired indirectly by observing another’s fear response to a specific stimulus or by absorbing fear-inducing information B.6.3) Cognitive Factors - certain styles of thinking make some people particularly vulnerable to anxiety disorders - tendency to be vulnerable to anxiety disorder is due to: > misinterpret harmless situations as threatening > focus excessive attention on perceived threats > selectively recall information that seems threatening B.6.4) Stress - evidence that before the onset disorder, patients tend to feel stress C) DISSOCIATIVE DISORDERS - people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity C.1) Dissociative Amnesia and Fugue - overlapping disorders characterized by serious memory deficits - dissociative amnesia: sudden loss of memory for important personal information that is too extensive to be due to normal forgetting - dissociative fugue: lose memory for their entire lives along with their sense of personal identity > forget family, where they work, where they live but remember to do things like solving math problem C.2) Dissociative Identity Disorder (DID) / Multiple Personality Disorder - co-existence in one person of 2 or more largely complete and usually very different personalities > various personalities are often unaware of each other and seen more in women than men C.3) Etiology of DID - excessive stress and rooted in severe emotional trauma that occurred during childhood - however, very little is known about the cause of the disorder D) MOOD DISORDERS - disorder is debilitating but it doesn’t much of adaptive behavior as it tends to be episodic - Mood disorders: a loss of disorders marked by emotional disturbances of varied kinds that may spill over to disrupt (1) physical, (2) perceptual, (3) social and (4) thought processes - Unipolar disorder: emotional experience is just at one end of the mood continuum - Bipolar disorder : vulnerable to both ends going through the period of mania (excitement and elation) and depression D.1) Major Depressive Disorder (Unipolar disorder) - patients exhibit persistent feeling of sadness and become disinterest in the previous source of pleasure > anhedonia: a diminished ability to experience pleasure > the earlier one experiences depression the greater is the impairment on social and occupational functioning Types of diagnosis: 1) dysthymic disorder: mild symptoms. Chronic depression that is insufficient to justify diagnosis of a major depressive episode (chronic, but not enough to be diagnosed as major depressive episode) - self-discrepancies: can contribute to an individual’s negative self-evaluation and suicidal ideation D.2) Bipolar Disorder (Manic Depressive Disorder) - experience one or more manic episodes as well as periods of depression Type of diagnosis: 1) cyclothymic disorder: exhibit chronic but relatively mild symptoms of bipolar disturbance - bipolar patients end up spending more time in depressed states than maniac states D.3) Diversity in Mood Disorder (Major Depressive Disorder vs Bipolar Disorder) - 2 examples of subcategories: 1) Seasonal affective disorder (SAD): follows a seasonal pattern > winter depression > related to melatonin production and circadian-rhythm , so, patients are exposed to therapeutic light 2) Post-partum depression: occurs after childbirth  can include both manic and depression  temperament of the baby influences the depression experienced by the new mom  may be affected by the impairment in GABA D.4) Mood Disorders and Suicide - women attempt to commit suicide 3 times more often than men, but men are more likely to die D.5) Etiology of Mood Disorders (8) D.5.1) Genetic Vulnerability - twin studies suggest that genetic factors are involved and this is more intense for bipolar disorder compared to unipolar disorder - heredity can create predisposition to mood disorders D.5.2) Biological and Neurochemical Factors (2) 1) Mood and neurotransmitter - discovered link between mood disorders and abnormal levels of 2 neurotransmitters in the brain: norepinephrine and serotonin - effective drug treatment: affect the amount of neurotransmitter and seem to affect mood 2) Mood and structural abnormalities in the brain - depression and reduced hippocampal volume - hippocampus plays a major role in memory consolidation (smaller in depressed patient) > depression occurs when major life stress cause neurochemical reactions that suppress neurogenesis, resulting in reduced hippocampal formation > antidepressant drugs that elevate serotonin levels relieve depression because serotonin promotes neurogenesis D.5.3) Hormonal Factors - hypothalamus > pituitary gland to the adrenal cortex (releases corticosteroid hormones) > known as hypothalamus-pituitary-adrenocortical (HPA) axis > depressed patients tend to show elevated level of cortisol (stress hormone) D.5.4) Dispositional Factors - perfectionism is associated with depression - development of multidimensional perfectionism that assess 3 aspects of perfectionism 1) self-oriented perfectionism: tendency to set high standard to oneself 2) other-oriented perfectionism: setting high standard for others 3) socially prescribed perfectionism: tendency to perceive that others are setting high standard for oneself - Top 10 Sign You’re a Perfectionist: 1) cant stop thinking about a mistake you made 5) wont ask for help if it is perceived as a flaw or weakness 10) noticed the error in the title - 2 other personality-based models a) sociotropy: individuals invested in interpersonal relationships; concerned with avoiding conflicts and try to please others b) autonomy: oriented toward their independence and achievement D.5.5) Cognitive Factors 1) negative cognitive triad - tendency to have –ve views of: 1) themselves, 2) the world, 3) their future 2) Martin Seligman’s learned helplessness model of depression > most recent: hopelessness theory - asserts that depression is due to learned helplessness (passive giving up) - people who exhibit pessimistic explanatory style are vulnerable to depression - those who keep on ruminating about their depression remain depressed longer than those who try to distract themselves - -ve thinking leads to depression D.5.6) Interpersonal Roots - lack of social interaction - depressed people have fewer sources of social support than nondepressed people D.5.7) Sports Concussions and Depression - concussions can cause depression. Features of post-concussion syndrome > reduced activation in the dorsolateral prefrontal cortex and striatum and attenuated deactivation in medial frontal and temporal regions D.5.8) Precipitating Stress - people vary in their degree of vulnerability to mood disorders E) SCHIZOPHRENIC DISORDERS (disturbed thought) - coined by Eugen Bleuler : fragmentation of the thought process seen in the disorder > means split mind - Schizophrenia: disorders classified by 1) delusion, 2) hallucination, 3) disorganized speech and 4) deterioration of adaptive behavior (remember John Nash) - the difference > disturbed thought: lies at the core of schizophrenic disorder > disturbed emotion: lies at the core of mood disorders - schizophrenia is a costly illness as it requires a lengthy hospital care E.1) General Symptoms - the thinking can be bizarre and it can be a severe disorder E.1.1) Delusions and Irrational Thought - Disturbed and irrational thought processes are the key to schizo - Delusion: false beliefs that are maintained everyday eventhough they are clearly not in touched with everyday context > Delusion grandeur: p
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