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Chapter 4

Hisotrical Perspective on Deviant Behaviour Chapter 4

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University of Guelph - Humber
John Irwin

Hisotrical Perspective on Deviant Behaviour:  Ancient Chinese, Egypt, and Hewbrews all attributed deviance to the devil o Trephemination; used to release evil spirits from the body by chiseeling a hole in the skull; ended the abnormal behaviour through death  Medival Europe; disturbed people possessed by the devil; o Killingo f witches was justified; by throwing them in lakes to see if they float;  Greek; Hippcrates; metnal illnesses were disase just lik physical disorders; o Mental illnesss is in the brain;  Freud; psychoanalysis ushered in psychological interpretations of disordered behaviour  Vulnerability stress model; diathesis stress model; each of us has some degree of vuleerability for developing a psychological disorder given sufficient stress o Vulnerability or predisposition can be a biologoical basis such as our genotype over or under activity of neurotrasnmitter system in the brain o Hair trigger autonomic nervous system o Hormonal factor, it could be due to personality factor, low esteem, extreme pessimism  Envrionmental factors; poverty traumua, loss earlier in life o Culutral factors can create vulnerability to certain kinds of disorders  Vulnerability is part of the equation;  Predisodition creaste disorder only when a stressor or some recent or current event that requires person to cope ; combined the vulnerability to trigger the disorder  Person who lost both is parents, or a traumatic loss or genetic disposition has primeed to develop depressive disorde DSM 4; Diagnostic Categoires; 1. Anxiety disorder; itnense fequent or inappropriate anxiety no loss of reality contract, includs phobias, genrealized anxiety disorders,panic disorder, obsessive compulsive disorder PTSD 2. Mood disorders; marked disturbances of mood including depression and mania (extreme elation and excitement) 3. Somatofom disorders; physical symptos such as blindess, a paralysis, or pain that have no physical basis and are assumed to be caused psychological factors; also excessive peroccupations and worry about healht is called hyocondriasise 4. Dissociative disorders; psychological caused problems of consciiousness and self identification including amensia, and multiple personalities; dissociative identity disorders 5. Schizophrenic; and other psychotic disorders; severe disorders of thinking, perception and emotions that involve loss of contact with reality and disordered behaviour 6. Substance abuse disorders; personal and social problems associated with the use of psychoactive substances such as alcohol, heroin, and or other drugs 7. Sexual and gender identity disorders; 8. Inability to function sexually or enjoy sexuality (sexual dysfunctions) deviant sexual behaviours such as molestation and arousal by inappropriate objects a. Strong discomfort with ones gender accompanies by desire to be a member of the other sex 9. Eating disorders; include anorexia nervosa, self starvation, bulimia nervous; binging and purging, 10. Personality disorders; rigid, stable, maladaptive personality patterns such as antisocial, dependent, paranoid, narcissistic disorders Diagnosing Psychological Disorders:  Classification system has to meet standards of validity and realitbility  Reliability means the clincians use the system should high levels of agreement in their dianostic decisions,  Validity; diagnostic categories should accurately capture the essential features of various disorders  DSM 4;TR contains list of observable behaviours that must be presnt in order for a diagnosis to be made; o Allows diagnoistic information mto be rperesented along 5 dimensions; that take both the person and his or her situation in account;  Axis 1; primary diagnosis, represent the persons primay clinical symptoms,  2; reflects long standing personality or development disorders usch as ingrained inflexible aspects of personality that could influence the persons behaviour and response to treatmnet  3 note any physical condition that might be relevant such as high blood pressure  4; intensity of environmental stressors in the persons recent life a  5; coping abilitiys as reflected in recent adaptive functioning DSM5; intergrating categorical and dimensional approaches  Current classification system is categorical system, in which people are placed within specific diagnostic categories;  Criteria's are so specific and detailed athat many people 50 do not fit neatly into the categories;  People with the same diagnosis may share only certain symptoms but look very different  Categorical system does not provide way of capturing the severity of the persons disorder, nor can it capture sptoms that are adaptively important but not sever emough to meet the behavioural criteria for the disorders Dimensional system; beahviours are reated along a severity measure;  Based on assumption that psychological disorders difffer in degree rather than kind from normal personality functioning  Comorbidityhat exists among current diagnostic categories such as anxiety and depression reflect variation in the same underlying factors such as activity in the behavioural inhibition system or the personality trait of neuroticism Personality Triat Dimensions of the DSM Five - Negative Emotionality o Distress anxiety depression - Schizotypu o Odd unusual thinking - Disinhibition o Impulsivity, iressponsibility acting out • HIGH SCORE OF ALL THREE = Borderline type personality disorder - Introvesion o Social withdrawal, intimacy avoidance - Antogism; o Callousness, manipulation, hostility, aggression - Compulsivity o Perfectionism, rigidity  Antogism and Disinhibition High= antisocial and psychopathic type Critical Issues in Diadnostic Labelling; Social and Personal Implications  Diagnostic label attached to a personal becomes easy to accept the label as accurate decription of the individual rather than the behaviour o Difficult to look at the person's behaviour objectively, without preconcpetions about how they will act Legal Consequences:  Individuals judged to be dangerous themselves or others may involuntary be committed to metnal insitutions under certain circumstance; o When commited they lose fundamental rights, nmay be detained indefinitely if their behaviour does not improve  Law; mental status of individuals during crimes; o Compency; refers to defendants state of mind at the time of judicial hearing not when the time the crime was committed  Not competent to stand trial and institutionalized until judged competent o Insanity; presumed state of mind during the crime;  No gulity by reason of insabity; severly impaired during crime they lacked the capacity to appreciate the wrongfulness or to control their conduct  Not criminal responsibible; Anxiety Disroders:  The state of tension and apprehension that is a natural response to perceived threat  Anxiety disorders; the frequency and intensity of anxiety responses are out of proportion the situations that rigger them, and anxiety intereferes with daily life  Anxiety response has 4 comps; o Subjective emotional; including feelings of tension and apprehension o Cognitive ; subjective feelings of apprehension, sense of impending danger and a feeling of inability to cope o Physiological responses; increased heart rate, blood pressure, rapid breathing, nausea, dy mouth, diarrhea, fequennt urination o Behaviour responses; avoidance of certain situations and impaired task performance  Prevalence refers to the number of people who have disorder during a specified period of time o Anxiety disorders are most prevalent; North America; 18.6 percent of population  More frequent in females than men • 70 percent of cases; it interfere with life functions and or cause the person to seek medical psychological treatment Phobic Disorder:  Strong irrational fears of certain objects or sitautions,  Phobos; Freek god of ear;  Fears of less realistic but no less intense nature  People with phobias realize that their fears are out of prportion to the danger invovled but feel helpless to deal with these fears o Strenous effort to avoid the phobic situations or object  Agoraphobia; fear of open public places,  Social phobias; excessive fear of situations in which the person might be evaluate d and possibly embarrassed  Specific phobias; animals, water, spaces, water injections height  Can develop at any time in life, but most develop during childhod, adolescene and early adulthood; o Many phobias come from shyness during childhood o Once phobias develop they go away or they may broaden and intensify over time  Impairment is depedent on how often phobic stimulus is encountered in the individuals normal round of activity Generalized Anxiety Disorder;  Chronic state of diffuse, free floating anxiety that is not attached toe specific situations or objects; o Hard to concentrate, make decisions and rember commitmentsxiety might lst for month, on the end with the signs most contiously present o Onset tends to occur in childhood and adolescence Panic Disorder; - Occu suddently and unpredictabliy and they are much more intesne; - Symptoms are terrifying; not unusual for vvictims to feel like they are drying - Panic attack usually occur out of the blue, in absence of any indetnifable stimulus - Formal diagnosis requries recurrent attacks that do not seem tied to the environment - Panic disorder diagnosed unless they developed an inordniate fear of having future attacks OCD: 2 consists of two components;Cognitive and Behavioural ; either can occur alone  Obessions ar e repetitive and unwlecome thouhgts , images or impulses that invade consciousness are often abhorrent to the personon and difficult to dismiss or control  Compulsions; repetitive behavioural response as the women gleaningrituals o Reponse to obsessive thoughts and functon to reduce anxiety the those thoughts  Behavioural compulsions are difficult to control; invovle checking thinkgs repeatedly, cleaning, repeating task endlessly  ,if person does the perform the act= temendous anxiety, perhaps an panic atach  Phobic avoidance reponses = compulsion appear to reduce anxiety to be strenghted from a porcess of negative reinformenet because they allow a persono to avoid anxiety Casual Factors in Anxiety Disorders:  Biological factors; o Genetics factor may create bulernability to anxeity disorders; o Identical twices have concordance rate of about 40 % for anxiety disorders, compared with 4% with fraternal Psychological Factors Psychodynamic Theories:  Anixety is a central feature of psychoanaltic conception of abnormal behaviour;  Freud; neurotic anxiety occur when unaccpetable impulses threaten to overwhelm the ego's defenses and explode into action o Freud; phobic disorders, neurotic anxiety is displaced onto some external stimulus that has symbolic significance in relation to the underlying conflict  Obessesion and compulses ways of handling anxiety; obession is symbolically related but less terrifying than the underlying impulse;  Compulsion is a way of taking back or undoing ones unaccaptable urges when  Generalized anxiety and panic attacks arre thought to occur when ones defence are not strong enough to control ofr contain anxiety but strong enough to hidge the underlying conflict Cognitive Factors:  Role of malaadpatovive thought patterns and belief in anxiety disorders,  Anxiety disordered people catasrophize about demands and magnify them into threats  They anticipate that the worst will happen and feel powerless to cope ffectively  Attentional Process are sensitive to threatening stimuli; o Intrusive thoughts about previous traumatic events are cnetral feature of PTSD an dthe presence of Mood Disorders:  Another set of emotional based disorders are mood disorders; invovle depression and mania; o Together with anxiety disorders mood disorders are the most fequently experience psychological disorders  Anxiety and mood disorders have high comorbidity; co occurrence o Half of depressed people feel an anxiety disorder; Depression:  Clinical depression; the frequency, intensity and duration of depressive sy,ptoms are out of proportion to the person's life situation o Some people may responde to minor set back or loss with an intense major dperesison that leaves them unsable to function effectievely o `16.6 of Americans during their life, and 10 for Can over 18 from major dperession in their lifetimes  Less ofrm of depression called dysthemia; less dramatic effects on personal and occupational functioninig o More chronic and long lasting form of misery, occuring for years on end with intervals or normal mood that never last more than few weeks or months  Depression is a disorder of mood, there are three other types of symtoms; cognitive, motivational, and somatic  Negative mood state; is core feature of depression; reported feelings of sadness, misery, loneliness o Anxiety disorder; allowed people to retain their capacity to experinece pleasure, depressed people lose it; activites that use to bring happiness nad saitisfaction feel dull and flat;, sex eating lose their appeal  Cognitive symptonss; central part of depression; o Difficulties concentrating, making decisions, usually have lowe self esteem, believe they are inferior, inadequate, incompetent, o Expect failure to occur, and that it will be caused by their own indaequancies o View the future with great pessimism and hopelessness  Motivational Symptoms; inability to get started, perform behaviours that might produce pleasure and accomplishment; o In extreme depressive reaction, person may have prodded out of bed, clothed, fed o Sever depressions movements slow down and the person walks or talks slowly and with excruciating effort  Somatic; loss of appetitie, weightloss in moderate and sever depression o Sleep disturbances, insomnia, weightloss, and sleep disturbance = fatigue and weakness, whicch tend to add to the depressed feelings o Lose sexual desires, responsive nes o Weight gain in mild dperession; as a person eat compulsively Bipolar:  Depression = unipolar disorder  Bipolar; depression (dominant state) alternates with periods of mania; state of highly excited mood and behaviour that is quite the opposite of depression  Manic; mood is euphoric and congitions are grandiose o No limits to what a person can accomplish and does not recongize the ngetiave consequences that may ensue if grandiose plans are acted on o Motivational level; behaviour is hyperactive o Manic person engaged in frentic activity, o Manic people become very irritable and aggressive when their momentary goals are frustrated in anway o Manic state; sppech is rapid, pressured as if person must say as many words as possible in the time alloted; with all this activity comes greatly lessened need for sleep  People go days without sleeping, until exhaustions which sets in and mania slows down Prevalence and Course of Mood Disorders:  1/20 in Na are severly depressed;  Chance of having depressive episode of clinical proportions at least once in your life is 1/5  No age group is exempt from depression; appears in infants as young as 6 months, who have been separated from their mothers for long times,  Depresive symtpoms in chilldren and adolescen is high as the adult rate  Increase for 15-19 year old, and people born after 1960 more likely than their grandparents  Prevalence: depressive disorders is simmiliar across socioeconomic and ethnic groups; major different in our culture for sexes  Women twice as likely as men to suffer unipolar depression, o Womens first depressive episode = 20, mens = 40  Biochemical differents in nervous system or the monthly premenstrual dperssion that many women experience increase vulnerability to depressive disorder  Environment; sex role expectations for females in western cultures is to passive and dependent ni the face of stress or loss, focus on their feelings, where men are to dsitract them selfs  Depression disipates with time; lasts 5-10 months untreated  Once depressive episode has occurred; 3 possible patterns o Half of all causes= depression will never recur o 2nd pattern; recovery with recurrence  Usually people remain three years befroe another episodes • The time intervals after is subsequently shorter over the years  10% with major depressive episode will not recover; remain chronically depressed  Manic less common than depressive reactions are far more likely to recur o Less than 1% experience mania, those who do it reoccurs Casual Factors in Mood Disorders:  Biological Factors; o Depression by brain chemistry; underactivity in family of neurotransmiter that are invovled in with pleasure, reward, and when neural transmission decrease in these regions = lack of pleasure and motivaiton that characterize depression  Bipolar; stronger genetic basis than does unipolar depression o 50% of patients with B.D; have ap arent , child, grandparent with the disorder  5 times higher for identical twins vs fraternal twins  Manic= overproduction of neurotransmitters; that ater underactive in depression Pyschological Factors: Personality Based VUlernability o Freud; Karl Abraham; traumaitc lossess or rejections create vulnerability for later depression by triggering a grieving nad rage process that becomes part of the individuals personality  Subsequent loss and rejection can reactivate the original loss and cause a reaction  George Brown and Terril Harris; loss of parent at young age = depression in futrue  Humanistic o Martin Seligman; Depression cause; after 1960;  Focus on personal acontrol, and individuality = seed of depression  People defein their self worth in terms of individiau
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