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Chapter 14

Chapter 14 - Psychological Disorders.docx

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University of Toronto Mississauga
Dax Urbszat

Chapter 14 - Psychological Disorders The Medical Model Applies to Abnormal Behaviour  The medical model proposes that it is useful to think of abnormal behaviour as a disease. Viewing as disease helped people to be more sympathetic towards mentally ill and not yknow, put them in cages  Diagnosis involves distinguishing one illness from another  Etiology refers to the apparent causation and developmental history of an illness  Prognosis is a forecast about the probable course of an illness Criteria of Abnormal Behaviour 1. Deviance - when people violate the norms of society. Ex: transvestic fetishism - sexual disorder in which a man achieves sexual arousal by dressing in women's clothing 2. Maladaptive Behaviour - everyday adaptive behaviour is impaired. Ex: cocaine begins to interfere with a person's social or occupational functioning 3. Personal distress - individual's report of great personal distress  When only one criterion is met, people are viewed as disordered  Diagnosis involves value judgement of a person's view of what is normal  People are judged to have psychological disorder if behaviour is extreme Stereotypes of Psychological Disorders 1. Psychological disorders are incurable 2. People with psychological disorders are often violent 3. People with psychological disorders behave in bizarre ways and are very different from normal people o Study by David Rosenhan - health professionals may have difficulty distinguishing normality from abnormality Psychodiagnosis: The Classification of Disorders American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM)  Describe about 100 disorders  Revised in DSM-II  Diagnostic criteria were more explicit and detailed in DSM-III o Introduced a multiaxial system of classification (five axes) - Figure 14.3  DSM-IV used intervening research to refine criteria  3 x more in latest version (DSM-V) The Prevalence of Psychological Disorders Epidemiology - the study of the distribution of mental or physical disorders in a population Prevalence refers to the percentage of a population that exhibits a disorder during a specified time period Anxiety Disorders - a class of disorders marked by feelings of excessive apprehension and anxiety Generalized Anxiety Disorder - marked by chronic, high level of anxiety that is not tied to any specific threat (free-floating anxiety) Phobic Disorder - marked by a persistent and irrational fear of an object or situation that presents no realistic danger Panic Disorder - characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly Agoraphobia - a fear of going out to public places Obsessive-compulsive disorder (OCD) - marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) Posttraumatic stress disorder (PTSD) - involves enduring psychological disturbance attributed to the experience of a major traumatic event Etiology of Anxiety Disorders Biological Factors:  A concordance rate indicates the percentage of twin pairs or other pairs of relatives who exhibit the same disorder  There's a moderate genetic predisposition to anxiety disorders  Anxiety sensitivity make people vulnerable  Therapeutic drugs alter neurotransmitter activity at GABA synapses Conditioning and Learning:  Anxiety responses may be acquired through classical conditioning and maintained through operant conditioning  Seligman's concept of preparedness explain development of phobias  Updated notion of preparedness - evolved module for fear learning  Conditioned fears can be created though observational learning Cognitive Factors: People are more likely to suffer from problems with anxiety b/c they tend to: a. misinterpret harmless situations as threatening b. focus excessive attention on perceived threats c. selectively recall information that seems threatening Stress:  High stress helps precipitate the onset of anxiety disorders Somatoform Disorders - physical ailments that cannot be fully explained by organic conditions and are largely due to psychological factors Subtypes and Symptoms:  Somatization disorder - marked by a history of diverse physical complaints that appear to be psychological in origin  Conversion disorder is characterized by a significant loss of physical function (with no apparent organic basis), usually in a single organ system  Hypochondriasis/ hypochondria is characterized by excessive preoccupation with health concerns and incessant worry about developing physical illnesses Etiology of Somatoform Disorders Personality Factors: histrionic personality (self-centered, suggestible, excitable, highly emotional, and overly dramatic) & neuroticism Cognitive Factors: people 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 The Sick Role: becoming ill is a superb way to avoid having to confront life’s challenges  physical problems can provide a convenient excuse when people fail, or worry about failing, in endeavors that are critical to their self-esteem  Seek attention Dissociative disorders - are a class of disorders in which people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity Dissociative amnesia is a sudden loss of memory for important personal information that is too extensive to be due to normal forgetting In dissociative fugue, people lose their memory for their entire lives along with their sense of personal identity Dissociative identity disorder (DID) or multiple personality disorder involves the coexistence in one person of two or more largely complete, and usually very different, personalities o 1970s - dramatic increase in diagnosis Etiology of Dissociative Disorders  Due to stress Mood Disorders - a class of disorders marked by emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, social, and thought processes Major Depressive Disorder - people show persistent feelings of sadness and despair and a loss of interest in previous sources of pleasure Dysthymic disorder - consists of chronic depression that is insufficient in severity to justify diagnosis of a major depressive episode  Prevalence of depression is 2x higher in women than men (in childhood, it's the same)  Women tend to adapt a self-regulatory style and they are sensitive to discrepancies  They are more likely to experience greater stress and adversity and to ruminate about setback and problems Bipolar disorder (formerly known as manic depressive disorder) is characterized by the experience of one or more manic episodes as well as periods of depression. Cyclothymic disorder when they exhibit chronic but relatively mild symptoms of bipolar disturbance  Bipolar are less common than unipolar disorders  Bipolar is equal in men and women  25 (median age of onset)  Rapid-cycling pattern - people go through 4 or more manic or depressive episodes within a year Diversity in mood disorders Seasonal affective disorder (SAD) - a type of depression that follows a seasonal pattern for some people who experience either bipolar of major depressive episode  Most common = winter depression in Canada (especially Inuit in Canadian Arctic)  Onset is related to melatonin production and circadian rhythms  Treatment = phototherapy (person is exposed to therapeutic light for a couple of hrs a day with minimum side effect) Postpartum depression - a type of depression that sometimes occurs after childbirth  Symptoms include both depression and mania occur at a time of life when most women expect to be happiest and most excited after their children are born  Risk factors: immigrant women, new mothers & temperament of baby, previous episodes of depression, stress, adjustment problems, impairments in GABA receptors Mood Disorders and Suicide Suicide - one of the 3 leading causes of death of people b/w 15-34  Rate depends on age, gender, rural/urban residence  Ratio of suicide attempts and completed suicide - 20:1  Women attempt 3x more than men; but men complete 4x more suicide than women  Highest rate for people with mood disorder Preventing suicide: 1. Take suicidal talk seriously 2. Provide empathy and social support 3. Identify and clarify the crucial problem 4. Do not promise to keep someone's suicidal ideation secret 5. In an acute crisis, do not leave a suicidal person alone 6. Encourage professional consultation Etiology of Mood Disorders Genetic Vulnerability  Concordance rate for mood disorders in identical twins is higher than that for fraternal twins  Heredity can create predisposition to mood disorders Biological and neurochemical factors  Correlation of mood disorder and abnormal levels of norepinephrine and serotonin  Treatment affect availability of neurotransmitters in the brain  Correlation of depression and reduced hippocampal volume (hippocampus play a major role in memory consolidation)  Neurogenesis - generate new neurons in hippocampal formation  So suppression of neurogenesis is the central cause of depression  Treatment: antidepressant drugs that elevate serotonin levels (serotonin promotes neurogenesis) Dispositional Factors  Perfectionism is associated with depression, eating disorder, & problematic interpersonal relations  Three aspects: o Self-oriented perfectionism - set high standards for oneself o Other-oriented perfectionism - set high standards for others o Socially prescribed perfectionism - perceive that others are setting high standards for oneself  Personality-based models (by Beck) o Sociotropy - invested in interpersonal relations; over concerned w/ avoiding interpersonal problems; emphasize pleasing others o Autonomy - oriented toward own achievement and own independence 
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