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Chapter 14

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Feb/19/2004, Thursday CHANAPS Notes From Reading C HAPTER 14: PSYCHOLOGICAL DISORDERS I. Abnormal Behavior: Myths, Realities, and Controversies A. The Medical Model Applied to Abnormal Behavior 1. Medical Model – proposes that it is useful to think of abnormal behavior as a disease. 2. Szasz – Abnormal Behavior involves a deviation from social norms rather than an illness. i.e. “problems of living” and not “medical problems”. 3. Diagnosis – distinguishing one illness from another 4. Etiology – apparent causation and developmental history of an illness. 5. Prognosis – forecast of probable course of an illness. B. Criteria of Abnormal Behavior 1. Deviance – people are said to have a disorder if their behavior deviates from what society considers acceptable (norms). 2. Maladaptive Behavior – people may be judged to have a disorder of their everyday adaptive behavior is impaired i.e. substance abuse disorders. 3. Personal Distress – i.e. Depression/anxiety 4. Evolutionary Dysfunctions – a dysfunction occurs when an evolved psychological mechanism does not perform its naturally selected function adequately or effectively. C. Stereotypes of Psychological Disorders 1. Psych Disorders are incurable 2. People with Psych disorders are often violent and dangerous. 3. People with psych. disorders behave in bizarre ways and are very different from normal people. D. Psycho-Diagnosis: The Classification of Disorders 1. DSM scale used to diagnose disorders. 2. Axis I (Clinical Syndromes) and Axis II (Personality Disorders and Mental Retardation) used to make diagnosis of condition. 3. Axis III (General Medical Conditions), Axis IV (Psychosocial & Environmental Problems) & Axis V (GAF Scale) – used to record supplemental info. a. Axis V – current level of adaptive functioning. E. Prevalence of Psych Disorders 1. Epidemiology – study of distribution of mental/physical disorders in a population. 2. Prevalence – the percentage of a population that exhibits a disorder during a specific time period. a. Lifetime prevalence – the percentage of people who endure a specific disorder at any time in their lives. 3. 1/3 of population suffers from a psych disorder. Most commonly: anxiety, substance use, and mood disorders. II. Anxiety Disorders A. Introduction 1. Anxiety Disorder – class of disorders marked by feelings of excessive apprehension and anxiety. 4 types – generalized anxiety disorder, phobic, obsessive compulsive, and panic. Feb/19/2004, Thursday CHANAPS Notes From Reading C HAPTER 14: PSYCHOLOGICAL DISORDERS 2. Disorders may not be mutually exclusive, many who have one develop another later. B. Generalized Anxiety Disorder 1. GAD – marked by a chronic, high level of anxiety that is not tied to any specific threat. i.e. “free floating anxiety”. 2. Worry about minor matters related to family, finances, work, personal illness. 3. Physical symptoms: trembling, muscle tension, diarrhea, dizziness, heart palpations. C. Phobic Disorder 1. Phobic. Disorder – marked by a persistent and irrational fear of an object or situation that presents no realistic danger. a. Phobias may be common, but people with Phobic Disorders have fears which seriously interfere with everyday behavior. 2. Common Phobias incl. acrophobia (heights), claustrophobia, brontophobia (storms), hydrophobia, and various insect/animal phobias. 3. People usually realize fears are irrational but are unable to remain calm when confronted by a phobic object (or even imaging it). D. Panic Disorder and Agorophobia 1. Panic Disorder – characterized by recurrent attacks of overwhelming anxiety that usually occurs suddenly and unexpectedly. Accompanied by physical symptoms. a. Victim becomes apprehensive, refusing to leave house. 2. Agorophobia – fear of going out to public places – complication of Panic disorder. a. Typically affects females. E. Obsessive Compulsive Disorder 1. OCD – marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessing), and urges to engage in senseless rituals (compulsions) 2. Obsessions often center on inflicting harm on others, personal failure, suicide, sex acts. 3. Victims may feel as though they’ve lost control of their mind. 4. Typically arises in early adulthood. F. Etiology of Anxiety Disorders 1. Biological Factors a. Concordance Rate – indicates the percentage of twin pairs or other pairs of relations that exhibit the same disorders. b. Twin studies suggest low genetic disposition to anxiety disorders. c. Anxiety Sensitivity may make people vulnerable to anxiety disorders. i.e. Some people are highly sensitive to internal physiological symptoms of anxiety and prone to overreact with fear when they experience symptoms. d. Link between anxiety disorders and neurochemical activity in the brain. 2. Conditioning and Learning a. Many anxiety response may be acquired through classical conditioning and maintained through operant conditioning. Feb/19/2004, Thursday CHANAPS Notes From Reading C HAPTER 14: PSYCHOLOGICAL D ISORDERS i. Originally neutral stimulus (snow) may be paired with frightening event (avalanche) so it becomes a conditioned stimulus eliciting anxiety. (Example of Classical Conditioning) ii. Example of Operant Conditioning: Response – person avoids snow, so avoidance response is negatively reinforced by a reduction in anxiety. b. Preparedness (Seligman) – people are biologically prepared by their evolutionary history to acquire some fears easier than others. c. Conditioned fears may be acquired through observational learning. 3. Cognitive Fears a. Cognitive Theorists – people are more likely to suffer from problems w/ anxiety because they tend to: misinterpret harmless situations as threatening, pay attention to perceived threats, and recall info that seems threatening. b. i.e. some people are prone to anxiety disorders because they see threats in every corner of their lives. 4. Personality – people who score high in nuerotism tend to be self conscious, nervous, jittery, insecure, guilt prone, and gloomy. Correlated with anxiety disorders and poorer prognosis of recovery. 5. Stress – anxiety disorders are stress related. III. Somatoform Disorders A. Introduction 1. Psychosomatic Diseases – genuine physical ailments caused in part by psychological factors, esp. emotional distress. i.e. Ulcers, asthma, high blood pressure. a. Recorded on Axis III 2. Somatoform Diseases – physical ailments that can’t be fully explained by organic conditions and are largely due to psychological factors (however, they’re not “fake” illnesses). B. Somatization Disorder 1. Somatization Disorder – marked by a history of diverse physical complaints that appear to be psychological in origin. a. Mostly in women. Coexists w/ anxiety disorders and depression b. Victims report endless succession of minor physical ailments. c. Unlikely diversity of health problems helps physicians diagnose it. C. Conversation Disorder 1. Marked by significant loss of physical function (w/ no apparent organic basis) usually in a single organ system. a. Usual symptoms – partial/complete loss of vision, hearing, paralysis. b. People with conversion disorder are usually suffering more severe ailments that those w/ somatization disorder. D. Hypochondriasis (or Hypochondria) 1. Characterized by excessive preoccupation with health concerns and incessant worry about developing physical illness. 2. When physician gives normal diagnosis, victims are skeptical and go looking for a new doctor. Feb/19/2004, Thursday CHANAPS Notes From Reading C HAPTER 14: PSYCHOLOGICAL D ISORDERS 3. Frequently appears along with anxiety disorder and depression E. Etiology of Somatoform Disorders 1. Personality Factors a. Histrionic Personality – self centered, suggestible, excitable, emotional, dramatic i.e. thrive on attention. b. Neurotism 2. Cognitive Factors a. Some people focus excessive attention on their internal physiological processes and amplify normal bodily sensations into unnecessary medical treatment. 3. The Sick Role – indirect benefits of illness – avoiding confronting challenges, attention. IV.Dissociative Disorders A. Introduction 1. Dissociative Disorder – people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity. B. Dissociative Amnesia and Fugue 1. Sudden loss of memory for important personal info that is too important to be due to normal forgetting. a. May be for a single traumatic eve
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