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Chapter 14

Chapter 14 psych Notes.docx

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Dan Dolderman

Chapter 14 – Psychological Disorders - Capgras syndrome – involves a normal person believing that a family or friend has been replaced by an identical looking imposter, lacking the ability to link an emotional response to a familiar face- famous Tory Rosato had this - Psychopathology- sickness or disorder of the mind - Some disorders are much more likely to occur in women then in men and some are reversible HOWARE PSYCHOLOGICAL DISORDERS CONCEPTUALIZED AND CLASSIFIED? - Many behaviours normal in one setting may be deviant in another setting - Psychopathology – is more and more defined as thoughts and behaviours that are maladaptive rather than deviant - Must differentiate between what is known to be normal and abnormal - PSYCHOLOGICAL DISORDERS ARE CLASSIFIED INTO CATEGORIES: - Etiology- factors that contribute to the development of a disorder, and possible treatments - Not all patients with mental disorders suffer from the same disorder - Multiaxial system- the system used in the DSM that provides assessment along five axes describing important mental health factors - People are classified through the multiaxial system rather than being given a label - 5 axes or dimensions in which diagnoses include evaluations of: - Clinical disorders, mental retardation or personality disorders, medical conditions, psychosocial problems, and global or overall assessment of how well the person is functioning - PSYCHOLOGICAL DISORDERS MUST BE ASSESSED: - Determining if someone has a mental disorder isn’t as easy finding a physical disorder - Assessment- in psychology, examination of a person’s mental state to diagnose possible psychological disorders - 1 thing to do is make diagnosis, help to determine the solution to the problems - Prognosis- probable outcome - Assessment help to find the factors that are affecting the diagnosis - Mental status exam – snapshot of his or her psychological functioning, help to see if the disorder is mentally or physically - In the clinical interview- the interviewers skills determine the quantity and value of information obtained, they’re non-judgemental and trusting - STRUCTURED VERSUS UNSTRUCTURED INTERVIEWS: - Unstructured interviews- the topics of discussion vary as the interviewer probes different aspects of the person’s problems- highly flexible, overly dependent on interviewers skills - Structured interviews- standardized questions are asked in the same order each time, diagnosis depends on the responses to series of questions - The most common structured interview(SCID)valuable for research because results may be similar amongst groups - TYPES OF TESTING: - Apsychological assessor often can gain valuable information simply by observing the client’s behaviour - Behavioural assessments work best with children - Psychological testing-helps to assess personality - The Minnesota Multiphasic Personality Inventory is the most widely used questionnaire for psychological assessment has ten clinical scales to determine the various mental disorders - Common problem with ^ is that they respondents may make things up, lie and distort the truth - Other validity scales examine whether the test taker answers similar questions in the same manner each time and whether he or she responds ‘true’to items that are extremely rare - Neuropsychological testing- in this method, the client performs actions such as copying a picture, drawing design from memory, sorting things into different sizes - Looking at different brain regions - EVIDENCE BASEDASSESSMENT: - Evidence based assessment- approach to clinical evaluation in which research guides the evaluation of mental disorders, the selection of appropriate psychological tests and neuropsychosocial methods, and the use of critical thinking in making a diagnosis - Comorbidity- many mental disorders occur together - DISSOCIATIVE IDENTITY DISORDER IS A CONTROVERSIAL DIAGNOSIS: - Case study on Billy Milligan found innocent of robbery and rape charges on the grounds that he had been diagnosed with multiple personality disorder, although he did convict these crimes, the lawyer argued it wasn’t his fault - Must know his condition and how he was diagnosed to declare he has multiple personality disorder - Dissociative identity disorder(DID) – multiple personality disorder -the occurrence of two or more distinct identities in the same individual - Involves disruptions of identity, of memory and of conscious awareness - Mostly occurs in women who have been reported to be severely abused as children - Children cope with abuse by pretending it is happening to someone else and enter a trancelike state in which they dissociate their mental states from their physical bodies, over time it takes on its own identity - The separate identities differ tremendously from one another - Diagnoses of DID usually occur to people right after they have been convicted on crime for a long time - In most diagnosed cases as having DID were unaware of their other identities until after many therapy sessions - Sexual abuse can cause psychological problems including distortions of consciousness - PSYCHOLOGICAL DISORDERS HAVE MANY CAUSES: - Diathesis-stress model – a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event - Diathesis(underlying vulnerability or predisposition) can be biological or environmental - The vulnerability may not be strong enough to trigger a mental disorder, but a stressful situation can trigger the mental disorder - BIOLOGICAL FACTORS: - The biological perspective focuses on how physiological factors such as genetics contribute to psychological disorders - The fetus is pretty vulnerable and evidence indicates that some mental disorders may arise from prenatal problems such as malnutrition, exposure to toxin, and maternal illness all these can affect the central nervous system triggering mental disorders - The PET and FMRI have revealed brain regions that may function differently in individuals with mental disorders - Biological factors often reflect vulnerabilities and situational factors often play prominent roles in the expression of mental disorders - PSYCHOLOGICAL FACTORS: - A disordered behaviour is significantly shaped by the environment as well - Family-systems model- a diagnostic model that considers symptoms within an individual as indicating problems within the family - Developing a profile of an individual’s family interactions can be important in determining the factors of the disorder in the patient, or if they will be detrimental or beneficial to the therapy sessions - Socio-cultural model – a diagnostic model that views psychopathology as the result of the interaction between individuals and their cultures - Differences in disorders correlate with differences in lifestyles, expectations, and in opportunities among classes - People with disorders may find it hard to find a job, hence may be poor - COGNITIVE-BEHAVIOURAL FACTORS: - Cognitive-behavioural approach- a diagnostic model that views psychopathology as the result of learned, maladaptive cognitions - Aneutral stimulus paired with this unconditioned stimulus can eventually by itself produce a similar response (i.e. little boy playing with a white rat, and hears a loud noise, and hence that’s going to correlate with the boy being scared of the rat as well as the noise the next time)John B.Watson said many fears are learned rather than innate - Strict behaviourists felt that mental disorders result from classical and operant conditioning - Thoughts can be distorted and produce maladaptive behaviours and emotions - Individuals can easily be made aware of, the thought processes that give rise to maladaptive emotions and behaviours - SEX DIFFERENCES IN MENTAL DISORDERS: - Some mental disorders are more common for males and others for females - Dependence on alcohol, anti-social personality disorders and childhood attention deficit hyperactivity disorder is as twice likely to occur in males rather than females, and anorexia is most likely to occur in women 4 times more than men - Dividing disorders into two major groups: - 1. Internalizing disorders- those characterized by negative emotions such as distress and fear - 2. Externalizing disorders- those characterized by disinhibition, such as alcoholism, and anti-social behaviour - Internalizing disorders are more in females, and externalizing disorders are found more in males - CULTUREAND MENTAL DISORDERS: - Many mental disorders are very similar around the world, but still reflect cultural differences - KNOW DIAGRAM ON PG.640 ON INTERNALIZING AND ENTERNALIZING MODEL OF MENTAL DISORDERS - Culture-bound syndromes, disorders mainly found in specific cultures or regions - Cultural factors can be critical in determining how a disorder is expressed and how an individual will respond to different types of therapies - READ SUM UP PART 2 CANANXIETY BE THE ROOT OF SEEMINGLY DIFFERENT DISORDERS? - Anxiety is normal and can prepare us for upcoming events and motivate us to learn new ways of coping with life’s challenges - Anxiety disorders- characterized by excessive anxiety in the absence of true danger - THERE ARE DIFFERENT TYPES OF ANXIETY DISORDERS: - More than ¼ will have some type of anxiety disorder during their lifetimes - Those suffering from anxiety disorders feel tense, anxious, and apprehensive, depressed and irritable because they cannot see any solution to their anxiety - They can become restless and exhibit pointless motor behaviours - Chronic stress can produce weakening in the hippocampus, a brain structure involved in learning and memory - PHOBIC DISORDER: - Phobia- fear of a specific object or situation - Fear can be adaptive and good for us if something is dangerous for us - Specific phobias- affect 1/8 people involve particular objects and situations such as snakes, closed spaces, and heights - Common phobia is the fear of flying - Social phobia- specific phobia that is sometimes called social anxiety disorder, is a fear of being negatively evaluated by others (presentations, speaking out loud in social settings) - GENERALIZED ANXIETY DISORDER: - Adiffuse state of constant anxiety not associated with any specific object or event - Constantly worry about even the smallest things, can occur in response to anything - PANIC DISORDER: - Women are twice likely to be diagnosed then men - Panic order- an anxiety disorder characterized by sudden overwhelming attacks of terror - Cued by external stimuli or internal thought processes - Often feel they are going crazy are going to die - Agoraphobia- an anxiety disorder marked by fear of being in situations in which escape may be difficult or impossible(in a crowd in a shopping mall) causing panic attacks - OBSESSIVE-COMPULSIVE DISORDER: - OCD- an anxiety disorder characterized by frequent intrusive thoughts and compulsive actions - Obsessions are recurrent, and unwanted thoughts or ideas or mental images - Compulsions- patient feels driven to perform over and over again - Those with OCD anticipate catastrophe and loss of control - Anxiety patients are scared of what is going to happen, OCD patients however think of what they’ve done and check repeatedly - ANXIETY DISORDERS HAVE COGNITIVE,SITUATIONAL, AND BIOLOGICAL COMPONENTS: - Cognitive factors makes up one group - When anxious people are presented with neutral situations, they tend to perceive them as threatening - Situational factors- play a role in the development of anxiety disorders - Aperson can become fearful if the other person is fearful of something too (chain reaction) - Biological factors- are also important part in the development of anxiety disordersthe amygdala is greatly activated when anxious people see novel faces hence proving they become anxious easily - Some aspects of childhood temperament are preserved in the adult brain - People that have OCD are aware that their obsessions and compulsions are irrational, yet they are unable to stop them - Anxiety is somehow paired to a specific event, probably through classical conditioning, and the person engages in behaviour that reduces anxiety and therefore is reinforced through operant conditioning - This reduction of anxiety is reinforcing and increases the person’s chance of engaging in that behaviour again - The etiology of OCD is in part genetic - The neurotransmitter glutamate which is the major excitatory transmitter in the brain, causing increased neural firing - The caudate, brain structure in suppressing impulses is smaller in those that have OCD - After there is an increase in the glutamate activity, the prefrontal cortex which is involved in conscious control of behaviour, the becomes overactive in an effort to compensate - OCD can be triggered by environmental factors as well - Usually occurs to children at night, as children suddenly display odd symptoms of OCD such as engaging in repetitive behaviours, developing fears and obsessions - Both biological and cognitive-behavioural factors interact to produce the symptoms of OCD - READ SUM UP PART 3 ARE MOOD DISORDERS EXTREME MANIFESTATIONS OF NORMAL MOODS? - THERE ARE DIFFERENT TYPES OF MOOD DISORDERS: - Mood disorders reflect extreme emotions: depressive disorders feature persistent and pervasive feelings of sadness, and bipolar disorders involve radical fluctuations in mood - DEPRESSIVE DISORDERS: - Major depression- a disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities - The person may have other symptoms as loss of appetite, weight changes, sleep disturbances, etc. - Only long-lasting episodes that impair a person’s life are diagnosed as mood disorders - Dysthymia- a form of depression that is not severe enough to be diagnosed as major depression - Depression is known as the common cold in mental disorders - Leading risk factor for suicide - Depression rates in women are much higher than in males probably because that women’s’multiple roles in most societies as wage earners and family caregivers cause stress that result
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