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Chapter 16

Psychology 46-333 chapter 16 notes (disorders)

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Department
Psychology
Course
46-333
Professor
Brown
Semester
Summer

Description
Psychological
Disorders
 
 Dysfunctional
Behavior
 • Dysfunctional
or
abnormal
behavior
is
any
behavior
judged
to
be
disturbing,
atypical,
maladaptive
 or
unjustifiable
 • It
can
be
irrational,
unpredictable
and
unconventional
 • The
person
can
feel
distress
and
discomfort
from
their
behaviors
 • It
is
different
from
insanity
which
is
a
legal
defense
 – insanity
means
that
the
individual
could
understanding
the
difference
between
right
and
 wrong,
and
is
unable
to
control
their
actions
 – confidentiality—patient
confidentiality
can
come
into
play
in
legal
investigations
 – insanity
defense—not
understanding
the
difference
between
right
and
wrong
 
 Major
Perspectives
 • There
are
four
perspectives
on
psychopathology
or
the
study
of
dysfunctional
behavior:
 – medical
(or
biological)
model:
dysfunctional
behavior
is
the
result
of
an
organic
cause
 • Philippe
Pinel
and
Emil
Kraepelin
created
two
of
the
first
medical
classification
systems
 for
psychological
disorders

 – behavioral
model:
abnormal
behavior
is
the
result
of
maladaptive
learning
(reinforcement)

 – cognitive
model:
dysfunctional
behavior
is
the
result
of
irrational
or
distorted
thinking
that
 leads
to
emotional
problems
and
maladaptive
behaviors

 – psychodynamic
model:
dysfunctional
behavior
is
the
result
of
internal,
unconscious
conflicts
 and
motives

 
 Other
Perspectives
 • Also
considered
are
these
perspectives:
 – humanistic
model:
abnormal
behavior
is
the
result
of
roadblocks
that
people
encounter
on
the
 path
to
self‐actualization
whereby
people
become
detached
from
their
true
selves
and
adopt
a
 distorted
self‐image
which
leads
to
emotional
problems

 – ethical
model:
dysfunctional
behavior
is
the
result
of
a
lack
of
or
improper
ethical
values

 – sociocultural
model:
abnormal
behavior
is
the
result
the
stress
involved
in
coping
with
poverty
 and
other
social
ills
such
as
unemployment
and
racism

 – interactionist
(or
biopsychosocial)
perspective:
dysfunctional
behavior
is
the
result
of
a
 complex
interaction
between
biological
processes
and
genetic
predispositions,
psychological
 dynamics
and
social
influences
 
 Reasons
for
Classification
 • Psychological
disorders
have
been
classified
for
four
main
reasons:

 1. describe
the
disorder
 2. predict
the
course
it
will
take
in
the
future
 3. 
render
appropriate
treatment
 4. prompt
further
research
into
its
causes
and
treatments
 
 DSM­IV­TR
 • In
the
United
States,
the
DSM­IV­TR
(or
Diagnostic
and
Statistical
Manual
for
Mental
Disorders,
4th
 edition)
is
considered
the
authoritative
source
on
diagnosing
and
treating
psychological
disorders
 • The
DSM­IV­TR
distinguishes
between:
 – neurotic
disorders
which
are
affective
(or
emotional)
disorders
 – psychotic
disorders
which
are
affective
and
cognitive
(or
thinking)
disorders.
 
 
 
 
 
 Medical
Student
Syndrome
 • One
caution
in
examining
both
mental
and
physical
disorders
is
a
phenomenon
called
medical
 student
syndrome
 • In
this,
students
who
study
specific
disorders
begin
to
convince
themselves
that
they
are
suffering
 from
that
disorder
because
they
may
have
one
or
more
general
symptoms
 • Typically
this
is
not
the
case
and
worry
shifts
from
the
current
disorder
being
studied
to
the
next
 
 Determining
“Normal”
 • Who
determines
what's
"normal?"
 – you:
individuals
constantly
assess
the
normalcy
of
their
behaviors

 – society:
society
imposes
labels
of
normal
and
abnormal
behavior

 – the
experts:
applying
their
skill
and
knowledge
in
diagnosing
and
treating
psychological
 disorders
 
 • Psychologists
have
established
six
criteria
in
determining
the
distinction
between
normal
and
 abnormal
behavior:

 – unusualness
 – social
deviance
 – emotional
distress
 – maladaptive
behavior
 – dangerousness
 – faulty
perceptions
or
interpretations
of
reality.
 
 Labeling
 • Experts
caution
that
labeling
individuals
with
certain
disorders
can
predispose
them
to
certain
 self‐fulfilling
prophesies
and
cause
those
around
them
to
perceive
them
differently
based
on
 stereotypical
beliefs
 
 Anxiety
Disorders
 • Anxiety
disorders
involve:
 – behaviors
the
surround
overwhelming
anxiety
 – attempts
to
reduce
this
anxiety
through
maladaptive
means
 • Anxiety
disorders
are
among
the
most
common
psychological
disorders
treated
by
professionals
 
 Causes
of
Anxiety
Disorders
 • The
causes
of
anxiety
disorders
depend
on
the
model
of
psychopathology:
 – biological:
disorders
are
the
result
of
organic
causes;
neurotransmitter
imbalances
(anxiety,
 mood
and
schizophrenic
disorders)
and
hereditary
genetics
(schizophrenia)
cause
the
 disorder

 – behavioral:
behaviors
result
from
prior
reinforcement
or
conditioning
of
the
maladaptive
 behavior:
rewarding
avoidance
behaviors
can
contribute
to
phobias;
relieve
from
anxiety
 (negative
reinforcement)
reinforces
OCD

 – cognitive:
anxiety
is
based
on
incorrect
reasoning,
a
distortion
of
real
events
and
unrealistic
 expectations;
misinterpretation
of
minor
changes
in
bodily
sensations
promotes
anxiety
and
 panic
attacks;
social
phobias
may
occur
because
of
an
obsessive
fear
of
social
embarrassment
 or
negative
judgments

 – psychodynamic:
anxiety
disorders
are
the
result
of
an
unconscious
conflict
or
fear;
desire
to
 avoid
a
previously
abrasive
experience
can
generate
ritualistic
behaviors
to
reduce
anxiety
 (OCD);
phobias
may
be
a
result
of
childhood
traumas
that
have
been
repressed
 
 Generalized
Anxiety
Disorder
 • Generalized
anxiety
disorder
(GAD)
is
one
in
which
the
individual
feels
continually
and
 unexplainable
tense
or
anxious,
worries
that
bad
things
might
happen
 • This
anxiety
occurs
consistently
for
at
least
six
months
 
 • The
individual
typically
can
hide
these
symptoms
but
physical
symptoms
such
as
insomnia
or
 racing
heart)
may
occur
 • Freud
called
this
a
"free‐floating"
anxiety
because
the
individual
cannot
identify
what's
causing
 their
anxiety;
this
makes
it
hard
to
control
it
 • Lifetime
prevalence:
5%
 
 Panic
Attack
 • A
panic
attack
or
panic
disorder
is
a
condition
in
which
a
person
suffers
a
period
of
intense
 anxiety
 • Physical
reactions
include
disorientation,
tunnel
vision,
a
feeling
a
disconnectedness,
increased
 blood
pressure,
increase
heart
rate,
shortness
of
breath
 • Panic
attacks
typically
begin
in
the
mid‐20s
 • Agoraphobia
is
an
intense
fear
of
situations
with
no
escape
or
help
in
the
event
of
a
panic
attack
 • Lifetime
prevalence:
1‐4%
 
 Phobias
 • A
phobia
is
an
intense
irrational
fear
 • The
individual
usually
actively
avoids
the
situation
or
object
of
their
phobia
 • Specific
phobias
involve
fear
and
avoidance
of
specific
objects
or
situations
 • Social
phobias
involve
fear
and
avoidance
of
social
situations
or
performance
situations
 • Lifetime
prevalence:
specific
phobia
7‐11%,
social
phobia
3‐13%.
 
 Obsessive­Compulsive
Disorder
 • An
obsession
is
an
uncontrollable
thought
 • A
compulsion
is
an
uncontrollable
act
 • These
frequently
go
together
in
the
form
of
an
obsessive­compulsive
disorder
(OCD)
 • This
disorder
is
characterized
by
a
combination
of
repetitive
thoughts
and
uncontrollable
acts
 • The
onset
of
this
disorder
occurs
in
childhood
or
adolescence
 
 • Research
indicates
that
four
structures
in
the
brain
are
linked
along
a
circuit
to
promote
OCD
 behaviors:
 – the
amygdala
 – the
orbital
frontal
cortex
 – the
caudate
nucleus
 – the
thalamus
 • This
circuit
is
abnormally
active
in
individuals
with
OCD
 
 • Research
also
indicates
genetic
markers
on
six
sites
in
five
chromosomes
in
children
of
family
 members
with
OCD
 • A
seventh
gene,
located
on
the
ninth
chromosome,
appears
to
regulate
the
brain
chemical
 glutamate
 • Excessive
amounts
of
glutamate
stimulate
the
alarm
centers
in
the
brain
which
facilitates
the
 obsessive‐compulsive
behavior
 
 • Drug
medication
that
regulates
an
individual's
serotonin
level
has
shown
great
success
in
two‐ thirds
of
patients
 • The
most
common
obsessions
are
dirt
or
germs
(40%),
that
something
terrible
will
happen
 (24%),
symmetry
or
order
(17%)
and
religious
obsessions
(13%)
 • The
most
common
compulsions
are
ritualized
hand
washing
and
showering
(85%),
repeating
 rituals
(51%),
checking
(46%),
removing
contaminants
from
contacts
(23%)
and
touching
(20%)
 • Lifetime
prevalence:
2‐3%.
 
 
 
 
 • The
most
common
expressions
of
OCD:
 – Relationship
substantiation—searching
for
tiny
but
disqualifying
flaws
in
someone
else
 – Fear
of
injuring
others‐‐a
preoccupation
of
losing
control
and
injuring
or
killing
someone
else
 – Responsibility
anxiety‐‐a
fear
of
negligently
hurting
others
 – Scrupulosity­­intolerance
of
disorder
or
asymmetry
 – Contamination
anxiety­­compulsive
hand‐washing
and
fear
of
contamination
from
other
 objects
 – Sexual­orientation
fears­­fear
of
homosexual
stirrings
in
people
who
have
no
moral
or
social
 objections
to
it
 – Obsessive
hypochondria­­fear
of
illness
in
the
face
of
evidence
to
the
contrary
and
the
tendency
 to
reject
that
opinion
of
experts
 
 Post­Traumatic
Stress
Disorder
 • Posttraumatic
stress
disorder
(PTSD)
involves
overwhelming
anxiety,
flashbacks
and
troubling
 recollections
of
a
highly
traumatic
event
 – veterans
who
have
seen
heavy
combat
duty
and
women
who
have
been
raped
or
assaulted
 may
suffer
from
this
 • The
individual
attempts
to
avoid
situations
or
objects
that
might
trigger
the
disorder
 • Success
of
treatment
depends
on:

 – whether
the
individual
had
any
psychological
disorders
prior
to
PTSD
 – their
social
support
group
 – whether
the
individual
is
currently
experiencing
any
other
psychological
disorders.
 
 Psychosomatic
Disorders
 • Psychosomatic
(or
psychophysiological)
disorders
are
where
there
are
real
physical
disorders
but
 no
organic
or
biological
cause
 • These
illnesses
are
brought
on
by
psychological
not
physiological
factors
 • The
two
most
common
types
of
psychosomatic
disorders
are
migraine
headaches
and
stomach
 ulcers
 • These
are
usually
brought
on
by
overwhelming
stress
 
 Somatoform
Disorders
 • Somatoform
disorders
are
where
there
is
an
apparent
physical
illness
but
no
organic
or
biological
 cause.

 
 Causes
of
Somatoform
Disorders
 • The
causes
of
somatoform
disorders
depend
on
the
model:
 – biological:
there
is
no
biological
argument
since
there
are
no
biological
reasons
for
these
 disorders

 – behavior:
believe
the
disorder
allows
the
person
to
avoid
the
anxiety‐producing
situation
(see
 psychodynamic
explanation);
further
reinforcement
for
the
disorder
comes
in
the
form
of
 sympathy
and
support
from
others
for
having
the
physical
ailment
 – cognitive:
people
are
misinterpreting
and
exaggerating
minor
bodily
sensations
as
signs
of
 serious
illness

 – psychodynamic:
these
disorders
are
an
outward
sign
of
an
unconscious
conflict;
in
stopping
 the
expressions
of
the
id
by
the
ego,
leftover
sexual
or
aggressive
energy
is
converted
into
a
 physical
symptom
 • the
symptom
itself
is
symbolic
of
the
underlying
struggle
(e.g.
immobilization
of
the
arm
 would
prevent
the
person
from
carrying
out
a
violent
act)
 • the
symptom
has
the
secondary
gain
of
preventing
the
person
from
having
to
confront
the
 conflict
 
 
 
 
 Somatoform
Disorders
 • Somatozation
disorder
is
a
disorder
where
the
person
has
vague
physical
symptoms
and
 repeatedly
seeks
medical
treatment
but
no
organic
cause
is
found
for
the
illness
 • Conversion
disorder
is
a
disorder
where
the
person
suffers
from
paralysis,
blindness,
deafness,
 seizures.
loss
of
feeling
or
false
pregnancy
but
with
no
physiological
reason
for
it
 – in
about
80%
of
suspected
cases,
the
cause
turns
out
to
be
medical
 – this
disorder
is
rare
 • Hypochondriasis
is
a
disorder
where
a
person
takes
insignificant
physical
symptoms
and
 interprets
them
as
a
sign
of
a
serious
illness
despite
a
lack
of
evidence
of
any
organic
cause.

 • Body
dysmorphic
disorder
is
a
disorder
in
which
a
person
become
preoccupied
with
his
or
her
 imagined
physical
ugliness
that
makes
normal
life
impossible
 
 Organic
Disorders
 • Organic
disorders—disorders
in
which
medical
conditions
directly
produce
a
psychological
 disorder
 • For
example,
a
brain
injury
or
a
thyroid
disorder
may
directly
produce
a
mood
disturbance
 
 Dissociative
Disorders
 • Dissociative
disorders
involve
a
separation
(or
dissociation)
of
conscio
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