46-333 Chapter Notes - Chapter 16: Posttraumatic Stress Disorder, Catatonia, Insanity Defense

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Published on 19 Apr 2013
School
University of Windsor
Department
Psychology
Course
PSYC 3330
Professor
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!
insanity4defense—not!understanding!the!difference!between!right!and!wrong!
!
Major+Perspectives+
There!are!four!perspectives!on!psychopathology!or!the!study!of!dysfunctional!behavior:!
medical4(or4biological)4model:!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!!
behavioral4model:!abnormal!behavior!is!the!result!of!maladaptive!learning!(reinforcement)!!
cognitive4model:!dysfunctional!behavior!is!the!result!of!irrational!or!distorted!thinking!that!
leads!to!emotional!problems!and!maladaptive!behaviors!!
psychodynamic4model:!dysfunctional!behavior!is!the!result!of!internal,!unconscious!conflicts!
and!motives!!
!
Other+Perspectives+
Also!considered!are!these!perspectives:!
humanistic4model:!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!!
ethical4model:!dysfunctional!behavior!is!the!result!of!a!lack!of!or!improper!ethical!values!!
sociocultural4model:!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!
!
DSM=IV=TR+
In!the!United!States,!the!DSM<IV<TR!(or!Diagnostic4and4Statistical4Manual4for4Mental4Disorders,!4th!
edition)!is!considered!the!authoritative!source!on!diagnosing!and!treating!psychological!disorders!
The!DSM<IV<TR!distinguishes!between:!
neurotic4disorders!which!are!affective!(or!emotional)!disorders!
psychotic4disorders!which!are!affective!and!cognitive!(or!thinking)!disorders.!
!
!
!
!
!
Medical+Student+Syndrome+
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One!caution!in!examining!both!mental!and!physical!disorders!is!a!phenomenon!called!medical4
student4syndrome!
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!!
the4experts:!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+
Anxiety4disorders!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+
Generalized4anxiety4disorder4(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!
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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!panic4attack!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!
Specific4phobias!involve!fear!and!avoidance!of!specific!objects!or!situations!
Social4phobias!involve!fear!and!avoidance!of!social!situations!or!performance!situations!
Lifetime!prevalence:!specific!phobia!7‐11%,!social!phobia!3‐13%.!
!
Obsessive=Compulsive+Disorder+
An!obsession!is!an!uncontrollable!thought!
A!compulsion!is!an!uncontrollable!act!
These!frequently!go!together!in!the!form!of!an!obsessive<compulsive4disorder4(OCD)4
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:!
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