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Chapter 14

Psychology 2035A/B Chapter Notes - Chapter 14: Mayo Clinic, Clanging, Clifford Whittingham Beers

Course Code
Doug Hazlewood

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210 CHAPTER 14
Abnormal Behavior: Concepts and Controversies (APA Goals 1, 5)
Describe and evaluate the medical model of abnormal behavior.
Identify the most commonly used criteria of abnormality.
Describe the five axes of DSM-IV and controversies surrounding the DSM system.
Summarize data on the prevalence of various psychological disorders.
Anxiety Disorders (APA Goals 1, 4)
List and describe four types of anxiety disorders.
Discuss the contribution of biological factors and conditioning to the etiology of anxiety
Explain the contribution of cognitive factors and stress to the etiology of anxiety
Somatoform Disorders (APA Goals 1, 4)
Distinguish among the three types of somatoform disorders.
Summarize what is known about the causes of somatoform disorders.
Dissociative Disorders (APA Goals 1, 4)
Distinguish among the three types of dissociative disorders.
Summarize what is known about the causes of dissociative disorders.
Mood Disorders (APA Goals 1, 4)
Describe the two major mood disorders and discuss their prevalence.
Evaluate the degree to which mood disorders elevate the probability of suicide.
Clarify how genetic and neurochemical factors may be related to the development of
mood disorders.
Discuss how cognitive processes may contribute to mood disorders.
Outline the role of interpersonal factors and stress in the development of mood disorders.
Schizophrenic Disorders (APA Goals 1, 4)
Describe the prevalence and general symptoms of schizophrenia.
Identify the subtypes of schizophrenia and distinguish between positive and negative
Outline the course and outcome of schizophrenia.
Summarize how genetic vulnerability and neurochemical factors may contribute to the
etiology of schizophrenia.
Discuss evidence relating schizophrenia to structural abnormalities in the brain and
neurodevelopmental insults to the brain.
Analyze how expressed emotion and stress may contribute to schizophrenia.
APPLICATION: Understanding Eating Disorders (APA Goals 1, 4)
Describe the symptoms of anorexia nervosa, bulimia nervosa, and binge-eating disorder.

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211 CHAPTER 14
Discuss the history, prevalence, and gender distribution of eating disorders.
Explain how genetic factors, personality, and culture may contribute to eating disorders.
Clarify how family dynamics and disturbed thinking may contribute to eating disorders.
I. Abnormal Behavior: Concepts 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. Basis for many of the terms used to refer to abnormal behavior (e.g., mental illness,
psychological disorder, psychopathology)
3. Rise of medical model (in 18th, 19th centuries) brought improvements in treatment
4. Problems with model
a. Thomas Szasz suggests that abnormal behavior usually involves a deviation from
social norms rather than an illness
b. Results in derogatory labels being applied to people with disorders
5. Putting the model in perspective
a. Model is useful as an analogy
b. Diagnosis involves distinguishing one illness from another
c. Etiology refers to the apparent causation and developmental history of an illness
d. Prognosis is a forecast about the probable course of an illness
B. Criteria of abnormal behavior
1. Three criteria most frequently used
a. Deviance (e.g., transvestic fetishism: a sexual disorder in which a man achieves
sexual arousal by dressing in women's clothing)
b. Maladaptive behavior
c. Personal distress
2. Judgments about mental illness reflect prevailing cultural values, social trends, and
political forces
3. Normality and abnormality exist on a continuum
C. Psychodiagnosis: The classification of disorders
1. First version of Diagnostic and Statistical Manual of Mental Disorders (DSM)
published in 1952 by American Psychiatric Association
2. Current version, DSM-IV introduced in 1994, revised 2000
3. The multiaxial system
a. Axis I: clinical syndromes
b. Axis II: personality disorders
c. Axis III: general medical conditions
d. Axis IV: psychological and environmental problems
e. Axis V: global assessment of functioning
4. Work currently underway for next edition, DSM-V
a. Scheduled for 2011 publication
b. Decisions whether various syndromes should be added, eliminated, or renamed
5. Controversies surrounding the DSM

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a. There is enormous overlap among various disorders in symptoms, and people
often qualify for more than one diagnosis; the current categorical approach
should be replaced by a dimensional approach
c. It medicalizes everyday problems
D. The prevalence of psychological disorders
1. Epidemiology is the study of the distribution of mental or physical disorders in a
2. Prevalence refers to the percentage of a population that exhibits a disorder during a
specified time period
3. Estimates suggest that psychological disorders are more common than most people
realize (33-51% lifetime prevalence)
II. Anxiety Disorders
A. Anxiety disorders are a class of disorders marked by feelings of excessive apprehension
and anxiety
B. Generalized anxiety disorder is marked by a chronic, high level of anxiety that is not tied
to any specific threat
1. Worry excessively about minor matters
2. Worry about how much they worry
3. Frequently accompanied by physical symptoms (e.g., trembling, muscle tension, etc.)
4. Tends to have a gradual onset
C. Phobic disorders are marked by a persistent and irrational fear of an object or situation
that presents no realistic danger
1. Fears seriously interfere with everyday behavior
2. Tends to be accompanied by physical symptoms of anxiety
3. Common phobias include acrophobia (fear of heights), claustrophobia (fear of small,
enclosed places), brontophobia (fear of storms), hydrophobia (fear of water), and
various animal and insect phobias
D. Panic disorder and agoraphobia
1. Panic disorder is characterized by recurrent attacks of overwhelming anxiety that
usually occur suddenly and unexpectedly
2. Agoraphobia is a fear of going out to public places
E. Obsessive-compulsive disorder (OCD) is marked by persistent, uncontrollable intrusions
of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)
1. Obsessions can center on fear of contamination, inflicting harm on others, suicide, or
sexual acts
2. Compulsions usually involve stereotyped rituals that temporarily relieve anxiety
3. Specific types of obsessions tend to be associated with specific types of compulsions
4. Can be a particularly severe disorder, associated with social and occupational
F. Etiology of anxiety disorders
1. Biological factors
a. May be weak-to-moderate genetic predisposition
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