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Chapter 14

Psychology 2035A/B Chapter Notes - Chapter 14: Catatonia, Etiology


Department
Psychology
Course Code
PSYCH 2035A/B
Professor
Jane Dickson
Chapter
14

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Chapter 14 Reading Notes
“Psychological Disorders”
Abnormal Behaviour: General Concepts
Medical Model Applied to Abnormal Behaviour
oThe medical model proposes that it is useful to think of abnormal behavior as a disease.
oThe medical model gradually became the conventional way of thinking about abnormal behavior during
the 19th and 20th centuries and its influence remains dominant today
oThe medical model represented progress over earlier models of abnormal behavior, prior to the 18th century
most conceptions of abnormal behavior were based on superstition. People who behaved strangely were
thought to have been possessed by demons
oAs victims of an illness, these people were treated with more sympathy and less hatred and fear.
oIn recent decades some critics have suggested that the medical model may have outlived its usefulness. A
particularly vocal critic, Thomas Szasz said that strictly speaking, disease or illness could only affect the
body; therefore there can be no mental illness. Minds can be sick only in the sense that jokes are sick.
oEven after a full recovery, someone that was deemed mentally ill could have difficulty finding a place to
live or getting a job. The stigma of mental illness creates additional difficulties for people who already
have more than this stigma
oIn recent decades research has increasingly demonstrated that many psychological disorders are at least
partly attributable to genetic and biological factors, making them appear more similar to physical illnesses.
You would think that these trends would lead to a reduction in the stigma associated with mental illness,
but research suggests that the stigmatization of mental disorders has increased rather than decreased.
oThat said, the disease analogy is still the strongest
oMedical concepts such as diagnosis, etiology and prognosis have proven valuable in the treatment and
study of abnormality
Diagnosis involves distinguishing one illness from another
Etiology refers to the apparent causation and developmental history of an illness
Prognosis is a forecast about the probable course of an illness
Criteria of Abnormal Behavior
oAll people make judgments about normality in that they all express opinions about others mental health.
oIn making diagnoses, clinicians rely on a variety of criteria, the foremost of which are the following:
Deviance – people are often said to have a disorder because their behavior deviates from what their
society considers acceptable. For example, transvestic fetishism is a sexual disorder in which a
man achieves sexual arousal by dressing in womens clothing. This behavior is
Maladaptive Behavior – people are judged to have a psychological disorder because their
everyday adaptive behavior is impaired. This is key for diagnosing substance use. In and of itself,
alcohol and drug use is not unusual or deviant. However when the use of cocaine begins to interfere
with a person’s social or occupational functioning, a substance use disorder exists. In such cases, it
is the maladaptive quality of the behavior that makes it disordered.
Personal distress – frequently the diagnosis of a psychological disorder is based on an individual’s
report of great personal distress.
oAlthough 2 or 3 may apply in a particular case, you only have to have 1 criterion to be viewed as
disordered
oEveryone acts in deviant ways once in a while, and everyone displays some maladaptive behavior. People
are judged to have a psychological disorder only when their activities become extreme.
Psychodiagnosis: The Classification of Disorders
oThe elaborate system for classifying psychological disorders is called the DSM-IV. It asks for judgments of
individuals on 5 separate axes. The diagnosis of disorders were made on Axes I and Axes II, while the
other axes involved assessments of patients physical disorders, their level of stress, and their current level
of adaptive functioning.
oThe new system is called DSM 5 (so they can make incremental updates, like 5.1)
oIts major change was that the multiaxial system was retired.

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oAn issue with DSM 5 is that it follows a categorical approach, but there are numerous cases where there is
overlap between categories. A condition called comorbidity is the coexistence of two or more disorders.
The Prevalence of Psychological Disorders
oEpidemiology is the study of the distribution of mental or physical disorders in a population
oIn epidemiology, prevalence refers to the percentage of a population that exhibits a disorder during a
specified time period.
oIn the case of mental disorders, the most interesting data are the estimates of lifetime prevalence, the
percentage of people having a specific disorder at any time in their lives.
oStudies in the 80s and 90s found psychological disorders in roughly one third of the population.
Subsequent research which focused on a somewhat younger sample suggested that about 44% of the adult
population will struggle with some sort of psychological disorder at some point in their lives.
oThe most common types of psychological disorders are:
Substance use (drug and alcohol addiction)
Anxiety disorders (including obsessive compulsive disorders)
Depressive and bipolar
oPsychological disorders cause about three times as many disability days as cardiovascular diseases and
vastly more than cancer.
Anxiety Disorders and Obsessive Compulsive Disorder
Generalized Anxiety Disorder
oChronic high level of anxiety that is not tied to any specific threat
oSeen more frequently in females than males
oWorry constantly about yesterday’s mistakes and tomorrow’s problems. They hope their worrying will help
ward off negative events, but they nonetheless worry about how much they worry.
oGeneralized anxiety disorder tends to have a gradual onset, has a lifetime prevalence of about 5-6% and is
seen more frequently in females than in males
Phobic Disorder
oA persistent irrational fear of an object or situation that presents no realistic danger
oMild phobias are extremely common, but people are only said to have a phobic disorder when their fears
seriously interfere with their everyday behavior.
oCommon phobias include:
Acrophobia (fear of heights)
Claustrophobia (fear of small, enclosed places)
Brontophobia (fear of storms)
Hydrophobia (fear of water)
Various insect and animal phobias
oPeople troubled by phobias often realize their fears are irrational, but they still are unable to calm
themselves when they encounter a phobic object.
Panic Disorder and Agoraphobia
oA panic disorder is characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly
and unexpectedly
oAfter a number of anxiety attacks, victims often become apprehensive wondering when their next attack
will occur. Their concern about exhibiting panic in public sometimes escalates to the point where they are
afraid to leave home – agoraphobia
oAbout two thirds of the people diagnosed with panic disorder are female. The onset typically occurs during
late adolescence or early adulthood.
Obsessive-Compulsive Disorder
oObsessions = thoughts that repeatedly intrude ones consciousness in a distressing way. Compulsions =
actions that one feels forced to carry out.
oObsessive compulsive disorder is marked by persistent uncontrollable intrusions of unwanted thoughts and
urges to engage in senseless rituals.
oSpecific obsessions are related to specific compulsions.
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oFull fledged obsessive compulsive disorders occur in roughly 2-3% of the population. Most cases (75%)
emerge before the age of 30.
Etiology
oLike most psychological disorders, anxiety disorders and OCS develop out of complicated interactions
among a variety of factors. Conditioning and learning appear especially important, but biological factors
may also contribute.
oBiological Factors
Inherited differences in temperament might make some people more vulnerable than others to
anxiety disorders.
One theory says that anxiety sensitivity may make people vulnerable to anxiety disorders.
According to this notion, some people are very sensitive to internal physiological symptoms of
anxiety and are prone to overreact with fear when they experience these symptoms.
Recent evidence suggests a link between neurochemical activity and anxiety disorders.
Neurotransmitters are chemicals that carry signals from one neuron to another.
Therapeutic drugs (like valium) work to reduce excessive anxiety by altering activity at
synapses for a neurotransmitter called GABA.
This finding suggests that disturbances in the neural circuits using GABA may play a role in
some types of anxiety disorders.
Abnormalities in other neural circuits using the transmitter serotonin have been implicated
in obsessive-compulsive disorders.
oConditioning and learning
Many anxiety responses may be acquired through classical conditioning and maintained through
operant conditioning.
An originally neutral stimulus (the snow) may be paired with a frightening event (avalanche) so
that it becomes a conditioned stimulus eliciting anxiety. Once a fear is acquired through classical
conditioning, the person may start avoiding the anxiety-producing stimulus. The avoidance
response is negatively reinforced because it is followed by a reduction in anxiety.
Studies find that a substantial number of people suffering from phobias can identify a traumatic
conditioning experience that probably contributed to their anxiety disorder.
The tendency to develop phobias may be explained by the concept of preparedness.
People are biologically prepared by their evolutionary history to acquire some fears much
more easily than others
This theory explains why people are much more likely to develop phobias of ancient threats
(snakes) as opposed to more recent ones (electricity)
The preparedness theory has been updated and celled the evolved module for fear learning.
This evolved module is automatically activated by stimuli related to survival threats in
evolutionary history and is relatively resistant to intentional efforts to suppress the resulting
fears.
Consistent with this view, they have found that phobic stimuli associated with evolutionary
threats (snakes, spiders) tend to produce more rapid conditioning of fears and stronger fear
responses than modern fear-relevant stimuli such as guns and knives.
oCognitive factors
Cognitive theorists say that particular types of thinking make some people more vulnerable to
anxiety disorders
Some people are prone to suffer from problems with anxiety because they tend to:
Misinterpret harmless situations as threatening
Focus excessive attention on perceived threats
Selectively recall information that seems threatening
Some people are prone to anxiety disorders because they see threat in every corner of their lives
Study of anxious and non-anxious people: they were asked to read sentences. Those that were
anxious were more likely to perceive a neutral sentence as threatening (the doctor examined the
baby’s growth)
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