Textbook Notes (363,103)
Canada (158,195)
Psychology (4,731)
Psychology 1000 (1,558)
Dr.Mike (659)

16 - Psychological Disorders.docx

11 Pages
Unlock Document

Western University
Psychology 1000

Chapter 16 Psychologica l Disorders The Scope and Nature of Psychological Disorders  Abnormal Behaviour: personally distressing, dysfunctional, inappropriate, maladaptive, culturally deviant from norm (not good measurement) and culture (depending on time) or personal values (not good measurement)  Disorders with primarily physical symptoms but “caused” or maintained by psychological factors E.g. hypertension  Gastric ulcers - painful lesions of stomach lining partly due to living in stressful environment Historical Perspectives on Deviant Behaviour  Trephination: treat behaviour by releasing spirit attempt to escape body by chiselling a hole in the skull in Egypt  In Medieval Europe, abnormality thought people were involuntarily possessed or voluntarily joined the dark side  Diagnostic test – bind feet and hands and throw into a lake and if they float, they were impure  Greek Hippocrates believed the site of mental illness was the brain  Western view as biologically caused e.g. general paresis – mental deterioration, bizarre behaviour due to syphilis  Vulnerability-Stress (Diathesis-Stress) Model: how vulnerable to develop psychological disorder given stress o Biological: predisposition genotype, over/under neurotransmitter activity, autonomic NS trigger, hormones o Personality (low self-esteem or pessimism) o Environmental (poverty, trauma, low social support, maladaptive learning) and cultural  Stressors – economic e.g. occupational setbacks, demands, environmental trauma, interpersonal stresses, losses Diagnosing Psychological Disorders DSM-V: Integrating Categorical and Dimensional Approaches  Most widely used diagnostic classification system in North America o Diagnose made based on list of must be present behaviours but too specific and categories overlap o Takes both the person and life situation into account but not severity of disorder or symptoms o Axis I (primary diagnosis) – primary clinical symptoms o Axis II – long standing personality or developmental disorders o Axis III – relevant physical disorders e.g. high blood pressure o Axis IV – severity of psychosocial/environmental stressors o Axis V – global assessment of level of functioning (coping resources)  Dimensional system o Relevant behaviours rated along a severity measure o Psychological disorders are extensions of different degree o Normal, adaptive conscientiousness, subclinical, disordered, severely disordered maladaptive extremes  Revision o Categories are retained and incorporates dimensional scales of severity o E.g. personality disorders – negative emotionality, schizotypy (odd thinking), disinhibition (impulsive), introversion (social withdrawal), antagonism (manipulation) and compulsivity (perfectionism) o Helps link normal and abnormal personality functioning and find out personality for better treatment Critical Issues in Diagnostic Labelling  Social and Personal Implications – label makes it hard to see behaviour without thinking about how they should act  On Being Sane in Insane Places - once labelled, every behaviour performed was viewed as consistent with label  When people read a description of a disorder, people tend to see those symptoms in themselves Legal Consequences  Competency: defendant’s state of mind at time of judicial hearing (not at time crime committed) o Not competent = too disturbed to understand the nature of legal proceedings  Insanity: severely impaired, lack capacity either to appreciate wrongfulness of their acts or control conduct o Insanity is a legal term and not a psychological one o Guilty but mentally ill punishes them to the mental hospital for help then to prison when recover 2 Anxiety Disorders  Frequency and intensity of anxiety responses are out of proportion to situations that trigger them  Responses: o Subjective-emotional component – feelings of tension and apprehension o Cognitive component – subjective feelings of apprehension, sense of danger, feeling of inability to cope o Physiological responses – increased heart rate o Behavioural responses – avoidance of certain situations and impaired task performance  Incidences – number of new cases that occur during a given period  Prevalence – number of people who have a disorder during a specified period of time Phobic Disorder  Strong and irrational fears of certain objects or situations  They realize their fears are out of all proportion but feel helpless to deal with it so they make effort to avoid it  Agoraphobia: fear of open and public spaces  Social Phobias: excessive fear of situations in which the person might be evaluated and possibly embarrassed  Specific Phobias: e.g. fear of dogs, airplanes, enclosed spaces, illness, death  Animal fears common in women and fear of heights common in men  Degree of impairment depends how often the phobic stimulus is encountered Generalized Anxiety Disorder  Chronic state of diffuse or free floating anxiety that is not attached to specific situations or objects  Expect something awful to happen but doesn’t know what (mind is always on emergency mode) Panic Disorder  Occur suddenly and unpredictably and much more intense  Develop agoraphobia because of their fear that they will have an attack in a public  Diagnosis requires recurrent attacks that don’t tie to environmental stimuli  Usually affecting people in late adolescence or early adulthood Obsessive-Compulsive Disorder (OCD)  Cognitive and behavioural  Obsessions: repetitive unwelcome thoughts, images, impulses that invade and won’t go away in consciousness  Compulsions: repetitive behavioural responses that can be resisted only with great difficulty o Responses to obsessive thoughts and function to reduce anxiety of thought o If the person does not perform compulsive act, experience anxiety and even panic The Neuroscience of Obsessive Compulsive Disorder  Executive dysfunction model says problem is impulse control, behavioural inhibition of inappropriate behaviours o Altered activity in prefrontal cortex o Caudate nucleus (in basal ganglia) help regulate limbic system, prefrontal cortex to complete behaviours o Thalamic abnormality related to OCD symptom severity o Best explain compulsions and neural wiring  Modulatory control model suggests the lack of control of socially appropriate behaviours o Increased metabolism in orbitofrontal and medial prefrontal cortex o Control of socially appropriate behaviours and motivation o Damage includes inappropriate impulsive behaviours that fixate on one aspect on environment o Damage is heritable o Focus on obsessions and pathway of orbitofrontal cortex and cingulate 3 Causal Factors in Anxiety Disorders Biological Factors  Vulnerability from autonomic nervous system that overreacts to threat and create high physiological arousal  Hereditable overreactivity of right hemisphere neurotransmitter systems in emotional responses  Low levels of GABA inhibitory transmitter reduces neural activity in amygdala and physiological arousal  Serotonin may also be involved  Women exhibit more anxiety disorders than men do from sex-linked biological predisposition and less power  Evolutionary factors that predispose people to learn to fear certain stimuli Psychological Factors  Psychodynamic theories (Freud) o Neurotic Anxiety: unacceptable impulses threaten to overwhelm ego’s defences and explode into action  How ego’s defence deals with anxiety determines form of anxiety  In phobic disorders, anxiety is displaced onto external stimulus that has symbolic significance o Obsessions symbolically related to but less terrifying than underlying impulse o Compulsion is a way of taking back or undoing one’s unacceptable urges o Generalized anxiety when defences are not strong enough to control it but strong enough to hide conflict o However, not enough research support  Cognitive factors o Maladaptive thought patterns and beliefs and feel powerless to cope o Catastrophize about demands and magnify them (anticipate the worst) into sensitive threats o Intrusive thoughts about traumatic event are a central feature and presence of development of PTSD o Panic attacks triggered by exaggerated misinterpretations of normal anxiety symptoms  Anxiety as a learned response o Classically conditioned fear response or observational learning with environmental or internal cue o Negative reinforcement of anxiety reducing behaviour prevents extinction of fear Sociocultural Factors  Culture-bound Disorders: occur only in certain places  Koro: southeast Asian anxiety disorder where man fears his penis is going to retract into abdomen and kill him  Taijin Kyofushu: fearful of offending others (odours, blushing, inappropriate staring, facial expression, blemish)  Wingdigo: North American Indians fearful of being possessed by monsters that turn them into homicidal cannibals  Anorexia Nervosa: fear of getting fat in developed countries Eating Disorders  Anorexia nervosa o Restrict food intake to point of self-starvation o Weigh less than 85% of normal weight o Menstruation stops, strains the heart and produces bone loss and increase risk of death  Bulimia nervosa o Binge eat and then purge the food through inducing vomiting or laxatives o Most have normal body weight, repeated purging has gastric problems and badly eroded teeth General Out of Control Eating Regulation Causes  Industrialized countries emphasis beauty = thinness (cultural norm)  Anorexics are perfectionists and battle for success and control (me vs food and they will win)  Bulimics usually depressed, anxious, low impulse control, lack stable sense of personal identity, self-sufficiency o Bingeing triggered by stress, guilt, self-contempt o Purging reduces depression and anxiety  Predisposition through abnormal serotonin activity to regulate eating o Once started abnormal eating, e.g. low leptin levels try to remain to stay low even if eat more o Strong stomach acids in bulimics lose taste sensitivity so vomiting is more tolerable in the future 4 Mood (Affective) Disorders  Depression and mania (excessive excitement)  High comorbidity (co-occurrence) with anxiety Depression  Clinical depression – frequency, intensity and duration of depressive symptoms are out of proportion to situation  Dysthymia: less intense depression but more chronic and long-lasting  Negative mood state is the major feature in depression  Cognitive symptom o Difficulty concentrating, making decisions and have low self-esteem, inferior, inadequate, incompetent o Blame themselves for failure occurred or not in pessimistic and hopelessness behaviour  Motivational symptom o Inability to get started and perform behaviours that might produce pleasure or accomplishment o Extreme cases causes movement to slow down and talk slower  Somatic (physical) symptom o Loss of appetite, weight loss, sexual desire and responsiveness o Sleep disturbances (insomnia) o Fatigue and weakness Bipolar Disorder  Depression with alternate periods of mania (highly excited mood and opposite behaviour)  Mania – no limits to what can be accomplished and does not recognize the negative consequences o Hyperactive motivational behaviour causes less need for sleep and talk faster  Lithium carbonate prescribed to eliminate manic phase and depression does not return with few side effects Prevalence and Course of Mood Disorders  Any age could experience depression and men and women both equally likely to get bipolar disorder  Women more likely to get unipolar disorder in 20’s due to monthly premenstrual depression (40’s in men)  Depressive episode has occurred: o Does not occur again o Half show a second pattern, recovery with recurrence o Not recover and remain depressed  Manic episodes are more likely to recur but mania is uncommon Causal Factors in Mood Disorders Biological Factors  Genetically based temperament systems o Behavioural inhibition system (neuroticism)  Pain-avoidant, generates fear, anxiety  Depression = high BIS and low BAS  Norepinephrine, dopamine and serotonin underactivity  Lack of pleasure and loss of motivation  Antidepressant drugs increase activity o Behavioural activation system (extraversion)  Reward oriented  Activated by cues that predict future pleasure  Mania = high BAS and low BIS  With failure, BAS deactivation causes high BIS (depression)  Mania has stronger genetic basis o Overproduction of same neurotransmitter that are underactive in depression o Lithium chloride used to calm manic disorders by decreasing activity of transmitter 5 Psychological Factors  Personality-based vulnerability o Freud – early traumatic events create vulnerability o Humanistic perspective – “me” generation overemphasis on individuality and personal control  Self-worth of individual and have less commitment to traditional values of family, religion  React strongly to failure, view negative events as own inadequacies, feel meaningless  Cognitive processes o Victimize themselves through their own beliefs that they are defective, worthless and inadequate o Depressive Attributional Pattern: taking no credit for success but blaming themselves for failures o Learned Helplessness Theory: expect bad events will occur and nothing to do to prevent or cope them o Personal (my fault), stable (always my fault) and global (total loser) o Mania emotions linked to BAS  Autonomy (focus on individualistic achievement and self-sufficiency)  High performance standards  Self-criticism when goals are not obtained  Learning and environmental factors o Triggered by loss, punishing event or drastic decrease in positive reinforcement o Stop performing behaviours that previously provided reinforcement e.g. hobbies o Less social support because become less likeable o Behavioural activation of positive reinforcement pleasurable behaviours counteract depression o Children of depressed parents = poor parenting, experience many stressful events = no good coping skills Sociocultural Factors  Suicide rates are higher in Western countries than in Hong Kong and Taiwan o Strong connections to family and others reduce negative impact of loss and give strong social support  Cultural factors affect ways depression is manifested o Feelings of guilt in North American and Western European countries o Somatic symptoms of fatigue, loss of appetite and sleep difficulties in Latin, Chinese and African o Women more likely depressed in technologically advanced countries Understanding and Preventing Suicide  Suicide: wilful taking of one’s own life  Women take more suicide attempts but men are more likely to be successful o Higher depression rate in women due to love relationships o Men’s choice of more lethal methods due to failure in occupation  Depression p
More Less

Related notes for Psychology 1000

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.