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Chapter 13

Chapter 13 - Psychological Disorders

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Psychology 1000
Laura Fazakas- De Hoog

Chapter 13 "Psychological Disorders" Historical Perspectives on Psychological Disorders - the demonological view - belief that abnormal behaviour is caused by supernatural forces - trephination - procedure to "release" spirit - early biological view - believed that people with disordered behaviour were sick - emphasis given force by discovery general paresis (disorder characterized in advanced stages by mental deterioration and bizarre behaviour) - psychological perspective - neuroses - disorders that do not involve a loss of contact with reality (ex: obsessions, phobias, depression) - psychoses - anxiety that is so severe caused by unresolved conflicts makes person unable to deal with reality and withdraw from it (ex: schizophrenia) - behavioural perspective views disorder behaviour as a learned response - not a reflection of internal psychodynamics and unconscious conflicts - profoundly influenced understanding of how environmental factors help shape abnormal behaviour - avoidance responses in phobias and compulsive disorders seen as operant responses that are negatively reinforced through anxiety reduction - cognitive theorists emphasize important role of people's thoughts and perceptions about themselves and environment - key to understanding many maladaptive behaviours is to isolate specific thought patterns, beliefs, attitudes underlying them - humanistic perspective views abnormality as result of environmental forces that frustrate one's inherent self-actualization tendencies and search for meaning in life - socio-cultural perspective takes into account cultural context and cultural factors that may influence the situation - vulnerability-stress model - a model that explains behaviour disorders as resulting from predisposing biological or psychological vulnerability factors that are triggered by a stressor Defining and Classifying Psychological Disorders - judgement of abnormality (the 3 D's) = distressing to self or others + deviant: violates social norms + dysfunctional for person or society - DIagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) allows diagnostic information to be represented along 5 axes (or dimensions) - Axis I - primary diagnosis - represents the person's primary clinical symptoms - Axix II - reflects long-standing personality or developmental disorders that could influence one's behaviour and response to treatment - Axis III - notes any physical conditions that might be relevant (ex: high blood pressure) - Axis IV - reflecting vulnerability-stress model, one is rated based on intensity of environmental stressors in one's recent life - Axis V - one's coping resources as reflected in recent adaptive functioning - legal consequences - competency - refers to defendant's state of mind at time of judicial hearing (may be declared "not competent to stand trial) - insanity - relates to the presumed state of mind of defendant at the time crime was committed Anxiety Disorders - frequency and intensity of anxiety responses are out of proportion to situations that trigger them - anxiety interferes with daily life - anxiety responses have four components (1) subjective-emotional - feelings of tension and apprehension (2) cognitive - subjective feelings of apprehension, a sense of impending danger, a feeling of inability to cope (3) physiological responses - increased heart rate and blood pressure, muscle tension, rapid breathing, nausea, dry mouth, diarrhea, frequent urination (4) behavioural responses - avoidance of certain situations, impaired task performance - agoraphobia - fear of open and public places - generalized anxiety disorder - chronic state of diffuse or "free-floating" anxiety that is not attached to specific situations or objects - panic disorders - occur suddenly and unpredictably, very intense - victims develop agoraphobia (a fear of public places) - OCD consists of 2 components... (A) obsession - repetitive and unwelcome thoughts, images, or impulses that invade consciousness after often abhorrent to the person but very hard to dismiss (B) compulsions - repetitive behavioural responses that can be resisted only with great difficultly - biological factors - GABA - inhibitory transmitter that reduces neural activity in amygdala and other brain structures that stimulate physiological arousal - some believe abnormally low levels of GABA activity in arousal areas may cause some individuals to have highly reactive nervous systems that quickly produces anxiety responses - psychological factors - neurotic anxiety - occurs when unacceptable impulses threaten to overwhelm ego's defenses and explode into action - learned response - emotional conditioning - sociocultural factors - culture-bound disorders - behaviour disorders whose specific forms are restricted to one particular cultural context Mood (Affective) Disorders - dysthymia - a depressive mood disorder of moderate intensity that occurs over a long period of time but does not disrupt functioning as a major depression does - depressive disorders similar across socio-economic and ethnic groups - men and women do not differ in prevalence of bipolar disorder - women twice as likely as men to suffer unipolar depression - biological factors - depression is a disorder of motivation caused by under activity in family of neurotransmitters (that includes norepinephrine, dopamine, serotonin) - manic disorders stem from over-production of same neurotransmitters that are under-active in depression - psychological factors - depressed people victimize themselves through their own beliefs - depressive cognitive triad of negative thoughts concern... (i) the world (ii) oneself (iii) future seems to pop into consciousness automatically - depressive attributional pattern - the tendency of depressed people to attribute negative outcomes to their own inadequacies and positive ones to factors outside themselves - learned helplessness theory - a theory of depression that states that if people are unable to control life events, they develop a state of helplessness that leads to depressive symptoms - socio-cultural factors - less prevalent in Hong Kong and Taiwan where strong connections with family are visible Somatoform Disorders - somatoform disorders - involved physical complaints or disabilities that suggest a medical problem but have no known biological cause and are not produced voluntarily by the person - incidents tend to be higher in cultures that discourage open discussions of emotions or that stigmatize psychological disorders - hypochondriasis - people become unduly alarmed about any physical symptom they detect and are convinced that they have or are about to have a serious illness - pain disorders - experience intense pain that either is out of proportion to whatever medical condition they might have or for which no physical basis can be found - difference between somatoform disorders and psychophysiological disorders: psychological factors cause or contribute to real medical condition (ex: ulcer, asthma, hypertension, cardiac problem) - conversion disorder - serious neurological symptoms (ex: paralysis, loss of sensation, blindness) suddenly occur - those suffering from disorder typically exhibit "la belle indifference" - strange lack of concern about their symptom and its implications - dissociative disorders - involves a breakdown of this normal integration, resulting in significant alterations in memory or identity - there are three forms... - psychogenic amnesia - person responds to stressful event with extensive but selective memory loss - some can not remember their past; others can no longer recall specific events, people, places, etc but other contents of memory like language and cognitive/motor skills remain intact - psychogenic fugue - more profound dissociative disorder in which a person loses all sense of personal identity, gives up his/her customary life, wanders to a new faraway location, establishes new identity - usually triggered by highly stressful event or trauma - dissociative identity disorder (DID) - formerly known as multiple perso
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