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Chapter 13

Chapter 13 Psychology.docx

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Psychology 1000

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Chapter 13: Psychological Disorders  Historical Perspectives -abnormal behaviour caused by supernatural forces (work by the devil); trephination (sharp tool used to chisel a hole in the skull and eliminated abnormal behaviours) to cure people -Hippocrates suggested mental illnesses were like physical disorders; site of illness was the brain and was the first to suggest that a mental disorder could be caused by a physical dysfunction; general paresis (disorder characterized by mental deterioration and bizarre behaviour, resulting in massive brain deterioration caused by syphilis); first breakthrough if a psychological order linked to a physical illness  Psychological Perspectives -neuroses (obsessions, phobias, and depression that did not involve loss of contact with reality) -psychoses (severe disorders that are caused by great anxiety and person loses touch with reality; i.e. schizophrenia) -behavioural perspective views disordered behaviours as learned responses through classical conditioning, operating conditioning, and modelling -cognitive theorists emphasize the role of people’s thoughts and perceptions about themselves and the environment; key to understanding abnormal behaviours is to isolate specific thought patterns, beliefs, and attitudes that underlie them -humanistic theorists view abnormality as result of environmental forces that frustrate people’s self-actualization tendencies and searching for meaning in life -socio-cultural perspective takes into account the cultural context and factors that influence the forms that those abnormal behaviours take  Vulnerability-Stress Model -each person has some degree of vulnerability in developing a psychological disorder Vulnerability Factors Stressors  Genetic factors  Economic adversity  Biological characteristics  Environmental trauma  Psychological traits  Interpersonal stresses/losses  Previous maladaptive learning  Occupational setbacks or demands  Low social support -vulnerability (predisposition that can have a biological basis, such as genotype of brain malfunction) -stressors (recent/current event that requires a person to cope)  Defining and Classifying Psychological Disorders -abnormality is a social construction and can be affected by value judgments and political agendas -susto (soul loss) -drapetomania (obsessive desire for freedom that drove some slaves to flee from captivity) -judgment of abnormality depends on the “three D’s”: 1. Distressing to others (anxious, depressed, dissatisfied) 2. Dysfunctional for person/society (interfere with person’s ability to work and experience satisfying relationships with other people) 3. Deviance of a given behaviour (violates social norms)  Diagnosing Psychological Disorders -reliability (high levels of agreement in diagnostic decisions) -validity (diagnostic categories accurately capture essential features of the various disorders) -DSM-IV most widely used diagnostic classification system in North America; allows diagnostic information to be represented along 5 dimensions that take both the person and his/her life situation into account: 1. Axis 1 represents the person’s primary clinical symptoms; primary diagnosis 2. Axis 2 reflects long standing personality/development disorders that could influence person’s behaviour and response to treatment; personality/development disorders 3. Axis 3 notes physical conditions that might be relevant (i.e. high blood pressure); relevant physical disorders 4. Axis 4 notes the intensity of environmental stressors in the person’s recent life; severity of psychological stressors 5. Axis 5 refers to the coping sources as reflect in adaptive functioning; global assessment of level of functioning  Critical Issues in Diagnostic Labelling -once diagnostic label is attached to a person, it becomes too easy to use the label as an accurate description of the individual rather than the behaviour -2 important legal concepts: 1. Competency – defendant’s state of mind at the time of a judicial hearing 2. Insanity – presumed state of mind of the defendant at the time the crime was committed (can declare not guilty by reason of insanity)  Anxiety Disorders -intense, frequent, or inappropriate anxiety, but no loss of reality contact (includes phobias, general anxiety reactions, panic disorders, OCD, and PTSD) -have 4 components 1. Subjective emotional, including feelings of tension and apprehension 2. Cognitive, including subjective feelings of apprehension, sense of danger, and inability to cope 3. Physiological, including increased heart rate, muscle tension, nausea, diarrhea, etc. 4. Behavioural, including avoidance of certain situations and impaired task performance  Phobic Disorders -strong irrational fears of certain objects/situations -most common are agoraphobia (fear of public places), social phobias (fear of being evaluated and embarrassed by other people), and specific phobias (fear of dogs, snakes, elevators, etc.) -generalized anxiety disorder (chronic state of “free floating” anxiety that is not attached to objects or specific situations) -panic disorder (unpredictable panic attacks and pervasive fear will occur again; may include resulting agoraphobia) -obsessive compulsive disorder (OCD) is characterized by persistent, unwanted thoughts and compulsive behaviour; obsessions (repetitive and unwelcome thoughts, images, or impulses that invade consciousness and hard to control) and compulsions (repetitive behavioural responses); obsession are generated through orbital-frontal-cingulate pathway and compulsion involve prefrontal-caudate-thalamus circuit  Causal Factors in Anxiety Disorders -hereditary factors cause over-reactivity of neurotransmitter systems involved in emotional responses -trauma produced over-activity in emotional systems of the right hemisphere may produce vulnerability to PTSD -identical twins are more likely to have similar scores on anxiety tests than fraternal twins -search for biological processes associated with anxiety disorders are related to neurotransmitters in the brain (i.e. GABA) -GABA is a inhibitory transmitter that reduces neural activity in the amygdale and other brain structure that stimulate physiological arousal; low GABA = highly reactive nervous system that quickly produces anxiety responses in response to stressors -women exhibit anxiety disorders more often than men -biological preparedness (notion that evolutionary factors have produced an innate readiness to learn certain associations that have had survival implications in the past) -neurotic anxiety occurs when unacceptable impulses threaten to overwhelm the ego’s defences and explode into action (psychodynamic) -the cognitive perspective stresses the role of distortions (including tendencies to magnify degree of threat and danger, and in the case of a panic disorder, to misinterpret normal anxiety symptoms in ways that can evoke panic) -behavioural perspective views anxiety as a learned response established through classical conditioning/vicarious learning; avoidance responses for phobias and compulsive disorders are seen as operant responses that are negatively reinforced through anxiety reduction -sociocultural factors impact anxiety disorders through culture-bound disorders (behaviour disorders whose specific forms are restricted to one particular cultural context)  Eating Disorders -anorexia (intense fear of being fat and severely restrict food intake to the point of starvation) -bulimia (concerned with being fat, but binge eat and purge food by vomiting or laxatives) -different causes for eating disorders can range from: beauty norms, immigration, objectification theory, genetic factors, family interaction, etc.  Mood (Affective) Disorders -marked disturbances of mood (i.e. depression and mania) -major depression (intense depression that interferes with functioning) -dysthymia (depressive mood disorder of moderate intensity that occurs over a long period of time and does not disrupt functioning) -4 different types of symptoms: 1. Emotional – sadness, hopelessness, anxiety, misery, etc. 2. Cognitive – negative cognitions about self, world, and future (difficulty making decisions, low self-esteem, inferior, etc.) 3. Motivational – loss of interest, lack of drive, difficulty starting anything 4. Somatic – loss of appetite, lack of energy, sleep difficulty, weight loss/gain  Bipolar Disorder -depression (intense sadness) alternates with periods of mania (intense happiness) -speech often is rapid or pressured in mania  Prevalence and Course of Mood Disorders -1/5 chance of developing a depressive episode of life -high rate in both children and adults -similar across socio-economic and ethnic groups -once depressive episode occurs, 50% chance that depression will recur, 40% chance depression will never recur after recovery, and 10% chance of no recovery  Causal Factors in Mood Disorders -depression is a disorder of motivation caused by underactivity in neurotransmitters like norepinephrine, dopamine, and serotonin (play important roles in si
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