Transcript Chapter 14- Psychological disorders

Chapter 14: Psychological Disorders
(Abnormal Psychology)
Defining Abnormality
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Defining abnormality is not simple, it appears to be more a
matter of degree of behavioral change & distress rather than
the presence or absence of a behavioral change or distress
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Some criterion seem helpful in defining abnormality:
• Behavior is outside of social norms
(shouting at strangers…*shows what is “normal” is culturally dependent)
• Inability to function
(being unable to go to work due to alcohol abuse)
• Personal Distress
(trouble sleeping, worry all the time, thoughts of suicide)
• Prolonged Suffering
(depression that lasts months rather than days)
Normality-Abnormality
Continuum
DSM IV
Diagnostic and Statistical Manual (DSM IV)
1952- First edition
1994- 4th edition
2000- 4th revised
2013- Planned release for 5th edition
Five axis criteria for diagnostic classification of psych. disorders
Axis 1- Principal diagnosis - 16 categories
Axis 2- Personality or developmental disorders
Axis 3- Medical conditions
Axis 4- Recent sources of stress
Axis 5- Global Assessment of Functioning (GAF)
Schizophrenic Disorders
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Group of disorders marked by disturbances in
thought patterns. These disorders can be
accompanied by distortions in perception and
abnormal emotional responses.
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1% of population in every culture
30% resistant to drugs
Gradual vs. Sudden onset
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Subtypes of Schizophrenia
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Paranoid: marked by delusion of persecution and/or
grandeur, and frequent auditory hallucinations
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Disorganized: marked by inappropriate affect,
disorganized speech
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Catatonic: marked by motor disturbances ranging from
immobility to excessive, purposeless activity
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Undifferentiated: mixtures of symptoms from other
subtypes
Potential Causes of Schizophrenia
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Physiological Explanations
• neurochemicals- excess dopamine
• enlargement of the ventricles of the brain
(genetics- there is a 46% concordance rate for identical twins
with one twin suffering schizophrenia
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Environmental Explanations
• Stress- can precede the onset of schizophrenia and precede
subsequent relapses
• Unhealthy Family Dynamics- high expression of emotion and
communication difficulties in a family
• Date of birth- maybe flu season during time in womb? (see next
slide)
Risk Month Born
Relatives of ppl with
schizophrenia
Anxiety Disorders
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Generalized Anxiety Disorder: chronic anxiety that is not
caused by a specific stimulus
Panic Attacks: recurrent attacks of anxiety not due to a specific
event
Phobias: chronic, irrational fear of a specific object or situation
agoraphobia (open spaces), social phobia
Obsessive-Compulsive Disorder: persistent obtrusive thoughts
(obsessions) & need to engage in unnecessary rituals
(compulsions)
Post Traumatic Stress Disorder (PTSD): after traumatic life
event person has severe anxiety, helplessness, fear, flashbacks
Common Phobias
Less Common (but entertaining)…phobias list
Some Potential Causes of Anxiety Disorders
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Behavioral explanations: Classically
conditioned phobic responses
Neuro-chemical: decreases in GABA activity
and serotonin activity are associated with
anxiety disorders
Cognitive: people who suffer from anxiety
disorders may chronically overestimate the
severity of a perceived threat
Mood Disorders
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Depressive Disorder: persistent feelings of
sadness and a loss of interest in finding pleasure
(Major, dysthemic (two years +), post-partum,
seasonal affective disorder)
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Bipolar Disorder: marked by chronic experience
of manic and depressive episodes
Episodic Patterns in Mood
Disorders
Some Potential Causes of Depression
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Cognitive and Behavioral Mechanisms
• Behavioral: ”learned helplessness” believe outcomes in their life
are out of their control (external locus of control)
• Cognitive: negative self-talk is associated with depressive
episodes
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Physiological Mechanisms
• Neurotransmitters: decreased norepinephrine and serotonin is
associated with depression
• Genetics: there is a 65% concordance rate between identical
twins
Mood Disorders chart
Somatoform Disorders
Physiological issues without cause
 Hypochondriasis: excessive preoccupation with
becoming ill
 Conversion Disorder: significant loss of function
in one single organ system without a physiological
cause
Dissociative Disorders
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Dissociative Amnesia: sudden loss of memory for personal
information that is not due to normal forgetfulness
 Dissociative Fugue: a loss of memory and forming a new
identity
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Dissociative Identity Disorder (DID): the coexistence of
more than one personality in an individual
 Depersonalization: Feelings of unreality concerning the
self and environment. Anxiety producing. Many young
adults have felt this.
Personality Disorders- a few examples
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Antisocial Personality Disorder (sociopath): marked
by impulsive, callous, manipulative, aggressive, and
irresponsible behavior that lacks conscience (often
charming)
Narcissistic: exaggerated feelings of self-worth and
constant need for affirmation
Histrionic: OVERLY emotional/seductive
Borderline: irrational fear of abandonment, self injury
Avoidant: Dependent:
Schizotypical:
Obsessive-Compulsive:
Insanity Pleas
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Does not know right from wrong
A disorder alone does not absolve responsibility
John Hinkley - President Reagan
Ted Kaczynski, Jeffrey Dahmer, Andrea Yates, Kip
Kinkel- all found guilty by juries
Some Potential Causes of Somatoform Disorders
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Personality Factors: people with histrionic and
neurotic personality traits seem to be more
susceptible to the somatoform disorders
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Behavioral Factors: people who have previously
received a lot of attention because of illness may
begin to find reward in the somatoform disorders
Problems with DSM/disease model
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Thomas Szasz- no such thing as mental ill
Rosenhan- empty, hollow, thud- 19 days
Labeling theory
Not easy to classify- crossover
Infers more understanding than actual
Everyday problems
Insurance
Suicide
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White > Black,
Men > Women (China),
Woman attempts > Men attempts
Spike for men after 65
Alcoholics and depression very high rate
Few who talk about it do it, but most who do it
give clues ahead of time
Arizona over 1000 suicides last year- Mesa 60,
Chandler 30
Suicide facts
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Take all threats seriously
Most suicidal people are ambivalent and
want help
Asking a person can minimize anxiety and
act as a deterrent
An attempter is often upset or depressed
Clues and Warning Signs
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Change in interest or mood (including
extremely happy or peaceful.
Change in lifestyle, eating, sleeping
Change in perception of the world
Change in attitude about personal propertygiving away prized possessions
Teen Sex and Depression
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2800 14 to 17 year-olds
25% of sexually active girls feel depressed
all, most, or a lot of the time vs 8%
14% of sexually active girls have attempted
suicide vs 5%
6% of sexually active boys vs less than 1%