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INTRODUCTION TO PSYCHOLOGY
1
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CHAPTER TWELVE:
PSYCHOLOGICAL DISORDERS
AND TREATMENT

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Defining and Diagnosing
Abnormal Behavior

How can we distinguish normal from
abnormal behavior?

What are the major perspectives on
psychological disorders used by mental
health professionals?

What are the major categories of
psychological disorders?
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Defining Abnormal Behavior

Behavior that causes people to experience
distress and prevents them from
functioning in their daily lives
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Perspectives on Abnormality:
From Superstition to Science
Perspectives on Psychological Disorders
Figure 1 of Chapter 12
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Perspectives

Biomedical Perspective

Suggests that when an individual displays
symptoms of abnormal behavior, the
fundamental cause will be found through a
physical examination of the individual
Hormonal imbalance
 Chemical deficiency
 Brain injury

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Perspectives

Psychoanalytic Perspective


Abnormal behavior stems from childhood
conflicts over opposing wishes regarding sex
and aggression
Behavioral Perspective

Using basic principles of learning, behavior
itself is the problem
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Perspectives

Cognitive Perspective

Assumes that cognitions (thoughts and
beliefs) are central to a person’s abnormal
behavior
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Classifying Abnormal
Behavior: The DSM

DSM-IV-TR

Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, Text Revision

Comprehensive and relatively precise
definitions for more than 200 disorders,
divided into 17 major categories
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The DSM-IV-TR
Major Categories of Psychological Disorders
Figure 2 of Chapter 12
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The Shortcomings of DSM

David Rosenhan et al.
Sought admission to mental hospitals based
on statement that he or she was hearing
voices
 Pseudo-patients acted in a normal way after
that and the hospitals still diagnosed them as
severely abnormal


Labeling an individual as abnormal
imposes a dehumanizing, lifelong stigma
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Major Categories of
Psychological Disorders

What are the major psychological
disorders?
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Anxiety Disorders

When anxiety occurs without external
justification and begins to affect people’s
daily functioning
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Anxiety Disorders

Phobic Disorder

Individual suffers from a phobia

Phobia
Intense, irrational fear of a specific object or
situation
 Social phobia


Fear of strangers
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Anxiety Disorders
Some Types of Phobias
Figure 3 of Chapter 12
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Anxiety Disorders

Panic Disorder
Panic attacks
 Anxiety suddenly rises to a peak, and one
feels a sense of impending, unavoidable
doom


Generalized Anxiety Disorder

Long-term, persistent anxiety and
uncontrollable worry
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Anxiety Disorders
Frequency of Symptoms in Generalized Anxiety
Disorder
Figure 4 of Chapter 12
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Anxiety Disorders

Obsessive-Compulsive Disorder

Obsession


Persistent unwanted thought or idea that keeps
recurring
Compulsion

Irresistible urges to repeatedly carry out some act
that seems strange and unreasonable
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Anxiety Disorders

The Causes of Anxiety Disorders
Genetic factors
 Overactive autonomic nervous system
 Learned response to stress
 Inappropriate and inaccurate thoughts and
beliefs about circumstances in a person’s
world

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Mood Disorders

Disturbances in emotional experience that
are strong enough to intrude on everyday
living
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Mood Disorders

Major Depression

Severe form of depression that interferes with
concentration, decision making, and
sociability

One of the more common forms of mood
disorders
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Mood Disorders

Mania


Extended state of intense, wild elation
Bipolar Disorder
Periods of alternating mania and depression
 May occur over a few days or over a period of
years

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Mood Disorders

Causes of Mood Disorders

Genetic and biochemical roots

Response to learned helplessness

Stress experienced at certain points in the
lives of individuals
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Schizophrenia

Refers to a class of disorders in which
severe distortion of reality occurs

Characteristics
Decline from previous level of functioning
 Disturbances of thought and language
 Delusions
 Hallucinations and perceptual disorders
 Emotional disturbances
 Withdrawal

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Schizophrenia
Types of Schizophrenia
Figure 5 of Chapter 12
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Solving the Puzzle of
Schizophrenia

Predisposition Model of Schizophrenia

Genetic factors

Environmental influences on schizophrenia

Emotional and communication patterns of the
families of people with schizophrenia

Expressed emotion
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Solving the Puzzle of
Schizophrenia
Risk of Developing Schizophrenia Based on
Genetic Relatedness to a Person with
Schizophrenia
Figure 6 of Chapter 12
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Personality Disorders

Characterized by a set of inflexible,
maladaptive behavior patterns that keep a
person from functioning appropriately in
society
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Personality Disorders

Antisocial Personality Disorder
Sometimes referred to as sociopathic
personality
 Show no regard for the moral and ethical
rules of society or the rights of others
 Extremely manipulative and deceptive
 Con artist
 Impulsive and lack the ability to withstand
frustration
 Lack guilt or anxiety about their wrongdoing

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Personality Disorders

Borderline Personality Disorder
Difficulty developing a secure self-identity
 Tend to rely on relationships with others to
define self-identity
 Emotional volatility leads to impulsive and
self-destructive behavior, including selfmutilation
 Feel empty and alone
 May form intense, sudden, one-sided
relationships

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Personality Disorders

Narcissistic Personality Disorder
Characterized by an exaggerated sense of
self-importance
 Expect special treatment from others
 Inability to experience empathy for others

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Other Disorders

Psychoactive Substance-Use Disorder

Alcohol Use Disorders

Attention-Deficit Hyperactivity Disorder (ADHD)

Autism

Eating Disorders
 Anorexia
 Bulimia
 Binge-eating disorder
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Other Disorders

Sexual Disorders
Sexual desire disorders
 Sexual arousal disorders
 Paraphilias



Atypical sexual activities that may include
nonconsenting partners
Organic Mental Disorders
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Psychological Disorders
in Perspective

How prevalent are psychological
disorders?

What indicators signal a need for the help
of a mental health practitioner?
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Psychological Disorders in
Perspective
Problems Reported by Students Visiting a College Counseling
Center
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Figure 7 of Chapter 12
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The Social and Cultural Context
of Psychological Disorders
Prevalence of Psychological Disorders in the Previous 12
Months
Figure 8 of Chapter 12
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Deciding When You Need
Help


Long-term feelings of distress
that interfere with ability to
function effectively

Thoughts of inflicting harm on
oneself or suicide

A fear or phobia that prevents
you from engaging in everyday
activities

Inability to interact effectively
with others, preventing the
development of friendships
and loving relationships
Overwhelmingly high stress
and feelings of inability to cope
with a situation

Prolonged depression or
feelings of hopelessness

Withdrawal from other people
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Treatment of Psychological
Disorders

What are the goals of psychologically and
biologically based treatment approaches?

What are the psychodynamic, behavioral,
and cognitive approaches to treatment?

What are the humanistic approaches to
treatment?
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Treatment of Psychological
Disorders

What is interpersonal therapy?

How does group therapy differ from
individual types of therapy?

How effective is psychotherapy, and which
kind of psychotherapy works best in a
given situation?
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Psychotherapies

Treatment in which a trained professional
uses psychological techniques to help
someone overcome psychological
difficulties and disorders, resolve problems
in living, and/or bring about personal
growth
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Psychodynamic Approaches
to Therapy

Seek to bring unresolved past conflicts
and unacceptable impulses from the
unconscious into the conscious, where
clients may deal with problems more
effectively

Defense Mechanisms


Repression
Neurotic Symptoms
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Psychoanalysis: Freud’s
Therapy

Freudian psychotherapy, in which the goal
is to release hidden unconscious thoughts
and feelings in order to reduce their power
in controlling behavior
Free association
 Dream interpretation
 Transference

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Contemporary
Psychodynamic Approaches

Shorter duration

Therapist takes more of an active role
controlling the course of therapy

Therapist puts less emphasis on a
patient’s past history and childhood,
concentrating instead on an individual’s
current relationships and specific
complaints
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Behavioral Approaches
to Therapy

Make the fundamental assumption:


Both abnormal behavior and normal behavior
are learned
Classical Conditioning Treatments
Aversive conditioning
 Systematic desensitization
 Exposure treatments

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Behavioral Approaches
to Therapy
Systematic Desensitization: Steps to Achieve
Relaxation
Figure 9 of Chapter 12
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45
Behavioral Approaches to
Therapy

Operant Conditioning Techniques
Token system
 Contingency contracting
 Observational learning

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Cognitive Approaches to
Therapy

Cognitive-Behavioral Approach
Therapists attempt to change the way people
think as well as their behavior
 Highly structured and focused on concrete
problems
 Relatively short-term


Aaron Beck

Cognitive therapy
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Humanistic Therapy

Person-Centered Therapy
Aims to enable people to reach their potential
for self-actualization
 Unconditional positive regard



Expressing acceptance and understanding,
regardless of the feelings and attitudes the client
expresses
Empathetic
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Interpersonal Therapy (IPT)

Considers therapy in the context of social
relationships

Roots stem from psychodynamic
approaches

Focuses on interpersonal issues such as
conflicts with others, social skills issues,
role transitions, and grief
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Group Therapy and Family
Therapy

Group Therapy
Several unrelated people meet with a
therapist to discuss some aspect of their
psychological functioning
 Often centers on a common difficulty


Family Therapy

Involves two or more family members,
one (or more) of whose problems led to
treatment
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Evaluating Psychotherapy

Is Therapy Effective?

Hans Eysenck published a study challenging
its effectiveness

Spontaneous remission

Recovery without treatment
Issue is hotly debated
 Meta-analysis

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Evaluating Psychotherapy
Effectiveness of Different Types of
Treatment
Figure 10 of Chapter 12
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Evaluating Psychotherapy

Which Kind of Therapy Works Best?
For most people, psychotherapy is effective
 Psychotherapy does not work for everyone
 No single form of therapy works best for every
problem, and certain specific types of
treatment are better for specific types of
problems
 Most therapies share several basic similar
elements


Eclectic Approach
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53
Evaluating Psychotherapy
Effectiveness of Different Types of
Treatment
Figure 11 of Chapter 12
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Biomedical Therapy

How are drug, electroconvulsive, and
psychosurgical techniques used today in
the treatment of psychological disorders?
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Drug Therapy

Control of psychological disorders through
drugs; works by altering the operation of
neurotransmitters and neurons in the brain
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Drug Therapy
Drug Treatments for Psychological
Disorders
Figure 12 of Chapter 12
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Drug Therapy

Antipsychotic Drugs

Drugs used to reduce severe symptoms of
disturbance, such as loss of touch with reality
and agitation
Chlorpromazine
 Risperidone
 Olanzapine
 Paliperidone

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Drug Therapy

Antidepressant Drugs

Medications used in cases of severe
depression to improve the moods of patients

Work by changing the concentration of specific
neurotransmitters in the brain



Tricyclic drugs
MAO inhibitors
Selective serotonin reuptake inhibitors (SSRIs)
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Drug Therapy

Mood Stabilizers

Treats mood disorders

Bipolar




Lithium
Depakote
Tegretol
Can be a preventive treatment, blocking
episodes of manic depression
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Drug Therapy

Antianxiety Drugs

Reduce the level of anxiety a person
experiences and increase feelings of wellbeing
Xanax
 Valium

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Electroconvulsive Therapy
(ECT)

Procedure used in the treatment of severe depression

Electric current of 70 to 150 volts is briefly administered
to a patient’s head, causing a loss of consciousness and
often causing seizures

Transcranial magnetic stimulation (TMS)
 New and promising experimental alternative to ECT
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Psychosurgery

Brain surgery in which the object is to
reduce symptoms of a mental disorder
Prefrontal lobotomy
 Cingulotomy

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Biomedical Therapies
in Perspective

Gene Therapy

Critics state that therapies merely provide
relief of the symptoms and not the
underlying problems

Side Effects
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Community Psychology

Aims to prevent or minimize the incidence
of psychological disorders

Deinstitutionalization

Transfer of former mental patient out of
institutions and into the community
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