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PsychSmart
INTRODUCTION TO PSYCHOLOGY
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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?
3
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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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5
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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27
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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36
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?
39
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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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52
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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54
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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