Ch13 Psychological Disorders

CHAPTER 13 – PSYCHOLOGICAL DISORDERS MODULE 13.1 WHAT IS ABNORMAL BEHAVIOR? After you have mastered the information in this unit, you will be able to: Explain the criteria used to determine whether behavior is abnormal Discuss the major models of abnormal behavior Define psychological disorder Key Terms and Concepts: Hallucinations Delusions Culture-Bound Syndromes Dhat Syndrome Medical Model Biopsychosocial Model Diathesis-Stress Model Diathesis Psychological Disorders Charting the Boundaries Between Normal and Abnormal Behavior Criteria for abnormal behavior—no behaviors exclusive to psychological disorder Unusualness—experienced by only a few Social deviance—not considered socially acceptable Emotional distress—when prolonged, excessive, inappropriate Maladaptive behavior—causes distress, self-defeating, self-destructive Dangerousness—must consider within social context Faulty perceptions or interpretations of reality—hallucinations, delusions, distortions of reality Professionals use several criteria to make determination Cultural bases of abnormal behavior Always must consider social, cultural context when making evaluation Disorders may take different forms in different cultures Culture-bound syndromes—limited to occurring within just one culture Behaviors may also be considered disordered or not, depending on era in history (e.g., evaluation of homosexuality) Applying the criteria—apply several criteria in order to accurately evaluate Models of Abnormal Behavior Early beliefs Ancient times through Middle Ages—disturbed people thought possessed by demons or controlled by supernatural forces Treatment was exorcism, or more severe The medical model Eighteenthand nineteenthcenturies—medical advances Shift to belief that mental disturbance is an illness Psychological models Psychodynamic (Freud)—disturbance due to unconscious conflict, stemming from childhood Behavioral—disturbed, maladaptive behaviors learned the same way normal behaviors learned Humanistic Disturbance due to encountering roadblocks on path to self-actualization Individuals have lost touch with inner self, over-concern with standards of others, distorted self-image Cognitive Disturbances due to irrational, distorted thinking Interpreting negatively, exaggerating negative consequences The sociocultural model Must evaluate in terms of social, cultural context Problem may lie with social ills, failures of society Labeling sufferers results in social prejudices; compounds problem The biopsychosocial model Many useful models to explain abnormal behavior Disturbance is the result of combination, interaction of factors (including psychological, biological, sociocultural) Diathesis-stress model Diathesis is a predisposition, vulnerability (genetic or psychological) High stress triggers disorder, low stress does not What Are Psychological Disorders? Basic characteristics of psychological disorders Also known as mental disorders, mental illnesses Disturbances of behavior, mood, thoughts, or perceptions, which impair functioning How many are affected? Fifty percent of Americans have a diagnosable disorder at some point How are psychological disorders classified? Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) Descriptions, diagnostic criteria for every recognized psychological disorder Multiaxial system—practitioner examines patient on many dimensions Widely used; some concern that reliability, validity not fully established; may rely too much on medical model MODULE 13.2 ANXIETY DISORDERS After you have mastered the information in this unit, you will be able to: Describe the various types of anxiety disorders Explain the causal factors implicated in anxiety disorders Key Terms and Concepts: Anxiety Disorders Phobia Social Phobia Specific Phobia Acrophobia Claustrophobia Agoraphobia Panic Disorder Generalized Anxiety Disorder (GAD) Obsessive-Compulsive Disorder (OCD) Anxiety Sensitivity Types of Anxiety Disorders Basic characteristics of anxiety disorders Most commonly experienced psychological disorders Formerly classified as neuroses Characterized by excessive, inappropriate agitation; impedes one’s ability to function Phobias Affect seven to eleven percent of population Irrational or excessive fear of object or situation Types of phobic disorders Social phobia—fear of being with others, speaking in public Specific phobia—such as acrophobia (fear of heights), claustrophobia (fear of enclosed spaces) Agoraphobia—fear of open spaces, going out in public Individuals usually aware of problem; still cannot face source of fear Panic disorder Sudden episodes of sheer terror (panic attacks) Many physiological symptoms; feeling as if one is dying or having a heart attack Experience can be triggered by particular situations Generalized anxiety disorder (GAD) Pervasive, persistent fear, not related to specific object or location Unrest, constant worry, feelings of dread and foreboding Obsessive-compulsive disorder (OCD) Behaviors or thoughts repeated over and over again Obsessions are persistent thoughts; compulsions are rituals or repetitive behaviors Causes of Anxiety Disorders Biological factors Anxiety disorders run in families—suggests a genetic link Brain functioning may result in sense of alarm in some people Overactivity in certain parts of the brain Psychological factors Classical conditioning—neutral stimulus paired with one that is frightening Operant conditioning—negative reinforcement through relief of avoiding situation, engaging in compulsive behaviors Cognitive models—possible misinterpretation of bodily cues; excessive, unrealistic concerns about others’ social judgments MODULE 13.3 DISSOCIATIVE AND SOMATOFORM DISORDERS After you have mastered the information in the unit, you will be able to: Describe the dissociative and somatoform disorders Explain the causal factors implicated in dissociative and somatoform disorders Key Terms and Concepts: Dissociative Disorders Somatoform Disorders Dissociative Identity Disorder (DID) Conversion Disorder Hypochondriasis Secondary Gain Dissociative Disorders—interfere with cohesive sense of self, unity of personality Dissociative identity disorder (DID) Also known as multiple personality or split personality Two or more distinct personalities exist within same individual Dissociative amnesia Loss of memory about self or life experiences (no physical cause) Usually a traumatic or stressful event involved Causes of Dissociative Disorders May be an attempt to distance self from psychological pain, conflict DID—possible background of severe, repetitive physical abuse DID diagnosis still in question Somatoform Disorders—physical problem, no underlying physical cause Conversion disorder Called “hysteria” during time of Sigmund Freud Loss of physical function, loss of feeling in a limb Hypochondriasis—preoccupation with belief that one has a terrible illness Causes of Somatoform Disorders Freud’s explanation—manifestation of unconscious conflict Secondary gain—“problem” may help individual avoid anxiety-producing situations People may be reinforced for playing the “sick role” MODULE 13.4 MOOD DISORDERS After you have mastered the information in this unit, you will be able to: Describe the various types of mood disorders Explain the causal factors implicated in mood disorders Discuss the reasons for suicide and who is most at risk for committing suicide Key Terms and Concepts: Mood Disorders Major Depression Seasonal Affective Disorder (SAD) Dysthymic Disorder Bipolar Disorder Manic Episodes Cyclothymic Disorder Learned Helplessness Model Attributional Style Depressive Attributional Style Disinhibition Effect Basic Characteristics of Mood Disorders Severe, persistent disturbances of mood Impair ability to function, will to live Types of Mood Disorders Depressive disorders Major depression Extreme feelings of worthlessness, sadness, despondency Experienced twice as often by women as men Women may experience more stress, handle stress differently Seasonal affective disorder (SAD) Periods of depression during fall and winter Treated successfully by exposure to bright light Dysthymic disorder More mild but chronic form of depression—may last for years More common in women Bipolar disorders—alternating, fairly extreme moods of elation, depression Manic episodes—euphoria, boundless energy, possibly reckless Cyclothymic disorder Milder mood swings than bipolar individual About as many men as women affected Causes of Mood Disorders Psychological factors Psychodynamic explanation—anger against self Behavior model—too little reinforcement, especially social reinforcement Cognitive approach Aaron Beck (developed cognitive therapy) How people interpret events is related to depression Negative mind set, cognitive distortions are the problem Learned helplessness model (Martin Seligman) Stop making effort when people feel they have lost control over events Attributional style—how we explain outcomes Depressive attributional style—internal, global, stable interpretation for outcomes involving disappointments, experiences of failure Biological factors Chemical imbalances in the brain (involving neurotransmitters) Antidepressants (e.g., Prozac) increase levels of norepinephrine and serotonin Depression not just a lack of certain neurotransmitters Genetic link likely, especially with regard to bipolar disorder Exploring Psychology: The Personal Tragedy of Suicide Rate of occurrence 500,000 Americans each year make a serious attempt A leading cause of death among older teens, young adults Who is most at risk? Age—greatest among older adults Gender More women attempt suicide More males complete the act—use more lethal, violent methods Race/ethnicity—higher rate among white European Americans, Native Americans Factors in suicide Closely related to mood disorders, especially depression, bipolar disorder Suicide, like depression, may be linked to biochemical factors Disinhibition effect Possible result of low levels of serotonin Removes natural tendency to curb impulsive activity (including attempt to commit suicide) Alcohol dependence—again may lead to impulsivity Lack of coping responses among those who attempt, commit suicide Exit events—losing people who are sources of emotional support Copycat suicides among adolescents MODULE 13.5 SCHIZOPHRENIA After you have mastered the information in this unit, you will be able to: Define schizophrenia Describe the three specific types of schizophrenia Explain the causal factors implicated in schizophrenia Discuss the diathesis-stress explanation for schizophrenia Key Terms and Concepts: Schizophrenia Psychotic Disorder Thought Disorder Positive Symptoms Disorganized Type Catatonic Type Waxy Flexibility Paranoid Type Background Factors in Schizophrenia Disorder most closely related to typical concept of madness Involves bizarre, irrational behavior; roughly one percent of population is affected Slightly more common, more severe, and with earlier onset in men Tends to occur at uniform rates worldwide Onset corresponds to transition from adolescence to adulthood Symptoms of Schizophrenia A psychotic disorder—inability to distinguish reality from fantasy Experience things that in actuality do not exist Hallucinations—perceptions not based on actual stimuli (e.g., hearing voices) Delusions—adhering to beliefs that are clearly, completely false Exhibit bizarre behavior, incoherent speech, illogical thinking (positive symptoms) Thought disorder—ideas not really connected, organized, or meaningful Includes extreme withdrawal, isolation, apathy, blunted emotions (negative symptoms) Not all symptoms necessary for diagnosis of schizophrenia Types of Schizophrenia Disorganized Confused behavior, hallucinations, disorganized delusions May neglect personal hygiene, fail to control bodily functions Inappropriate emotions, difficulty in relating to others Catatonic Bizarre movements, postures, grimaces May adopt a motionless stupor, unresponsive for hours Waxy flexibility—body can be molded without difficulty by others A rare form of schizophrenia Paranoid Most common form of schizophrenia Delusions of grandeur, persecution, or jealousy May be accompanied by auditory hallucinations Causes of Schizophrenia Genetic factors Heredity plays an important role Higher rate of incidence among monozygotic than dizygotic twins Higher incidence in adopted children whose biological parents afflicted Expected that multiple genes are responsible for disorder Biochemical imbalances Dopamine pathways and dopamine receptors are implicated Helpful antipsychotic drugs (e.g., Thorazine) reduce dopamine activity Brain abnormalities MRIs, CTs reveal abnormal brain development Most affected areas are prefrontal cortex, limbic system Prefrontal cortex helps organize thoughts, carry out plans Limbic system involved in memories, emotional experiences Psychosocial influences Life stresses a factor, such as difficult family environment Diathesis-stress model Diathesis involves a genetic predisposition; creates vulnerability Sufficient stressful experiences trigger onset of disorder MODULE 13.6 PERSONALITY DISORDERS After you have mastered the information in this unit, you will be able to: Describe the personality disorders Outline the characteristics associated with antisocial personality disorder Discuss the causal factors implicated in antisocial personality disorder Key Terms and Concepts: Personality Disorders Narcissistic Personality Disorder Paranoid Personality Disorder Schizoid Personality Disorder Borderline Personality Disorder Antisocial Personality Disorder Background Characteristics of Personality Disorders Excessively rigid patterns of behavior Maladaptive because limits adjustment to environment, needs of others Types of Personality Disorders Narcissistic personality disorder—inflated sense of self Paranoid personality disorder—extreme suspiciousness, distrust of others Schizoid personality disorder Little or no interest in social relationships Limited range of emotional expression Appear distant and aloof Borderline personality disorder Stormy relationships with others Unstable self-image, dramatic mood swings Ten personality disorders identified by DSM Antisocial personality disorder (APD)—the most widely studied Symptoms of Antisocial Personality Disorder People with this disorder have also been labeled psychopaths, or sociopaths Flagrant disregard for rules of society Complete lack of regard for well-being of others Not a psychotic disorder; antisocial personality is in touch with reality Impulsive, irresponsible, take advantage of others Lack remorse for misdeeds, mistreatment of others Not concerned or threatened by punishment or possibility of punishment May be unusually intelligent, exhibit superficial charm Most often found in males Causes of Antisocial Personality Disorder Possible brain abnormalities in males Lower levels of activity in frontal lobes of cerebral cortex Possible structural damage to prefrontal cortex Craving for stimulation may have genetic link Environmental factors Characteristics of homes, families where APD individuals raised Lack of parental warmth Parental neglect, rejection Use of harsh punishment Emotional, physical abuse History of abuse may lead to lack of empathy, lack of genuine emotional ties Failure to develop concern for others, moral compass, conscience APD individuals treat others with callous disregard MODULE 13.7 APPLICATION: SUICIDE PREVENTION After you have mastered the information in this unit, you will be able to: Outline the steps you can take to help someone who is threatening suicide Background Factors in the Occurrence of Suicide Difficult to detect, even by professionals A challenging situation, but there are steps one can take to help prevent Facing the Threat—General Guidelines Recognize that threatened suicide is serious Also consider seriously indicators that are implied but not overt Show warmth, compassion, understanding Suggest alternatives Evaluate immediacy of the event Encourage the individual to agree regarding getting help Take the individual to get help CHAPTER 13 – PSYCHOLOGICAL DISORDERS MODULE 13.1 - WHAT IS ABNORMAL BEHAVIOR? Hallucinations Delusions Culture-Bound Syndromes Medical Model Biopsychosocial Model Diathesis-Stress Model Diathesis Psychological Disorders MODULE 13.2 - ANXIETY DISORDERS Anxiety Disorders Phobias Social Phobia Specific Phobia Acrophobia Claustrophobia Agoraphobia Panic Disorder Generalized Anxiety Disorder (GAD) Obsessive-Compulsive Disorder (OCD) Anxiety Sensitivity MODULE 13.3 - DISSOCIATIVE AND SOMATOFORM DISORDERS Dissociative Disorders Somatoform Disorders Dissocaitive Identity Disorder (DID) Conversion Disorder Hypochondriasis Secondary Gain MODULE 13.4 - MOOD DISORDERS Mood Disorders Major Depressive Disorder Seasonal Affective Disorder (SAD) Dysthymic Disorder Bipolor Disorder Manic Episodes Clclothymic Disorder Learned Helplessness Model Attributional Style Depressive Attributional Style Disinhibition Effect MODULE 13.5 – SCHIZOPHRENIA Schizophrenia Psychotic Disorder Thought Disorder Positive Symptoms Negative Symptoms Disorganized Type Catatonic Type Waxy Flexibility Paranoid Type MODULE 13.6 - PERSONALITY DISORDERS Personality Disorder Narcissistic Personality Disorder Paranoid Personality Disorder Schizoid Personality Disorder Borderline Personality Disorder Antisocial Personality Disorder (APD)