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CHAPTER 14 - PSYCHOLOGICAL DISORDERS

 

Identifying Abnormal Behavior: Four Basic Standards

Behavior may be judged by four criteria to determine if it is abnormal. Keep in mind that just because a behavior meets one of the criterion does not necessary make it abnormal in the psychopathological sense.

 

1)      Statistical infrequency - behaviors that occur much less frequently could be considered abnormal. Ex: Not a lot of people out there hear voices

2)      Disability & dysfunction - Is your ability to care for yourself impaired? Impairment in your ability to function socially, occupationally & with your family, can constitute abnormality

3)      Subjective discomfort or Personal distress - are you distressed? Ex: depressed people do not feel happy. Do you report being in pain?

4)      violation of norms - does your behavior deviates from what their society considers acceptable.

a)      Psychopaths are not distressed by their d/o, but their behavior violates social norms

i)        Ex: Killing people is not generally accepted in our society

b)      When considering this criterion, you MUST consider the culture that you are in. That is "normal" is relative to the culture (the culture you are living in -or- the culture that that person is from)

c)      Some d/os are culture-bound - they only exist in certain cultures. Some examples are shown for you on page 483 in Figure 14.2.

 

Explaining Abnormality: From Superstition to Science

v     Abnormal behavior was formally attributed to the work of evil spirits. It was treated by trephining (chipping holes in the skull). Later, exorcisms were the treatment of choice. People who behave abnormally were thought to be possessed. Later, it was thought that they were in cahoots with the devil.

v     Asylums - abnormal folk were sent off to asylums (prisons). Pinel ordered them to be released from their chains. Big surprise: many improved.

v     Modern Times

      Medical model currently dominates field. This is the basis for psychiatry - viewing d/os as physical diseases to be treated w/ medicine, surgery.

      Probs w/ psychiatric labeling & the medical model

         Opposed by some (Szasz) - make ppl passive, less willing to work to change.

         Ppl may live up to their labels. Ex: Rosenhan's study of "mental patients"

      ψ view things differently than psychiatry. See page 486 in Figure 14.3. ψ offers the seven perspectives for considering abnormal beh.

 

Classifying Abnormal Behaviors: The Diagnostic & Statical Manual IV-TR

The DSM-IV-TR (American Psychiatric Assc). contains a set of criteria for each d/o. Provides us with a uniform sys for describing ψgical d/os. Overview of categories: Table 14.2, page 488.

 

 

DISSOCIATIVE DISORDERS

Diss. D/os involve the splitting apart of aspects of memory or consciousness.

v     Dissociative Amnesia & Fugue

      Great loss of memory

      Amnesia - loss of an event; Fugue is like loss of life

      Usu assc'd w/ a traumatic, very stressful event

v     Dissociative Identity Disorder - formerly MPD

      2+ separate personalities w/in the same person

         The diff pers can be very different from one another

         Some may emerge to handle diff kinds of situations

v     Etiology of Dissociative Disorders

      These d/os are usu assc'd w/ extreme stress.

      DID is also assc'd w/ extreme abuse & trauma.

ANXIETY DISORDERS

v     Extreme, unwanted feelings of anxiety. Some anx is normal, however, this level is not.

v     Most frequently occurring of mental disorders in the general population.

v     Generalized Anxiety Disorder

      D/o char by chronic anxiety that isnt linked to a specific target.

      Ppl w/ this d/o may feel constantly anxious & worried. Cannot stop it.

      They are often subject to a # of physical problems as a result.

         Try to imagine the toll of being in a constant state of stress & worry. Think about how you feel during finals. Now imagine feeling that way all the time.

      Can impair your ability to cope w/ life's usual probs

v     Phobias

      There is a specific target for the anx. This is a very irrational fear. You are aware that your fear is irrational. However, whatever it is that you have the phobia about will cause you extreme anxiety.

v     Panic Disorder & Agoraphobia

      Panic d/o has unexpected panic attacks - a sudden attack of strong anx. Has physical symptoms that mimic heart probs.

      Panic D/o can contribute to the dev of agoraphobia - fear of being someplace where help would be difficult to get or escape would be difficult or embarrassing.

         In extreme cases, may not leave your home.

v     Obsessive-Compulsive Disorder

      Obsessions - unwanted thoughts (cause anxiety); compulsions - actions that one carries out to alleviate the anx. It's a vicious cycle. Can you determine the role of operant conditioning in the maintenance of this d/o?

      Some common obsessions & compulsions: obsessed with germs, so compulsively clean your home. Obsessed with worries about orderliness, so may compulsively count.

v     Social Phobia - fear of social or performance situations in which they may be evaluated, observed, or embarrassed.

v     Stress Disorders

      Acute Stress D/o & PTSD

         What distinguishes the two is the time period involved. These are not just d/os that affect military veterans.

         These d/os dev in response to an identifiable stressor

v     Etiology of Anxiety Disorders

      Biological Factors - genetic factors are involved. Also, linked to chemical probs in the brain.

      Conditioning & Learning - may be acquired through conditioning. Some of these may be acquired classically, but maintained operantly.

         Ex: consider Little Albert's phobia of fluffy, white things. Do you now see how learning can play a role in the development of abnormal behaviors

         Observational learning can also play a role in the dev of anx d/os. Can you think of any anx responses that you have that are the product of watching a model such as a parent or other family member of friend?

      Cognitive Factors

         Hypervigilant, neurotic ppl may be more prone to the dev of these d/os. Focusing too much on info that might be threatening.

 

MOOD DISORDERS

Involve a disturbance in mood (how aptly named)

v     Major Depressive Disorder

      Persistent feelings of sadness, loss of interest, guilt, worthlessness. Changes in appetite, sleep pattern, behavioral patterns, fatigue. May see probs in conc.

      Feelings of sadness, low

v     Bipolar Disorder

      Alternations btw highs and lows. See depressive symptoms & also manic symptoms.

         Manic symptoms include decreased need for sleep, increased activity, very excitable, feelings of euphoria, impaired judgment, accelerated thought & lang processes.

v     Causes of Mood Disorders: Biological Versus Psychosocial Factors

      Biological factors - abnormal brain activity, abnormal chemical activity are linked w/ these d/os. Env factors do play a role, but also seems to be a genetic role in the d/os.

      Psychosocial Factors

         What is the role of your thought processes & behaviors?

        Depression may be caused by faulty thought processes - attributional probs, continually indoctrinating yourself w/ faulty beliefs.

         Also may be related to a deficit in social skills - unable to secure reinforcement from the env.

         learned helplessness - things are bad and I can't change them for the better

 

SCHIZOPHRENIA

v     Schiz means "split mind" There are diff types. Schiz usu appears in early adulthood, Can come on slowly or suddenly. There are general symptoms.

      Perceptual Symptoms - probs w/ sensory info - it can be distorted or exaggerated. Ex: hallucinations - sensory perceptions that are not real or are greatly distorted. Ex: people who are hearing voices in their heads.

      Language and Thought Disturbances - impairments in language & thought abilities. Rules that govern lang may no longer be applicable. Words may blend together to form new words, or words will be strung together in a way that does not make sense (word salad). Or - may not be any speech at all. Thought probs- delusions - false beliefs.

         Paranoid delusions

         Delusions of persecution

         Delusions of grandeur

         Delusions of Reference

      Emotional Disturbances - emotions may be volatile, or quickly changing & unpredictable. Affect may be blunted or flat, or they may show an innapropriate emotional response for the situation.

      Behavioral Disturbances - probs w/ motor activity can vary from extreme activity to none at all.

 

Types of Schizophrenia

Diff types of SZ shown page 503 in Table 14.3

v     Paranoid type

      They have delusions of persecution

v     Catatonic type

      Char by motor disturbances

v     Disorganized type

      Disorganized speech, thought, behav, & emotions

v     Undifferentiated type

      This category is for people that exhibit a mixture of symptoms of the other subtypes. "Wastebasket" type - doesn't fit nicely into any of the others

v     Residual

      No longer showing full symptoms

 

SZ may also be classified:

1)      Positive symptoms - symptoms are exaggerations of normal functioning, or additional things added in

a)      Ex: hallucinations and other exaggerated perceptions

2)      Negative symptoms - decreases from base level. Ex: Decreased verbal ability, social w/drawal.

 

Causes of Schizophrenia

v     Biological Causes - evidence supports hereditary role in the d/o. Linked to chemical probs in brain ---> dopamine hypothesis (excess DA activity). Also, structural diffs in brain btw SZ and non-SZ ppl.

v     Psychosocial Theories - if you are prone to dev SZ, stress can trigger the onset. (Stress is evil sometimes, ain't it?) Can also trigger a relapse. Communication probs in the family may also contribute. Extreme communication probs & emotionality in the fam.

 

PERSONALITY DISORDERS
Personality disorders are PERVASIVE, LONG LASTING patterns of maladaptive behavior.

 

Antisocial Personality Disorder

v     violation of the rights of other people, lack of guilt, manipulation, aggression. May cause lots of distress for others. But the APD is usu not distressed by the behavs.

      Ex: Make your serial killers of the world - John Mohammed & Derrick Todd Lee.

v     Impulsive, do not sympathize w/ others. Don't care about others.

v     May be genetic link to the d/o. Also linked w/ abusive, harsh home settings.

 

Borderline Personality Disorder

v     Marked by unstable self-image, moods, relationships, behavior. Formation of intense, yet highly unstable relationships. Tendency to see things as all or none, in absolutes. You are either good or bad. No wiggle room in between.

v     May see suicidal & other self-injurious behavs like self-mutilation.

v     Linked to unstable childhood of deprivation & abuse.

 

COMORBIDITY

Comorbidity - a d/o does not exist alone - it is diagnosed along with another d/o occurring at the same time. This is more of a generality, not an exception. Particularly when it comes to d/os related to alcohol & substance use.

 

As always - this is not intended to replace the use of your textbook or notes or coming to class! I reserve the right to add, delete, or other modify this outline at any time. PLEASE remember to read your textbook and come to class. This chapter in the textbook is absolutely wonderful!