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
Ø
Medical model currently
dominates field. This is the basis for psychiatry - viewing d/os as physical
diseases to be treated w/ medicine, surgery.
Ø
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"
Ø
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.
Diss.
D/os involve the splitting apart of
aspects of memory or consciousness.
Ø
Amnesia
- loss of an event; Fugue is like loss of life
Ø Usu assc'd w/ a traumatic,
very stressful event
v
Dissociative
Identity Disorder - formerly MPD
Ø
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
Ø These
d/os are usu assc'd w/ extreme stress.
Ø DID is
also assc'd w/ extreme abuse & trauma.
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
Ø
D/o
char by chronic anxiety that isn’t linked to a specific target.
Ø
Ppl
w/ this d/o may feel constantly anxious & worried. Cannot stop it.
Ø
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.
Ø Can impair your ability to
cope w/ life's usual probs
v
Phobias
Ø 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
Ø
Panic
d/o has unexpected panic attacks - a sudden attack of strong anx. Has physical symptoms that mimic heart
probs.
Ø
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
Ø
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?
Ø 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
Ø
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
Ø
Biological
Factors - genetic factors are involved.
Also, linked to chemical probs in the brain.
Ø
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?
§
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
Ø Persistent feelings of
sadness, loss of interest, guilt, worthlessness. Changes in appetite, sleep pattern, behavioral patterns,
fatigue. May see probs in conc.
Ø Feelings of sadness, low
v
Bipolar Disorder
Ø
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
Ø 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.
Ø
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.
Ø 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.
Ø
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
Ø 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.
Ø
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
Ø
They
have delusions of persecution
v
Catatonic
type
Ø
Char
by motor disturbances
v
Disorganized
type
Ø
Disorganized
speech, thought, behav, & emotions
v
Undifferentiated
type
Ø
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
Ø
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.
Ø
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!