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Chapter 14

Chapter 14. Psychological Disorders. Learning Objectives. Discuss the definition of abnormality Explain the medical model, criteria for defining abnormality, and the effects of labeling Discuss how psychological disorders are classified

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Chapter 14

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  1. Chapter 14 Psychological Disorders

  2. Learning Objectives • Discuss the definition of abnormality • Explain the medical model, criteria for defining abnormality, and the effects of labeling • Discuss how psychological disorders are classified • Describe common anxiety, somatoform, dissociative, and mood disorders • Describe schizophrenia and personality disorders • Explain the origin of psychological disorders • Biological, psychological and environmental causes

  3. Think – Pair – Share • How do you define abnormality? Criterion Short Description 1. 2. 3. 4. • Which one would be sufficient to be labeled as abnormal? • What would prompt you to get help or encourage others to seek help?

  4. Introduction • What is a mental disorder? • How are mental disorders classified? • Do psychological disorders exist? • Statistic: • One out of every four Americans will suffer from a major mental disorder. Think of three of your friends, if they’re OK…

  5. Being Sane in Insane Places • Rosenhan and colleagues • Reported hearing voices • Once committed, normal behavior • 19 days to get out

  6. What Is A Mental Disorder? • Abnormal is a judgment call • Functioning on a continuum • Psychopathological functioning involves disruptions in emotional, behavioral, or thought processes that lead to personal distress, or that block one's ability to achieve important goals

  7. What Is Abnormal? • Three classic symptoms: • Hallucinations • False sensory experiences • Delusions • Disorders of logical thinking • Inappropriate affect • Affect for no apparent reason, too much of too little for the situation

  8. Indicators of Abnormality • Criteria • Distress or disability • Maladaptiveness • Rarity • Violation of social norms

  9. Historical Perspective • Historically, people have always been fearful of psychopathology • Hippocrates and the four humors • Middle Ages – demon possessed • Hysteria – the wandering womb

  10. Historical Perspective • Around 1700 • Development of the medical model • Illness rather than immoral behavior or demon possession • Physical cause

  11. Medical Model - Pinel

  12. Psychological Models • Anton Mesmer • Interested in treating people with animal magnetism • Developed hypnosis

  13. Psychological Models • Jean Martin Charcot • Hypnotism as a treatment for neuroses • Pseudoseizures vs. Seizures • Freud

  14. Modern Perspectives • Biological Perspectives • Causes are underlying brain malfunction • Psychological Perspectives • Behavioral • Cognitive • Cognitive-behavioral • Interactionist Perspective

  15. Classification • Goals • Common language • Understand etiology • Treatment plan • Diagnostic and Statistical Manual-IV-TR • Describes more than 300 disorders • Emphasis on description rather than etiology or treatment

  16. DSM-IV • Uses dimensions or axes to classify • Axis-I: Clinical disorders • Axis-II: Personality disorders and mental retardation • Axis-III: General medical concerns • Axis-IV: Psychosocial and environmental problems • Axis-V: Global Assessment of Function

  17. Affective Disorders • Bipolar disorder (manic-depression) • Periods of severe depression alternating with periods of mania

  18. Affective Disorders • Unipolar disorder (Major depression) • Seasonal Affective Disorder • Mood Disorders: Causes • Biology • Psychology • Cognitive triad • Learned Helplessness

  19. Affective Disorders • Gender Differences • Women have higher rate of depression • Women have ruminative response • Men distract themselves • Suicide • Second leading cause of death among college students • Not an impulsive act

  20. Anxiety Disorders • Panic disorder • Feels like a heart attack • Panic attacks are unexpected and feared • Agoraphobia

  21. Anxiety Disorders • Phobias • Social phobia • Specific phobias • Phrenophobia – fear of going crazy • Preparedness hypothesis

  22. Affective Disorders • Obsessive-compulsive disorder • Obsession • Compulsion • Biological causes for OCD • Behavioral therapy such as extinction of ritual behaviors • Changes in behaviors lead to changes in brain function

  23. Somatoform Disorders • Conversion Disorder • Paralysis or weakness with no clear physical cause and no correspondence to neural substrates • Hypochondriasis • Excessive concern over disease

  24. Dissociative Disorders • Dissociative Fugue • Combination of amnesia and ‘flight’ from life • Depersonalization Disorder • ‘Out of body’ experience • Dissociative Identity Disorder • Multiple personality • Causes

  25. Eating Disorders • Anorexia Nervosa • Not a loss of appetite, food obsessed • 85% of normal weight • Refuses to maintain body weight • Bulimia Nervosa • Normal body weight • Binge-purge cycles

  26. Schizophrenic Disorders • A severe form of psychopathology in which personality seems to disintegrate, thought and perception are distorted, and emotions are blunted • Hallucinations • Delusions • Other symptoms

  27. Schizophrenic Disorders • Categories of Symptoms • Positive – added to normal experience • Negative – removed from normal experience • Disorganized • Inappropriate behavior, emotions • Incoherent language – word salad

  28. Schizophrenic Disorders • Catatonic • Displays frozen, rigid, or excitable motor behavior • Extreme negativism and resistance • Paranoid • Delusions of grandeur, persecution, and jealousy • Usually later in life than other forms

  29. Paranoid Schizophrenia

  30. Schizophrenic Disorders • Undifferentiated • Grab-bag • More than one type is covered • Residual • Major period of psychosis in the recent past, but are symptom free • Minor positive symptoms • Remission

  31. Causes of Schizophrenia • Biological causes • Antipsychotic drugs and dopamine • Abnormal brain architecture • Twin studies and adoption studies • Environmental causes • 90% of relatives are not schizophrenic • Concordance for twins is only 50% • Diathesis-stress model

  32. Personality Disorders • Chronic, inflexible, maladaptive pattern of perceiving, thinking, or behaving • Paranoid Personality Disorder • Distrust and suspiciousness about motives of others • Narcissistic Personality Disorder • Grandiose sense of self-importance • Antisocial Personality Disorder • No remorse at violating norms and laws

  33. Ecological Model • Pathology is result of interaction between person and society • Mismatch between individual’s abilities and norms of society • World Health Organization findings • Society specific disorders in DSM-IV • All cultures recognize pathology, but have different symptoms

  34. Consequences of Labeling • Diagnosis should be objective • Assignment of diagnosis often leads to confirmation of diagnosis - Rosenhan • Thomas Szasz – mental illness does not exist • Labels allow for control of social problems

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