Transcript Ciccarelli Chapter 14 - Psychological Disorders

Psychological Disorders
The same behavior may be deemed
normal under some circumstances but
abnormal in others.
Abnormal behavior is psychopathology
What is Normal vs. What is
Abnormal
 Abnormal behavior is based on a combination of : 1)
Unusualness – experienced by only a few; the behavior is
statistically significant - the occurrence of that behavior is low
(rare); 2) Social deviance – All societies establish standards or
social norms that define socially acceptable behaviors.
Deviation from these norms (the standards of the society) is
often used as a criterion for labeling behavior as abnormal; what
is the situational context? 3) Emotional distress – i.e., anxiety or
depression are considered abnormal when inappropriate,
excessive, or prolonged relative to the person’s situation; what is
the subjective discomfort? 4) Maladaptive behavior – Behavior is
maladaptive when it causes personal distress, is self-defeating,
is associated with significant health, social, or occupational
problems, or the behavior does not allow the person to fit into
the situational context.
 5)*Dangerousness – Violent or dangerous behavior
that is outside the sanctioned context, that behavior
could be viewed as being abnormal; and 6) Faulty
perceptions or interpretations of reality – i.e.,
Hallucinations – involves distorted perceptions of
reality; Delusions – fixed but unfounded beliefs.
 Abnormality or psychological disorder, then, is any
pattern of behavior that causes people significant
____________, causes them to ___________
themselves or others, or harms their ability to
________________ in daily life.
Must have at least two criteria to
form a diagnosis of abnormality
 1. Is the behavior _______________?
 2. Does the behavior go against social
norms?
 3. Does the behavior cause the person
significant subjective discomfort?
 4. Is the behavior maladaptive?
 5. Does the behavior cause the person to be
___________________ to self or others?
Cultural Bases of Abnormal
Behavior
 Psychologists are now taking into account the cultural
context when making judgments about abnormal
behavior. This is called the sociocultural perspective.
 Cultural relativity refers to the unique characteristics of
the culture in which a person with a disorder was
nurtured to be able to correctly diagnose and treat the
disorder.
 Culture-bound syndromes – refers to psychological
disorders occurring in only one or a few cultures.
 MODELS OF ABNORMAL BEHAVIOR: Early Beliefs –
From ancient times through the Middle Ages, people
thought that those displaying abnormal behavior were
controlled by supernatural forces or possessed by
demonic spirits.
Models of Abnormality
 *The Biological/Medical Model – Is based on the belief that abnormal
behavior patterns represent mental illnesses that have a biological
cause and can be classified by their particular characteristics or
symptoms. This model explains disorders such as anxiety, depression,
and schizophrenia as caused by ___________________, genetic
problems, brain damage and dysfunction, or some combination of
those causes.
 *Psychological Models – The first major psychological model of
abnormal behavior was the psychodynamic model developed by
Sigmund Freud. Freud believed that abnormal behavior arises from
__________________ conflicts during childhood that remain
unresolved. Freud explained disordered behavior as being the result of
repressing one’s threatening thoughts, memories, and concerns in the
unconscious mind. These repressed thoughts and urges try to
resurface, and disordered behavior develops as a way of keeping the
thoughts repressed. Therefore, psychological symptoms are merely
the outward expressions of inner turmoil; unconscious conflicts are at
the root of abnormal behavior patterns.
 *The Behavioral model is based on the belief that most
forms of abnormal behavior are __________________ in
the same ways that normal behavior is
_________________.
 *The Humanistic model argues that human beings possess
an intrinsic ability to make conscious choices and to strive
toward self-actualization. Therefore, abnormal behavior
develops when people encounter ____________________
on the path toward personal growth or self-actualization.
 *The Cognitive model believes that __________________
or distorted thinking leads to emotional problems and
maladaptive behavior.
 *The Sociocultural Model argues that abnormal behavior
may have more to do with social ills or failures of
_________________ than with problems within the
individual. Socioculltural theorists believe that the stress of
coping with poverty and social disadvantage can eventually
take its toll on mental health.
 The Biopsychosocial Model argue that most forms of
abnormal behavior are not simply products of biology or
environment alone; rather, they result from complex
interactions of biological, psychological, and sociocultural
factors. **An example of the biopsychosocial model is the
diathesis-stress model.
 **According to the diathesis-stress model, certain
people have a vulnerability or predisposition called
a diathesis, which increases their risks of
developing a particular disorder.
 *WHAT ARE PSYCHOLOGICAL DISORDERS?
They are distinctive patterns of abnormal behavior
that involves a disturbances of mood, behavior,
thought processes, or perception that result in
significant personal distress or impaired
functioning.
Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition, Text Revision
(DSM-IV-TR)
 The DSM-IV-TR describes about 250 different psychological
disorders. Each disorder is described in terms of its
__________________, the typical _________ the disorder takes
as it progresses, and a checklist of specific criteria that must be
met in order for the diagnosis of that disorder to be made. Each
disorder is broken down into 5 categories or axes.
 Axis I: Clinical Disorder and Other Conditions that may be a
Focus of Clinical Attention.
 Axis II: Personality Disorders and Mental Retardation
 Axis III: General Medical Conditions
 Axis IV: Psychosocial and Environmental Problems
 Axis V: Global Assessment of Functioning
Anxiety Disorders
 Anxiety disorders refer to a class of psychological disorders
characterized by excessive or inappropriate anxiety reactions.
The major types are: phobias, panic disorder, generalized
anxiety disorder, and obsessive-compulsive disorder. Freefloating anxiety is anxiety that is ________________ to any
realistic, known source.
 Phobias are irrational or excessive fears of particular objects or
situations. The three types are: social phobia, specific phobia,
and agoraphobia. Persons with social phobia have an intense
fear of social interactions. Persons with specific phobia have an
excessive fear of specific situations or objects. Persons with
agoraphobia have a fear venturing into open places or going out
in public; they cannot avoid their phobia’s source because it is
simply being _______________ in the real world.
Panic Disorders
 Panic Disorders is a type of anxiety disorder involving
repeated episodes of sheer terror called panic attacks.
Panic attacks are characterized by intense physical
symptoms that includes profuse sweating, numbness or
tingling, and pounding of the heart. These symptoms may
lead people to think they are having a heart attack, or are
losing control.
 Obsessive-Compulsive Disorder – Is a disorder in which
intruding, recurring thoughts or obsessions create anxiety
that is relieved by performing a repetitive, ritualistic
behavior(compulsion).
 Generalized Anxiety Disorder – Refer to persons that
experience persistent anxiety that is not tied to any
particular object or situation for at least six months. The
person seems to worry incessantly.
Causes of Anxiety Disorders
 CAUSES OF ANXIETY DISORDERS – Freud explained anxiety
as being a kind of danger signal that repressed urges or conflicts
were threatening to surface.
 Behaviorist argue that anxious behavioral reactions are learned.
 Cognitive psychologist view anxiety disorders as the result of
illogical, irrational thought processes, e.g. Magnification – the
tendency to interpret situations as far more _______________,
harmful, or ________________ than they actually are. All-ornothing thinking – the tendency to believe that one’s
performance must be_____________ or the result will be a total
failure. Overgeneralization – the tendency to interpret a single
_______________ event as a never ending pattern of defeat
and failure. Minimization – the tendency to give
______________________ importance to one’s successes or
positive events and traits.
Biological Factors – Causes of
Anxiety Disorders
factors – One possibility is that biochemical changes in the
________________ involving neurotransmitter imbalances trigger a kind of internal
alarm system that induces feelings of panic in susceptible people. Also, General anxiety
disorder has been linked to an imbalance in several neurotransmitters in the nervous
system, including lower levels of both serotonin and GABA (Gamma-Aminobutyric Acid –
involved in the regulation of sleep and anxiety).

**Biological

Psychological Factors – Some phobias may be learned through classical conditioning in
which a previously neutral or benign stimulus becomes paired with an aversive stimulus.

People with high levels of anxiety sensitivity, or fear of fear (phobophobia) itself, may
overreact to anxiety symptoms, which in turn can lead to escalating anxiety that
culminates in a full-fledged panic attack.
Anxiety disorders reflect the interplay of biological and psychological factors.
Anxiety disorders are found around the world, although the particular form the disorder
takes might be different in various cultures, e.g., ataque de nervios that occurs in some
Latin cultures.


Somatoform Disorders:
Sickness as a State of Mind
 Somatoform disorders are viewed as being a
psychological defenses against anxiety. They are disorders
that take the form of bodily illnesses and symptoms but for
which there are no real physical disorders.
 Psychophysiological disorder is the modern term for
psychosomatic disorder. Psychosomatic disorders are
disorders in which ________________________ stress
causes a real physical disorder or illness.
 ______________________ Is a somatoform disorder in
which the person is terrified of being sick and worries
constantly, going to doctors repeatedly, and becoming
preoccupied with every sensation of the body.
 Somatization disorder is a somatoform disorder in which
the person dramatically ________________ of a specific
symptom such as nausea, difficulty swallowing, or pain for
which there is no real physical cause.
More Somatoform Disorders
 __________________ are limited to those functions
controlled by the somatic nervous system.
Symptoms are the loss of motor and/or sensory
functions. The person may experience dramatic,
sudden, and specific symptoms such as blindness,
paralysis, deafness, or numbness of certain body
parts, none of which have real physical causes. Like
somatization disorder, conversion disorder usually
occurs when a stressful situation has also occurred
or is threatening to occur, such as a soldier facing
the return to combat.
Causes of Somatoform Disorders
 Dissociative Amnesia – People with dissociative amnesia
experience a loss of memory for information about
themselves or their life experiences. The absence of any
physical cause for their amnesia suggests that the disorder
is psychological in nature.
 CAUSES OF DISSOCIATIVE DISORDERS: Dissociative
amnesia may represent an attempt to disconnect or
dissociate one’s conscious state from awareness of
traumatic experiences or other sources of psychological
pain or conflict.
 Somatoform Disorders – Refer to persons that have
physical ailments or complaints that cannot be explained
medically.
 Conversion Disorder – Refers to persons that
suffer a loss of physical function, such as loss of
movement in a limb (hysterical paralysis), loss of
vision (hysterical blindness), or loss of feeling in a
hand or arm (anesthesia). Yet there is no physical
cause that can account for these symptoms.
 Hypochondriasis – Refers to persons preoccupied
with the idea that there is something terribly wrong
with their health. They attribute their physical
complaints or symptoms to a serious underlying
disease.
Causes of Somatoform Disorders
 According to Freud, the hysterical symptom (loss
of movement in a limb) is the outward sign of an
unconscious dynamic struggle between opposing
motives. The ego seeks to protect the self from
the flood of anxiety that would occur if these
unacceptable impulses were to become fully
conscious.
 Secondary gain is the reward value of having a
psychological or physical symptom, such as
release from ordinary responsibilities.
Mood Disorders
 Mood Disorders involves persons that have a persistent or
severe disturbances of mood; not just an occasional up
and down swing.
 Major Depressive Disorder – Is the most common type of
depressive disorder, characterized by periods of downcast
mood, feelings of worthlessness, and loss of interest in
pleasurable activities. When left untreated, it can last
months, even a year or more.
 Seasonal affective disorder (SAD) is a type of major
depression that involves a recurring pattern of winter
depressions followed by elevations of mood in the spring
and summer.
 Dysthymic disorder (dysthymia) is a relatively mild
but chronic form of depression.
 Bipolar Disorder – Are characterized by alternating
moods that shift between euphoric feelings and
depression. The two major types of bipolar
disorders are: bipolar disorder and cyclothymic.
Persons with bipolar disorder experience mood
swings between periods of manic episodes and
periods of depression.
 Cyclothymic disorder is characterized by a pattern
of milder mood swings than those seen in bipolar
disorder.
Causes of Mood Disorders
 Psychological Factors – The classic
psychodynamic theory espoused by Freud held
that depression involves anger turned inward
against the self.
 Cognitive theorists focus on how our thoughts and
interpretations of events contribute to emotional
disorders such as depression. Another
psychological model of depression, the learned
helplessness model, suggests that people become
depressed when they come to believe that they
are helpless to control the reinforcements in their
lives.
 Attributional style is the way in which a person
explains the outcome of events in his or her life.
 Depressive attributional style is the characteristic
way of explaining negative events in terms of
internal, stable, and global causes.
 Biological factors play important roles in
depression, including irregularities in
neurotransmitter functioning, abnormalities in
neural pathways, and genetics. Serotonin is a key
brain chemical in regulating moods.
Why people commit suicide?
 Irregularities in serotonin functioning can result in
a disinhibition effect- the removal of inhibitions that
might otherwise constrain impulsive behavior,
including impulses to commit suicide.
 SCHIZOPHRENIA – Is a severe and chronic
psychological disorder characterized by
disturbances in thinking, perception, emotions,
and behavior.
 Psychotic disorder is characterized by a break with
reality. Thought disorder is the breakdown in the
logical structure of thought and speech, revealed
in the form of a loosening of associations.
Types of Schizophrenia
 Disorganized Type is characterized by
confused behavior and disorganized
delusions, among other features.
 Catatonic type is characterized by bizarre
movements, postures, or grimaces.
 Paranoid type is characterized by the
appearance of delusional thinking
accompanied by frequent auditory
hallucinations.
Causes of Schizophrenia
 Genetic Factors play an important role in determining the
risk of developing schizophrenia.
 Biochemical Imbalances in the nerve pathway in the brain
that utilize the neurotransmitter dopamine appears to
contribute to the development of schizophrenia.
 PERSONALITY DISORDERS are a cluster of
psychological disorders characterized by excessively rigid
patterns of behavior. These behavioral patterns become
self-defeating because they make it difficult for people to
adjust to external demands and interfere with their
relationships with others.
 Narcissistic personality disorder is characterized by a
grandiose sense of self.
 Paranoid personality disorder is characterized by extreme
suspiciousness or mistrust of others.
 Schizoid personality disorder is characterized by social
aloofness and limited range of emotional expression.
 Borderline personality disorder is characterized by unstable
emotions and self-image.
 Antisocial personality disorder is characterized by callous
attitudes toward others and by antisocial and irresponsible
behavior.
Suicide Prevention
 1) Recognize the seriousness of the situation – Don’t fall
for the myth of thinking that people who talk about suicide
are not truly serious; 2) Take implied threats seriously –
Some suicidal people don’t come right out and say they are
planning to kill themselves; 3) Express understanding –
Engage the person in conversation to allow his or her
feelings to be expressed; 4) Focus on alternatives – Tell
the person that other ways of dealing with his or her
problems may be found; 5) Assess the immediate danger –
Ask the person whether he or she has made a specific plan
to commit suicide; 6) Enlist the person’s agreement to seek
help – Insist that the person accompany you to a health
professional or nearby hospital emergency room; and
 7) Accompany the person to seek help – Above
all, don’t leave the person alone.
 Say: It’s Possible for a better life!
By Les Brown
 THE END
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