Ch15 - Abnormal Behavior
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Transcript of Ch15 - Abnormal Behavior
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Chapter 15
Psychological Disorders
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Historical Perspective
• Perceived Causes– movements of sun or moon
• lunacy- full moon
– evil spirits
• Ancient Treatments– exorcism, caged like animals,
beaten, burned, castrated, mutilated, blood replaced with animal’s blood
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Psychological Disorders
•Psychological Disorder– a “harmful dysfunction” in which
behavior is judged to be:•atypical- not enough in itself•disturbing- varies with time & culture•maladaptive- harmful•unjustifiable- sometimes there’s a good
reason
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Insane• Legal Definitions:
• Not “Crazy”
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Normal vs. Abnormal•The 3 D’s
–Distress (to self or others)–Disfunction (for person or society)
–Deviance (violates social norms)
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Psychological Disorders• Medical Model
– concept that diseases have physical causes
– can be diagnosed, treated, and in most cases, cured
– assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital
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Psychological Disorders
• Bio-psycho-social Perspective– assumes that biological,
sociocultural, and psychological factors combine and interact to produce psychological disorders
– Need to also look at causes from each separate perspective as well!
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Psychological Disorders- Etiology
• DSM-IV – TR (most recent version 2000)– American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)
– a widely used system for classifying psychological disorders
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DSM IV-TR• Multi-axial
• Over 350 diagnostic categories classified along 5 dimensions or axes that take both the person and his/her life situation
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DSM IV-TR• Axis I = primary diagnosis including patients
primary clinical symptoms present at the time• Axis 2 = reflect longstanding personality
disorders or retardation• Axis 3 = notes any medical conditions that
might be relevant (i.e. high blood pressure, concussion…)
• Axis 4 = rates intensity of psychosocial or environmental problems of patient’s life
• Axis 5 = patient’s coping resources/adaptive functioning
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DSM IV-TR• Axis I = Panic disorder• Axis 2 = dependent personality disorder• Axis 3 = high blood pressure,
hypertension• Axis 4 = severe stressors: divorce, job
loss• Axis 5 = serious symptoms; fair overall
functioning
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DSM IV
• Reliabilty clinicians using the system should show high levels of agreement in their diagnostic decisions
• Validity – diagnostic categories should accurately capture the essential features of various disorders
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Vulnerability Stress Model• Vulnerability in all people toward
developing a psychological disorder, given sufficient stress.
• Diasthesis-Stress hypothesis - proposes that genetic factors place a person at risk while environmental stress factors transform the potential into an actual disorder
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Psychological Disorders- Etiology
• Neurotic disorder (term seldom used now)
– usually distressing but that allows one to think rationally and function socially
– Freud saw the neurotic disorders as ways of dealing with anxiety
• Psychotic disorder– person loses contact with
reality– experiences irrational ideas
and distorted perceptions
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Disorders vs. Psychosis• Disorders - for the most part, are
considered “transient situation disorders” (problems in everyday living) and have a generally positive prognosis.
• Psychosis - typically no cure, treatment often helps, but often requires hospitalization.
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Anxiety Disorders
• General Characteristics
• Not just symptom, but depth and breadth of a collection of systems (syndrome)
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Anxiety Disorders
• Anxiety Disorders – distressing, persistent anxiety
or maladaptive behaviors that reduce anxiety
• Generalized Anxiety Disorder– person is tense, apprehensive,
and in a state of autonomic nervous system arousal
• Phobia– persistent, irrational fear of a
specific object or situation
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Anxiety Disorders
• Obsessive-Compulsive Disorder– characterized by unwanted repetitive thoughts
(obsessions) and/or actions (compulsions)• Panic Disorder
– marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation
• PTSD– Severe anxiety disorder that can occur in
people who have been exposed to traumatic life events
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Anxiety Disorders
• PET Scan of brain of person with Obsessive/ Compulsive disorder
• High metabolic activity (red) in frontal lobe areas involved with directing attention
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Somatoform & Dissociative Disorders
• Involve physical complaints or disabilities that suggest a medical problem but have no known biological cause and are not voluntarily produced by the person
• Soma = body– Body manifestations– Hypochondriasis– Pain disorders– Conversion disorders
• Malingering - faking it to escape responsibility
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Dissociative Disorders
• Dissociative Disorders– conscious awareness becomes separated
(dissociated) from previous memories, thoughts, and feelings •psychogenic amnesia•psychogenic fuge
• Dissociative Identity Disorder (DID)– VERY rare dissociative disorder in which a
person exhibits two or more distinct and alternating personalities
– formerly called multiple personality disorder
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Dissociative Disorder Causes• Frank Putnam’s trauma-
dissociation theory
–The development of new personalities occurs in response to severe stress
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Mood Disorders (Affective Disorders)
• AFFECT - deals with mood or emotion
• “Flat Affect” - negative mood state or absence of emotions
• Dysthymia - the common cold of mental illness
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Mood Disorders
• Mood Disorders – characterized by emotional
extremes• Major Depressive Disorder
– a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities
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Mood Disorders
• Manic Episode– a mood disorder marked by a
hyperactive, wildly optimistic state
• Bipolar Disorder– a mood disorder in which the
person alternates between the hopelessness and lethargy of depression and the overexcited state of mania
– formerly called manic-depressive disorder
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Mood Disorders-Depression
Percentageof population
aged 18-84experiencing
majordepression
at somepoint In life
20
15
10
5
0
USA Edmonton Puerto Paris West Florence Beirut Taiwan Korea New Rico Germany Zealand
Around the worldwomen are more
susceptible todepression
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Mood Disorders- Suicide
15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+
Suicides per100,000 people
70
60
50
40
30
20
10
0
Males Females
The higher suicide rateamong men greatly increases in late adulthood
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Mood Disorders-Suicide
• Increasing rates of teen suicide
1960 1970 1980 1990 2000Year
12%
10
8
6
4
2
0
Suicide rate,ages 15 to 19(per 100,000)
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Mood Disorders-Bipolar
• PET scans show that brain energy consumption rises and falls with emotional swings
Depressed state Manic state Depressed state
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Schizophrenia• Schizophrenia
– literal translation “split mind”
– Split from reality– Characterized by “pieces of
personality” and absence of “wholeness”
– Lay public’s idea of “split personality - actually DID• ***Not to know this shows
great ignorance!
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Schizophrenia
• Schizophrenia
– a group of severe disorders characterized by:•disorganized and
delusional thinking•disturbed perceptions•inappropriate emotions
and actions
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Schizophrenia
• Delusions– false beliefs, often of
persecution or grandeur, that may accompany psychotic disorders
• Hallucinations– false sensory
experiences such as seeing something without any external visual stimulus
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SchizophreniaSubtypes of Schizophrenia
Paranoid: Preoccupation with delusions or hallucinations
Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion
Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrot-like repeating of
another’s speech or movements
Undifferentiated Schizophrenia symptoms without fitting one of the or residual: above types
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Schizophrenia
Lifetime riskof developingschizophrenia
for relatives of
a schizophrenic
4
0
3
0
2
0
1
0
0
Generalpopulation
Siblings Children Fraternaltwin
Childrenof two
schizophrenia
victims
Identicaltwin
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Personality Disorders• Distinct enough to have their
own category in the DSM• Personality Disorders
– disorders characterized by inflexible and enduring patterns of maladaptive behavior that impair social functioning
– usually without anxiety, depression, or delusions
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Personality Disorders• Resistant to change
– “Ingrained Patterns”
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Personality Disorders
• Antisocial Personality Disorder– disorder in which the person
(usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members
– may be aggressive and ruthless or a clever con artist
– Not against being social, but against social norms of a culture
– Commonly hear about Serial killers– Tend to be charming, manipulative,
and persistently violate the rights of others
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Personality Disorders• PET scans illustrate reduced activation in a
murderer’s frontal cortexNormal Murderer
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Childhood Disorders
• Autism– Biological foundations, but no cause
determined
ADD/ADHDSome genetic components possible May not go away in adulthood
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Rates of Psychological Disorders
Percentage of Americans Who Have Ever Experienced Psychological Disorders
Disorder White Black Hispanic Men Women Totals
Ethnicity Gender
Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8%Generalized anxiety 3.4 6.1 3.7 2.4 5.0 3.8Phobia 9.7 23.4 12.2 10.4 17.7 14.3Obsessive-compulsive disorder 2.6 2.3 1.8 2.0 3.0 2.6Mood disorder 8.0 6.3 7.8 5.2 10.2 7.8Schizophrenic disorder 1.4 2.1 0.8 1.2 1.7 1.5Antisocial personality disorder 2.6 2.3 3.4 4.5 0.8 2.6
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