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CH_14_Compatibility_Mode_ - HISTORICAL PERSPECTIVES...

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Unformatted text preview: HISTORICAL PERSPECTIVES PSYCHOLOGICAL DISORDERS ON Chapter 14 DEVIANT BEHAVIOR • Supernatural forces/devil (Chinese, Egyptians, Hebrews) • Trephination to release spirit tool to chisel hole in skull • Vulnerability-stress model: we all have some degree of vulnerability (v. low v. high) for developing Ψ disorder, given sufficient stress: 1. Biological basis 2. Personality factor • “Diagnostic” tests for witches impurities float to surface 3. Environmental factor 4. Cultural factor • Hippocrates just like physical diseases 1 DEFINING & CLASSIFYING WHAT IS “ABNORMAL”? Three criteria • Distressing • Dysfunctional • Deviance Abnormal behavior PSYCHOLOGICAL DISORDERS DIAGNOSING Ψ DISORDERS The Diagnostic & Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) • Axis I: primary diagnosis/symptoms • Axis II: longstanding personality disorders or mental retardation • Axis III: medical conditions • Axis IV: psychosocial/environmental problems • Axis V: coping resources/adaptive functioning (GAF) CONSEQUENCES OF DIAGNOSTIC LABELING Social & Personal Consequences: Description of individual vs. behavior Influence on people’s interactions (psychiatric hospital exp) Creating/worsening Ψ disorders Legal Consequences: • Competency: defendant’s state of mind at time of judicial hearing • Insanity: presumed state of mind at time of defendant crime was committed 2 ANXIETY • Anxiety: state of tension & apprehension as a natural response to perceived threat • Anxiety disorders: frequency & intensity of anxiety responses are our of proportion to situations that trigger them, & anxiety interferes with daily lives Four components: 1. Subjective-emotional: tension & apprehension 2. Cognitive: worrisome, inability to cope thoughts DISORDERS PHOBIC DISORDER Phobias: strong & irrational fears of certain objects/situations • Realize irrationality but feel helpless avoid phobic situation/object • Agoraphobia: fear of open/public places from which escape is difficult • Social phobia: excessive fear of situations in which person might be evaluated & possibly embarrassed • Specific phobias: fear of dogs, snakes, spiders, airplanes, elevators, enclosed spaces, water, injections, or germs 3. Physiological: fast heart rate & blood pressure, muscle tension, rapid breathing, nausea, dry mouth, diarrhea, frequent urination 4. Behavioral: avoiding situations, impaired performance GENERALIZED ANXIETY DISORDER GAD :chronic (ongoing) state of diffuse, or freefloating anxiety that is not attached to specific situations or objects • • May last for months, with signs almost continuously present • Can markedly interfere with daily functioning • Hard to concentrate, make decisions, & remember commitments 3 PANIC DISORDER : occurs suddenly & unpredictably, & are more intense than GAD • • Persistent fear of future attacks Many develop agoraphobia housebound • Appear in late adolescence/adulthood • Obsessions: repetitive & unwelcome thoughts, images, or impulses that invade consciousness, are often abhorrent to person, & are difficult to dismiss • Compulsions: repetitive behavioral responses that can be resisted only with great difficulty (their function is to reduce anxiety) Absence of identifiable environmental stimulus • OBSESSIVE-COMPULSIVE COMPULSIVE DISORDER DISORDER Checking things repeatedly, cleaning/hand washing, repeating tasks endlessly • Or else anxiety or panic attack • POSTTRAUMATIC POSTTRAUMATIC STRESS DISORDER DISORDER • Strengthened through negative reinforcement (avoid anxiety) SOMATOFORM PTSD: severe anxiety disorder that can occur in people who have been exposed to traumatic life events • • • • War veterans, refugees, rape or torture victims Women exhibit twice the rate Increase vulnerability to later disorders depressive, alcohol-related importance of prompt intervention Four major symptoms: 1. Anxiety, arousal, & distress 2. Relive trauma recurrently in flashbacks, dreams, & fantasy 3. Numb to world & avoid stimuli that remind 4. Intense survivor guilt when others killed DISORDERS 4 physical complaints/disabilities that suggest a medical problem but have no known biological cause & are not produced voluntarily • Hypochondrasis: unduly alarmed about any physical symptom they detect & convinced they have or about to have a serious illness • Pain disorder: intense pain either out of proportion to whatever medical condition or with no physical basis at all • Conversion disorder: serious neurological symptoms, like paralysis, loss of sensation, blindness…, suddenly occur (Glove anesthesia, psychogenic blindness) DISSOCIATIVE DISORDERS DISSOCIATIVE DISORDERS Breakdown of normal personality integration, resulting in significant alterations in memory or identity • Psychogenic amnesia: respond to stressful event with extensive but selective memory loss • Psychogenic fugue: (more profound) lose all sense of personal identity, give up customary life, wanders to new faraway location, & establishes new identity MOOD Dissociative Identity (Multiple Personality) Disorder: • 2/more separate personalities coexist in same person (host personality & alters) Causes: • Trauma-dissociation theory: development of new personalities in response to severe stress (from early childhood abuse) DID: Dissociation or Role-Playing? DISORDERS 5 BIPOLAR DISORDER Depression (usually the dominant state) alternates with Mania: state of highly excited mood & behavior opposite of depression DEPRESSION Appears in as young as 6-month old infants As high in children/adolescents as adults Onset between 15 – 19 years old Women twice as likely Women suffer in 20s; men in 40s Major depression: intense depressed state that leaves one unable to function effectively in life • • • • • • • Dysthymia: less intense form that has less dramatic effects on personal & occupational functioning (more chronic) CAUSES of Mood Disorders • • Biological (genes, neurochemical) Psychological • • Personality-Based Vulnerability Cognitive processes: • • • Depressive attributional pattern: attributing success/positive event to factors outside self while attributing negative outcomes to personal factors • • Depressive cognitive triad: negative thoughts about the WORLD, ONESELF, & FUTURE Learned helplessness theory: depression occurs when people expect bad events to occur & there’s nothing they can do to prevet them/cope with them Learning & Environmental Factors Sociocultural SCHIZOPHRENIA 6 SCHIZOPHRENIA SUBTYPES of Schizophrenia Severe disturbances in thinking, speech, perception, emotion, & behavior • Paranoid schizophrenia: delusions of persecution and/or grandeur • Disorganized schizophrenia: confusion & incoherence with severe deterioration of adaptive behavior (personal hygiene, social skills, & self-care) • Catatonic schizophrenia: striking motor disturbances, from muscular rigidity to random/repetitive movements (waxy flexibility) • Undifferentiated schizophrenia: exhibit some symptoms & thought disorders of above but do not have enough of specific criteria to be diagnosed in those categories • Distorted reality • Disordered attention, thought, or perception • Social withdrawal • Neglect of personal grooming • Delusions: false beliefs sustained in face of opposing evidence (persecution, grandeur) • Hallucinations: false perception with compelling sense of reality • Disorganized speech • Blunted, flat, or inappropriate affect SUBTYPES of Schizophrenia CAUSAL FACTORS • Biological Factors • • • • Positive symptoms: bizarre behaviors, like delusions, hallucinations, & disordered speech & thinking Negative symptoms: absence of normal reactions, like lack of emotional expression, loss of motivation, & absence of speech (poorer chance of recovery) Genetic Predisposition (48%) Brain Abnormalities: neurodegenerative hypothesis brain atrophy; OR thalamus abnormalities Biochemical Factors: Dopamine hypothesis: particularly positive symptoms are produced by overactivity of dopamine system in areas of brain, that regulate emotional expression, motivated behavior, & cognitive functioning * (Bidirectionality problem) • 7 CAUSAL FACTORS CAUSAL FACTORS • • Psychological Factors • Regression (psychoanalytic): retreat to earlier more secure stage of psychosocial development in face of overwhelming anxiety • Sociocultural Factors Cognitive: defect in attention mechanism Schizophrenia highest in lower-socioeconomic pops Environmental Factors • Stressors • Social drift hypothesis: as people develop schizophrenia, their personal & occupational functioning deteriorates, so that they drift down socioeconomic ladder Odd movements & less EE negative reactions • Social causation hypothesis: higher levels of stress for low-income people • • • Expressed emotion: high levels of criticism, hostility, & overinvolvement (48% relapse) PERSONALITY Personality disorders: stable, ingrained, inflexible, & maladaptive ways of thinking, feeling, & behaving • Increase likelihood of Axis I diagnosis • Poorer course of recovery • 10 – 15 % population prevalence DISORDERS 8 The 10 PDs & their Clusters ANTISOCIAL PD A. Dramatic/Impulsive Cluster : lack a conscience; exhibit little anxiety/guilt; impulsive & unable to delay gratification of their needs (+ lack emotional attachment) • • • • Antisocial PD Histrionic PD Narcissistic PD Borderline PD B. Anxious/Fearful Cluster • • • Avoidant PD Dependent PD Obsessive-Compulsive PD • Causes • Biological Factors: genetics, under-aroused NS, impulsiveness, prefrontal love neurological deficits • Ψ & Environmental Factors: • Undeveloped superego, Inadequate adult identification C. Odd/Eccentric Cluster • Failure to anticipate long-term consequences Schizoid PD Schizotypal PD Paranoid PD • Learning thru modeling (parents, deviant peers) • Impaired ability to develop conditioned fear responses deficit in avoidance learning • • • BORDERLINE PD : collection of symptoms of serious instability in behavior, emotion, identity, & interpersonal relationships • Extreme anger, loneliness, & emptiness • Momentary loss of personal identity • Impulsive behavior • Repetitive self-destructive behavior • CHILDHOOD Causes • Interpersonal strife, abuse, inconsistent parenting • Splitting: failure to integrate positive & negative aspects of another’s behavior into a coherent whole • Biology: genes, abnormality in neurotransmitter or selfregulation areas • Unstable or rapidly changing societies DISORDERS 9 ADHD Attention Deficit/Hyperactivity Disorder • Boys (4x): aggressive & impulsive • Girls: inattentive • Causes unclear yet: • Genetic factors • Environmental factors (inconsistent parenting) AUTISTIC DISORDER : long-term extreme unresponsiveness to others, poor communication skills, & highly repetitive & rigid behavior • Echolalia: exact echoing of phrases spoken by others • Odd & repetitive stereotyped behaviors • Some exhibit extraordinary savant • Causes: • Cold & un-giving family environment (Ψ-dynamic) • Abnormal brain growth & cerebellum development • Genetics • Theory of mind poorly developed skills 10 ...
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