Psychological disordersPsychological disordersPsychopathologyPsychopathology

Abnormal psychologyAbnormal psychology

Chapter 14Chapter 14

Medical modelMedical model• Disease basedDisease based• Diagnosis= Diagnosis=

distinguish distinguish from other from other diseasesdiseases

• Etiology= Etiology= causecause• Prognosis= Prognosis= probable probable

outcomeoutcome

Figure 14.1Figure 14.1Historical conceptions Historical conceptions

of mental illnessof mental illness• Demonic possessionDemonic possession• Evil spiritsEvil spirits• Inhumane treatmentInhumane treatment

MythsMyths

1.1.No cureNo cure

2.2.Violent and dangerousViolent and dangerous

3.3.BizzarreBizzarre

Historical treatment Historical treatment of people with mental of people with mental

illnessillness• Philippe PinelPhilippe Pinel

• Dorothea Dix Dorothea Dix

Thomas SzazThomas Szaz

1.1.Criticized use of Criticized use of medical modelmedical model

2.2.““Problems in living”Problems in living”

Defining abnormal Defining abnormal behaviorbehavior

1.1.MMaladaptivealadaptive

2.2.UUnjustifiablenjustifiable

3.3.DDistressingistressing

4.4.AAtypicaltypical

Concept check 14.1Concept check 14.1

Applying the criteria of Applying the criteria of Abnormal behaviorAbnormal behavior

David RosenhanDavid Rosenhan

Describe his study…Describe his study…

David RosenhanDavid Rosenhan

1.1. Claimed they “heard Claimed they “heard voices” and admitted to voices” and admitted to mental hospitalmental hospital

2.2. Staff identified their Staff identified their behavior as symptomaticbehavior as symptomatic

3.3. Controversy over Controversy over findingsfindings

DiagnosisDiagnosis

1.1.Classification or Classification or taxonomytaxonomy

2.2.Dangers in labelingDangers in labeling

DSM-IV-TRDSM-IV-TR

1.1.Diagnostic and Diagnostic and Statistical Manual of Statistical Manual of Mental DisordersMental Disorders

2.2.Version IV-Text Version IV-Text RevisedRevised

DSM-IV-TRDSM-IV-TR

1.1.American Psychiatric American Psychiatric AssociationAssociation

2.2.Prototypical modelPrototypical model3.3.No CAUSENo CAUSE4.4.No TREATMENTNo TREATMENT

DSM-IV-TRDSM-IV-TR1.1. Axis 1:Axis 1: Clinical disorders Clinical disorders2.2. Axis 2:Axis 2: Personality disorders and Personality disorders and

mental retardationmental retardation3.3. Axis 3:Axis 3: General medical General medical

conditionsconditions4.4. Axis 4Axis 4: Psychosocial and : Psychosocial and

environmental problemsenvironmental problems5.5. Axis 5:Axis 5: Global assessment of Global assessment of

functioningfunctioning

DSM-IV-TRDSM-IV-TR

1.1. Axis 1:Axis 1: C Coolool

2.2. Axis 2:Axis 2: Pe Peopleople

3.3. Axis 3:Axis 3: Ge Gett

4.4. Axis 4: Axis 4: PP

5.5. Axis 5:Axis 5: G G’s’s

DSM-IV-TRDSM-IV-TR

You need to know the 5 You need to know the 5 axial system!!!axial system!!!

You You love love lovelove love love page page 565565

PrevalencePrevalence

• Epidemiology- study of Epidemiology- study of prevalenceprevalence

• Prevalence- % of Prevalence- % of population with the population with the disorderdisorder

Clinical syndromes (Axis I)Clinical syndromes (Axis I)

1.1. Childhood disordersChildhood disorders2.2. Organic mental disordersOrganic mental disorders3.3. Substance relatedSubstance related4.4. Schizophrenia and other Schizophrenia and other

psychotic disorderspsychotic disorders5.5. Mood disordersMood disorders

Clinical syndromes (Axis I)Clinical syndromes (Axis I)

6.6. Anxiety disordersAnxiety disorders

7.7. Somatoform disordersSomatoform disorders

8.8. Dissociative disordersDissociative disorders

9.9. Sexual and gender-identitySexual and gender-identity

10.10.Eating disordersEating disorders

Anxiety DisordersAnxiety Disorders

1.1. Generalized anxiety disordersGeneralized anxiety disorders2.2. PhobiaPhobia3.3. PanicPanic4.4. Agoraphobia or social phobiaAgoraphobia or social phobia5.5. Obsessive-compulsive Obsessive-compulsive

disorderdisorder6.6. Post traumatic stress disorderPost traumatic stress disorder

Etiology of Anxiety Etiology of Anxiety DisordersDisorders

Remember anxiety Remember anxiety disorders are differentdisorders are different

Understand the etiology for Understand the etiology for each oneeach one

Etiology of Anxiety Etiology of Anxiety DisordersDisorders

1.1. BiologicalBiological

2.2. Conditioning and Conditioning and learninglearning

3.3. Cognitive factorsCognitive factors

4.4. StressStress

Anxiety DisordersAnxiety Disorders

Make a DSM-IV-TR multi-Make a DSM-IV-TR multi-axial diagnosisaxial diagnosis

Case study activityCase study activity

Somatoform DisordersSomatoform Disorders

• Soma= bodySoma= body

• Physical ailments that Physical ailments that cannot be explained cannot be explained by organic conditionsby organic conditions

Somatoform DisordersSomatoform Disorders

1.1. SomatizationSomatizationdiverse complaintsdiverse complaints

2.2. ConversionConversionloss of one systemloss of one system

“ “La belle indifference”La belle indifference”3.3. HypochondriasisHypochondriasis

ConversionConversion

Etiology of Somatoform Etiology of Somatoform DisordersDisorders

1.1. Defense mechanismsDefense mechanisms2.2. PersonalityPersonality– Histrionic and NarcissiticHistrionic and Narcissitic

3.3. CognitiveCognitive4.4. Sick roleSick role• ReinforcementReinforcement• What are the benefits?What are the benefits?

Concept check 14.2Concept check 14.2

Distinguishing anxiety and Distinguishing anxiety and somatoform disorderssomatoform disorders

Dissociative disordersDissociative disorders

• Lose contact with Lose contact with identity or memoryidentity or memory

1.1. AmnesiaAmnesia2.2. FugueFugue3.3. Dissociative Identity Dissociative Identity

Disorder (DID)Disorder (DID)

Dissociative amnesiaDissociative amnesia

• Remember Remember notnot due to due to neurological impairment!neurological impairment!

• Retrograde (old memories)Retrograde (old memories)

• Anterograde amnesia Anterograde amnesia – new memoriesnew memories

– hippocampushippocampus

Dissociative fugueDissociative fugue

• Usually a traumatic eventUsually a traumatic event

• Lose memory of identityLose memory of identity

• Leave their homeLeave their home

• Bourne IdentityBourne Identity

DIDDID

• Dissociative Identity Dissociative Identity DisorderDisorder

• Used to be Multiple Used to be Multiple Personality DisorderPersonality Disorder

• Not Not schizophreniaschizophrenia

DIDDID

• Be careful of what you Be careful of what you see on TV and Moviessee on TV and Movies

• Not everything is Not everything is accurate!accurate!

Etiology of DIDEtiology of DID

• Relatively little Relatively little understandingunderstanding

• Excessive stressExcessive stress

• Positive correlation with Positive correlation with childhood abusechildhood abuse

Mood disordersMood disorders

• Affect= emotionsAffect= emotions

1.1. Major depressive Major depressive disorderdisorder

2.2. Dysthmic disorderDysthmic disorder

3.3. Double depressionDouble depression

Mood disordersMood disorders

4.4. BipolarBipolar5.5. CyclothmiaCyclothmia6.6. Bipolar IIBipolar II7.7. Seasonal affective disorder Seasonal affective disorder

(SADS)(SADS)8.8. Postpartum depressionPostpartum depression

Etiology of Mood disordersEtiology of Mood disorders

1.1. Genetic vulnerabilityGenetic vulnerability

2.2. Neurochemical factorsNeurochemical factors

3.3. Cognitive factorsCognitive factors

4.4. Interpersonal rootsInterpersonal roots

5.5. StressStress

Etiology of Major depressive Etiology of Major depressive disorderdisorder

1.1. NotNot bipolar disorder bipolar disorder

2.2. NeurochemicalNeurochemical• SerotoninSerotonin

• NorephinephrineNorephinephrine

3.3. CognitiveCognitive

Cognitive etiology of Major Cognitive etiology of Major Depressive DisorderDepressive Disorder

• Learned helplessnessLearned helplessness

• Pessimistic explanatory Pessimistic explanatory stylestyle

• HopelessnessHopelessness

• RuminateRuminate

Depression ResearchersDepression Researchers

• Aaron BeckAaron Beck

• Martin SeligmanMartin Seligman

• Susan Nolen-HoeksemaSusan Nolen-Hoeksema

• Alloy and AbramsonAlloy and Abramson

Featured StudyFeatured Study

Does negative thinking Does negative thinking CAUSECAUSE depression? depression?

Featured StudyFeatured Study

What was the What was the

• Independent variable Independent variable

• Dependent variableDependent variable

Featured StudyFeatured Study

• Independent variable Independent variable

cognitive stylecognitive style

• Dependent variableDependent variable

depressiondepression

Featured StudyFeatured Study

• Independent variable was Independent variable was not not manipulatedmanipulated

• Quasi-experimental Quasi-experimental designdesign

Schizophrenic disordersSchizophrenic disorders

• DelusionsDelusions

• HallucinationsHallucinations

• Deterioration of adaptive Deterioration of adaptive behaviorbehavior

• Disturbed emotionDisturbed emotion

Schizophrenic disordersSchizophrenic disorders

• DelusionsDelusions– False beliefsFalse beliefs– ““I am superman”I am superman”

• HallucinationsHallucinations– False sensory perceptionsFalse sensory perceptions– ““I see superman”I see superman”

Schizophrenic SubtypesSchizophrenic Subtypes

1.1. Paranoid typeParanoid type

2.2. Catatonic typeCatatonic type

3.3. DisorganizedDisorganized

4.4. UndifferentiatedUndifferentiated

5.5. ResidualResidual

Andreasen’s alternative Andreasen’s alternative approachapproach

1.1. Positive symptomsPositive symptoms• HallucinationsHallucinations• DelusionsDelusions

2.2. Negative symptomsNegative symptoms• Flat emotionsFlat emotions• Withdrawal or apathyWithdrawal or apathy• Lack of speechLack of speech

Etiology of SchizophreniaEtiology of Schizophrenia

1.1. Genetic vulnerabilityGenetic vulnerability2.2. Neurochemical Neurochemical 3.3. Structural abnormailitiesStructural abnormailities4.4. NeurodevelopmentalNeurodevelopmental5.5. Expressed emotionExpressed emotion6.6. StressStress

Concept check 14.3Concept check 14.3

Distinguishng Distinguishng schizophrenic and mood schizophrenic and mood disordersdisorders

Personality disordersPersonality disorders

Extreme, inflexibly Extreme, inflexibly personality traits that personality traits that cause distress or cause distress or impairment in impairment in functioningfunctioning

Personality disorders Personality disorders

CategoriesCategories

1.1. Anxious/FearfulAnxious/Fearful

2.2. Odd/EccentricOdd/Eccentric

3.3. Dramatic/ImpulsiveDramatic/Impulsive

Personality disordersPersonality disorders

1.1. Anxious/FearfulAnxious/Fearfula)a) AvoidantAvoidantb)b) DependentDependentc)c) Obsessive-compulsiveObsessive-compulsive

2.2. SchizoidSchizoid3.3. SchizotypalSchizotypal4.4. ParanoidParanoid

Personality disordersPersonality disorders

2.2. Odd/EccentricOdd/Eccentrica)a) SchizoidSchizoid

b)b) SchizotypalSchizotypal

c)c) ParanoidParanoid

d)d) Schizoaffective (not in book)Schizoaffective (not in book)

Personality disordersPersonality disorders

3.3. Dramatic/ImpulsiveDramatic/Impulsivea)a)HistrionicHistrionic

b)b)NarcissisticNarcissistic

c)c)BorderlineBorderline

d)d)AntisocialAntisocial

Antisocial personality Antisocial personality disorderdisorder

• Impulsive, callous, Impulsive, callous, manipulative, aggressive, manipulative, aggressive, irresponsible, irresponsible, no no remorseremorse

• Often involved in crimeOften involved in crime

Antisocial personality Antisocial personality disorderdisorder

• Used to be called sociopathUsed to be called sociopath

• Hannibal Lecter, Ted BundyHannibal Lecter, Ted Bundy

• Etiology: Etiology: – Physiological, slow to Physiological, slow to

conditioncondition

– Environmental factorsEnvironmental factors

Psychological Disorders and Psychological Disorders and the Lawthe Law

• Insanity pleaInsanity plea

• Involuntary commitment Involuntary commitment (Baker act)(Baker act)

Culture and pathologyCulture and pathology

• Cultural variationCultural variation

• Culture-bound disordersCulture-bound disorders– Koro: fear of penis Koro: fear of penis

withdrawing into abdomenwithdrawing into abdomen

– Windigo: fear of becoming a Windigo: fear of becoming a cannibalcannibal

Stress-vulnerability modelStress-vulnerability model

• Diathesis stress modelDiathesis stress model

• Multiple causationMultiple causation

• Interaction of factorsInteraction of factors

• Figure 14.23, page 597Figure 14.23, page 597

Eating disordersEating disorders

• Anorexia nervosaAnorexia nervosa

• Bulimia nervosaBulimia nervosa– BingeBinge

– purgepurge

Etiology of Eating disordersEtiology of Eating disorders

1.1. Genetic vulnerabilityGenetic vulnerability

2.2. PersonalityPersonality

3.3. Cultural values Cultural values

4.4. FamilyFamily

5.5. Cognitive factorsCognitive factors

Critical thinkingCritical thinking

1.1. Representative heuristicRepresentative heuristic

2.2. Availability heuristicAvailability heuristic

3.3. Cumulative probabilityCumulative probability

4.4. Conjunctive probabilityConjunctive probability