psychopathology chapter 12 this multimedia product and its contents are protected under copyright...
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PsychopathologyPsychopathology
Chapter 12Chapter 12
This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or part, of any images; any rental, lease, or lending of the program. ISBN: 0-205-37181-7
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Evolving Concepts of Mental Disorder
• How do we define “abnormality”?• Medical model
“disease” view, biological causes• Psychological models
Psychogenic – Caused by psychological factors
(thoughts, beliefs, childhood, experiences)
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Indicators of Abnormality
DistressDistress MaladaptivenessMaladaptiveness
IrrationalityIrrationality UnpredictabilityUnpredictability
Observer Observer discomfortdiscomfort
Unconventional Unconventional and undesirable and undesirable
behaviorbehavior
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Classifying System
DSM-IV – (1994)Fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders• the most widely accepted classification
system in the United States• Common terminology across disciplines• Etiology –
The causes of, or factors related to, the development of a disorder
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Explosion of Mental Disorders
• Supporters of new categories answer that is important to distinguish disorders precisely.
• Critics point to an economic reason: diagnoses are needed for insurance reasons so therapists will be compensated.
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Problems with DSM-IV
• Danger of overdiagnosis
• Power of labels (self-fulfilling prophecy)
• Confusion of serious disorders with normal problems
• Illusion of objectivity and universality
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• Diagnostic labels can compound the problem (Rosenhan Study**)
What are the ConsequencesWhat are the Consequencesof Labeling People?of Labeling People?
• The cultural context of mental disorder
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:general state of apprehension or psychological tension
Generalized Anxiety disorder (GAD)Post-traumatic Stress disorder (PTSD)Panic disorder –
Marked by panic attacks that have no connection to events in a person’s present experience
PhobiasAgoraphobia- Fear of public places/open spaces
Social Phobia- fear of being observed by others
I. Anxiety Disorders
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Obsessive-compulsive disorder – Condition characterized by patterns of persistent, unwanted thoughts and behaviors
Anxiety Disorders
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A loss of memory for personal information
AmnesiaAmnesia
Dissociative fugue
Dissociative identity disorder
II. Dissociative Disorders
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Amnesia with the addition of “flight” from one’s home, family, and job
Amnesia
Dissociative fugueDissociative fugue
Dissociative identity disorder
Dissociative Disorders
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Condition in which individual displays multiple identities
Amnesia
Dissociative Fugue
Dissociative Dissociative identity disorderidentity disorder
Dissociative Disorders
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The D.I.D./M.P.D. Controversy
• First view– MPD is common but often unrecognized or
misdiagnosed.– The disorder starts in childhood as means of coping.
– Trauma produced a mental splitting.
• 2nd view– Created through pressure and suggestions by
clinicians.
– Range: Only Handfuls of people to 10000 since 1980.
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III. Mood Disorders
Bipolar disorder – Mental abnormality involving swings of mood from mania to depression
Mania – Pathologically excessive elation or manic excitement
Depression – Pathological sadness or despair
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Unipolar depression
• Incidence
• Causes of depression
• Seasonal affective disorder (SAD) – Believed to be caused by deprivation of sunlight
Mood Disorders
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Symptoms of Depression
• Depressed mood. • Reduced interest in almost all activities.• Significant weight gain or loss, without dieting. • Sleep disturbance • Change in motor activity • Fatigue or loss of energy.• Feelings of worthlessness or guilt.• Reduced ability to think or concentrate. • Recurrent thoughts of death.
DSM IV Requires 5 of these within the past 2 weeks
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Vulnerability-Stress Model
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IV. Schizophrenic Disorders
Schizophrenia –
Psychotic disorder involving distortions in thoughts, perceptions, and/or emotions(most likely to hospitalized)
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Features incoherent speech, hallucinations, delusions, and bizarre behavior
DisorganizedDisorganized
Catatonic
Paranoid
Undifferentiated
Major Types of Schizophrenia
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Involves stupor or extreme excitement
Disorganized
CatatonicCatatonic
Paranoid
Undifferentiated
Major Types of Schizophrenia
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Prominent feature: combination of delusions and hallucinations
Disorganized
Catatonic
ParanoidParanoid
Undifferentiated
Major Types of Schizophrenia
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Persons displaying a combination of symptoms that do not clearly fit in one of the other categories
Disorganized
Catatonic
Paranoid
UndifferentiatedUndifferentiated
Major Types of Schizophrenia
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Theories of Schizophrenia
• Genetic predispositions
• Structural brain abnormalities
• Neurotransmitter abnormalities
• Prenatal abnormalities
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V. Problem Personalities
• Personality Disorder– Rigid, maladaptive patterns that cause personal
distress or an inability to get along with others.
• Narcissistic Personality Disorder– exaggerated sense of self-importance and self-
absorption.– preoccupation with fantasies of success and
power, and a need for constant attention
• Paranoid Personality Disorder– habitually unreasonable and excessive
suspiciousness and jealousy.
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Personality Disorders cont’d
Antisocial personality disorder – Characterized by aggressiveness, lack of guilt, and exploitation of others
• Must have 3 of these criteria and a history of behaviors– Repeatedly break the law.
– They are deceitful, using aliases and lies to con others.
– They are impulsive and unable to plan ahead.
– They repeatedly get into physical fights or assaults.
– They show reckless disregard for own safety or that of others.
– They are irresponsible, failing to meet obligations to others.
– They lack remorse for actions that harm others
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VI. Somatoform Disorders
Somatoform disorders – Psychological problems appearing in the form of bodily symptoms or physical complaints
Conversion disorder – marked by paralysis, weakness, or loss of sensation, but with no discernable physical cause
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Glove Anesthesia
Somatoform Disorders
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Hypochondriasis – Somatoform disorder involving excessive concern about health and disease
Somatoform Disorders
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VII. Drug Abuse and Addiction
• Biology and addiction.– a person’s biochemistry, – metabolism, and – genetic predisposition
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Learning, Culture, and Addiction
• Addiction patterns vary according to cultural practices and the social environment.
• Policies of total abstinence tend to increase addiction rates rather than reduce them.
• Not all addicts have withdrawal symptoms when they stop taking a drug.
• Addiction does not depend on the properties of the drug alone, but also on the reason for taking it.
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Failure of the Addiction Prediction• 75% of US Soldiers who
tested “drug positive” in reported being addicted during their tour.
• Fewer reported post-Vietnam drug use (blue bar).
• Even fewer still showed dependency(green bar).
• This contradicts what the biomedical model of addiction would predict.**
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Debating the Causes of Addiction
• Problems with drugs are more likely when:– A person has a physiological vulnerability to a drug.– A person believes she or he has no control over the
drug.– Laws or customs encourage people to take the drug in
binges, and moderate use is neither tolerated nor taught.
– A person comes to rely on a drug as a method of coping with problems, suppressing anger or fear, or relieving pain.
– Peer group uses drugs or drinks heavily, forcing the person to choose between using drugs or losing friends.