Intro To Psych - Ch 12 Psychopathology

Front 1

What makes behavior Abnormal?

What is abnormal psychology?

Back 1

Abnormal psychology is the application of psychological behavioral science to understanding and treating mental disorders.

Front 2

What makes behavior Abnormal?

What is a psychological disorder?

Back 2

is an ongoing dysfunctional pattern of though, emotion, behavior that causes significant distress and that is considered deviant to one's culture or society.

They are out of the patient's control, can sometimes be treated with the use of drugs, and are often covered by medical insurance. They have both biological (nature) and environmental (nurture) influences.

The bio-psycho-social model of illness is a way of understanding disorders that assumes that disorders are caused by biological, psychological and social factors.

Biological influences include:
genetics, brain structure and neurotransmitters

Psychological influences include:
responses to stress
patterns in negative thinking

Socio-cultural influences include:
cultural expectations, stigma and prejudice, homelessness, abuse

Front 3

What makes behavior Abnormal?

What is comorbidity?

What is stigma?

Back 3

Comorbidity is a situation that occurs when people who suffer from one disorder also suffer at the same time from one or more other disorders. (i.e., people diagnosed with anxiety disorders also often have mood disorders

Stigma is a disgrace or defect that indicates that person beings to a culturally devalued social group.

Front 4

What makes behavior Abnormal?

What is the DSM?

Back 4

Stands for Diagnostic and Statistical Manual of Mental Disorders, it is a1000p manual in which the criteria for description of behaviors if psychological disorders is compiled. It is used by therapists, researchers, drug companies, health insurance companies and policy makers.

The DSM categorizes the diagnosis of disorder according to 5 dimensions (or axes) relating different aspects of disorder or disability. It does not attempt to specify the exact symptoms that are required for a diagnosis but rather uses categories and qualifiers to indicate various levels of severity.

It has been criticized regarding the nature of its categorization, that it classifies more and more behaviors as disorders with every revision, and that it focuses on Western illness. But it is still a comprehensive, practical and necessary tool that provides common language to describe disorder. The DSM approach allows for a systematic assessment of the patient taking into account the mental disorder, the patient's medical condition, psychological and cultural factors and the way the patient functions in everyday life.

Axis I:
Is a clinical syndrome such as mood, anxiety or learning disorder present?

Axis II:
Is a personality disorder or mental retardation present?

Axis III:
Is a general medical condition, such as heart disease, diabetes or cancer present?

Axis IV:
Are social or environmental problems such as homelessness, divorcem schools problems, or other stressors present?

AxisV:
What is the global assessment of this person's functioning in a range of activities?

Front 5

What makes behavior Abnormal?

ADHD, Autsism and Asperger's

Back 5

There is much controversy over 3 common disorders because they are being diagnosed much more significantly than they were in the past.

ADHD, aka attention-deficit/hyperactivity disorder is a developmental behavioral disorder characterized by problems with focus, maintaining attention and the inability to concentrate with symptoms starting before age 7. It is the most common disorder in children around the world.

But are the increases in diagnosis due to the fact that children are more distracted and hyperactive, due to greater awareness, due to tendency to over diagnose? Maybe drug co's are involved because rx meds for ADHD include Ritalin.

Autism is a disorder of neural development characterized by impaired social interaction and communication and by restricted and repetitive behavior with symptoms beginning before age 7.

Asperger's is a developmental disorder that affects the child's ability to socialize and communicate effectively with others and in which symptoms begin before age 7.

There are instances when a doctor and psychologist disagree on a diagnosis - i.e., autism vs asperger's.

Front 6

Anxiety and Dissociative Disorders:

Generalized Anxiety Disorder

Panic Disorder

Phobias

Back 6

Anxiety is the nervousness or agitation that we can experience often about something that is going to happen. Anxiety us important and useful because it is associated with the sympathetic nervous system and the physiological and behavioral responses that help protect us from danger. However, too much anxiety can be debilitating.

Anxiety disorders are psychological disturbances marked by irrational fears, often of everyday objects and situations.

Generalized Anxiety Disorder:
a psychological disorder in which a person worries excessively about money, health, work, family life, etc for at least 6 months even though he knows that the concerns are exaggerated and the anxiety causes significant distress and dysfunction. Symptoms can include: irritability, sleep troubles, difficulty concentrating, muscle aches, trembling, perspiration and hot flashes.

Panic Disorder:
a psychological disorder characterized by sudden attacks of anxiety and terror that have led to behavioral changes in a person's life. Symptoms can include shortness of breath, heart palpitations, trembling, dizziness, choking sensation, nausea and intense feelings of dread and doom

Phobias:
is a specific fear of a certain object, situation or activity. Arachnophobia is a fear of spiders, Acrophobia is a fear of heights, Social phobia is fear of people and social situations, Agoraphobia is anxiety about being in places or situations from which escape might be difficult (crowded streets or stores, bridges, tunnels and highways).

Front 7

Anxiety and Dissociative Disorders:

Obsessive Compulsive Disorders

Post-Traumatic Disorder

Back 7

OCD:
a disorder that is diagnosed when an individual continuously experiences distressing or frightening thoughts, engages in obsessions (repetitive thoughts) or compulsions (repetitive behaviors) in an attempt to calm these thoughts. (compulsive behaviors become so time costuming that they cause significant dysfunction in everyday life).

PTSD:
experience high level of anxiety and reexperience the trauma (flashbacks) and a strong desire to avoid any reminders of the event. Lose interest in things they used t enjoy, startle easily, have difficulty feeling affection and may experience rage, depression and insomnia. Risk factors include degree of trauma's severity, lack of familial and community support, etc.

Front 8

Anxiety and Dissociative Disorders:

Dissociative Amnesia and Fugue

Dissociative Identity Disorder

Explaining Anxiety and Dissociation Disorders

Back 8

A dissociative disorder is a condition that involves disruptions or breakdowns of memory, awareness, and identity. The dissociation is used as a defense against trauma.

Dissociative Amnesia
is a psychological disorder that involves extensive but selective memory loss and there is no physiological explanation for the forgetting. The amnesia is normally brought on by a trauma - a situation that causes so much anxiety that the individual forgets in order to escape. They remember how to do everyday functions but often forget their name, age, family and friends.

Dissociative Fague
typically experience same as dissociative amnesia but loses complete memory of identity and may often assume a new one but often far away from home.

Dissociative Identity Disorder
previously known as "multiple personality disorder" it is the most severe of the dissociative disorders it is a disorder in which to or more distinct personalities exist in the same person and there is an extreme memory disruption regarding personal info ration about the other personalities. The "host personality" is the personality usually in charge of the body but the "alter personalities" can take over usually in a stressful situation. There is some controversy with clinicians saying that maybe they are faking, role-playing or using the disorder to justify behavior. Some feel that the famous "Sybil" who had 16 distinct personalities was actually inadvertently hypnotized by her therapist who suggested the existence of other personalities.

An explanation for anxieties:
Both nature and nurture contribute to the development of anxiety disorders. Evolutionary experiences contribute to fear of dangerous situations. Healthy fears of the dark, storms, high places, closed spaces, spiders and snakes helped people survive. There is also evidence that anxiety disorders are heritable and genetic studies have found genes that are linked to the expression of the these disorders. People w/ PTSD tend to have slightly smaller hippocampus and this may lead them to be very sensitive to traumatic events. People who were abused as children tend to be more anxious than those with normal childhood. Anxieties are also learned through classical and operant conditioning...so 1 dog bite can turn into a fear of all dogs and 1 embarrassing experience in public can lead to fear of all public places.

An explanation for dissociation:
unsure, little evidence of a genetic predisposition. Seem to be almost entirely environmentally determined...severe emotional trauma in childhood coupled with strong stressors seem to be underlying cause.

Front 9

Mood Disorders:

Mood

Dysthymia

Major Depressive Disorder

Bipolar Disorder

Back 9

Mood
can be defined as the positive or negative feelings that are in the background of our everyday experiences. Mood disorder are those in which a person's mood negatively influence his physical, perceptual, social and cognitive processes.

Dysthymia
mild but chronic depressive symptoms that last at least 2 years.


Major Depressive Disorder
is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem and by loss of interest or pleasure in normally enjoyable activities. They feel intense sadness, despair, and loss of interest in things the enjoy.

Bipolar Disorder
characterized by swings in mood, from overly "high" to sad and hopeless, and back again, with periods of near normal mood in between. Highs are often marked with impulsivity and agitation.

An explanation:
in part genetic, they are heritable. Neurotransmitters are vital in mood disorders - serotonin, dopamine are all known to influence mood. But psychological and social determinants are also important in creating mood disorders and depression. Mood states are influenced in large part by our cognitions. Unfortunately, negative emotions create negative behaviors, which sad to negative responses which creates even more depression.

Front 10

Schizophrenia

Back 10

Schizophrenia
is a serious psychological disorder marked by delusions, hallucinations, loss of contact with reality, inappropriate affect, disorganized speech, social withdrawal and deterioration of adaptive behavior. It is the most chronic and debilitating of all psychological disorders, it affects men and women equally, occurs similarly through cultures and ethnicities. Onset is usually between 16-30, rarely after 45 or in children.

Many symptoms but not all patients have them.

Positive symptoms: refer to presence of abnormal behaviors or experiences such as hallucinations that are not observed in normal people.

Negative symptoms: refer to the loss of deterioration of thoughts and behaviors that are typical of normal functioning.

Cognitive symptoms: are the changes in cognitive processes that accompany schizophrenia...lose touch with reality i.e., psychosis

General positive symptoms of schizophrenia:
almost always suffer from hallucinations (imaginary sensations that occur in the absence of real stimulus or which are gross distortions of the real stimulus). Most common are auditory hallucinations, visual are less common. Common are also delusions (false beliefs not commonly shared by others within one's own culture) such as delusions of grandeur, persecution, etc. Some also suffer from the positive symptoms of derailment (the shifting from the subject to another without any one line of thought), grossly disorganized behavior (such inappropriate behavior like inappropriate sexual behavior, peculiar appearance or dress, unusual agitation, strange body movements, etc.),

General negative symptoms of schizophrenia:
social withdrawal, poor hygiene and grooming, poor problem solving abilities, distorted sense of time, Some also suffer flat effect (express almost no emotional response even though they report feeling emotions); some tend to have incoherent language such as "echo speech" (repeating others). Although not all schizophrenia patients have negative symptoms those who do have the poorest outcome as they cannot work or care for themselves.

Cognitive symptoms include difficulty comprehending infrmation and using it to make decisions, difficulty maintaining focus and attention, issues with working memory.

Explaining schizophrenia:
no single cause, rather a variety of biological and environmental risk factors that interact in a complex way to increase likelihood. Seems there may be a genetic component. Also seems that neurons and neurotransmitter levels play a role.

Front 11

Personality Disorders:

Borderline Personality

Antisocial Personality

Back 11

Personality disorders:
these are Axis II disorders which are longer term but less incapacitating. They are conditions characterized by inflexible thinking patterns, feelings or ways of relating to others in personal, social and work situations. These disorders are problematic but less likely to bring people to a therapist for treatment.

Three types: odd/eccentric behavior, dramatic/erratic behavior, anxious/inhibited behavior. They are highly comorbid which makes diagnosing difficult.

Borderline:
often related to suicidal people. Characterized by prolonged disturbance in personality accompanied by mood swings, unstable personal relationships, identity problems, threats of self-destructive behavior, fears of abandonment. They often show clinging dependency and engage in manipulation to try to maintain relationships. Because they fear abandonment they can be compulsively social yet their tendencies to be angry, demanding, and suspicious of others is repellent. They constantly engage in behavior that requires a "saving" response and are a burden to poise, hospitals and therapists (i.e., society). They feel chronically empty, bored and hate to be alone.

Explanation for BPD
genetic and environmental. BPD is frequently linked to neurotransmitter imbalance and it is heritable. Environementally, seems to stem from early disturbed childhood relationship with parents. Often comorbid with major depressive disorder, PTSD, etc.

Antisocial Personality Disorder
is characterized by a disregard of the rights of others and a tendency to violate those rights without being concerned about doing so. Often begins in childhood or adolescence and continues throughout adulthood. Also referred to as "sociopaths" or "psychopaths", to be diagnosed with ADP requires the person to be 18 yrs of age with a documented history of conduct disorder. People with ADP engage in violence against animals and people, lie, have drug and alcohol abuse problems. They are egocentric and impulsive.

Explanations for ADP
both biological and environmental factors implicated in ADP. Genetic predisposition and biological abnormalities can lead to the disorder. Neglectful or abusive parenting styles can be a factor as well.

Front 12

Somatoform, Factitious, Sexual

Somatization (Briquet's syndrome or Brissaud-Marie syndrome)

Hypochondriasis

Factitious

Back 12

Somatization (Briquet's syndrome or Brissaud-Marie syndrome)
person experiences numerous long-lasting but seemingly unrelated physical ailments that have no identifiable physical cause. Might complain about joint aches, vomiting, nausea, muscle weakness ad sexual dysfunction...they are real but entirely due to psychological factors. Most likely to occur under stress then disappear over time.

Conversion Disorder
patient experiences specific neurological symptoms such as numbness, blindness or paralysis but where no neurological explanation is observed.

Body Dysmorphic Disorder (BDD)
patient has imagined or exaggerated sense of body parts or body odors.

Hypochondriasis
a preoccupation with excessive worry about serious illness

Factitious Disorder
patients fake physical symptoms because they enjoy the attention and treatment they receive at the hospital. Have societal costs...

Front 13

Sexual Dysfunction

Gender Identity

Paraphilia

Back 13

defined as
occurs when the physical sexual response cycle is inadequate for reproduction or for sexual enjoyment.

Gender Identity Disorder
refers to the identification with a sex. Sometimes as young as 3 yrs old feel trapped in the body of the wrong sex. GID or transsexualism is diagnosed when the person displays repeated and strong desire to be the other sex, persistent discomfort ith one's sex, accompanied by significant distress and dysfunction. Causes are unknown. DSM may change categorizations.

Paraphilia
related to sexual practices and interests, sexual deviation where sexual arousal is obtained from a consistent pattern of inappropriate responses to objects or people and in which the feelings are distressing and dysfunctional. Ex, exhibitionism, fetishism, frotteurism, sadism, masochism, etc

Hypoactive sexual desire disorder
most common, refers to persistently low or nonexistent sexual desire