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Ch15 - Abnormal Behavior


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Chapter 15

Ch15 - Abnormal Behavior

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