30 Apr Choose a psychological disorder form Chapter 15 and answer the following questions with information from the book and outside sources. Name the disorder. Who is mo
Choose a psychological disorder form Chapter 15 and answer the following questions with information from the book and outside sources. Name the disorder. Who is most diagnosed with the disorder? How prevalent is the disorder in society? What are the symptoms of the disorder? Is the disorder hereditary? What do you think about the disorder based on your research? 20 sentences
PSYCHOLOGY 2e
Chapter 15 PSYCHOLOGICAL DISORDERS
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COLLEGE PHYSICS
Chapter # Chapter Title
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DEFINITION OF A PSYCHOLOGICAL DISORDER
Psychopathology – the study of psychological disorders, including their symptoms, etiology (causes), and treatment.
Psychological disorder – a condition characterized by abnormal thoughts, feelings, and behaviors.
Behaviors, thoughts, and inner experiences that are atypical, dysfunctional, or dangerous are signs of psychological disorders.
However, there is no single definition of psychological abnormality or normality.
Just because something is atypical, does not mean it is disordered. Red hair is considered unusual, but not abnormal.
Isla Fischer, (b) Prince Harry, and (c) Marcia Cross are three natural redheads.
(credit a: modification of work by Richard Goldschmidt; credit b: modification of work by Glyn Lowe; credit c: modification of work by Kirk Weaver)
DEFINITION OF A PSYCHOLOGICAL DISORDER
Cultural Expectations
Violating cultural expectations is not enough by itself to identify a psychological disorder.
Social norms vary between cultures – what is considered appropriate in one culture may be viewed differently in another.
Hallucinations is a violation of cultural expectations in Western Societies. People who report hallucinations are likely to be labeled with a psychological disorder.
However, in some other cultures, certain types of hallucinations are highly valued.
Harmful Dysfunction
Wakefield (1992):
Proposed a more influential concept in which he defines psychological disorders as a harmful dysfunction.
Dysfunction occurs when an internal mechanism (e.g., cognition, perception, learning) breaks down and cannot perform its normal function.
For a dysfunction to be be classed as a disorder, it must also be harmful – leads to negative consequences for the individual or for others, as judged by the standards of the individual’s culture.
DEFINITION OF A PSYCHOLOGICAL DISORDER
American Psychological Association (APA) Definition
A psychological disorder is a condition that consists of the following:
Significant disturbances in thoughts, feelings, and behaviors.
Outside of cultural norms.
The disturbances reflect some kind of biological, psychological, or developmental dysfunction.
The disturbances lead to significant distress or disability in one’s life.
E.g. difficulty performing appropriate and expected roles.
Despite the many existing definitions, there is no universal agreement on where the boundary between disordered and not disordered is.
THE DIAGNOSTIC & STATISTICAL MANUAL OF MENTAL DISORDERS (DSM)
Diagnosis – appropriately identifying and labeling a set of defined symptoms
Requires classification systems that organize psychological disorders systematically.
Diagnostic and Statistical Manual of Mental Disorders:
Published by the American Psychiatric Association.
First published in 1952 and has since undergone numerous revisions.
The first two editions listed homosexuality as a disorder but was removed in 1973.
DSM-5 is the classification system used by most mental health professionals.
Categorizes and describes each disorder.
Diagnostic features – overview of the disorder.
Diagnostic criteria – specific symptoms required for diagnosis.
Prevalence – percent of population thought to be afflicted.
Risk factors.
Provides information about comorbidity (the co-occurrence of two disorders).
PREVALENCE RATES (DSM-IV)
The graph shows the breakdown of psychological disorders, comparing the percentage prevalence among adult males and adult females in the United States.
The DSM-IV, has since been supplanted by the DSM-5. Most categories remain the same; however, alcohol abuse now falls under a broader Alcohol Use Disorder category.
COMORBIDITY (DSM)
Obsessive-compulsive disorder and major depressive disorder frequently occur in the same person.
THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD)
Published by the World Health Organization (WHO).
Classification and criteria for specific disorders are similar to the DSM but some differences exist.
Used to examine general health of populations and monitor prevalence of diseases/health problems internationally.
Worldwide, the ICD is more frequently used for clinical diagnosis, whereas the DSM is more valued for research.
DSM includes more explicit disorder criteria as well as extensive explanatory text.
DSM is the classification system used among U.S. mental health professionals.
SUPERNATURAL PERSPECTIVES
For centuries, psychological disorders were viewed from a supernatural perspective.
Supernatural perspective – psychological disorders attributed to a force beyond scientific understanding.
Practitioners of black magic (sorcery).
Possessed by spirits.
Witchcraft.
Treatments included torture, beatings, and exorcism.
In The Extraction of the Stone of Madness, a 15th century painting by Hieronymus Bosch, a practitioner is using a tool to extract an object (the supposed “stone of madness”) from the head of an afflicted person.
DANCING MANIA
Epidemic in Western Europe (11th-17th centuries) in which groups of people would suddenly begin to dance with wild abandon.
Some would dance for days or weeks, screaming of terrible visions.
Although the cause is unknown, the behavior was attributed by many to supernatural forces.
BIOLOGICAL PERSPECTIVES
View psychological disorders as linked to biological phenomena:
Genetic factors, chemical imbalances, and brain abnormalities.
Supported by evidence that most psychological disorders have a genetic component.
A person’s risk of developing schizophrenia increases if a relative has schizophrenia. The closer the genetic relationship, the higher the risk.
DIATHESIS-STRESS MODEL
Psychosocial Perspective
Emphasizes the importance of learning, stress, faulty and self-defeating thinking patters, and environmental factors.
Views the cause of psychological disorders as a combination of biological and psychosocial factors.
Diathesis-Stress Model:
Integrates biological and psychosocial factors to predict the likelihood of a disorder.
Diathesis + Stress → Development of a disorder
People with an underlying predisposition for a disorder (diathesis) are more likely than others to develop a disorder when faced with adverse environmental or psychological events.
A diathesis can be a biological or psychological vulnerability.
ANXIETY DISORDERS
Fear vs Anxiety
Fear – an instantaneous reaction to an imminent threat.
Anxiety – apprehension, avoidance, and cautiousness regarding a potential threat, danger, or other negative content.
Motivates us to take action, avoid certain things.
Level and duration of anxiety usually matches the magnitude of the potential threat. However, some people experience anxiety that is excessive, persistent and out of proportion with the actual threat.
Anxiety Disorders
Characterized by excessive and persistent fear and anxiety, and by related disturbances in behavior.
Prevalence:
Effects approximately 25%-30% of the U.S. population during their lifetime.
More common in women than men.
Most frequently occurring class of mental disorders.
SPECIFIC PHOBIA
Involves excessive, distressing, and persistent fear or anxiety about a specific object or situation.
People may realize their fear and anxiety is irrational but may still go to great lengths to avoid the stimulus.
Prevalence – affects 12.5% of the U.S. population at some point in their lifetime.
Common specific phobias include:
Acrophobia – heights.
Aerophobia – flying.
Arachnophobia – spiders.
Claustrophobia – enclosed spaces.
Agoraphobia:
Listed as a separate anxiety disorder.
Characterized by intense fear, anxiety, and avoidance of situations in which it might be difficult to escape or receive help if one experiences a panic attack.
These situations include public transportation, crowds, being outside the home alone.
ACQUISITION OF PHOBIAS THROUGH LEARNING
Rachman (1977): 3 Major Learning Pathways
Classical Conditioning.
Child is bitten by dog (US) → dogs become associated with biting (CS) → child experiences fear around dogs (CR).
Conditioned fears develop more readily to fear-relevant stimuli (images of snakes and spiders) than to fear-irrelevant stimuli (images of flowers).
Vicarious Learning.
Child observes cousin react with fear around spiders → child later expresses the same fears even though spiders have never presented any danger to him.
Verbal transmission of information.
A child is continuously told that snakes are dangerous → child starts to fear snakes.
Why are certain types of phobias more common than others?
One theory argues that because our ancestors associated certain stimuli with danger (e.g., snakes, spiders, and heights), we are evolutionarily predisposed to associate those stimuli with fear.
SOCIAL ANXIETY DISORDER
Characterized by extreme and persistent fear or anxiety and avoidance of social situations in which the person could potentially be evaluated negatively by others, leading to serious impairments in life.
Associated with lower educational attainment, lower earning, poor work performance, unemployment.
Safety behaviors – mental or behavioral acts that reduce anxiety in social situations by reducing the chance of negative social outcomes.
E.g., avoiding eye contact or rehearsing sentences before speaking.
Prevalence – experienced by about 12% of Americans during their lifetime.
Comorbidity – high rate of comorbidity with alcohol use disorder.
Individuals may self-medicate to reduce anxiety in social situations.
Risk Factors
Fears of social situations possibly develop through conditioning.
92% of a sample of adults with social anxiety disorder reported a history of severe teasing in childhood.
Behavioral inhibition – a consistent tendency to show fear and restraint when presented with unfamiliar people or situations.
PANIC DISORDER
Panic disorder – recurrent and unexpected panic attacks, along with at least one month of persistent concern about additional panic attacks, worry over the consequences of the attacks, or self-defeating changes in behavior related to the attacks.
Comorbidity – anxiety disorders or major depressive disorder.
Panic attack – a period of extreme fear or discomfort that develops abruptly and reaches a peak within 10 minutes.
Can be expected (in response to an external trigger) or unexpected.
Panic attacks alone are not a disorder.
Some of the physical manifestations of a panic attack are shown. People may also experience sweating, trembling, feelings of faintness, or a fear of losing control, among other symptoms.
PANIC DISORDER CAUSES
Genetics
43% heritability.
Neurobiological Theories
Locus coeruleus in the brainstem is possibly involved.
Major source of norepinephrine (neurotransmitter that triggers flight-or-flight response).
Activation is associated with anxiety and fear and produces panic-like symptoms in nonhuman primates.
Conditioning Theories
Panic attacks are classical conditioning responses to subtle bodily sensations resembling those normally occurring when one is anxious or frightened.
Cognitive Theories
Individuals with panic disorder are prone to interpret ordinary bodily sensations catastrophically, setting the state for panic attacks.
In some patients, reducing catastrophic cognitions about sensations has proven to be as effective as medication in reducing panic attacks.
GENERALIZED ANXIETY DISORDER
A relatively continuous state of excessive, uncontrollable, and pointless worry and apprehension.
Diagnosis Criteria
The diffuse worrying and apprehension is not part of another disorder.
Symptoms occur more days than not for at least 6 months.
Symptoms are accompanied by any three of the following symptoms:
Restlessness, difficulty concentrating, being easily fatigued, muscle tension, irritability, and sleep difficulties.
Prevalence
Affects about 5.7% of U.S. population during their lifetime.
Females are 2 times as likely as males to experience the disorder.
Comorbidity
Comorbid with mood disorders and other anxiety disorders.
GENERALIZED ANXIETY DISORDER CAUSES
Cognitive Theories
Worry represents a mental strategy to avoid more powerful negative emotions perhaps stemming from earlier unpleasant or traumatic experiences.
Worrying acts a distraction from remembering painful childhood experiences.
Longitudinal study found childhood maltreatment was strongly related to development of the disorder during adulthood.
(credit: Freddie Peña)
OBSESSIVE COMPULSIVE DISORDER (OCD)
Involves thoughts and urges that are intrusive and unwanted (obsessions) and/or the need to engage in repetitive behaviors or mental acts (compulsions).
Obsessions – persistent, unintentional, and unwanted thoughts and urges that are highly intrusive, unpleasant, and distressing.
Common obsessions:
Concerns about germs and contamination
Doubts
Order and symmetry
Aggressive or lustful urges
Compulsions – repetitive and ritualistic acts, typically carried out primarily as a means to minimize the distress that obsessions trigger or to reduce the likelihood of a feared event.
Not performed out of pleasure.
The person usually knows these obsessions and compulsions are irrational but suppressing them is extremely difficult.
Prevalence
Experienced by approximately 2.3% of the U.S. population in their lifetime.
OBSESSIVE-COMPULSIVE DISORDER (OCD)
Repetitive hand washing and (b) checking (e.g., that a door is locked) are common compulsions among those with obsessive-compulsive disorder.
Other common compulsions include cleaning, ordering, and counting.
(credit a: modification of work by the USDA; credit b: modification of work by Bradley Gordon)
BODY DYSMORPHIC DISORDER
Involves a preoccupation with a perceived flaw in the individuals physical appearance that is either nonexistent or barely noticeable to other people.
Causes person to think they are unattractive or deformed.
Typically involve skin, face, or hair, but can focus on any bodily area.
Causes person to engage in repetitive and ritualistic behavioral and mental acts.
Constantly looking in the mirror.
Trying to hide the offending body part.
Comparison with others.
Cosmetic surgery.
Prevalence
Affects approximately 2.4% of adults in the U.S.
Slightly higher rates in women than in men.
HOARDING DISORDER
Involves great difficulty in discarding possessions, regardless of how valueless/useless they are, usually resulting in an accumulation of items that clutter living or work areas.
Why are they unable to let go of items?
They think items might be useful at a later time.
Sentimental attachment to items.
Excessive clutter prevents the individual using necessary living spaces such as the kitchen or bed.
Diagnosed as long as the hoarding is not a symptom of another disorder.
(credit: “puuikibeach”/Flickr)
OCD CAUSES
Genetics
5 times more frequent in first-degree relatives of people with OCD.
Identical twins – 57% concordance rate.
Fraternal twins – 22% concordance rate.
Genes involved regulate the function of serotonin, dopamine, and glutamate.
Conditioning Theories
Symptoms of OCD are learned responses resulting from both classical and operant conditioning.
Neutral stimulus + unconditioned stimulus → anxiety or distress.
Once association has been acquired, encounters with the NS trigger anxiety and obsessive thoughts.
Anxiety and obsessive thoughts continue until a strategy is identified to relieve it.
Relief may be ritualistic behavior or mental activity that reduces anxiety.
Compulsive acts become negatively reinforcing.
OCD CAUSES
Brain Anatomy
OCD Circuit:
Several interconnected regions that influence perceived emotional value of stimuli and selection of behavioral and cognitive responses.
Abnormalities in these areas may produce symptoms of OCD.
Orbitofrontal cortex – involved in learning and decision making.
Becomes hyperactive in people with OCD when provoked with tasks such as looking at photos of a toilet or a pictures hanging crookedly on a wall.
DEFINITION OF PTSD
Diagnosis Criteria
Individual was exposed to, witnessed, or experienced the details of a traumatic experience (“actual or threatened death, serious injury, or sexual violence”) (APA, 2013).
PTSD was first recognized in soldiers who had engaged in combat.
Symptoms occur for at least one month.
Symptoms
Intrusive and distressing memories of the event.
Flashbacks – states during which individual relives the event and behaves as if it were occurring at that moment.
Avoidance of stimuli connected to the event.
Persistently negative emotional states.
Feelings of detachment from others.
Irritability.
Proneness toward outbursts.
Exaggerated startle response.
Prevalence – Experienced by approximately 7% of the U.S. population in their lifetime.
RISK FACTORS FOR PTSD
Risk Factors
Trauma experience.
Those involving harm by others carry greater risk than those that do not.
Lack of immediate social support.
Social Support (comfort, advice, and assistance from relatives, friends, and neighbors) can reduce the risk of developing PTSD.
Subsequent life stress.
Female gender.
Low socioeconomic status.
Low intelligence.
Personal history of mental disorders.
History of childhood adversity.
Family history of mental disorders.
Personality characteristics – neuroticism and somatization (tendency to experience physical symptoms when one encounters stress).
Possession of one or two short versions of a gene that regulates serotonin.
LEARNING & THE DEVELOPMENT OF PTSD
Conditioning Theories
Traumatic event (UCS) → Extreme fear and anxiety (UCR).
Cognitive, emotional, physiological, and environmental cues associated with the traumatic event become conditioned stimuli.
Traumatic reminders (CS) → Extreme fear and anxiety (CR).
Cognitive Theories
Two key processes in development and maintenance of PTSD:
Disturbances in memory for the event.
Poorly encoded memories of trauma can become fragmented, disorganized, and lacking in detail.
Individuals cannot remember event in a way that gives meaning and context.
May become haunted by these fragments involuntarily triggered by stimuli associated with the event.
Negative appraisals of the trauma and its aftermath (e.g., ”I deserve to be raped because I am stupid”).
May lead to dysfunctional behavioral patterns that maintain symptoms and prevent changes in the problematic appraisals.
MOOD DISORDERS
Characterized by massive disruptions in mood and emotions that can cause a distorted out look on life, and impair ability to function.
Depressive Disorders
Depression (intense and persistent sadness) is the main feature.
Bipolar and Related Disorders
Mania (extreme elation and agitation) is the main feature.
Manic episode – “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy lasting at least one week.” (APA, 2013).
MAJOR DEPRESSIVE DISORDER
Diagnosis Criteria
“Depressed mood most of the day, nearly every day” (APA, 2013).
Loss of interest and pleasure in usual activities.
At least 5 symptoms for at least a two-week period.
Symptoms cause significant distress or impair normal functioning and are not caused by substances or a medical condition.
Major depressive disorder is episodic (symptoms are usually present at their full magnitude for a certain period of time and then gradually diminish).
Symptoms
Weight loss or weight gain/increased or decreased appetite.
Difficulty falling asleep or too much sleep.
Psychomotor agitation or psychomotor retardation.
Fatigue/loss of energy.
Feelings of worthlessness or guilt.
Difficulty concentrating, indecisiveness.
Suicidal ideation – thoughts of death, thinking about/planning suicide, suicide attempt.
MAJOR DEPRESSIVE DISORDER
Prevalence
Affects around 6.6% of the U.S. population each year and 16.9% of the U.S. population in their lifetime.
More common among women than men.
Comorbidity
Comorbid with anxiety disorders and substance abuse disorders.
Risk Factors
Unemployment.
Low income.
Living in urban areas.
Being separated, divorced, or widowed.
SUBTYPES OF DEPRESSION
Seasonal pattern – applies to situations in which a person experiences the symptoms of major depressive disorder only during a particular time of year.
Peripartum onset (postpartum depression) – major depression during pregnancy or in the four weeks following the birth.
Persistent depressive disorder (dysthymia) – depressed moods most of the day nearly every day for at least two years, as well as at least two of the other symptoms of major depression.
Chronically sad but do not meet all the criteria for major depression.
BIPOLAR DISORDER
Involves mood states that fluctuate between depression and mania.
Symptoms of Mania
Excessively talkative.
Excessively irritable.
Exhibit flight of ideas – talk loudly and rapidly, abruptly switching from one topic to another.
Easily distracted.
Exhibit grandiosity – inflated but unjustified self-esteem and self-confidence.
Show little need for sleep.
Take on several tasks at once.
Engage in reckless behaviors.
Prevalence
Onset is typically before the age of 25.
Affects 1 out of 100 people in the U.S. in their lifetime.
36% of these individuals attempt suicide.
Comorbidity – anxiety disorder and substance abuse disorder.
BIOLOGICAL BASIS OF MOOD DISORDERS
Genetics
Major Depressive Disorder:
Relatives have double the risk of developing the disorder.
Identical twins – 50% concordance rate.
Fraternal twins – 38% concordance rate .
Bipolar Disorder:
Relatives have over 9 times the risk.
Identical twins – 67% concordance rate.
Fraternal twins – 16% concordance rate.
Hormones
Elevated levels of corti
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