Psychological Disorders Chapter 15 Abnormal Behaviour Example • Two weeks ago, a man jumped from a 401 overpass after throwing his 5 year old daughter off. He died and she is still in guarded condition in the hospital. He left a suicide note that seemed to indicate that he wanted to punish his wife. • What would cause someone to take such a drastic act? What Is Abnormal Behaviour? Abnormal behaviour is characterized as (a) not typical (b) socially unacceptable (c) distressing (d) maladaptive (e) result of disorganized cognition Perspectives on Abnormality • Model: • Abnormal psychology: Models of Abnormal Behaviour The Medical-Biological Model • focuses on the physiological conditions that initiate and underlie abnormal behaviour • Many terms used in abnormal psychology borrowed from medical field • Diagnose, treat, cure with emphasis on drugs and hospitalization The Psychodynamic Model • rooted in Freud’s theory of personality • assumes psychological disorders result from anxiety produced by unresolved conflicts outside a person’s awareness The Humanistic Model • focuses on individual uniqueness and decision making • Maladjustment occurs when a person’s needs are not met The Behavioural Model • Abnormal behaviour is learned through selective reinforcement and punishment The Cognitive Model • Human beings engage in both prosocial and maladjusted behaviours because of their thoughts The Sociocultural Model • Maladjustment occurs within and because of a context • Frequency and type of disorders varies across cultures The Evolutionary Model • humans evolved in a specific environment • Maladjustments may be expressions of behaviour that would once have been normal in evolutionary history Which Model Is Best? • Some psychologists use only one model to analyze all behaviour problems • Others may take an eclectic approach Diagnosis: DSM Diagnosing Psychopathology: The DSM Diagnostic and Statistical Manual of Mental Disorders (DSM) Diagnosing Psychopathology GOALS of DSM Table 15.1 Major Classifications of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (TR) Diagnosising Psychopathology Criticisms: - Potential biases - Symptom focus rather than etiology - Too complex - Medical model focus - Reliability - Pathologize everyday behaviour Anxiety Disorders Defining Anxiety • Anxiety : a generalized feeling of fear and apprehension that may be related to a particular situation or object often accompanied by increased physiological arousal Generalized Anxiety Disorder Diagnostic Criteria: • Excessive anxiety and worry for at least 6 months • Difficult to control the worry • At least three of the following: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance • Focus of anxiety is NOT associated with other anxiety disorders • Symptoms cause clinically significant distress • Not due to direct effects of substance abuse or medical condition Generalized Anxiety Disorder • Prevalence • Risk factors • Comorbidity Phobic Disorders • Phobic disorders : • Three main Types Agoraphobia • Excessive fear and avoidance of being alone in a place from which escape may be difficult or embarrassing • Accompanied by panic attacks • More common in females than males (5.8% : 2.8%) • Often brought on by interpersonal stress Social Phobia • Excessive fear and avoidance of situations where one might be scrutinized by others • Fear of acting in a way that may lead to humiliation or embarrassment • Affects males and females equally • Identified in all cultures Specific Phobias • Irrational and persistent fear and avoidance of a particular object or situation • 5 – 12% of the population has one or more specific phobias • Categories of specific phobias: Obsessive-Compulsive Disorder • Persistent, uncontrollable thoughts and irrational beliefs that cause compulsive rituals that interfere with daily life – Obsessions = – Compulsions = Obsessive-Compulsive Disorder • 80% of cases report both obsessions and compulsions • Compulsions are used to combat anxiety associated with obsessions • 2% of the population (males = females) • Neurological mechanisms identified (frontal lobe and amygdala) Mood Disorders Depressive Disorders • Depressive disorders • Major depressive disorder Symptoms of Major Depressive Disorder • Poor appetite • Insomnia • Weight loss • Loss of energy • Feelings of worthlessness and guilt • Inability to concentrate Major Depressive Disorder: Onset and Duration • Onset – usually prior to age 40 • Duration – days, weeks, or months – Single episode or recurring episodes Major Depressive Disorder: Prevalence • Major depressive disorder affects about 1.3 million Canadians each year • Women are twice as likely as men to be diagnosed Major Depressive Disorder: Clinical Evaluation • Diagnosis of depression (or any other mental disorder) should involve a complete clinical evaluation: • A physical examination • A psychiatric history • A mental status examination Causes of Major Depressive Disorder Biological Theories: e.g. Monoamine theory Learning and Cognitive Theories • Learning and thoughts underlie depression • Lewinsohn: • Beck: Figure 15.2 Lewinsohn’s View of Depression Learned Helplessness • The behaviour of giving up or not responding exhibited by people and animals exposed to negative consequences over which the feel they have no control • Seligman suggests that people’s beliefs about the causes of failure determines whether they will become depressed The Biopsychosocial Model Diathesis-stress model • Combination of factors lead to vulnerability • Vulnerability: person’s diminished ability to deal with life events • Increased vulnerability means less stress is needed to initiate depression Bipolar Disorder • originally known as manicdepressive disorder • People with the disorder experience behaviour varying between two extremes Bipolar Disorder • Manic Phase: • Depressed Phase: MEDIA DEPICTION OF DEPRESSION Dissociative Disorders Dissociative Disorders • Dissociative disorders are characterized by a sudden, temporary, alteration in consciousness, identity, behaviour, and/or memory Dissociative Disorders Dissociative Disorders include: • Dissociative amnesia – • Dissociative identity disorder - MEDIA DEPICTION OF DID Schizophrenia Schizophrenia • Schizophrenic disorders – • Psychosis – Essential Characteristics of Schizophrenic Disorders • People who suffer from schizophrenia can have significantly different symptoms, yet still be given the same label • Schizophrenia is a group or class of disorders and each case is identified according to some kind of basic disturbance in one of the following areas: language, thought, perception, affect (emotions), and behaviour Essential Characteristics of Schizophrenic Disorders • Positive symptoms – • Negative symptoms - Schizophrenia: Language and Thought Disturbances • Difficulty maintaining logical thought and coherent conversation • Word Salad – • Neologism – Delusions - mistaken beliefs maintained in spite of strong evidence to the contrary. Three common delusions include: Thought broadcasting Thought insertion Thought withdrawal Schizophrenia: Perceptual Disturbances • The senses of people with schizophrenia may either be enhanced or blunted • Sensory stimulation is jumbled and distorted • Hallucinations – • Auditory hallucinations are most common Schizophrenia: Emotional Disturbances • inappropriate affect – • ambivalent affect – • flat affect – Schizophrenia: Behavioural Disturbances • Disturbances in behaviour may take the form of unusual actions that have special meaning • The abnormal behaviours of individuals with schizophrenia are often related to disturbances in their perceptions, thoughts and feelings Five Types of Schizophrenia • Paranoid - • Catatonic - two subtypes: • Excited type • Withdrawn type • Disorganized - characterized by severely disturbed thought processes, incoherence, disorganized behaviour, and inappropriate affect Five Types of Schizophrenia (cont’d) • Residual - • Undifferentiated – Causes of Schizophrenia • Diathesis-stress model of schizophrenia - Causes of Schizophrenia Biological Factors: • Genetics • Neurotransmitters – • Brain Function – Psychosocial (Environmental) Factors: Nature and Nurture • The development of schizophrenia does not occur through a simple mechanism • Both biology and environment are involved • Vulnerability is a diminished ability to deal with demanding life events MEDIA DEPICTION OF SCHIZOPHRENIA Personality Disorders Personality Disorders • Axis II of the DSM classification system • Personality disorders – psychological disorders characterized by inflexible and longstanding maladaptive behaviours that typically cause stress and/or social or occupational problems Personality Disorders: Clusters • Three broad classes: A) odd or eccentric – B) dramatic, emotional, or erratic – C) anxious or fearful –