ABNORMAL BEHAVIOR
 Historical aspects of mental disorders
 The medical model
 What is abnormal behavior?
 3 criteria
 Deviant
 Maladaptive
 Causing personal distress
 A continuum of normal/abnormal
PREVALENCE, CAUSES, AND COURSE
 Epidemiology
 Prevalence
 Lifetime prevalence
 Diagnosis
 Etiology Prognosis
PSYCHODIAGNOSIS: THE CLASSIFICATION OF
DISORDERS
 American Psychiatric Association – published first taxonomy in 1952
 Diagnostic and Statistical Manual of Mental Disorders – 4th ed. (DSM
- IV)
 Multiaxial system
 5 axes or dimensions – F 14.3
 Axis I – Clinical Syndromes
 Axis II – Personality Disorders or Developmental Disorders
 Axis III – General Medical Conditions
 Axis IV – Psychosocial and Environmental Problems
 Axis V – Global Assessment of Functioning
 DSM
Figure 14.4 –
Example multiaxial
evaluation
TWO MAJOR CLASSIFICATIONS IN THE DSM
NEUROTIC DISORDERS
PSYCHOTIC DISORDERS
Distressing but one can
still function in society
and act rationally.
Person loses contact with
reality, experiences
distorted perceptions.
AXIS I CLINICAL SYNDROMES AND AXIS II
PERSONALITY DISORDERS
 Anxiety Disorders
 Somatoform Disorders
 Dissociative Disorders
 Mood Disorders
 Schizophrenic Disorders
 Eating Disorders
 Axis II – Personality Disorders
CLINICAL SYNDROMES: ANXIETY
DISORDERS
 Generalized anxiety disorder
 “free-floating anxiety”
 Phobic disorder
 Specific focus of fear
 Panic disorder and agoraphobia
 Physical symptoms of anxiety/leading to agoraphobia
 Obsessive compulsive disorder
 Obsessions
 Compulsions
 PTSD
ETIOLOGY OF ANXIETY DISORDERS
 Biological factors
 Genetic predisposition, anxiety sensitivity
 GABA circuits in the brain
 Conditioning and learning
 Acquired through classical conditioning or
observational learning
 Maintained through operant conditioning
 Cognitive factors
 Judgments of perceived threat
 Personality
 Neuroticism
 Stress
 A precipitator
CLINICAL SYNDROMES: SOMATOFORM
DISORDERS
 Somatization Disorder
1.
Conversion Disorder
2. Hypochondriasis
 Etiology
 Reactive autonomic nervous system
 Personality factors
 Cognitive factors
 The sick role
CLINICAL SYNDROMES: DISSOCIATIVE
DISORDERS
 Dissociative amnesia
 Dissociative fugue
 Dissociative identity disorder
 Etiology
 severe emotional trauma during
childhood
 Controversy
 Media creation?
 Sybil
 Repressed memories
CLINICAL SYNDROMES: MOOD DISORDERS
 Major depressive disorder
 Dysthymic disorder
Bipolar disorder (manic-depressive disorder)
 Cyclothymic disorder
 Seasonal Affective Disorder
 Etiology
 Age of onset
 Genetic vulnerability
 Neurochemical factors
 Cognitive factors
 Interpersonal roots
 Precipitating stress
CLINICAL SYNDROMES: SCHIZOPHRENIA
 General symptoms
 Delusions and irrational thought
 Deterioration of adaptive behavior - avolition
 Hallucinations – any modality but usually auditory
 Disturbed emotions – 66%
 Prognostic factor
 Gradual onset
 Sudden onset
SUBTYPING OF SCHIZOPHRENIA
4 subtypes
 Paranoid type
 Catatonic type
 Disorganized type
 Undifferentiated type
New model for classification
 Positive vs. negative symptoms
ETIOLOGY OF SCHIZOPHRENIA
 Genetic vulnerability
 Neurochemical factors – Dopamine hypothesis
 Structural abnormalities of the brain – prefrontal lobe
and ventricles
 The neurodevelopmental hypothesis
 Expressed emotion
 Precipitating stress – stress-vulnerability model
Figure 14.19 The dopamine hypothesis as an explanation for schizophrenia
NEUROLOGICAL CHANGES IN SCHIZOPHRENIA
Figure 14.21 – Neurodevelopment hypothesis of schizophrenia
Figure 14.22 –
Expressed emotion and
relapse rates in
schizophrenia
Slide 33 – The stress-vulnerability model of schizophrenia
PERSONALITY DISORDERS
 Anxious-fearful cluster
 Avoidant, dependent, obsessivecompulsive
 Dramatic-impulsive cluster
 Histrionic, narcissistic,
borderline, antisocial
 Odd-eccentric cluster
 Schizoid, schizotypal, paranoid
 Etiology
 Genetic predispositions,
inadequate socialization in
dysfunctional families
 Prognosis
PSYCHOLOGICAL DISORDERS AND THE LAW
 Insanity
 M’naghten rule
 The insanity defense
 Involuntary commitment – varies by states
 danger to self
 danger to others
 in need of treatment
 Culture and pathology
EATING DISORDERS
 Issues of weight
 Anorexia nervosa
 Criteria and subtypes: restrictive and binge/purge
 Bulimia nervosa
 Binge eating
 History and prevalence
 Age onset
 Etiology
 Genetics
 Personality – perfectionism
 Cultural issues - “perfect” body type and digital photograph
 Family role
 Cognitive factors
Figure 14.25 - Age of anorexia nervous in the United States – Lucas et al.
(1991)