myers’ psychology psychological disorders5) post traumatic stress disorder (ptsd) follows a...
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Myers’ PSYCHOLOGY
Psychological Disorders
James A. McCubbin, PhD
Clemson University
Worth Publishers
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David Rosenhan suspected that terms such as sanity,
insanity, schizophrenia, mental illness, and abnormal might
have fuzzier boundaries that the psychiatric community
thought.
He also suspected that some strange behaviors seen in
mental patients might originate in the abnormal
atmosphere of the mental hospital, rather than the patients
themselves. Education
・AB, Yeshiva College, 1951
・MA, Columbia University,
1953
・PhD (psychology),
Columbia University, 1958
Professor, Stanford
University
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Dangers of Labeling David Rosenhan
Being Sane in Insane Places
In 1973 sociologist David Rosenhan designed a clever
study to examine the difficulty that people have shedding the
"mentally ill" label. He was particularly
interested in how staffs in mental
institutions process information about
patients.
Rosenhan & seven associates had themselves
committed to different mental hospitals
complaining of hearing voices. All but one were
diagnosed as schizophrenic.
•Once admitted, they acted totally normal.
•Remained hospitalized for average 19 days (9 to
52)
•Only the patients detected their sanity
•When discharged their chart read,
“schizophrenia in remission”
No professional staff member at
any of the hospitals ever realized
that any of Rosenhan’s
pseudopatients was a fraud.
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According to a study conducted by the National
Institute of mental health:
*15.4% of the population suffers from diagnosible
mental health problems
*56 million Americans meet the criteria for a
diagnosible psychological disorder (Carson 1996, Regier
1993)
*Over the lifespan, +/- 32% of Americans will suffer
from some psychological disorder. (Regier1988)
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Normal or Abnormal?
Not easy task:
*Is Robin Williams normal?
Marilyn Manson?
*Is a soldier who risks his life
or her life in combat normal?
*Is a grief-stricken woman
unable to return to her
routine three months after
her husband died normal?
Is a man who climbs
mountains as a hobby
normal?
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Some abnormalities are easy:
Hallucinations (false sensory experiences)
Delusions (extreme disorders of thinking)
Affective problems (emotion: depressed, anxious,
or lack of emotion)
CORE CONCEPT:
Medical model: takes a “disease” view
Psychology model: interaction of biological, mental, social,
and behavioral factors
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Psychological Disorder
– a “harmful dysfunction” in which behavior is judged to be:
• atypical- (not enough in itself)
• disturbing- (varies with time & culture)
• maladaptive- (harmful)
• unjustifiable- (sometimes there’s a good reason)
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Show
THE WORLD OF ABNORMAL
BEHAVIOR:
#1 Looking at Abnormal Behavior
#2 The Nature of Stress
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Carol D. Ryff argues that we must define mental illness
in terms of the positive. She names 6 core
dimensions:
1) Self-acceptance:
positive attitude towards self
multiple aspects of self
positive about past life
2) Positive self relations with other people:
warm, trusting, satisfying interpersonal relationships
capable of empathy, affection, intimacy
3) Autonomy
independent, self-determined
able to resist social pressures
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4) Environmental mastery:
sense of mastery and competence
makes good use of opportunities
creates contexts that support their personal needs
5) Purpose of Life:
has goals and directedness
feels there is meaning to past and present life
6) Personal Growth:
see oneself as growing and expanding
open to new experiences
change in ways that reflect self-knowledge and
effectiveness
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Historical Perspective
Perceived Causes
*movements of sun or moon
*lunacy- full moon
*demons & evil spirits
Ancient Treatments
*exorcism, caged like animals, beaten,
burned, castrated, mutilated, blood
replaced with animal’s blood
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Historical Perspective
Hippocrates (400 bc) *first step in scientific view of mental disturbance.
*imbalance (excess) among four body fluids called “humors”
Humors Origin Temperament
Blood heart sanguine (cheerful)
Choler (yellow bile) liver choleric (angry)
Melancholer spleen melancholy (depressed)
(black bile)
Phlegm brain phlegmatic (sluggish)
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Psychological Disorders
Medical Model
*concept that diseases have physical causes
*can be diagnosed, treated, and in most cases, cured
*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
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Psychological Disorders
Bio-psycho-social
Perspective
*assumes that biological,
sociocultural, and
psychological factors
combine and interact to
produce psychological
disorders
Biological
(Evolution,
individual
genes, brain
structures
and chemistry)
Psychological
(Stress, trauma,
learned helplessness,
mood-related perceptions
and memories)
Sociocultural
(Roles, expectations,
definition of normality
and disorder)
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Psychological Disorders- Etiology
DSM-IV-TR
*American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)
*a widely used system for classifying psychological disorders
*presently distributed as DSM-IV-TR (text revision)
*today used as “convenient shorthand” to avoid labeling.
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DSM-IV-TR organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of the disorder or disability:
1) Axis 1 -- Clinical disorders including major mental disorders, as well as developmental or learning problems. Common disorders in this category include depression, bipolar, anxiety, ADHD, and schizophrenia.
2) Axis 2 -- Pervasive or personality disorders, including mental retardation. Common disorders in this category include borderline PD, schizotypal PD, narcissistic PD, antisocial PD, paranoid PD.
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DSM-IV-TR continued:
3) Axis 3 -- Acute medical conditions and physical disorders. Common disorders in this category include brain trauma, brain injury, brain disease..
4) Axis 4 -- Psychosocial and environmental factors contributing to the disorder. Common factors in this category include a man suffering from depression after losing his job, or his wife dying, et. al.
5) Axis 5 -- Global Assessment of Functioning or Children’s Global Assessment Scale (under 18)
Additions to DSM-IV
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Psychological Disorders- Etiology
Neurotic disorder (term seldom used now)
*usually distressing but that allows one to think
rationally and function socially
*Freud saw the neurotic disorders as ways of
dealing with anxiety
Psychotic disorder
*person loses contact with reality
*experiences irrational ideas and distorted
perceptions
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PREPAREDNESS HYPOTHESIS:
Suggests that we have an innate biological
tendency, acquired through natural selection, to
respond quickly and automatically to stimulti
that posed a survival threat to our ancestors.
(Ohman & Mineka, 2001)
This explains why we
develop phobias for
snakes and lightening
more easily than others.
QuickTime™ and aTIFF (Uncompressed) decompressor
are needed to see this p icture.
QuickTime™ and aTIFF (Uncompres sed) decompres sor
are needed to see this picture.
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•ANXIETY DISORDERS
•MOOD DISORDERS
•DISSOCIATIVE DISORDERS
•SCHIZOPHRENIA
•PERSONALITY DISORDERS
•BIOPSYCHOSOCIAL DISORDERS
•SUBSTANCE ABUSE DISORDERS
•SEXUAL DISORDERS
•DEVELOPMENTAL (CHILDHOOD)
DISORDERS
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ANXIETY
DISORDERS
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1) PANIC DISORDER w/AGORAPHOBIA
2) GENERALIZED ANXIETY DISORDER
3) PHOBIAS
a) simple
b) social
c) agoraphobia
4) OBSESSIVE-COMPULSIVE DISORDER (OCD)
5) POST TRAUMATIC STRESS DISORDER (PTSD)
6) SOMOTOFORM
a) hypochondria
b) conversion (hysteria)
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Anxiety Disorders
Anxiety Disorders
*distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
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Anxiety Disorders 1) Panic Disorder
*marked by a minutes-long episode of intense dread in
which a person experiences terror and accompanying
chest pain, choking, racing heart, sweating, muscle-
spasms, or other frightening sensations
*common thinking patterns include:
"I’m losing control.....”
"I feel like I’m going crazy.....”
"I must be having a heart attack.....”
"I’m smothering and I can’t breathe.....”
1a) Panic Disorder w/Agoraphobia
*fear of leaving home for fear of having a panic attack
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2) Generalized Anxiety Disorder
person is tense, apprehensive, and in a state of autonomic nervous system arousal
*Chronic (6 months) unrealistic or excessive worry
about 2 or more elements in one’s life.
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3) Phobias
a) Simple
Excessive, irrational fear of objects or situations
b) Social
Persistent fear of scrutiny by others doing something humiliating (stage fright or speech phobia)
c) Agoraphobia
Fear of being in a place or situation with no escape. (childhood environments in which one did not feel safe)
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Anxiety Disorders Phobias
persistent, irrational fear of a specific object or situation
Ablutophobia: washing, bathing
Acrophobia: heights
Algophobia: pain
Arachibutyrophobia: peanut butter
sticking to roof of mouth
Caligynephobia: beautiful women
Cleptophobia: stealing
Demophobia: crowds
Ecclesiophobia: church
Ergophobia: work
Genophobia: sex
Gynephobia: women
Ichthyophobia: fish
Lutraphobia: otters
Macrophobia: long waits
Medorthophobia: erect penis
Parthenophobia: virgins
Pophyrophobia: color purple
Somniphobia: sleep
Testophobia: taking a test
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Anxiety Disorders Common and uncommon fears
Afraid of it Bothers slightly Not at all afraid of it
Being
closed in,
in a
small
place
Being
alone
In a
house
at night
Percentage
of people
surveyed
100
90
80
70
60
50
40
30
20
10
0
Snakes Being
in high,
exposed
places
Mice Flying
on an
airplane
Spiders
and
insects
Thunder
and
lightning
Dogs Driving
a car
Being
In a
crowd
of people
Cats
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Anxiety Disorders
4) Obsessive-Compulsive Disorder *unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
*feel obsessed w/something they do not want to think about and/or
compelled to carry out some action, often pointlessly ritualistic.
*1 in 50 adults has OCD
*Exact pathophysiologic process that underlies OCD has not been
established.
*Research suggests that abnormalities in serotonin (5-HT)
transmission in the central nervous system are central to this
disorder.
*Supported by the efficacy of specific serotonin reuptake inhibitors
(SSRIs) in the treatment of OCD.
AS GOOD AS IT GETS
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Anxiety Disorders
Common Obsessions and Compulsions Among
People With Obsessive-Compulsive Disorder
Thought or Behavior Percentage*
Reporting Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins 40
Something terrible happening (fire, death, illness) 40
Symmetry order, or exactness 24
Excessive hand washing, bathing, tooth brushing, 85
or grooming
Compulsions (repetitive behaviors)
Repeating rituals (in/out of a door, 51
up/down from a chair)
Checking doors, locks, appliances, 46
car brake, homework
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Anxiety Disorders
• PET Scan of brain of person
with Obsessive/ Compulsive
disorder
• High metabolic activity (red) in
frontal lobe areas involved
with directing attention
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Good examples of obsessions and their closely
related compulsions:
Obsession: A mother tormented by
concern that she might inadvertently
contaminate food as she cooks dinner.
Compulsion: Every day she sterilizes all
cooking utensils in boiling water and
wears rubber gloves when handling food
Obsession: A young
woman is continuously
terrified by the thought
that cars might careen
onto the sidewalk and
run over her.
Compulsion: She
always walks as far from
the street pavements as
possible and wears red
clothes so that she will
be immediately visible
to an out-of-control car.
Obsession: A woman cannot rid herself
of the thought that she might
accidentally leave her gas stove turned
on, causing her house to explode
Compulsion: Every day she feels the
irresistible urge to check the stove
exactly 10 times before leaving for work.
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5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the
normal experience (rape, war, murder, beatings, torture, natural disasters)
*1 in 12 adults in the U.S.
suffer from PTSD
*incessant reliving of event,
recurring dreams, intrusive
memories, flashbacks,
intensive fears, sleep
problems.
*lasting biological effects:
causes the brain’s hormone-
regulating system to develop
hair-trigger responsiveness
Perpetration-induced traumatic stress (PITS)
*soldiers who had killed in combat were found to suffer higher rates of PTSD than other troops
*other studies include grief, survivor’s guilt, fear
p341 Zim
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Holocaust Survivors Why do survivors of the Holocaust, a very traumatic experience, tended
to show no signs of PTSD?
*Differential Focus of Good= looking for good
in their lives
*Survival for some purpose = to tell the story
*Psychological distancing
*Mastery = helping others; create a sense of
worthiness and self-esteem
*Will to live = human determination to live
*Hope
*Social Support = drew social support from
individual friendships or with others who
shared the same life situation
Example of this would be Boys of Buchenwald
Group of four hundred orphaned boys who has witnessed unimaginable horrors that were relocated to orphanages in France.
Elie Wiesel
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5a) Stockholm Syndrome Follows a psychologically distressing event that is outside the normal
experience (rape, war, murder, beatings, torture, natural disasters)
*captor threatens to kill and is able to do so
*victim cannot escape or life depends on the
captor
*victim is isolated from outsiders
*captor is perceived as showing some degree
of kindness
*victim denies anger at abuser & focuses on
good qualities
*”fight or flight” reactions are inhibited
*victim fears interference by authorities--fears
the captor will return from jail
*victim is grateful to abuser for sparing her life
Example of this disorder would be Patty Hearst
Kidnapped by the Symbionese Liberation Army
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a) Hypochondria
Fear of having serious disease where no evidence of illness can be found.
b) Conversion (hysteria)
Physical malfunction or loss of bodily control w/no underlying pathology but apparently related to psychological conflict.
6) Somotoform Disorders
Disorders, involving physical complaints for
which no organic basis can be found.
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TREATMENTS:
*Medical model: antianxiety drugs (valium, librium,
xanax)
*Psychoanalysis: observational learning, childhood
(mom/dad), free association, resistance (transference)
*Learning Theories: classical conditioning,
counterconditioning, systematic desensitization
*Behaviorists: principles of learning, aversive
conditioning, operant conditioning (token economy)
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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Show
THE WORLD OF AbNORMAL
BEHAVIOR:
#3 The Anxiety Disorders
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MOOD
DISORDERS
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1) DEPRESSIVE DISORDERS
a) major depression
b) dysthymia
2) BIPOLAR DISORDER
a) mania
b) major depression
3) SEASONAL AFFECTIVE DISORDER (SAD)
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QuickTime™ and aTIFF (Uncompressed) decompressor
are needed to see this picture.
Mood Disorders
1) Depressive Disorders *most common disorders” 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
Mood Disorders
characterized by emotional extremes
a) Major Depressive Disorder
Unhappy for 2 weeks without reason, appetite changes, insomnia, inability to
concentrate, worthlessness, hallucinations
b) Dysthymia
Unhappy for over 2 years
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Mood Disorders 2) Bipolar Disorder
*a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state
of mania
*formerly called manic-depressive disorder
a) Manic Episode
a mood disorder marked by a hyperactive, wildly optimistic state, excessive excitement, silliness, poor judgment, abrasive, rapid flight
of ideas
b) Major depression
Lethargic, sleepy, social withdrawal, irritability
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Symptoms of Mania
1) Mood or emotional symptoms: euphoric, expansive, and elevated. In some
cases, dominant mood is irritability. Even when
euphoric, manic people are close to tears and if
frustrated, will burst out crying.
2) Grandiose cognition: manics believe no
limits to their abilities and do not recognize the
painful consequences of trying to carry out their
plans. May be delusional about themselves.
3) Motivational symptoms: hyperactivity has
intrusive, dominating, domineering quality. Some
engage in compulsive gambling, reckless driving,
or poor financial investment.
4) Physical symptoms: lessened need for
sleep. After a few days, exhaustion settles in.
•Between .6 and
1.1 percent of
U.S. population
will have bipolar
disorder in their
lifetime.
•It affects both
sexes equally.
•Onset is sudden.
•First episode
occurs between
ages 20 and 30.
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Mood Disorders-Bipolar
PET scans show that brain energy consumption rises and falls with emotional swings
Depressed state Manic state Depressed state
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Mood Disorders-Depression
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Mood Disorders-Depression
12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+
Age in Years
Famous People with Bipolar Disorder
10%
8
6
4
2
0
Percentage
depressed Females
Males
Canadian depression rates
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3) Seasonal Affective Disorder (SAD)
Experience depression during certain times of the year
*usually winter (less sunlight)
*treated w/light therapy
*Alaska (dark for months)
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Aaron Beck’s work with depressed patients convinced him
that depression is primarily a disorder of thinking rather than
of mood. He argued that depression can best be described
as a cognitive triad or negative thoughts about oneself, the
situation or the future.
Cognitive errors included the following:
1) overgeneralizing: drawing global conclusions about worth, ability, or
performance on basis of single fact
2) Selective abstraction: focusing on one insignificant detail and ignoring
others
3) Personalization: incorrectly taking responsibility for events in the world
4) Magnification & minimization: bad events magnified and good events
minimized.
5) Arbitrary inference: drawing conclusions without sufficient evidence
6) Dichotomous thinking: seeing everything in one extreme or its opposite.
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Mood Disorders-Depression
Altering any one
component of
the chemistry-
cognition-mood
circuit can alter
the others
Brain
chemistry Cognition
Mood
Generally speaking, a deficit of serotonin is
associated with depression.
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Mood Disorders-Depression
A happy or
depressed
mood
strongly
influences
people’s
ratings of
their own
behavior Negative Positive
behaviors behaviors
Self-ratings
35%
30
25
20
15
Percentage of
observations
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Mood Disorders-Depression
The vicious
cycle of
depression
can be
broken at
any point
1
Stressful
experiences
4
Cognitive and
behavioral changes
2
Negative
explanatory style
3
Depressed
mood
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Mood Disorders-Depression
Boys who
were later
convicted
of a crime
showed
relatively
low
arousal
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EXAMPLES of Mood Disorders:
Andrea Yates: postpartum
depression and the insanity
plea. It has been suggested
that at the far end of the
postpartum psychological
spectrum lie postpartum
psychosis. In Andrea’s
case, it represented a state
of mind in which killing one’s
children seemed the best
way to protect them.
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Mood Disorders- Suicide
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Mood Disorders-Suicide
Increasing rates of teen suicide
1960 1970 1980 1990 2000
Year
12%
10
8
6
4
2
0
Suicide rate,
ages 15 to 19
(per 100,000)
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REASONS for suicide:
1) Unendurable psychological pain: if you reduce the pain just a little, most
suicidal people will choose to live.
2) Frustrated psychological needs: (security, achievement, trust, friendship)
3) Search for a solution: Suicide is never done without purpose --“How do I get
out of this?”
4) Attempt to end consciousness: goal is to stop awareness of painful
existence.
5) Helplessness & hopelessness: loss of power
6) Constriction of options: Not seeing the broad picture; limited options.
7) Ambivalence: Some is normal--In typical case, victim cuts throat and calls for
help.
8) Communication of intent: 80 percent gives clear clues to family & friends
9) Departure: quitting job, running away from home, leaving spouse are all
departures but suicide is the ultimate departure.
10) Lifelong coping patterns: look for earlier episodes--often a style of problem
solving that is characterized as “cut and run.”
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LONELINESS
Sharon Brehm reports that gender interacts with
marital status in the following ways:
•Married females report greater loneliness than
do married males
•Among those never married, males report more
loneliness than do females
•Among the separated and divorced, males report
greater loneliness than do females
•Among those whose spouse has died, males
report greater loneliness than do females.
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REASONS for Loneliness
1) Being unattached
2) Alienation: being misunderstood & feeling different
3) Being alone: coming home to empty house
4) Forced isolation: hospitalized or housebound
5) Dislocation: starting new job or school
Four major strategies in coping with Loneliness:
1) Sad passivity: sleeping, drinking, overeating, watching TV
2) Social contact: calling friend
3) Active solitude: studying, reading, exercising, going to movie
4) Distractions: spending money, going shopping
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TREATMENTS:
*Medical model: For bipolar-- lithium carbonate, carbamazepine,
and valproate. For depression--tricyclics; the newer selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO inhibitors). Electroconvulsive therapy (ECT) uses small amounts of electricity applied to the scalp to affect neurotransmitters in the brain.
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: interpersonal therapy
*Humanistic: client-centered therapies, responsibility, active-listening,
emotional support and assistance in recognizing signs of relapse to avert a full-blown episode
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Show
THE MIND
#31 Mood Disorders: Mania & Depression
#32 Mood Disorders: Hereditary Factors
#33 Mood Disorders: Medication and Talk
Therapy
And
THE WORLD OF AbNORMAL PSYCHOLOGY:
#8 Mood Disorders
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DISSOCIATIVE
DISORDERS
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1) PSYCHOGENIC AMNESIA
2) PSYCHOGENIC FUGUE
3) DISSOCIATIVE IDENTITY DISORDER
(Multiple Personality Disorder)
4) DEPERSONALIZATION DISORDER
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Dissociative Disorders
Dissociative Disorders
– conscious awareness becomes separated
(dissociated) from previous memories,
thoughts, and feelings
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Dissociative Disorders
1) Psychogenic Amnesia
– Sudden inability to recall important
information--NOT as a result of physical
“blow” or drug-related.
2) Psychogenic Fugue
– Loss of memory--flees to a new location and
establishes new lifestyle
– After recovery, events during fugue are not
remembered
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Dissociative Disorders 3) Dissociative Identity Disorder
– rare dissociative disorder in which a person
exhibits two or more distinct and alternating
personalities
– formerly called multiple personality disorder
*often history of child or sex abuse
In 2008, Herschal Walker, the 1982 Heisman
Trophy winner from the University of Georgia,
released his book “Breaking Free” which related
his experiences with DID. He reported not
being able to remember winning the
Heisman in 1982 or darker events, such as threatening his then-wife.
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4) Depersonalization Disorder
– Persistent, recurring feelings that one is not
real or is detached from one’s own
experience or body.
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depression,
mood swings,
suicidal tendencies,
sleep disorders (insomnia, night
terrors, and sleep walking),
panic attacks and phobias
(flashbacks, reactions to stimuli
or "triggers"),
alcohol and drug abuse,
compulsions and rituals,
psychotic-like symptoms
(including auditory and visual
hallucinations),
eating disorders
headaches,
amnesias,
time loss,
trances, and "out of body
experiences."
self-persecution,
self-sabotage
violence (both self-inflicted and
outwardly directed).
People with Dissociative Disorders may experience any of the
following:
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Dissociative Disorders are now understood
to be fairly common effects of severe
trauma in early childhood, most typically
extreme, repeated physical, sexual, and/or
emotional abuse. Posttraumatic Stress
Disorder (PTSD), widely
accepted as a major mental
illness affecting 8% of the
general population in the
United States, is closely
related to Dissociative
Disorders. In fact, 80-100%
of people diagnosed with a
Dissociative Disorder also
have a secondary diagnosis
of PTSD
Recent
research
suggests the
risk of suicide
attempts
among people
with trauma
disorders may
be even higher
than among
people who
have major
depression.
There is
evidence that
people with
trauma disorders
have higher rates
of alcoholism,
chronic medical
illnesses, and
abusiveness in
succeeding
generations.
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TREATMENTS:
*Medical model: therapy to recall the memories, hypnosis
or a medication called Pentothal (thiopental) can
sometimes help to restore the memories
*Psychoanalysis: help an individual deal with the trauma
associated with the recalled memories. Fugue--Hypnosis.
Dissociative identity disorder-- long-term psychotherapy
that helps the person merge his/her multiple personalities
into one.
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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SHOW:
Sybil Part I
Sybil Part II
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PERSONALITY
DISORDERS
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1) Paranoid Personality Disorder (PPD)
2) Obsessive-Compulsive Personality Disorder(OCPD)
3) Antisocial Personality Disorder
4) Borderline Personality Disorder
5) Schizoid Personality Disorder
6) Schizotypal Personality Disorder
7) Narcissistic Personality Disorder
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Personality Disorders
Personality Disorders
*disorders characterized by inflexible and
enduring behavior patterns that impair
social functioning
*usually without anxiety, depression, or
delusions
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Personality Disorder Types
1) Paranoid Personality Disorder Suspicious, envious, extreme jealousy,
tendency to interpret actions of others as
demeaning or threatening.
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Personality Disorder Types
2) Obsessive-Compulsive Personality Disorder
*Obsession: Recurring thoughts or images that seems irrational & out of control (locking doors, worry, dying)
*Compulsion: irresistible urge to act or engage in ritualistic behavior
***interferes with daily life
Treatment: A physician in this instance is best sticking with the
facts of the presenting problem and underlying disorder rather than offering vague impressions of their opinion. Since the individual with this disorder tends to be meticulous and concerned with details, the treatment regimen -- once accepted -- will likely be adhered to rigorously, without incident.
Example: Howard
Hughes
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Personality Disorder Types 3) Antisocial Personality Disorder
*disorder in which the person exhibits a lack of conscience for wrongdoing, even toward friends and family members
*may be aggressive and ruthless or a clever con artist, no regard for truth, irresponsible behavior, failure to conform to social norms
*Intelligent, charming
*social skills
*75% men
*Potentially dangerous
Example:
Hannibal Lecter in
Silence of the
Lambs
Treatment--Because many people who suffer from this disorder will be mandated to therapy in a forensic or jail setting, motivation on the patient's part may be difficult to find. Therapy should focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family relationships, learning new coping skills, etc. In an outpatient setting, the focus of therapy can also be on these types of issues, but a part of the therapy should be devoted to discussing the antisocial behavior and feelings (or lack thereof).
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Personality Disorder Types
4) Borderline Personality Disorder *Unpredictable, impulsive, angry outbursts
*Experiences guilt, remorse, & appropriate emotions
*75% female Treatment: Dialectical Behavior Therapy: teaches the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.
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**Although carriers of this personality disorder are
frequently found among street criminals and con artists,
they are also well represented among successful
politicians and business people who put career, money,
and power above everything and everyone.
**Two to three percent of the population in the U.S.
may have antisocial personality disorder.
**Chronic lying, stealing, and fighting are common signs.
**Violations of social norms begin early in life--
disrupting class, getting into fights, and running
away from home.
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5) Schizoid Personality Disorder *Lack of interest in social relations
*Inability to express feelings
6) Schizotypal Personality Disorder *Egocentricity, avoidance of others, eccentricity of
thought
*Oversensitive & frequently see chance events as related to themselves.
*Individuals with this disorder usually distort reality more so than someone with Schizoid Personality Disorder.
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Personality Disorder Types
7) Narcissistic Personality Disorder *Preoccupied with receiving attention & nurturance
*Exaggerated sense of self-importance
Treatment: Hospitalization of patients with severe Narcissistic Personality occurs frequently, such as those who are quite impulsive or self-destructive, or who have poor reality-testing.
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Personality Disorders
• PET scans illustrate reduced activation in
a murderer’s frontal cortex
Normal Murderer
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Personality Disorders
Percentage
of criminal
offenders
35
30
25
20
15
10
5
0
Total crime Thievery Violence
Childhood
poverty
Obstetrical
complications
Both poverty
and obstetrical
complications
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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
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TREATMENTS:
*Medical model:
*Psychoanalysis: SchizoidPD--individual therapy (brief), SchizotypalPD-
-the clinician must exercise care to not directly challenge delusional or
inappropriate thoughts…warm, supportive, and client-centered environment should be established with initial rapport.
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: BorderlinePD--Dialectical Behavior
Therapy: teaches the client how to learn to better take control of their
lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.
*Humanistic: Group setting (BPD), client-centered therapies (OCPD),
responsibility, active-listening, NarcissisticPD--Small staff-patient groups--feelings are shared and patients' comments taken seriously by staff, constructive work assignments, recreational activities, and opportunities to sublimate painfully conflictual impulses.
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Show
THE MIND
#35 The Mind of The Psychopath
and
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#5 Personality Disorders
Gacy or Bundy
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SCHIZOPHRENIC
DISORDERS (also called Psychotic Disorders)
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Schizophrenia literally means “split mind,” meaning a split from
reality that shows itself in disorganized thinking, disturbed
perceptions and inappropriate emotions and actions.
PSYCHOTIC: split from reality
The term coined by
Emil Kraepelin, who
established the
diagnostic category
“dementia praecox” and
Eugen Bleuler, who
introduced the term
“schizophrenia.” 1874, Medicene,
Leipzig & Wurtzburg,
Germany
(1857-1939)
Medicene, University
of Bern
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Possible symptoms of psychotic illnesses include:
*Disorganized or incoherent speech
*Confused thinking
*Strange, possibly dangerous behavior
*Slowed or unusual movements
*Loss of interest in personal hygiene
*Loss of interest in activities
*Problems at school or work and with relationships
*Cold, detached manner with the inability to express
emotion
*Mood swings or other mood symptoms, such as
depression or mania
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CAUSES:
•chemical imbalances (“mad as a hatter”)
•excess D4 dopamine receptors (in autopsies) (drugs that
block dopamine receptors lessen the symptoms)
•now researching neurotransmitter glutamate (direct neurons
to pass along an impulse)
•abnormal brain activity: low in frontal lobes
•research shows (during hallucinations) increased activity in
thalamus, amygdala, and cortex
•greater than normal cerebral cortex tissue loss between
ages 13 and 18.
•genetics: enlarged, fluid-filled cranial cavities
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Identical Twin studies show:
*48% probability of having schizophrenia if your twin
does.
*single placenta: 6 in 10 chance
*separate placentas: 1 in 10 chance
*one study showed the older the father, the greater risk
of schizophrenia in offspring
The GENAIN QUADRUPLETS (b.1930) were monozygous
women all suffered from schizophrenia, demonstrating a
large genetic component to the disease. The girls (Nora,
Iris, Myra, Hester) were fictitiously named for NIMH
(National Institute of Mental Health). Both parents had
mental disorders during their lifetime.
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A common finding in
the brains of people
with schizophrenia is
larger than normal
lateral ventricles.
significant vertical
displacement of the
lateral ventricles in
corresponds to the
displacement of the
corpus callosum.
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DIANTHESIS-STRESS HYPOTHESIS:
The idea that biological factors may place
the individual at risk for schizophrenia (or
others), but environmental stressors
transform this potential into an actual
disorder.
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1) DISORGANIZED
2) CATATONIC
3) PARANOID
4) UNDIFFERENTIATED
5) RESIDUAL
*6) PARANOID DELUSIONAL DISORDER
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1) DISORGANIZED SCHIZOPHRENIC
• confused and incoherent,
• jumbled speech
• emotionless or flat or inappropriate, even silly or childlike.
(flat affect or lack of affect)
• disorganized behavior that may disrupt their ability to
perform normal daily activities (showering or preparing
meals)
• hallucinations and delusions
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Disorganized speech is of two types:
NEOLOGISMS: “new words”
WORD SALAD: “disorganization”
“I had belly bad luck and brutal and outrageous.” (I have
stomach problems and don’t feel good) “I gave all the work
money. (I paid tokens for my meal) I was raised in packs (with
other people) and since I was in littlehood (little girl) she
blamed a few people with minor words (she scolded people).
The lion will have to change from dogs into cats until I can meet my
father and mother and we depart some rats. I live on the front part of
Whitton’s head. You have to work hard if you don’t get into bed. She
did. She said, “Hallelujah, happy landings.” It’s all over for a squab
true tray and there ain’t not squabs, there ain’t no men, there ain’t no
music, there ain’t no nothing besides my mother and my father who
stand alone upon the Island of Capri where there is no ice, there ain’t
no nothing but changers, changers, changers…….
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2) CATATONIC SCHIZOPHRENIC
•Physical symptoms
• immobile and unresponsive to the world around them
• very rigid and stiff, unwilling to move
• waxy flexibility
• occasional grimacing or bizarre postures.
• might repeat a word or phrase just spoken by another person.
• increased risk of malnutrition, exhaustion, or self-inflicted injury.
Catatonic excitement: patients become agitated and
hyperactive.
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3) PARANOID SCHIZOPHRENIC
• preoccupied with false beliefs (delusions) about being
persecuted or being punished by someone
• thinking, speech and emotions, however, remain fairly
normal.
•the paranoid delusions of persecution or grandiosity
(highly-exaggerated self-importance) are less well
organized--more illogical--than those of the patient with
purely delusional disorder.
•delusions are usually auditory
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4) UNDIFFERENTIATED SCHIZOPHRENIC
* diagnosed when the person's symptoms do not clearly
represent one of the other three subtypes.
5) RESIDUAL SCHIZOPHRENIC
* suffered from schizophrenia in the past but no
hallucinations or delusions
• mildly disturbed thinking
• emotionally impoverished
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**6) PARANOID DELUSIONAL DISORDER
• characterized by non-bizarre delusions in the absence of
other mood or psychotic symptoms
•delusions involving real-life situations that could be true,
such as being followed, being conspired against or having
a disease
• delusions persist for at least one month.
• non-bizarre refers to situations such as: being followed,
being loved, having an infection, or being deceived by
one’s spouse
• needs to be evaluated with respect to religious and
cultural differences.
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TREATMENTS:
*Medical model: Start: olanzapine (Zyprexa), quetiapine
(Seroquel), risperidone (Risperdal), or aripiprazole (Abilify)….Then: chlorpromazine, fluphenazine, and haloperidol…. Last resort: Clozapine (Clozaril) (has side effects)
*Psychoanalysis: medication, psychological counseling
and social support.
*Learning Theories:
*Behaviorists: medication, psychological counseling and
social support.
*Cognitive Therapies:
*Humanistic: medication, psychological counseling and
social support.
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Show
ABC Schizophrenia
And
THE WORLD OF ABNORMAL
PSYCHOLOGY
#9 The Schizophrenias
Mindstorm
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BIOPSYCHOSOCIAL
DISORDERS
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1) CORONARY HEART DISEASE
2) MIGRAINE HEADACHES
3) BREAST CANCER
4) ANOREXIA NERVOSA
5) BULIMIA NERVOSA
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Biopsychosocial Disorders
1) Coronary Heart Disease (Ch 14, p. 539-
541)
*Lethal blockage of arteries that supply blood to
heart muscle
*Causes: age, gender, family history, blood
pressure, chloresterol, weight, lifestyle,
psychological state (type A personality)
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Biopsychosocial Disorders
2) Migraine Headaches (not in book)
*Intensely painful, recurring headache--reduced flow of bloodto certain parts of brain--overarousal of sympathetic nervous system
*Causes: stress, change in weather, hormonal changes
*Family history
***Seeing zigzag lines or flashing lights, tingling, numbness in arms & legs.
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Biopsychosocial Disorders
3) Breast Cancer (Ch 14, p.543-544)
*Over 50, no children, family history
*Stressful life leads to higher level of the disease
Swedish researchers say that being under
stress may double a woman's risk of
developing breast cancer.They based their
findings on surveys of more than 1,400
Swedish women in the late 1960s who
were part of a long-term health-care study.
They found that women who reported
being under stress had twice the risk of
developing breast cancer as women who
managed to stay cool, calm, and collected.
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Biopsychosocial Disorders
4) Anorexia Nervosa (Ch 12, p.454-467)
*Eating disorder, intense abhorrence of obesity, insistance that one is fat
*Loss of 25%+ original body fat
*Refusal to maintain normal weight
5) Bulimia Nervosa (Ch 12, p. 464-467)
*Unable to stop eating voluntarily
*Preoccupation with weight gain
*Attempt to lose weight thru binge eating, self-induced vomiting & overuse of laxatives and diuretics
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A surplus of serotonin is associated
with anorexia
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1) INJURY
2) ALZHEIMERS DISEASE
3) KORSAKOFF’S SYNDROME
4) PARKINSON’S DISEASE
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Neurophysical Disorders
1) Injury (not in book)
*Brain trauma
2) Alzheimers (Ch 4, p 177-178)
**trouble remembering recent events, activities, or the names of familiar people or things
**Age (number of people w/disease doubles every 5 years past age 65 )
**family history (usually occurs between age 30-60 if it’s genetic). . . . One risk factor for this type of AD is a protein called apolipoprotein E (apoE).
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Neurophysical Disorders
3) Wernicke’s-Korsakoff’s Syndrome (not in book)
*memory disorder caused by a lack of vitamin B1 (thiamine).
*affects short-term memory.
*Most common cause: alcoholism
*A related disorder, Wernicke's syndrome, often occurs before Korsakoff's syndrome. Because they often occur together, the range of symptoms caused by the two diseases is often called Wernicke's-Korsakoff syndrome. The main symptoms of Wernicke's syndrome occur acutely. They include:
• Difficulty with walking and balance
• Confusion
• Drowsiness
• Paralysis of some eye muscles
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Neurophysical Disorders
3) Korsakoff’s Syndrome
*Thiamine is necessary for memory and other brain functions. People who drink a lot of alcohol often replace food with alcohol. As a result, they take in fewer vitamins, leading to vitamin deficiencies. In addition, alcohol increases the body's need for B vitamins while interfering with its ability to absorb, store, and use thiamine.
*A genetic abnormality may make some people more susceptible to Korsakoff's syndrome when they drink large amounts of alcohol and consume diets low in vitamins.
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Neurophysical Disorders
4) Parkinson’s Syndrome (not in book)
*tremor in hand, foot, mouth, or chin
*stiffness or rigidity of the limbs and trunk
*bradykinesia (slowness of movement)
*postural instability, or impaired balance and coordination
*Occurs in about 1% of people over 65, 15% in ages 74-85, and
over 50% of people over 85
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Neurophysical Disorders
• Parkinson’s Disease (not in book)
caused by the progressive impairment or
deterioration of neurons (nerve cells) in
an area of the brain known as the
substantia nigra. When functioning
normally, these neurons produce a vital
brain chemical known as dopamine.
Dopamine serves as a chemical
messenger allowing communication
between the substantia nigra and
another area of the brain called the
corpus striatum. This communication
coordinates smooth and balanced
muscle movement. A lack of dopamine
results in abnormal nerve functioning,
causing a loss in the ability to control
body movements.
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Neurophysical Disorders
• Parkinson’s Disease – Why Parkinson’s
occurs and how the neurons become impaired is not known. However, increasing evidence suggests that it may be inherited.
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TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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Show
THE WORLD OF AbNORMAL
PSYCHOLOGY
#10 Organic Brain Disorders
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SUBSTANCE ABUSE
DISORDERS
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1) ALCOHOL
2) COCAINE
3) METHALAMPHETAMINES
4) NICOTINE
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Substance Abuse Disorders
1) Alcohol (Ch 7, p.294-304)
*Drinking impairs life adjustments
*Health, personal relationships, occupational functioning
*Strong relationship between alcohol & violence.
Am I drinking too much?
YES, if you are:
・A woman who has more than seven drinks* per week or more than
three drinks per occasion
・A man who has more than 14 drinks* per week or more than four
drinks per occasion
・Older than 65 years and having more than seven drinks* per week
or more than three drinks per occasion *--One drink = one 12-oz bottle of beer (4.5 percent alcohol) or one 5-oz glass of wine (12.9 percent alcohol) or 1.5 oz of 80-
proof distilled spirits.
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Substance Abuse Disorders
2) Cocaine (Ch 7, p.294-304)
*Chronic abuse can promote acute psychotic symptoms & hallucinations
*Activates the part of the brain as areas of pleasure & rewards (food, sex, water)
*Long term effects include:
Addiction
Irritability and mood disturbances
Restlessness
Paranoia
Auditory hallucinations
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Substance Abuse Disorders
3) Methamphetamines
*synthetic amphetamines or stimulants that are produced and sold illegally in pill form, capsules, powder and chunks.
*has a structure similar to dopamine (the brain's pleasure transmitter) and causes neurons to release large amounts of dopamine to produce a high. ……… leads to permanent brain damage as natural dopamine production sites are destroyed - forcing the user to become even more reliant on meth for pleasure.
*known as meth, crank, glass, speed, crystal, ice, batu, chalk, shabu, or zip QuickTime™ and a
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Substance Abuse Disorders
4) Nicotine (Ch 7, p.294-304)
*Poisonous substance in cigarettes
*450,000 related deaths per year.
**Used as a coping device
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TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#6 Substance Abuse Disorders
The Meth Epidemic
Psych in Film, Ver 2, #25, Lost
Weekend (alcoholism)
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SEXUAL
DISORDERS
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1) GENDER IDENTITY DISORDER (TRANSSEXUALISM)
2) SEXUAL DISFUNCTION
3) PARAPHILIAS
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Sexual Disorders (Ch 12, p.467-482)
1) Gender Identity Disorder (Transsexualism)
*Confusion or uncertainty between biological sex and gender identity.
2) Sexual Disfunction
*Inhibitions in sexual response
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Sexual Disorders
3) Paraphilias
– Fetishism, zoophilia, pedophila, exhibitionism, voyeurism, masochism, sadism et. al.
– Sexual response to unusual objects or situations
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TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories: classical conditioning.
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#7 Sexual Disorders
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DEVELOPMENTAL
(CHILDHOOD)
DISORDERS
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1) ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
2) CONDUCT DISORDER
3) SEPARATION ANXIETY DISORDER
4) AUTISM
5) DYSLEXIA
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1) Attention Deficit Hyperactivity Disorder (ADHD) (not
in book)
*Maladaptive behavior that interferes with effective task-oriented
behavior
*Impulsively, excessive motor activity, exaggerated muscular
activity, difficulty maintaining attention
*controversial diagnosis
*Critics claim ADHD is overdiagnosed (i.e.)blame
children for unskilled parents or teachers.
*drug treatment includes stimulants
*stimulant drug therapy combined with behavioral
therapy can improve attention and diminished
hyperactivity in 70% of ADHD children.
*Strattera -- a drug used for ADHD is a norepinephrine
retake inhibitor
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2) Conduct Disorders (not in book)
*Persistant, repetitive violation of rules and disregard for rights of others
*Fighting, defiance, disobedience, destruction of property, attention seeking, inattentiveness, over-aggressive behavior, bullying, physical aggression, cruel behavior toward people and pets, destructive behavior, lying, truancy, vandalism, and stealing.
*ODD--Oppositional Defiant Disorder: disobedient, hostile behavior towards authority figures
*clinically significant impairment in social, academic, or occupational functioning.
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3) Separation Anxiety Disorder (not in book)
*Excessive anxiety about separation from people to whom the child is attached
*Unrealistic fears, oversensitivity, self-consciousness, nightmares, chronic anxiety
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4) Autism (p. 147-148, 424, 668)
*Pervasive developmental disorder occurring in infancy or childhood
*Qualitative impairment in reciprocal social interaction & communication--restricted repertoire of activities & interests
Example: Sally and Ann are playing together, when Sally puts a piece of candy
in a box and leaves the room. While Sally is gone, Anne opens the box,
removes the candy and stashes it in her purse. When Sally comes back, where
will she look for the candy?
Normal children will say that Sally will look in the box. Autistic
children are most likely to say (if they communicate at all) that
Sally will look in the purse. The autistic child lacks “theory of
mind”. Severely autistic children cannot imagine themselves
in Sally’s place.
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5) Dyslexia
*reading difficulties
*affects 1 of 5 children
*involves the abnormalities in the brain’s language-processing circuits.
Another cause may be language itself:
*English: bizarre spelling menagerie, containing 1120 ways
to spell only 40 different sounds, are more likely to be
dyslexic than
*Italian: 33 combinations of letters for 25 sounds.
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TREATMENTS:
*Medical model: Stimulants (ADHD)
*Psychoanalysis:
*Learning Theories: Token Economy
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#11 Behavior Disorders of Childhood
Psych in Film, Ver 2, #26, Mercury
Rising (autism), #20, Sixteen Candles,
#21, Snow Falling on Cedars (cross-
cultural), #15, Parenthood (special
needs child)
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ADJUSTMENT
DISORDERS
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ADJUSTMENT DISORDERS:
Other conditions that may be a focus of
clinical attention.
*mild depression
*physical complaints
*marital problems
*academic problems
*job problems
*parent-child problems
*bereavement
*malingering (faking an illness)
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TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
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SHOW
Psych in Film, ver 2, #28, American Werewolf
in London (sleep disorders)
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Questions for
Review
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1) RECALL In Rosenhan’s study, who discovered that the
“pseudopatients” were feigning mental illness?
a) psychiatrists
b) psychologists
c) Nurses and aides working on the ward
d) Other patients
e) Other physicians
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2) APPLICATION Which of the following symptoms most clearly suggests
the presence of abnormality?
a) hallucinations
b) worries
c) Unusual behavior
d) creativity
e) distraction
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3) RECALL Hippocrates proposed that mental disorder was caused
by
a) Possession by demons
b) An imbalance in four bodily fluids
c) A fungus growing on rye grain
d) Traumatic memories in the unconscious
e) The taking of potions.
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4) RECALL The behavioral perspective emphasizes the influence of
__, while the cognitive perspective emphasizes __.
a) Genetics / conscious processes
b) Conscious processes / unconscious processes
c) Heredity / environment
d) Medical factors / psychological factors
e) The environment / mental process
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5) UNDERSTANDING THE CORE CONCEPT Which of the following would be least likely to be
noticed by a clinician using strictly the medical
model of mental disorder?
a) delusions
b) Severe disturbances in affect
c) An unhealthy family environment
d) A degenerative brain disease
e) hallucinations
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6) RECALL The DSM IV is based on the
a) Cognitive perspective
b) Behavioral perspective
c) Eclectic view
d) Psychoanalytic view
e) medical model
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7) RECALL Which disorder involves extreme swings of mood from
elation to depression?
a) Panic disorder
b) Bipolar disorder
c) schizophrenia
d) Unipolar depression
e) PTSD
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8) APPLICATION According to the preparedness hypothesis, which one of
the following phobias would you expect to be most
common?
a) Fear of snakes (ophidiophobia)
b) Fear of books (bibliophobia)
c) Fear of horses (equinophobia)
d) Fear of the number 13 (triskaidekaphobia)
e) Fear of water (aquaphobia)
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9) RECALL Which of the following disorders involves a deficiency in
memory?
a) phobia
b) Antisocial personality
c) Dissociative fugue
d) obsessive-compulsive diorder
e) schizophrenia
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10) RECALL Which of the following is a disorder in which the
individual displays more than one distinct
personality?
a) schizophrenia
b) Depersonalization disorder
c) Bipolar disorder
d) phobia
e) Dissociative identity disorder
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11) RECALL Which of the following is primarily a disorder of young
American women?
a) Bipolar disorder
b) schizophrenia
c) Anorexia nervosa
d) Antisocial personality disorder
e) Dissociative identity disorder
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12) RECALL Hallucinations and delusions are symptoms of
a) schizophrenia
b) Somatoform disorders
c) Anxiety disorders
d) Depersonalization disorders
e) Panic disorders
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13) RECALL Which category of disorder is most common?
a) schizophrenia
b) Dissociative disorder
c) Eating disorders
d) The adjustment disorders and “other conditions that
may be a focus of clinical attention”
e) Mood disorders
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14) UNDERSTANDING THE CORE CONCEPT The DSM-IV groups most mental disorders by their
a) treatments
b) causes
c) symptoms
d) theoretical basis
e) cures
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15) UNDERSTANDING THE CORE CONCEPT Which unfortunate consequence of diagnosing mental
disorders is emphasized chapter?
a) The inaccuracy of diagnosis
b) Stigmatizing those with mental disorders
c) Adding to the already overcrowded conditions in
mental hospitals
d) That some cultures do not recognize mental
disorders
e) The importance of the insanity defense.
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16) RECALL Which one of the following statements is true?
a) Mental disorders have a similar prevalence in all cultures
b) In general, biology creates mental disorder, while culture
merely shapes the way a person experiences it.
c) Culture-specific stressors occur primarily in developing
countries
d) Cultures around the world seem to distinguish between
people with mental disorders and people who are
visionaries or prophets.
e) Mental disorders are more prevalent in Eastern culture.
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17) RECALL Insanity is
a) Psychological term
b) Psychiatric term, found in DSM-IV under
“psychotic disorders.”
c) Legal term
d) Term that refers either to “neurotic” or “psychotic”
symptoms
e) A classification for those seeking treatment.
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18) RECALL A long-standing pattern of irresponsible behavior that
hurts others without causing feelings of guilt or
remorse is typical of
a) An obsessive-compulsive disorder
b) An antisocial personality disorder
c) A narcissistic personality disorder
d) Paranoid schizophrenia
e) Dissociative fugue.
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19) APPLICATION A young woman wanders into a hospital, claiming not to
know who she is, where she is from, or how she got
there. Her symptoms indicate that she might be
suffering from a(n) ____ disorder
a) anxiety
b) affective
c) personality
d) dissociative
e) mood
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20) RECALL ____ has been called the “common cold of
psychopathology” because it occurs so frequently and
because almost everyone has experienced it, at least
briefly, at some time.
a) Obsessive-compulsive disorder
b) Bipolar disorder
c) Depression
d) Paranoid schizophrenia
e) Autism
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21) RECALL A person who suffers from ____ cannot eat normally but
engages in a ritual of “binging”--periodic binges of
overeating--followed by “purging” with induced
vomiting or use of laxitives.
a) Anorexia nervosa
b) Bulimia nervosa
c) Inhibition
d) Mania
e) Depression
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22) RECALL The ____ type of schizophrenia is characterized by
delusions.
a) residual
b) catatonic
c) paranoid
d) undifferentiated
e) disorganized
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23) RECALL Rosenhan believes that his “pseudopatients” were not
recognized as normal because
a) The staff members in the mental hospital were
incompetent
b) The staff members in the mental hospitals were just
as disturbed as the patients
c) Mental illness is a myth
d) Staff members did not expect patients to be normal
e) He denied the existance of psychological disorders
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24) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
____Extreme disorders of thinking, involving
persistent false beliefs.
B
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25) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____A developmental disorder marked by
disabilities in language and social interaction.
J
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26) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ A class of disorders including bipolar
disorder.
D
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28) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ A class of disorders including panic
disorder.
E
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29) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ A disorder characterized by an unstable
personality given to impulsive behavior for which
includes remorse after the fact.
I
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30) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ A class of disorders including
depersonalization disorder.
G
![Page 178: Myers’ PSYCHOLOGY Psychological Disorders5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the normal experience (rape, war, murder,](https://reader033.vdocuments.mx/reader033/viewer/2022043005/5f8b504f35bf674d2d7d2960/html5/thumbnails/178.jpg)
31) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ A class of disorders including conversion
disorder.
F
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32) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ False sensory experiences that may
suggest a mental disorder.
A
![Page 180: Myers’ PSYCHOLOGY Psychological Disorders5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the normal experience (rape, war, murder,](https://reader033.vdocuments.mx/reader033/viewer/2022043005/5f8b504f35bf674d2d7d2960/html5/thumbnails/180.jpg)
33) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ The view that mental disorders are
diseases that have objective physical causes and
require specific treatments.
C
![Page 181: Myers’ PSYCHOLOGY Psychological Disorders5) Post Traumatic Stress Disorder (PTSD) Follows a psychologically distressing event that is outside the normal experience (rape, war, murder,](https://reader033.vdocuments.mx/reader033/viewer/2022043005/5f8b504f35bf674d2d7d2960/html5/thumbnails/181.jpg)
34) MATCHING
a) Hallucinations f) Somatoform disorders
b) Delusions g) Dissociative disorders
c) Medical model h) Diathesis-stress hypothesis
d) Mood disorders i) Borderline personality disorder
e) Anxiety disorders j) Autism
_____ The proposal that genetic factors place the
individual at risk while environmental stress factors
transform this potential into schizophrenic disorder.
H
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#21, Zimbardo, Psychopathology