1、Chapter 12 Psychological Disorders,What is Normal?,Psychopathology: Scientific study of mental, emotional, and behavioral disorders Subjective Discomfort: Feelings of discomfort, unhappiness, or emotional distress Statistical Abnormality: Having extreme scores on some dimension, such as intelligence
2、, anxiety, or depression Social Nonconformity: Disobeying societal standards for normal conduct; usually leads to destructive or self-destructive behavior,Figure 12.1,FIGURE 12.1 The number of people displaying a personal characteristic may help define what is statistically abnormal.,What Is Normal?
3、 (contd),Situational Context: Social situation, behavioral setting, or general circumstances in which behavior takes place Is it normal to walk around strangers naked? If you are in a locker room and in the shower area, yes! Cultural Relativity: Judgments are made relative to the values of ones cult
4、ure,Clarifying and Defining Abnormal Behavior (Mental Illness),Maladaptive Behavior: Behavior that makes it difficult to function, to adapt to the environment, and to meet everyday demands Mental Disorder: Significant impairment in psychological functioning,Clarifying and Defining Abnormal Behavior
5、(Mental Illness),Psychotic Disorder: Severe psychiatric disorder characterized by hallucinations and delusions, social withdrawal, and a move away from reality Organic Mental Disorder: Mental or emotional problem caused by brain pathology (i.e., brain injuries or diseases) Mood Disorder: Disturbance
6、s in affect (emotions), like depression or mania Anxiety Disorder: Feelings of fear, apprehension, anxiety, and distorted behavior,Clarifying and Defining Abnormal Behavior (Mental Illness),Somatoform Disorder: Physical symptoms that mimic disease or injury (blindness, anesthesia) for which there is
7、 no identifiable physical cause Dissociative Disorder: Temporary amnesia, multiple personality, or depersonalization (like being in a dream world, feeling like a robot, feeling like you are outside of your body) Personality Disorder: Deeply ingrained, unhealthy, maladaptive personality patterns Sexu
8、al and Gender Identity Disorder: Problems with sexual identity, deviant sexual behavior, or sexual adjustment,Clarifying and Defining Abnormal Behavior (Mental Illness),Substance Related Disorders: Abuse or dependence on a mind or mood-altering drug, like alcohol or cocaine Person cannot stop using
9、the substance and may suffer withdrawal symptoms if they do Neurosis: Archaic; once used to refer to excessive anxiety, somatoform, dissociative disorders, and some kinds of depression,DSM,DSMDiagnostic & Statistical Manual of Mental Disorders Published by American Psychiatric Association used by cl
10、inicians and researchers to diagnose and classify mental disorders,General Risk Factors for Contracting Mental Illness,Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability Psychological Factor
11、s: Low intelligence, learning disorders _ Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems Other sources of psychological st
12、ress,Figure 12.11,FIGURE 12.11 A combination of vulnerability and stress may produce psychological problems. The top bar shows low vulnerability and low stress. The result? No problem. The same is true of the next bar down, where low vulnerability is combined with moderate stress. Even high vulnerab
13、ility (third bar) may not lead to problems if stress levels remain low. However, when high vulnerability combines with moderate or high stress (bottom two bars) the person “crosses the line” and suffers from psychopathology.,Personality Disorders: Antisocial Personality Disorder (ASPD),Definition: A
14、 person who lacks a conscience (superego?); typically emotionally shallow, impulsive, selfish, and manipulative toward others Oftentimes called psychopaths or sociopaths Many are delinquents or criminals, but many are NOT crazed murderers displayed on television Create a good first impression and ar
15、e often charming Cheat their way through life (e.g., Dr. Michael Swango) Blind to signs of disgust in other people,ASPD: Causes and Treatments,Possible Causes: Childhood history of emotional deprivation, neglect, and physical abuse Underarousal of the brain Very difficult to effectively treat; will
16、lie, charm, and manipulate their way through therapy,Anxiety-Based Disorders,Anxiety: Feelings of apprehension, dread, or uneasiness Adjustment Disorders: When ongoing stressors cause emotional disturbance and push people beyond their ability to effectively cope Usually suffer sleep disturbances, ir
17、ritability, and depression Examples: Grief reactions, lengthy physical illness, unemployment can be some triggers for anxiety,Anxiety-Based Disorders (contd),Anxiety Disorders: When stress seems greatly out of proportion to the situation at hand usually accompanied by some form of avoidance 3 Main T
18、ypes Generalized Anxiety Disorder (GAD): Duration of at least six months of chronic, unrealistic, or excessive anxiety Panic Disorder (w/ or w/o agoraphobia) Phobia,Generalized Anxiety Disorder,Extreme anxiousness and worry for at least 6 months Anxiousness/anxiety do not fade when life circumstance
19、s get better Multiple topics of worry,Panic Disorders,Panic Disorder (without Agoraphobia): A chronic state of anxiety with brief moments of sudden, intense, unexpected panic (panic attack) Panic Attack: Feels like one is having a heart attack, going to die, or is going insane Symptoms include verti
20、go, chest pain, choking, fear of losing control Panic Disorder (with Agoraphobia): Panic attacks and sudden anxiety still occur, but with agoraphobia,Agoraphobia,Agoraphobia (with Panic Disorder): Intense, irrational fear that a panic attack will occur in a public place or in an unfamiliar situation
21、 Intense fear of leaving the house or entering unfamiliar situations Can be very crippling Literally means fear of open places or market (agora) Agoraphobia (without Panic Disorder): Fear that something extremely embarrassing will happen away from home or in an unfamiliar situation.,Specific Phobias
22、,Irrational, persistent fears, anxiety, and avoidance that focus on specific objects, activities, or situations People with phobias realize that their fears are unreasonable and excessive, but they cannot control them.,Social Phobia,Intense, irrational fear of being observed, evaluated, humiliated,
23、or embarrassed by others (e.g., shyness, eating, or speaking in public),Review: 3 Anxiety Disorders,1. Phobiaobjects, situation, social Causes: not only experiencealso inherit tendencies (prepared fears) 2. Generalized Anxietyconstant anxiety and worry 3. Panic Disorderdiscrete panicky episodes,Obse
24、ssive-Compulsive Disorder (OCD),Extreme preoccupation with certain thoughts and compulsive performance of certain behaviors Obsession: Recurring images or thoughts that a person cannot prevent Cause anxiety and extreme discomfort Enter into consciousness against the persons will Most common: Being d
25、irty or wondering if you performed an action (turned off the stove),Compulsions,Compulsion: Irrational acts that person feels compelled to repeat against his/her will Help to control anxiety created by obsessions Checkers and cleaners,Table 16.2 Obsessive-Compulsive Tendencies,Anxiety,Feelings of te
26、nsion, uneasiness, apprehension, worry, and vulnerability We are motivated to avoid experiencing anxiety,Figure 10.6,FIGURE 10.6 The approximate relationship between the id, ego, and superego, and the levels of awareness.,Theoretical Causes of Anxiety Disorders: Psychodynamic,Psychodynamic (Freud):
27、Anxiety caused by conflicts among id, ego, and superego. Forbidden id impulses for sex or aggression are trying to break into consciousness and thus influence behavior; person fears doing something crazy or forbidden. Superego creates guilt in response to these impulses. Ego gets overwhelmed and use
28、s defense mechanisms to cope.,Other Theoretical Causes of Anxiety Disorders,Humanistic-Existential: Unrealistic self-image conflicts with true self,Other Theoretical Causes of Anxiety Disorders,Behavioristic: Anxiety symptoms and behaviors are learned, like everything else Conditioned emotional resp
29、onses generalize to new situations Anxiety Reduction Hypothesis: When reward of immediate relief from anxiety perpetuates self-defeating avoidance behaviors Cognitive: When distorted thinking causes people to magnify ordinary threats and failures, leading to anxiety and distress,Freudian Defense Mec
30、hanisms,Defense Mechanisms: Habitual and unconscious (in most cases) psychological processes designed to reduce anxiety,More on Defense Mechanisms,Work by avoiding, denying, or distorting sources of threat or anxiety If used short term, can help us get through everyday situations If used long term,
31、we may end up not living in reality Protect idealized self-image so we can live with ourselves,Freudian Defense Mechanisms: Some Examples,Denial: Most primitive; denying reality; usually occurs with death and illness Repression: When painful memories, anxieties, and so on are held out of our awarene
32、ss Reaction Formation: Impulses are repressed and the opposite behavior is exaggerated,More Defense Mechanisms,Projection: When ones own feelings, shortcomings, or unacceptable traits and impulses are seen in others; exaggerating negative traits in others lowers anxiety Rationalization: Justifying p
33、ersonal actions by giving “rational” but false reasons for them,Name that defense mechanism! Your ex-spouse, who cheated on you, writes a best-selling nonfiction book arguing that human beings are not naturally monogamous and have an instinctive need for variety.,Name that defense mechanism! You are
34、 in love with your best friends new flame. The friendship is an old one and very valuable to you. You tell everybody that your friends new love interest is a terrible human being and you dont understand the attraction at all.,Mood Disorders,Major disturbances in emotion, such as depression or mania
35、Depressive Disorders: Sadness or despondency are prolonged, exaggerated, or unreasonable Bipolar Disorders: Involve both depression, and mania or hypomania Seasonal Affective Disorder (SAD): Depression that only occurs during fall and winter. May be related to reduced exposure to sunlight Photothera
36、py: Extended exposure to bright light to treat SAD,Major Mood Disorders,Lasting extremes of mood or emotion and sometimes with psychotic features (hallucinations, delusions) Major Depressive Disorder: A mood disorder where the person has suffered one or more intense episodes of depression; one of th
37、e more serious mood disorders. Bipolar I Disorder: Extreme mania and deep depression; one type of manic-depressive illness. Mania: Excited, hyperactive, energetic, grandiose behavior Bipolar II Disorder: Person is mainly sad but has one or more hypomanic episodes (mild mania),Suicide: Major Risk Fac
38、tors,Drug or alcohol abuse Prior suicide attempt Depression or other mood disorder Availability of a firearm Severe anxiety or panic attacks Family history of suicidal behavior Shame, humiliation, failure or rejection,Figure 12.14,FIGURE 12.14 Adolescent suicide rates vary for different racial and e
39、thnic groups. Higher rates occur among whites than among non-whites. White male adolescents run the highest risk of suicide. Considering gender alone, it is apparent that more male than female adolescents commit suicide. This is the same as the pattern observed for adults.,Figure 12.15,FIGURE 12.15
40、Suicidal behavior usually progresses from suicidal thoughts, to threats, to attempts. A person is unlikely to make an attempt without first making threats. Thus, suicide threats should be taken seriously,Common Characteristics of Suicidal Thoughts and Feelings (Shneidman),Escape Unbearable Psycholog
41、ical Pain: Emotional pain that the person wishes to escape Frustrated Psychological Needs: Such as searching for love, achievement, or security Constriction of Options: Feeling helpless and hopeless and deciding that death is the only option left,Stress Disorders,Occur when stresses outside range of
42、 normal human experience cause major emotional disturbance Symptoms: Reliving traumatic event repeatedly, avoiding reminders of the event, and numbing of emotions Acute Stress Disorder: Psychological disturbance lasting up to one month following stresses from a traumatic event,Post-Traumatic Stress
43、Disorder (PTSD),PTSD lasts more than one month after the traumatic event has occurred; may last for years Typically associated with combat and violent crimes (rape, assault, etc.),Dissociative Disorders,Dissociative Amnesia: Inability to recall ones name, address, or past Memory loss is partial or c
44、omplete for personal information Dissociative Fugue: Sudden travel away from home and confusion about personal identity,Dissociative Identity Disorder (DID),Person has two or more distinct, separate identities or personality traits; previously known as Multiple Personality Disorder “Sybil” or “The T
45、hree Faces of Eve” are good examples Often begins with horrific childhood experiences (e.g., abuse, molestation, etc.) Therapy often makes use of hypnosis,Somatoform Disorders,Hypochondriasis: Person is preoccupied with fears of having a serious illness or disease Interpret normal sensations and bod
46、ily signs as proof that they have a terrible disease No physical disorder can be found Somatization Disorder: Person expresses anxieties through numerous physical complaints Many doctors are consulted but no organic or physical causes are found,Somatoform Disorders (contd),Pain Disorder: Pain that h
47、as no identifiable organic, physical cause Appears to have psychological origin Conversion Disorder: Severe emotional conflicts are “converted” into physical symptoms or a physical disability Caused by anxiety or emotional distress but not by physical causes Glove Anesthesia: Loss of sensitivity in
48、areas of skin normally covered by a glove,Figure 12.4,FIGURE 12.4 (left) “Glove” anesthesia is a conversion reaction involving loss of feeling in areas of the hand that would be covered by a glove (a). If the anesthesia were physically caused, it would follow the pattern shown in (b). (right) To tes
49、t for organic paralysis of the arm, an examiner can suddenly extend the arm, stretching the muscles. A conversion reaction is indicated if the arm pulls back involuntarily.,Other Theoretical Causes of Anxiety Disorders,Humanistic-Existential: Unrealistic self-image conflicts with real self-image Exi
50、stential: Anxiety reflects loss of meaning in ones life Behavioristic: Anxiety symptoms and behaviors are learned, like everything else Conditioned emotional responses that generalize to new situations,More Theoretical Causes of Anxiety Disorders,Avoidance Learning: When making a particular response
51、 delays or prevents the onset of a painful or unpleasant stimulus Anxiety Reduction Hypothesis: When reward of immediate relief from anxiety perpetuates self-defeating avoidance behaviors Cognitive: When distorted thinking causes people to magnify ordinary threats and failures, leading to anxiety and distress,
