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Chapter 14
Psychological Disorders – 8th Edition
Table of Contents
Abnormal Behavior
Historical aspects of mental disorders – F 14.1
The medical model
What is abnormal behavior? – 3 criteria – F 14.2
• Deviant
• Maladaptive
• Causing personal distress
A continuum of normal/abnormal
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Prevalence, Causes, and Course
Epidemiology
Prevalence - % of population that displays the
disorder during a specific period
Lifetime prevalence – F 14.5
Diagnosis
Etiology – causes
Prognosis
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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 Mental Retardation
– Axis III – General Medical Conditions
– Axis IV – Psychosocial and Environmental Problems
– Axis V – Global Assessment of Functioning
Example Figure 14.4
DSM V – to be published in 2011-12
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Fig. 14-3, p. 555 Figure 14.3 – DSM-IV
overview
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Figure 14.4 –
Example multiaxial
evaluation
The DSM multiaxial system
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Axis I Clinical Syndromes and Axis II Personality Disorders
Anxiety Disorders – p. 583
Somatoform Disorders – p. 586
Dissociative Disorders – p. 589
Mood Disorders – p. 590
Schizophrenic Disorders – p. 598
Eating Disorders – p. 613
Axis II – Personality Disorders – p. 604
Table of Contents
Clinical Syndromes: Anxiety Disorders
Generalized anxiety disorder
– “free-floating anxiety”
Phobic disorder
– Specific focus of fear
Panic disorder and agoraphobia (definition issue
– p. 582)
– Physical symptoms of anxiety/leading to agoraphobia
Obsessive compulsive disorder
– Obsessions
– Compulsions
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Etiology of Anxiety Disorders
Biological factors – F 14.6 – Genetic predisposition, anxiety sensitivity
– GABA circuits in the brain
Conditioning and learning – Acquired through classical conditioning or observational
learning – F 14.7
– Maintained through operant conditioning
Cognitive factors – Judgments of perceived threat – F 14.8
Personality – Neuroticism
Stress – F 14.9 – A precipitator
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Clinical Syndromes: Somatoform Disorders
Somatization Disorder
Conversion Disorder – Figure 14.10
Hypochondriasis
– Etiology
• Reactive autonomic nervous system
• Personality factors
• Cognitive factors
• The sick role
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Clinical Syndromes: Dissociative Disorders
Dissociative amnesia
Dissociative fugue
Dissociative identity disorder
– Etiology
• severe emotional trauma during childhood
– Controversy
• Media creation?
• Sybil
• Repressed memories
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Clinical Syndromes: Mood Disorders
Figure 14.11 and Table 14.1
Major depressive disorder – Dysthymic disorder
Bipolar disorder (manic-depressive disorder) – Cyclothymic disorder
Etiology – Age of onset – F 14.12
– Genetic vulnerability – F 14.14
– Neurochemical factors
– Cognitive factors – negative thinking – F 14.15, F 14.16
– Interpersonal roots
– Precipitating stress
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XX 14.14
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XX 14.16
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XX 14.17
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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
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Subtyping of Schizophrenia
4 subtypes
– Paranoid type – most
common subtype - John
Nash
– Catatonic type
– Disorganized type
– Undifferentiated type
New model for classification
– Positive vs. negative
symptoms
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Etiology of Schizophrenia
Genetic vulnerability – F 14.18
Neurochemical factors – Dopamine hypothesis – F 14.19
Structural abnormalities of the brain – prefrontal lobe and ventricles – F 14.20
The neurodevelopmental hypothesis – F 14.21
Expressed emotion – F 14.22
Precipitating stress – stress-vulnerability model – Slide 33
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Figure 14.18 – Genetic vulnerability -
schizophrenia
Table of Contents Figure 14.19 The dopamine hypothesis as an explanation for schizophrenia
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Neurological Changes in Schizophrenia
XXXX Figure 14.20
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Figure 14.21 – Neurodevelopment hypothesis of schizophrenia
Figure 14.22 –
Expressed emotion
and relapse rates in
schizophrenia
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Slide 33 – The stress-vulnerability model of schizophrenia
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Personality Disorders
Table 14.2 – description and male/female percents
Anxious-fearful cluster – Avoidant, dependent, obsessive-compulsive
Dramatic-impulsive cluster – Histrionic, narcissistic, borderline, antisocial
Odd-eccentric cluster – Schizoid, schizotypal, paranoid
Etiology – Genetic predispositions, inadequate socialization in
dysfunctional families
Prognosis
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Psychological Disorders and the Law
Insanity
– M’naghten rule
– The insanity defense – Figure 14.23 – perception versus
actual cases
Involuntary commitment – varies by states
– danger to self
– danger to others
– in need of treatment
Culture and pathology – p. 610 - 611
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XXX 14.23
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John Hinkley, Jr. – assassination attempt of President Reagan in 1981
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Eating Disorders – p. 613-615
Issues of weight – slide 41
Anorexia nervosa – Criteria and subtypes: restrictive and binge/purge
Bulimia nervosa
Binge eating
History and prevalence – Age onset – Figure 14.25
Etiology – Genetics
– Personality – perfectionism
– Cultural issues - “perfect” body type and digital photograph
– Family role
– Cognitive factors
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Figure 14.25 - Age of anorexia nervous in the United States – Lucas et al.
(1991)
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XXXXX Slide 41