Chapter 14: Psychological Disorders

Abnormal Behavior The medical model What is abnormal behavior? –Deviant –Maladaptive –Causing personal distress A continuum of normal/abnormal

Figure 14.2 Normality and abnormality as a continuum

Prevalence, Causes, and Course Epidemiology-study of distribution of mental or physical disorders in a population Prevalence- % of a population that exhibits a disorder at a specific time period Lifetime prevalence- see graph Diagnosis Etiology Prognosis

Figure 14.5 Lifetime prevalence of psychological disorders

Psychodiagnosis: The Classification of Disorders American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders – 5th ed. (DSM - 5)

The Five Axes are Gone!!! Adios, Sayonara, Goodbye! 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

The Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM5 represents the latest scientific thinking in both criteria content and organizational structure of mental disorders. Developmental Lifespan: Each chapter starts with disorders typically diagnosed in childhood first, followed by those in adolescence, adulthood, and later life.

And the 20 Chapters in the DSM V are: Neurodevelopmental Disorders very broad, including Intellectual disabilities, and autism spectrum disorders Schizophrenia Spectrum and Other Psychotic Disorders Bipolar and Related Disorders Depressive Disorders Anxiety Disorders Obsessive-Compulsive and Related Disorders Trauma- and Stressor-Related Disorders Dissociative Disorders Somatic Symptom Disorders Feeding and Eating Disorders

Chapters Continued Elimination Disorders Sleep-Wake Disorders Sexual Dysfunctions Gender Dysphoria Disruptive, Impulse Control and Conduct Disorders Substance Use and Addictive Disorders Neurocognitive Disorders Personality Disorders Paraphilic Disorders Other Disorders

Clinical Syndromes Anxiety Disorders Somatoform Disorders (now Somatic Symptom Disorders) Dissociative Disorders Mood Disorders Schizophrenic Disorders

Anxiety Disorders Generalized anxiety disorder –“free-floating anxiety” Phobic disorder –Specific focus of fear Panic disorder and agoraphobia Obsessive compulsive disorder –Obsessions –Compulsions Posttraumatic Stress Disorder

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

Figure 14.6 Twin studies of anxiety disorders

Figure 14.7 Conditioning as an explanation for phobias

Figure 14.8 Cognitive factors in anxiety disorders

Somatoform Disorders Somatic Symptom Disorders Conversion Disorder Hypochondriasis gone! now call it “Illness Anxiety Disorder” –Etiology Reactive autonomic nervous system Personality factors Cognitive factors The sick role

Figure Glove anesthesia

Clinical Syndromes: Dissociative Disorders Dissociative amnesia Dissociative fugue Dissociative identity disorder –Etiology severe emotional trauma during childhood –Controversy Media creation?

Clinical Syndromes: Mood Disorders Major depressive disorder –Dysthymic disorder Bipolar disorder –Cyclothymic disorder Etiology –Genetic vulnerability –Neurochemical factors –Cognitive factors –Interpersonal roots –Precipitating stress

Figure Episodic patterns in mood disorders

Figure Twin studies of mood disorders

Figure Negative thinking and prediction of depression

Figure Interpersonal factors in depression

Clinical Syndromes: Schizophrenia General symptoms –Delusions and irrational thought –Deterioration of adaptive behavior –Hallucinations –Disturbed emotions Prognostic factors

Subtyping of Schizophrenia 4 subtypes are gone!!!! –Paranoid type- bye! –Catatonic type- adios! –Disorganized type – see ya! –Undifferentiated type – scram! Model for classification –Positive vs. negative symptoms

Etiology of Schizophrenia Genetic vulnerability Neurochemical factors Structural abnormalities of the brain The neurodevelopmental hypothesis Expressed emotion Precipitating stress

Figure The dopamine hypothesis as an explanation for schizophrenia

Figure The neurodevelopmental hypothesis of schizophrenia

Personality Disorders 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

Table 14.2 Personality Disorders

Psychological Disorders and the Law Insanity –M’naghten rule Involuntary commitment –danger to self –danger to others –in need of treatment

Figure The insanity defense: public perceptions and actual realities

Culture and Pathology Cultural variations Culture bound disorders –Anorexia nervosa –Bulimia