6. psikopatologi

PT10603 PERSONALITY AND INDIVIDUAL DIFFERENCESPSYCHOPATHOLOGY

BY: MISS PATRICIA JOSEPH KIMONG

PSYCHOPATHOLOGY Abnormal psychology Studies the causes, treatment & consequences of psychological disorders/ mental illnesses such as depression, anxiety & psychoses

Differential psychology attempts to explain between individual Personality refers to individual differences in general/ normal behavior Psychopathology focuses on abnormality

ABNORMALITY Conventional criteria for defining abnormality Statistical deviance- an approach that conceptualizes abnormality in terms of behaviors that are extreme, rare/ unique as opposed to typical

Social norm approach A rule/ guideline determined by cultural factors for what kind of behavior is considered appropriate in social contexts E.g. some governments condemn the consumption of alcoholics drink, whereas others have very relaxed attitudes towards drug

Personal distress Individuals level of suffering takes into consideration and whether they want to get rid of the suffering Disadvantages : abnormality is not always associated with subjective suffering or the experience of discomfort

Maladaptiveness The extent to which behavior interferes with a persons capacity to carry out everyday tasks such as studying/ relating to others E.g. anxiety disorders such as phobias, panic attack & obsessivecompulsive disorder

Mental illness approach An approach to psychological disorder that integrates physical & psychological variables in order to understand the processes underlying abnormal behavior Clinical psychologists & psychiatrists focus on specific symptoms that meet the criteria for predefined diagnosis

HISTORICAL Hippocrates, the Greek philosopher & physician credited with the invention of medicine, believed in the connection between psychological & physical disorders He explained pathologies which were common disorders in ancient Greek society.

Psychological illness was attributed to a physiological dysfunction. Psychological symptoms have physiological causes is represented by the somatogenic approaches to psychopathology

Plato: disorders are intrapsychical (all in the mind) conflicts & embedded in some of the salient psychogenic theories of abnormal psychology. All in the mind

Psychopathology did not develop as major area of psychology until the beginnings of the twentieth century Symptoms were regarded as the expression of supernatural forces that controlled the individuals mind & body Treated through obscure rituals Exorcism & shamanism

Ancient Egyptians: have special temples for the mentally ill & performed rituals & included the use of opium to reduce pain. Behavioral abnormalities treated with violence Mentally ill individuals were marginalized

Nolen- Hoeksema, (2001)- in 1484 possessed individuals to be burned alive. Bedlam, established in 1243- 1800, the first formal attempt at psychopathological hospitalization 1970, Phillippe Pinel (1745-1826) proposed the moral treatment for mental disorders & categorize symptoms.

Modern Approaches Somatogenic by Wilhelm Griesinger (1817-1868) Brain pathology was the cause of all mental disorders Emil Kraepelin (1856-1926)- first classification of symptoms, labeling and describing different psychological disorders Case Phineas Gage- how strutural changes in the brain may impair normal psychological functioning

Franz Anton Mesmer )(17341815) believed psychological disorders to be the expression of psychical rather than physical factors & caused by magnetic fluids astrological energy force inside peoples body. Developed a hypnotic method mesmerism

Jean Martin Charcot (1825-1893) believed that psychological disorders were caused by a degeneration of the brain, nonetheless experimented with mesmerism. Found that patients experienced substantial relief after being able to talk about their symptoms under hynopsis. Catharsis

Psychoanalysis & Psychodynamic theories Freuds studies hysterical disorder Development of psychoanalysis/ psychodynamics (exploration of the unconscious) Unconscious intrapsychical origin to mental ilness. All behaviors are influenced by unconscious processes Used to understand human behavior (philosophy, literature & sociology)

Psychopathological symptoms as a compromise between unconscious and conscious forces that represents a symbolic expression or repressed events. Treatments may last for 10/20 years Based on case studies & is largely untestable Based on circular interpretations & speculative theories not robust & representative empirical evidence

Behaviorism In the first half of the twentieth century while psychoanalysis was gaining momentum in Europe Study of empirically observable behavior Uninterested in hypothetical psychodynamic conflicts Symptoms would be a consequence of reinforcing/ punishing specific behaviors

Witmer (1867-1956) imported to the US the techniques he learned in Germany from Wilhelm Wundt First experimental clinic - study of the deficiencies in children

Ivan Pavlov (1849-1936) & John Watson (1878-1958) applied the principles of classic conditioning to the study of phobias

Thorndike (1874-1949) Skinner (1904-1909)= rewarding desirable behaviors was more effective than punishing undesirable ones (operant conditioning)

Cognitive Emerged in 1960s & 1970sattempted to understand the internal mental processes (cognitions) Peoples subjective interpretations of events can have a direct impact on their behavior & emotion.

Bandura (1896) conceptualized this idea as self efficacy (individuals belief about the extent to which they can successfully execute the appropriate behaviors to control & influence important life events)

Ellis (1973)= Rational Emotive Therapy, conceptualizes illness as the result of irrational negative beliefs about oneself & the world Dryden & DiGiuseppe (1990), role of therapist= changes in the patients beliefs

Biological approaches Divided into : Nerophysiology- dealing with the processes/ functions of the brain. Neuroanatomy- dealing with the structure of the brain Neurotransmitter (chemical messenger that carry information between neurons & other cells Imbalance=psychological disorders

Eg.serotonin affects emotion & impulse regulation ; dopamine levels have been linked to psychosis & schizophrenia

Endocrine system (production & release of hormones) in the blood= affect mood, levels of energy & reactions to stress

The Biophychosocial Model A multidisiplinary approach ro psychopathology based on the idea that mental illness results from combination of biological, psychological, environmental & social factors.

Diathesis- stress model (some people possess an enduring, inherited vulnerability which is likely to result in psychological disorder when they experience an unbearable life event

Diagnosis 2 frameworks: 1) Idiographic adopted by psychoanalytic & psychodynamic theories) Emphasizes the singularity of mental illness Assumes psychological disorders to be manifested differently in every individual

2) Nomothetic preestablished categories & compare every case with previously defined, described & classified psychological disorders

2 taxonomies diagonosing mental disorders ICD- International Classification of Diseases, Injuries & Causes of death (WHO,1992) DSM- Diagnostic & Statistical Manual Of Mental Disorder (APA,1994)

Diagnosis in DSM are based on: Some core symptoms that need to be present Prespecified periods of time for symptoms to be present & sometimes Symptoms that should not be present

Major Psychological DisordersSchizophrenia Psychotic disorder characterized by the patients lack of insight & loss of contact with reality & episodic Unable to distinguish between inner & external reality Severe thinking & perception impairment

Syndromes: Hallucinations (fake perceptions) Delusions (false beliefs) Disorganied speech Diorganized behavior Negative symptoms Passivity Neurocognitive deficits

Experience more than one of the syndromes Conceptualized by Kraepelin as early madness Not involved double personality & aggressive manner Types : catatonic, hebephrenic & paranoidresidual & undifferentiated

Catatonic-Kinetic abnormalities Hebephrenic-Disorganized thought disorder & decreased affect Paranoid- vivid & horrifying hallucinations (thought disorder & disorganized behavior) Residual- Positive symptoms (the presence of something unusual-delusions, hallucinations & thought disorder) Undifferentiated- Symptoms which are not representative of any other type of schizophrenia)

Treated by antipsychotic/ neuroleptic drugs Cognitive therapy + antipsychotic drugs can help to reduce hallucination & delusions

Affective Disorders Exaggerated intensity of mood experiences throughout long periods of time Unrelated/ disproportionate reactions to external life real- life events Depression- persistent low mood (eg speech reduction, lack of joy, often suicidal, feeling of guilt, pessimistic) Learned helplessness & hopelessness

Mania- opposite extreme of affect than depression Exacerbated elevated mood & an inappropriate sense of well-being\ Eg. Optimism, over confidence Abnormal talk & speech (eg. inconsistency & incoherent) Psychotic symptoms (delusions of grandeur) Manic behavior- overactivity & increased sexual & aggressive impulses

Treated with lithium & antipsychotics & hospitalization

Anxiety disorders & obsessional states Experience of high levels of anxiety Anxiety can be experienced psychologically (eg. unpleasant & dreadful feelings) & somatically (muscular tension & increased heart attack)

Common anxiety disorders is phobias (experience of irrational/ disproportionate fear of an object/ phobic stimulus that leads individual to avoid contact with that object Treatment: systematic desensitization (progressive exposure to the phobic object)

Obsessive-compulsive disordera disorder characterized by intense & repetitive obsessions that generate anxiety Tends to start in early adulthood Rituals to relieve the individual from anxiety

Causes of phobias Psychodynamic-conflict between unconscious sexual/ aggressive impulses & social/culture norms Behaviors- induced in humans as in animals through association & conditioning Cognitive- sensitive/ have more vulnerable schemas to interpret events

Biological- a ubiquitous human emotion Neuropsychological- overactivity of the noradrenaline neurotransmitters is associated with anxiety attacks whilst serotonin has been associated with the adaptational function of preparing the individual for danger & stress Diathesis-stress model- psychological & biological

Eating disorders Exacerbated worry about food, body shape, weight & related physical symptoms Related to cultural, economic & social factors- experience of anxiety Anorexia (1. a serious & permanent concern about ones body shape, weight & thinness, 2. an active pursuit & maintenance of low body weight, 3 the absence of menstrual periods in female- disturbance of hormonal status)

Associated with anxiety fail to stop from eating. Anorexia individuals quiet, unassertive, anxious, and sexually inexperienced. Also tend to be ambitious and achievement-oriented, but have low self estee.

Bulimia nervosa- person to indulge in alcohol & drugs consumption Treatment: psychotherapy & psychopharmacological drugs Treatment- group/ family in treatment

Personality Disorders A persistent pattern of thinking, feeling & behaving that deviates from cultural expectations & impairs a persons educational, occupational & interpersonal functioning Begins at early age, are stable over time & are pervasive & inflexible

DSM Cluster A: antisocial, borderline, narcissistic & histrionic- odd & eccentric behaviors as well as disregard for others Cluster B: schizotypal, schizoid & paranoiddramatic, erratic & emotional behavior Cluster C- avoidant, obsessive-compulsive, dependent & passive-aggressive-anxious &fearful behaviors

Combination of the Big 5 with personality disorder+ve correlation: Neuroticism (N) -ve correlation: Agreeableness (A) & Conscientiousness Variable in direction & strength: Extraversion (E) & Openness (O) Eg. Histrionic personality disorder- higher in E, avoidant personality disorder- lower in E

Conclusions Modern conceptualizations of normality are based on statistical frequency, personal distress, social norms & maladaptiveness Diagnostic approach: clinical psychology & psychiatry

Causes of psychological disorders: genetics dispositions (schizophrenia), situational demands

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