Defining Psychopathology

PSYCHOLOGY 3eSaundra K. Ciccarelli, J. Noland White• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Copyright © Pearson Education 2012Modified by Jackie Kroening

Copyright © Pearson Education 2012

Modified by Jackie Kroening

Defining Psychopathology

Psychopathology: The study of abnormal thoughts, feelings and

behaviors


Ancient times: Evil spirits released via trepanning

Hippocrates:Mental illness from imbalance of body’s four humors

Middle Ages:Spirit possession and exorcism

Renaissance:Mentally ill labeled witches

14.1 How has mental illness been explained in the past, how is abnormal behavior defined today, and what is the impact of cultural differences in defining abnormality?

Early Explanations of Mental Illness

http://www.apa.org/

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1

2

3

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5Causes a person to be dangerous to self or others

Deviant from social norms

Statistically rare

Causes subjective discomfort

Does not allow day-to-day functioning

What Is Abnormal Behavior?



The Sociocultural Perspective

Sociocultural perspective: Abnormal/normal behavior is product of behavioral shaping within context of: • Family influences• Social group to which

one belongs• Culture within

which family and social group exist

Cultural relativity: Need to consider norms and customs of another culture when diagnosing person from that culture with a disorder• Culture-bound

syndromes

Models of Abnormality

** Psychological disorders - any pattern of behavior that causes people significant distress, causes them to harm others, or harms their ability to function in daily life.



Models of Abnormality

Behavior is caused by biological changes

in the chemical, structural, or geneticsystems of the body.

Abnormal behavior comes from irrational beliefs and illogical patterns of thought.

Abnormal behavior is learned.

Abnormal behavior stems from repressed conflicts

and urges that are fighting to become conscious.

Abnormal behavior is the result of the

combined and interactingforces of biological,

psychological, social,and cultural influences.

Cognitive perspective

Psychodynamic model

Biopsychosocial model

Biological model

Behaviorism

EXPLANATION OF DISORDER



DSM-IV-TR (DSM 5 released 5/2012)

DSM-IV-TR: • Manual of psychological

disorders and their symptoms

• Divides disorders and relevant facts about person being diagnosed along five different axes



Five Axes of the DSM-IV-TR

Clinical disorders

Personality disorders; mental retardation

General medical conditions

Psychosocial, environmental

problems

Global assessment of

functioning

III

IIIIVV



How Common Are Psychological Disorders?

26.2 percent of American adults over age 18 have a mental disorder in any given year.• 57.7 million people in U.S.



Disorders in the United States



The Pros and Cons of Labels

Labels:• Help establish distinct diagnostic

categories• Help patients receive effective treatment• Can be dangerous or overly prejudicial

Rosenhan study at psychiatric hospitals:• Psychological labels long lasting and

powerful• Affect how other people see mental

patients and how patients see themselves

Anxiety Disorders: What, Me Worry?



Phobic Disorders

** Phobia: Irrational, persistent fear of an object, situation, or social activity• Social phobia: Fear of negative

evaluation in social situations• Specific phobias: Fear of

objects, situations, or events• Agoraphobia: Fear of

place/situation from which escape is difficult or impossible



Common Phobias



Panic Disorder

Panic disorder: Frequent, disruptive panic attacksPanic attack: Sudden, intense panic; multiple physical and emotional symptoms

Panic disorder with agoraphobia: Fear of panic attack in unfamiliar, public place

** The average duration of a panic attack is approximately 10-15 minutes



Obsessive-Compulsive Disorder

** Obsessive-compulsive disorder:• Obsessive, recurring thoughts

create anxiety.• Compulsive, ritualistic,

repetitive behavior or mental acts reduce that anxiety.



Acute and Posttraumatic Stress Disorders

• Acute stress disorder (ASD): From exposure to a major stressor, with numerous symptoms including moments when the event is “relived” in dreams and flashbacks for as long as 1 month after occurrence

• Posttraumatic stress disorder: Symptoms of ASD last more than 1 month



Generalized Anxiety Disorder

Generalized anxiety disorder: Feelings of dread/doom and physical stress lasting at least six months



Behavioral: Disordered behavior learned through operant and classical conditioning techniques

Psychodynamic: Repressed urges and desires trying to come into consciousness, create anxiety that is controlled by the abnormal behavior

Biological: Chemical imbalances in the nervous system, genetic transmission

Cognitive: Excessive anxiety from illogical, irrational thought processes

Causes of Anxiety Disorders

Mood Disorders: The Effect of Affect



Mood Disorders

• Affect: An emotional reaction• Mood disorders: Severe

disturbances in emotion • Person with mood disorder

experiences emotions that are extreme and, therefore, abnormal

14.5 What are the different types of mood disorders and their causes?



Major Depression

Major Depression: Severe depression, sudden, no apparent external cause• Most common of mood

disorders• Twice as common in women

as in men



Prevalence of Major Depressive Disorder



Bipolar Disorder

Bipolar disorder:Severe mood swings

between major depressive episodes and manic episodes



Cognitive: See depression as the result of distorted, illogical thinking

Behavioral: Link depression to learned helplessness

Biological: Variation in neurotransmitter levels or specific brain activity; genes and heritability play a part

Causes of Mood Disorders

Eating Disorders



Condition in which a person develops a cycle of “binging” and uses unhealthy methods to avoid weight gain

Condition in which eating is reduced to the point that a weight loss of 15 percent below expected body weight or more is the result

Anorexia Nervosa Bulimia Nervosa

Eating Disorders14.6 What are the two primary types of eating disorders, how do they differ, and who are they most likely to affect?



Possible Signs of Eating Disorders

Dissociative Disorders: Altered Identities



Dissociative Disorders

Dissociative disorders: Break in conscious awareness, memory, and/or sense of identity• Dissociative amnesia: Memory loss for

personal information, either partial or complete

• Dissociative fugue: Travel from familiar surroundings with amnesia for trip and possibly personal identity

• Dissociative identity disorder: Person seems to have two or more distinct personalities

14.7 How do the various dissociative disorders differ, and how do they develop?



Cognitive and behavioral: Trauma-related thought avoidanceis negatively reinforced by reduction in anxiety and emotional pain

Psychodynamic: Point to repression of memories, seeing dissociation as a defense mechanism against anxiety

Biological: Lower than normal activity levels in areas responsible for body awareness; depersonalization disorder

Causes of Dissociative Disorders

Schizophrenia: Altered Reality



Schizophrenic Disorders

Schizophrenia: Severely disordered thinking, bizarre behavior, inability to separate fantasy from reality



Symptoms of Schizophrenia

• Excesses of, or additions to, normal behavior

• Delusions: Unshakeable, false beliefs– Delusional disorder:

Primary symptom is delusion

• Hallucinations: Seeing or hearing things that don’t exist

• Less than, or an absence of, normal behavior

• Poor attention• Flat affect: A lack of

emotional responsiveness• Poor speech production

14.8 What are the main symptoms, types, and causes of schizophrenia?

POSITIVE NEGATIVE



Categories of Schizophrenia

• Periods of statue-like immobility mixed with bursts of wild, agitated movement and talking

• Delusions of persecution, grandeur, and jealousy, together with hallucinations

• Hallucinations• Confused

speech• Inappropriate

emotion• Social

impairments

Disorganized Catatonic Paranoid



Causes of Schizophrenia

• Positive symptoms appear to be associated with overactivity of dopamine areas of brain; negative with lower dopamine activity

• Genetics, brain structural defects have been implicated• Genetics supported by twin and adoption studies• Biological roots supported by universal lifetime

prevalence across cultures of approximately 7–8 people out of 1,000

• Stress-vulnerability model: Suggests people with genetic markers for schizophrenia will not develop the disorder unless they are exposed to environmental or emotional stress at critical times in development



Genetics and Schizophrenia

Source: Gottesman (1001)

Personality Disorders: I’m OK, It’s Everyone Else Who’s Weird



Personality Disorders14.9 How do the various personality disorders differ, and what is thought to be the cause of personality disorders?

Personality disorders: Persistent, rigid, maladaptive behavior interfering with normal social interaction



Personality Disorders

Antisocial personality disorder: No morals or conscience, impulsive, lacks regard for consequences




Borderline personality disorder: Moody, unstable, unclear sense of identity, clings to others






Genetic factors: Biological relatives of people with personality disorders more likely to develop similar disorders

Cognitive-behavioral: Specific behaviors learned over time, associated with maladaptive belief systems

Family relationships: Linked to disturbances in family communications and relationships

Stress tolerance: Look at the lower than normal stress hormones in antisocial personality disordered persons as responsible for their low responsiveness to threatening stimuli

Causes of Personality Disorders



• DSM constantly being revised to include the findings of current research

• Some changes involve terminology used to describe disorders and their symptoms

• Push for greater social relevance and attention to cultural differences

14.10 What are some of the future directions in psychopathology?

Future Directions in Psychopathology

Defining Psychopathology

Documents

pattern of behavior

abnormalnormal behavior

psychological term

term abnormality

living person

possessed person

term psychological disorder

legal term