PSYC 201 Chapter 15, Spring 2018

Page of 1 10 Psychological Disorders 1- Abnormal Behavior Abnormal behavior is a behavior that is deviant, maladaptive or personally distressful over a long period of time: • Deviant behavior means not within social standard or the context it is placed in ( example washing your hands 10 times, acceptable in a lab environment). • Maladaptive behavior is a behavior that presents danger to the person or to his surroundings. • Personally distress means that the person engaging finds it troubling. Can lead to guilt and shame. -> Only one of these criteria is required to be considered abnormal, could be a mix. Theoretical Approaches to Psychological Disorders: • Biological Approach => organic, biological causes to these disorders. Has a biological origin = Medical Model. • Psychological Approach => Experience, thoughts, emotions, personality, observational learning, beliefs etc. are the cause for these disorders. • Sociocultural Approach => omnipresent in qualifying the behavior as deviant. Culture matters in complex ways ( right for woman = ab behavior ). Role of culture + social factors like poverty, family, gender etc. • BioPsychoSocial Model => Combine the 3 approaches and states that they work all at once together. Vulnerability-stress hypothesis or diathesis-stress model = pre- existing conditions (gene, experience…) may out the person at risk. And combined with stressful experience, it leads to psychological disorders. Classifying these disorders -> DSM-5 or ICD-10 Many critics to DSM-5 like too much biological perspective, too much social norms and subjectivity etc. Autism Spectrum Disorder: • Impaired social interactions and communication, repetitive behavior, restricted interests etc. • There is no single cause but mainly biological ( neurological and genetic…) + social ( reacting parents…) Somatic Symptom Disorder: • Also called Somatoform disorder • Person experiences bodily (somatic) symptoms and then excessive thoughts and feelings about them. • ADHD = person exhibits one or more of the following: inattention, hyperactivity and impulsivity. Jeffry Takla Page of 2 10 2- Anxiety and Anxiety-Related Disorders Anxiety disorders involves fear that are uncontrollable, disrupting the ordinary life. Feature motor tension, hyperactivity, anxious/worried expectations and thoughts. - DSM-5 recognize 12 types of anxiety disorders, the 4 most common ones: Generalized Anxiety Disorder: • Persistent for at least 6 months. • Individual is unable to specify the reasons for anxiety. • Biological factors like genetic predisposition, neurotransmitter (GABA), Sympathetic Nervous system affected etc. • Sociocultural factors like harsh self-standard, overly strict/cold parents, history of uncontrollable traumas or stressors. Panic Disorder: • Individual experience recurrent, sudden onset of terrors, often without warning and with no specific cause. • Biological factors like genetic predisposition, neurotransmitter (GABA, Norepinephrine, Serotonin), high level of brain chemical Lactate. Learning associations where they overgeneralize fear. • Sociocultural factors where women are more susceptible for this disorder due to weaker hormone level regulation in anxiety-provoking situations. Specific Phobia: • Individual has an irrational, overwhelming, persistent fear of a particular object or situation. • Factors can be classical conditioning, observational learning or others. • women more likely than men. • One risk factor is that if one of the parent has a psychological disorder, not necessarily a specific phobia, the child is likely to have this disorder. Social Anxiety Disorder (SAD): • Also called Social Phobia • Individual has an intense fear of being humiliated or embarrassed in social situations, prevent them from showing who they really are. • Genetic predisposition, Neural circuity (through amygdala, thalamus, prefrontal cortex), neurotransmitter (oxytocin). • Overprotective/Rejective parents. Jeffry Takla Page of 3 10 - DSM-5 recognize also 2 other types related to anxiety but not classified as one of them: Obsessive-Compulsive Disorder (OCD): • Individual has anxiety-provoking thoughts that will not go away and/or urges him to perform repetitive, ritualistic behaviors to prevent future situations (do everything twice to avoid bad luck). • Genetic predisposition, neurotransmitter (Serotonin and dopamine), high level of glutamate, forms of learning (learned that doing this will lead to a specific outcome) =avoidance learning (avoid a negative punishment). OCD Related Disorders: • Hoarding disorder = compulsive collecting, poor organization skills and poor cognitive skills (example: don’t want to throw old things because of uncertainty of later use). • Excoriation disorder = skin picking, more common in women, symptom of autism too. • Trichotillomania = hair pulling, not necessity on the head (eyebrows or other body parts). • Body Dysmorphic Disorder = Preoccupation with physical appearance, comparing self to other; lead to maladaptive behavior (excessive exercises etc.) Post Traumatic Stress Disorder (PTSD): • Happens after a traumatic event where this disorder overwhelms the individual and his ability to cope. • Happens also if the person hears about it • Symptoms: flashbacks + black outs, difficulty with memory/concentrating, impulsive behavior, lack of sleep etc. • Genetic predisposition, cultural background plays a role too because not everyone who experience the traumatic episode reacts the same. Jeffry Takla Page of 4 10 3- Disorders Involving Emotion and Mood Depressive Disorders: • The individual suffers from depression, not pleasure in life. • Major Depressive Disorder (MDD) involves a significant depressive episode for at least 2 weeks. Symptoms: trouble sleeping, fatigue, feeling worthless, no history of euphoric mood, no interest etc. • Persistent depressive disorder is for more than 2 months; poor concentration, sleep and lack of energy. • Biological factors: genetic predisposition, brain structure and function ( part relative to identify reward), neurotransmitter (Serotonin). Only generate vulnerability, stressful environment is a must. • Psychological factors: learning & cognitive theories, learned helplessness + Thinking about a negative experience over and over again + Pessimistic attributional style (internal cause problem ) ≠ optimistic attributional style. • Sociocultural factors: SES (low socioeconomic status) more likely to develop depression, alcoholism, woman>men. Bipolar Disorder: • Extreme mood swings from mania (over euphoric, energetic etc) periods to depressive ones, in cycles. • Two types: Bipolar I where the euphoric episodes are so strong that hallucinations might happen. Whereas Bipolar II is a milder version. • Biological factor: Genetics plays great role here (high chance of twins having this disorder), brain activity ( metabolic activity decrease in depression phase, increase in the other), neurotransmitter (norepinephrine, serotonin). • Sociocultural factors: childhood experiences (physical, sexual or verbal abuse) • Could be confused with Disruptive Mood Dysregulation Disorder. Jeffry Takla Page of 5 10 4- Dissociative Disorders Psychological disorder that involves a sudden loss of memory or change in identity due tot he dissociation of the individual’s conscious awareness from previous memories and thoughts. Related to amygdala and hippocampus. Dissociative Amnesia: • A type of amnesia characterized by extreme loss that’s caused by psychological stress. • Mainly identity and autobiographical experiences are forgotten. Dissociative Identity Disorder (DID): • Also called Multiple Personality Disorder • The individual has 2 or more distinct personality, each one with its own memories, behaviors and relationships. • Might be caused by a sort of coping with intense trauma. • Media plays a role • Kind of social construction where they compartmentalize different aspect of self (including conflicts) to independent identities. Jeffry Takla Page of 6 10 5- Schizophrenia Psychosis is a psychological state where a person’s perceptions and thoughts are not part of the reality. Schizophrenia: • Characterized by highly disordered thought processes. • Refer to the individual as Psychotic. Symptoms: -Positive Symptoms = something added above normal behavior: • Hallucinations = sensory experiences without a real stimuli (visual and auditory). • Delusions = False, unusual, or magical beliefs not part of the individual’s culture. (ex: CIA, I am Jesus etc.) • Thoughts disorder = thoughts of the individual are unusual, bizarre and meaningless ( new words in speech etc.) • Referential thinking = attributing meaning to random event ( dead bird = sign of god) • Movement disorder = unusual behavior and body movements. + Catatonia = state of immobility, freezing for a period of time. -Negative Symptoms = deficit and decrease of normal function • Flat effect = display little or no emotion • Lacking the ability to read the emotions of others + no goal-directed behavior. -Cognitive Symptoms = deficit in executive functioning • Difficulty in attention, memory, and interpreting information. Biological factors: • Genes • Abnormality in brain structure (enlarged ventricles that deteriorate parts of the brain), problems in prenatal development may cause it. • Neurotransmitter Regulation (dopamine, blocking dopamine to reduce the symptoms) + abnormality in glutamate receptors (high level might treat it) Psychological factors: • Stress may contribute to the development Sociocultural factors: • Not a cause but affect the development • History of Schizophrenia in the family + lower social functioning might be a sign of potential Schizophrenia. -> Treat early (after first psychotic episode) is an important goal. Jeffry Takla Page of 7 10 6-Personality Disorders Personality disorders are chronic, maladaptive cognitive-behavioral patterns integrated in the personality. Antisocial Personality Disorder (ASPD): • Characterized by guiltlessness, irresponsibility, law breaking etc. • 7 symptoms in DSM-5 ( 3 of them are enough to attribute this disorder): 1.Failure to conform to social norms 2.Deceitfulness 3.Impulsivity 4.Aggressiveness 5.Disregard for safety of self or others 6.Irresponsibility 7.Lack of remorse • Genetic play a great role when paired with childhood experience (its the gene that differentiates them) , prefrontal cortex affected • Low level of autonomic nervous system (keeping their cool during deception or stressful situations including punishments) • Psychopaths are a subgroup who engage in violence, have a lower level of gray matter than the others. -> Hard to treat because they’re deceitful, and its like an act of weakness. Borderline Personality Disorder (BPD): • Characterized by 4 symptoms: 1.Unstable affect, 2.Unstable sense of self and identity including self defensive impulsive behavior, 3.Negative interpersonal relationships (shifts between idealization and devaluation) 4.Self-harm (suicide, mutilation etc.) • Engage in maladaptive behavior (alcohol, drugs etc) • Genetics combined with childhood experiences (abuse etc.) • Cognitive factors like being powerless, and others are dangerous so they develop a Hyper-vigilance = tendency to be over alert. + Splitting where they differentiate between hated enemies and friends that can not do wrong. -> Reducing stress might treat this disorder. Jeffry Takla Page of 8 10 Jeffry Takla Page of 9 10 7-Suicide Attempting or committing suicide is considered an abnormal behavior. Biological factors: • Genetic predispositions (suicide runs in the family) • Low level of Serotonin and serotonin-linked genes. • Poor physical health (specially if chronic). Psychological factors: • 90% have mental disorders (anxiety and depression the most) • Stressful circumstance • Interpersonal Theory of Suicide -Thomas Joiner = A desire to die (person’s social needs are not met) + Acquired capability for suicide ( overcome the fear of death, sin etc.) Sociocultural factors: • Cultural and religious norms play a huge role (↓) • Culture of honor (↑) • Gender: Male 4 time more likely Jeffry Takla Page of 10 10 8- Psychological Disorders and Health and Wellness Labeling a psychological disorder (Stigma) like it only happens to others has many consequences: Prejudice and Discrimination: -> Negative stereotypes like prone to violence or incompetent in all fields. This leads to discrimination; as long as the individual can perform all the tasks required, he or she should be paid/treated the same. Physical health: -> People with psychological disorders armor likely to be physically ill, obese, smoke, drink etc. Despite that, they can still lead healthy lifestyles and make positive changes!! Overcoming Stigma: -> Individual suffering from psychological disorders should be more visible to society and not be ashamed. We should not have a restricted, close minded idea about them. Acknowledge that they have great potential and are not that different from us, a more positive environment. Jeffry Takla