Chapter 14

Medical model

It is useful to think of abnormal behavior as a disease

Diagnosis

Involves distinguishing one illness from another

Etiology

Apparent causation and developmental history of an illness

Prognosis

Forecast about probable course of an illness

Variety of criteria for diagnoses

Deviance, Maladaptive behavior, personal distress

Deviance of criteria

Behavior deviates from what society considers acceptable.

Transvestic fetishism

Sexual disorder in which a man achieves sexual arousal by dressing in women's clothing

Maladaptive Behavior of criteria

Adaptive behavior is impaired

Key criterion of diagnosis of maladaptive behavior

Substance use

Personal Distress of criteria

Individuals report of great distress

Value judgements in diagnosis of psychological disorders

What represents normal or abnormal behavior

Major issue in the development of the DSM-5

Reduce the system commitment to a categorical approach

Critics notes on DMS-5

Enormous overlap among various disorders' symptoms, making boundaries between diagnosis much fuzzier. People qualify for more than one diagnosis

Fundamental axiom of DSM-5

Assumption people can reliably be placed in discontinous (nonoverlapping) diagnostic categories

Dimensional approach

Describe disorders in terms of how people score on a limited number of continuous dimensions such as the degree to which they exhibit anxiety, depression, etc.

Difficulties of the dimensional approach

Experts would've had to agree about which dimension to assess and how to measure them

Area of concern related to DSM

Nearly exponential growth

Increase in specific diagnosis in DSM from first edition to current

128 to 541

Generalized anxiety disorder

Marked by a chronic, high level of anxiety that is not tied to any specific threat.

Physical symptoms that can be attached to generalized anxiety disorder.

Trembling, muscle tension, diarrhea, dizziness, faintness, sweating, and heart palpitations.

Generalized anxiety disorder lifetime prevalence

5% is seen about twice as much in female as males.

Specific phobia

Involves a persistent and irrational fear of an object or situation that presents no realistic danger.

Panic disorder

Recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly.

2/3 of people diagnoses with panic disorder are

female

onset of panic disorder

late adolescence or early adulthood

Agoraphobia

Fear of going out to public places

Obsessions

Thoughts that repeatedly intrude on one's consciousness in a distressing way

Compulsions

Actions one feels forced to carry out

Obsessive-compulsive disorder (ocd)

Marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)

Obsessive-compulsive disorders part of the population

2%-3%

Posttraumatic stress disorder(PTSD)

involves enduring psychological disturbance attributed to the experience of a major traumatic event.

Concordance Rate

Percentage of twin pairs or other pairs of relatives who exhibit the same disorder.

Concordance rate hypothesis

Relatives who share more genetic similarity show high concordance rates than relatives who share less genetic overlap

Neurotransmitters

Chemicals that carry signals from one neuron to another.

Biological factor in some type of anxiety orders

Disturbances in the neural circuits using GABA

Biological factor in obsessive-compulsive disorders

Abnormalities in neural circuits using serotonin

Came up with theory of preparedness

Martin Seligman

Concept of preparedness

Explains why people develop phobias of ancient sources of threat (snakes and spiders) more than modern sources of threat (electrical outlets or hot irons)

Came up with evolved module for fear learning

Arne Ohman and Susan Mineka

Evolved module for fear learning

Evolved module is automatically activated by stimuli related to past survival threats in evolutionary history and it is relatively resistant to intentional efforts to suppress resulting fears.

Cognitive theorist reasons for people especially vulnerable to anxiety problems

misinterpret harmless situations as threatening, focus excessive attention on perceived threats, selectively recall information that seems threatening.

OCD is linked to deficits in

Executive Function

Executive Function

Basic cognitive process that underlie self-regulation, planning, and decision making.

Dissociative disorders

Class of disorders in which people lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity.

Dissociative amnesia

Sudden loss of memory for important personal information that is too extensive to be due to normal forgetting

In dissociative amnesia what can people remember

Matters unrelated to their identity; how to drive a car

Dissociative identity disorder (DID)

Involves a disruption of identity marked by the experience of two or more largely complete, and usually very different, personalities.

Old name from Dissociative identity disorder

Multiple personality disorder

Why was the multiple personality disorder change to Dissociative Identity Disorder

Name implied that different people inhabited the same body

DID patients somatic symptoms

Headaches, chronic pain, self-harm behaviors, hallucinations

Possession-related phenomena

People feel "possessed" by supernatural forces

When was a dramatic increase seen in DID diagnosis

1979s

Dissociative amnesia cause

Stress

Earlier versions of DSM lumped these in mood disorders

Major depressive disorder and bipolar disorder

Most common disorder in depressive disorders

Major depressive disorder

Major depressive disorder

People show persistent feelings of sadness and despair and a loss of interest in previous sources of pleasure

Central feature of major depression

anhedonia

anhedonia

diminished ability to experience pleasure

Average age of depression onset

30-35; substantial majority of cases emerge before 40.

Average number of depressive episodes

five to six

Average length of depressive episodes

6 months

Substantial portion of people who meet DSM criteria for major depression would be better characterized

Experience normal, although intense and unpleasant, reactions to severe stressful events

Emotional symptoms of a depressive episode

Dysphoric, gloomy mood, diminished ability to experience pleasure, sense of hopelessness

Emotional symptoms of manic episodes

Euphoric, enthusiastic mood, excessive pursuit of pleasurable activities, unwarranted optimist

Behavioral symptoms of depressive episodes

Fatigue, loss of energy, insomnia, slowed speech and movement, social withdrawal

Behavioral symptoms of manic episodes

Energetic, tireless, hyperactive, decreased need for sleep, rapid speech and agitation, increased sociability

Cognitive symptoms of depressive episodes

Impaired ability to think and make decisions, slowed thought processes, excessive worry, rumination, guilt, self-blame, unrealistic negative evaluations of one's worth

Cognitive symptoms of manic episode

Grandiose planning, indiscriminate decision making racing thoughts, easily distracted, impulsive behavior, inflated self-esteem, confidence

Bipolar disorder

Marked by the experience of both depressed and manic periods

Manic episode mood

elevated to point of euphoria, self-esteem rise, optimism, energy, extravagant plans, hyperactive, days without sleep, talks rapidly and shifts topics. Judgement impairs.

DSM-5 distinguishes between

bipolar I disorder and bipolar II disorder

Bipolar I disorder

full manic episodes

bipolar II disorder

involves milder hypomanic episodes marked by shorter duration and less impairment.

What percent of the population does Bipolar I and II disorders affect

1%

Suicide stats

Women attempt suicide three times more often than men, men are more likely to kill themselves in an attempt, they complete four times as many sucides as men

Suicide rates for people with depression

50%-60%

Heritability of bipolar disorder

65%-80%

Heritability of depression

40%

Heredity can create what to mood dysfunction

predisposition or vulnerability

Twin studies found what in concordance rates for mood disorders

Huge disparity between identical and fraternal twins

Two neurotransmitters with correlations of mood disorders

Norepinephrine and serotonin

Correlation of depression and what pert of the brain

reduced hippocampal volume

Depression patients have an abnormally high reactivity in what part of the brain

amygdala

depression leads to a reduced activation in specific areas of the brain that process

anticipation and experience of reward and reinforcement

learned helpless

passive "giving up" behavior produced by expose to unavoidable aversive events

People who exhibit pessimistic explanatory style are vulnerable to?

depression

hindsight bias

tendency to mold one's recall of the past to fit with how events turned out

schizophrenia meaning

split mind

Schizophrenia

marked by delusions, hallucination, disorganized thinking and speech, and deterioration of adaptive behavior

Schizophrenia emerges

during adolescence or early adulthood

Percent of the population diagnosed with schizophrenia over the course of their lives

1%

Delusions

false beliefs that are maintained even though they clearly are out of touch with reality

Delusions of persecution percentage of people with schizophrenia

80%

Delusions of persecution

Brief suspicions about strangers behavior to enduring concerns about elaborate plots attributed to family or friends

Delusions of grandeur

People believe they are famous or important

Schizophrenic thinking

chaotic rather than logical and linear. loosening of associations

Hallucinations

Sensory perceptions that occur in the absence of a real, external stimulus or are gross distortions of perceptual imput.

Schizophrenia emotional term

little emotional responsiveness

four subtypes of schizophrenic disorders

paranoid, catatonic, disorganized, undifferentiated schizophrenia.

paranoid schizophrenia

dominated by delusions of persecution, along with delusions of grandeur