Exam #3 review - chapterss 9-12 - Abnormal Psychology

Chapter 9

Eating Disorders As Psychopathology

  • Serious disturbances in eating behavior

  • distorted body image and weight concerns

  • medical and psychological consequences

  • High comorbidity with mood and anxiety disorders

Anorexia Nervosa

  • Restriction of energy intake leading to low body weight

  • Intense fear of gaining weight

  • disturbance in body image perception

  • Subtypes: restricting type and bing-purge type

Medical Consequences of Anorexia Nervosa

  • cardiovascular complications

  • hormonal disruption and amenorrhea

  • bone density loss and osteoporosis

  • electrolyte imbalances and organ damage

Bulimia Nervosa

  • recurrent episodes of binge eating

  • compensatory behaviors (vomiting, laxatives, fasting, exercise)

  • self-evaluation strongly influenced by body shape

  • weight is often within normal range

Binge-Eating Disorder

  • recurrent bing eating without compensatory behaviors

  • sense of lack of control during episodes

  • eating rapidly or when not hungry

  • often associated with distress and obesity risk

Prevalence and Demographics

  • higher prevalence among females

  • typical onset during adolescence or young adulthood

  • increasing recognition across genders and cultures

  • sociocultural influences and body ideals

Biological Factors

  • genetic vulnerability

  • neurotransmitter involvement (serotonin, dopamine)

  • hormonal influences related to appetite regulation

  • bracing systems involved in reward and impulse control

Psychological Factors

  • Perfectionism and need for control

  • low self-esteem and body dissatisfaction

  • emotion regulation difficulties

  • dieting and cognitive distorting about weight

Sociocultural Influences

  • cultural emphasis on thinness

  • media and social comparison

  • peer and family pressures

  • internalization of unrealistic body standards

Treatment Approaches

  • cognitive behavioral theatre (CBT)

  • family-based treatments for adolescents

  • medical monitoring and nutritional rehabilitation

  • medication in some cases

Prognosis and Recovery

  • Early interventions improves outcomes

  • relapse risk remains significant

  • recovery often involves psychological and medical support

  • importance of long-term monitoring

Chapter 10

  • Enduring patterns of cognition, emotion, and behavior that deviate from cultural expectations

  • Pervasive, inflexible, and stable over time

  • Cause significant distress or impairment in functioning

Diagnostic Criteria

  • Impariement in identity and interpersonal functions

  • Persistence across time and contexts

  • Not better explained by other disorders or substances

Interpersonal Impact of Personality Disorders

  • Individuals often create significant difficulties in relationships

  • Behavior may be perceived as

    • Confusing

    • Unpredictable

    • Exasperating

    • Socially unacceptable

  • Maladaptive traits (suspiciousness, hostility, fear of rejection)

    • Shapes responses to new situations

  • Patterns are repetitive and resistant to change

  • Limited insight

    • Failure to learn from past relationship problems

Example: Dependent personality Pattern

  • Excessive need for reassurance and support

  • Overwhelming demand in relationships (inability to be alone)

  • Relationship strain — Partner withdrawal or termination

  • Pattern repeats

    • Quickly enters a new dependent relationship

    • Little evaluation of partner suitability

Would Individuals with Dependent Personality patterns be able to function independently?

  • Individuals are capable of functioning independently, but

    • Experience intense anxiety or distress when doing so

    • Strongly prefer guidance, reassurance, or support from others

    • Difficulty is not ability, but confidence and fear of abandonment

  • Tend to:

    • Avoid making decisions alone

    • Seek excessive advice or reassurance

    • Rely on others to take responsibility

Classification Framework

  • DSM-5-TR Classification System

  • Personality disorders are grouped into three clusters based on descriptive similarities

  • Clusters reflect broad behavioral and emotional patterns, not causes

Cluster A

  • Odd/Eccentric

    • Paranoid: mistrust and suspicion

    • Schizoid: emotional detachment

    • Schizotypal: Social discomfort and odd beliefs

Cluster B

  • Dramatic/Erratic

    • Antisocial: disregard for others

    • Borderline: unstable self and relationships

    • Histrionic: attention-seeking

    • Narcissistic: grandiosity & lack of empathy

Cluster C

  • Anxious/Fearful

    • Avoidant: social inhibition

    • Dependent: Excessive need for care

    • Obsessive-Compulsive: rigidity & perfectionism

Limitations of Cluster Approach

  • Clusters are descriptive, not etiological

    • They group similar behaviors, but do not exmplain the underlying causes

  • Significant symptom overlap across clusters

    • Individuals may meet criteria for multiple personality disorders

  • High rates of comorbity

    • personality disorders frequently co-occur with other disorders

  • Increasing shift toward a dimensional model

    • Focus on personality traits along a continuum rather than strict categories

Case Example: Borderline PD

  • Fear of abandonment

  • Instability in relationships

  • Impulsivity (e.g., binge eating)

  • Example: College student whose friendships shift abruptly, fears rejection, and engages in self-harm when stressed.

Case example: Narcissistic PD

  • Grandiosity

  • Need for admiration

  • Lack of empathy

  • Example: Executive seeking constant praise, dismisses co-workers; input, and becomes hostile when criticized

Etiology and Risk Factors

  • Genetic predispositions

  • Childhood trauma and attachment disruptions

  • Interaction of temperament and environment

Comorbidity

  • Mood disorders

  • Substance-related isorders

  • Anxiety Disorders

Assessment and Limitations

  • Structured Clinical Interview for DSM Disorders (SCID-5-PD)

  • personality inventories (MMPI-2, MCMI-IV)

  • Importance of clinical interview and collateral history

Difficulties in Diagnosing Personality Disorders

  • High risk of misdiagnosis

    • Occurs more frequently than in many other disorder categories

  • Imprecise diagnostic criteria

    • Less clearly defined and herder to apply in practice

    • Example: “excessive need for reassurance” is subjective

  • Reliance on clinical judgement

    • Based on inferred traits and long-term patterns

    • Less objective than symptoms like panic attacks or depressed mood

  • Assessment limitations

    • Semi-structured interviews and self-report tools improve relatability

    • However, low agreement across methods remains a concern

    • Are we diagnosing a disorder or diagnosing overlapping traits

Diagnosis

  • A client shows:

    • Fear of abandonment (Borderline PD)

    • Need for reassuarance (Dependent PD)

  • Clinician A diagnosis Borderline PD

  • Clinician B diagnosis Dependent PD

  • Low reliability (disagreement)

    • raises concerns about validity (are these distinct disorders?)

Treatment Approaches

  • Psychotherapy (Dialectical Behavior therapy for BPD)

  • Cognitive Behavioral Therapy adaptations

  • Pharmacotherapy for co-occurring symptoms

Cultural and Stigma Considerations

  • cultural context shapes the expression and perception of traits

  • Stigma interferes with help-seeking

Summary

  • Personality disorders are pervasive, enduring, and impairing

  • Grouped in three clusters (A,B,C)

  • Diagnosis requires careful assessment

  • treatments vary by disorder and individual needs

Chapter 11

What Are Substance-Related Disorders?

  • Maladaptive patterns of substance use

  • Clinically significant impairment

  • Includes use disorders and induced disorders

Common Substances

  • Alcohol

  • Opioids

  • Stimulants

  • Cannabis

  • Sedatives

DSM-5-TR Criteria Overview

  • Loss of Control

  • Social impairment

  • Risky use

  • Tolerance

  • Withdrawal

Tolerance

  • Need more substance for the same effect

  • Reduced effect with the same amount

Withdrawal

  • Symptoms after stopping use

  • Varies by substance

  • Can be physical and psychological

The brain and Addiction

  • Dopamine reward system

  • Reinforcement of behavior

  • Long-term brain changes

Risk factors

  • Biological (genetics)

  • Psychological (coping, trauma)

  • Social (Peers, environment)

Behavioral patterns

  • Craving

  • Compulsive use

  • Continued use despite harm

Alcohol Use Disorder

  • Most common disorder

  • Socially accepted substance

  • High relapse rates

Opioid Use Disorder

  • High addiction potential

  • Severe withdrawal

  • High overdose risk

Stimulants and Cannabis

  • Stimulants increase alertness

  • crash effects

  • Cannabis dependence risk

Comorbidity

  • Depression

  • Anxiety

  • Personality Disorders

  • Self-medication

Treatment Approaches

  • Detoxification

  • Medication-assisted treatment

  • CBT

  • Motivational interviewing

Relapse

  • Common in recovery

  • Triggered by stress

  • Requires long-term management

Prevention

  • Education

  • Family Involvement

  • Reducing stigma

  • Policy efforts

Critical Thinking

Is addiction a disease?

Yes, addiction is a disease that requires treatment and management. Addiction is driven by a combination of genetic factors, environment, and developmental factors. There is loss of control of their intake, even when they want to stop. Continued misuse of substances changes brain chemistry and anatomy.

Why does relapse occur?

trauma, stress/stressors, environment and influence from peers.

Role of environment vs biology?

Your biology creates the physical vulnerability to addiction and your environment sets the tone for the path of addiction

environmental factors can trigger a genetic predisposition to addiction or act as protective factors

environmental - trauma, abuse, neglect, or growing up in a home with parental substance abuse, peer pressure and social environment, avavilibilty and exposure , chronic stress,

protective factors environmental

biological - genetic predisposition, Brain chemistry - addiction can physically rewire the brain’s circuitry, changing the function of neurotransmitters, Metabolism - genetic variations can affect how quickly the body metabolizes substances , which can increase the risk of addiction.

Chapter 12

Gender- Dysphoria: Definition

  • distress due to incongruence between the experienced and assigned gender

  • Requires clinically significant distress or impairment

  • Seperate from gender non-comformity

Gender Dysphoria: Diagnostic Features

  • Strong desire to be another gender

  • discomfort with primary/secondary sex

  • Desire to be treated as another gender

  • Symptoms persist for at least 6 months

Gender Dysphoria: development & Prevlanace

  • Can emerge in childhood, adolescence or adulthood

  • More commonly diagnoses in assigned, males at brith

  • Not all children persist into adulthood

Gender Dysphoria: Treatment

  • Affirmative psychological support

  • Hormone therapy

  • gender-affirming care/surgery

  • ethical considerations in treatment

Sexual Dysfunction

  • disturbances in sexual response or pleasure

  • Must be persistent and cause distress

  • Influenced by psychological and biological factors

Types of Sexual dysfunctions

  • Erectile disorder

  • Female orgasmic disorder

  • Premature ejaculation

  • Genito-pelvis pain/Penetration Disorder

Causes of Sexual Dysfunctions

  • Biological: Hormones, illness

  • Psychological: anxiety, depression

  • relational factors

  • Cultural influences

Treatment of Sexual Dysfunctions

  • Cognitive-Behavioral Therapy (CBT)

  • Sensate focus exercises

  • Medical interventions

  • Couples therapy

Paraphilic Disorder

  • Recurrent, intense sexually arousing fantasies or behaviors

  • Involve non-consenting individuals or harm

  • Must cause distress or impairment

Types of Paraphilic Disorders

  • Exhibitionistic Disorder

  • Voyeuristic Disorder

  • Frotteuristic Disorder

  • Pedophilic Disorder

Etiology of Paraphilic Disorders

  • Learning theories

  • Conditioning processes

  • Neurobiological factors

  • developmental influences

Treatment of Paraphilic Disorders

  • Cognitive-behavioral interventions

  • relapse prevention

  • Pharmacological treatments

  • Legal and ethical considerations

Sexual Abuse Overview

  • Sexual abuse involves sexual contact with physical or psychological coercion. Victims cannot reasonably consent ( ex. children)

  • There primary types of

    • Pedophilia

    • Incest

    • Rape

    • Only pedophilia is classified in the DSM-5-TR

Childhood Sexual Abuse - Prevalence

  • Global prevalence: 1.6% report childhood sexual abuse. US prevalence: 4-6%. Prevalence varies depending on the definition of childhood (Up to ages 12-19)

  • types of sexual contact counted

  • Inclusions of non-contact sexual acts (e.g., exhibitionism)

Consequences of Childhood Sexual Abuse

  • Increased risk for mental disorders: fear/anxiety disorders

  • Substance use disorders

  • Elevated risk of suicidal thoughts and behaviors.

  • Possible sexual dysfunctions: sexual aversion

  • Promiscuity

  • Research limitations: causal links are difficult to establish.

Controversies and Challenges

  • Hight-profile cases raised questions about the validity of children’s testimony

  • recovered memories

  • Claims of repressed abuse members in adulthood

  • Controversial and difficult to validate

  • Example: McMartin Preschool case

  • Children reported bizarre abuse stories

  • Court acquittals due to leading/coercive interviews

  • Highlighted limitations in interviewing children.

Key Takeways

  • Sexual abue includes pedophilia, incest, and rape, with only pedophilia in DSM-5-TR

  • Childhood sexual abuse is prevalent and linked to long-term mental health risks

  • Legal and ethical controversies complicate investigation and treatment. Accurate assessment requires careful clinical and forensic evaluation.

Summary

  • Gender dysphoria involves identity-related distress

  • Sexual dysfunctions affect sexual functioning

  • paraphilic disorders involve atypical arousal patterns

  • All require careful, ethical clinical treatment.