Ch141. Psychopathology* Psychopathology: A disorder of the mind i. Mental illnessA. The medical modela. Psychological abnormalities are diseasesi. Differs from prior conceptualizations (supernatural, criminality)b. Distinguishes “normal from “Abnormal”i. Diagnose - what do the symptoms suggest?c. The goal is to cure illnessi. Today we focus on diagnosis, Thursday on treatmentsB. What is “abnormal”?a. The DSM-IV-TR (2000)i. Two main goals:1. Categorizes mental disorders2. Describe features of each disorder to aid clinicians in distinguishing disorders from one anotherii. First edition published in 1952iii. Now more than 300 disorders b. Three key elements of “mental disroders”i. Symptoms involve distrubances in behavior, thoughts, or emotionsii. Symptoms stem from internal dysfunctioniii. Symptoms cause personal distress or impairmentc. Identifying disorders should not be a “popularity contest”i. Just because the behavior is uncommon or socially undesirable does not make it a disorder1. Drapetomania (1851) – a “psychological disorder” that caused slaves to want to escape2. Homosexuality was dropped from the DSM in 1974.C. Labelinga. Labels can cause people to be treated badlyi. The Rosenhan (1973) study (p. 557) “on being sane in insane places”1. 7 normal people go to psychiatric hospitals2. Claim they’re hearing voices (e.g., “thud” and Hollow”); no other symptoms 3. All hospitals admitted the “patients,” who immediately stopped reporting any symptoms4. Staff interpreted normal behavior ( writing innotebook, waiting in line) as evidence of mental illness5. Took 9 to 62 days for patients to be releasedD. What causes mental disorders?a. Rarely is there a single cause (virus or bacteria)b. Diathesis-stress model: mental disorders result from a combination of predispostions and stressi. Diathesis: An underlying vulnerability1. Ex: genetics, childhood abuseii. Stress: a precipitating event1. Ex: unemployment, divorcec. This model is largely accurate for most mental disorders Anxiety Disorders- Anxiety: Tense negative emotional state- Some amount of anxiety is good, but excessive anxiety is destructive- Yerkes Dodson Law- Anxiety disorders: excessive anxiety in the absence of true dangerA. Phobiasa. Persistent, excessive fear and acoidance of specific objects activites or situationsi. Ex heights, spiders, snakes, fling, enclosedspaces, social situationsb. The person strives to avoid exposurec. Occurrence in Americans: 11%B. Generalized anxiety disorder (GAD)a. Chronic excessive worry, along wit 3+ of the following syptoms: restlessness, fatigue, concentration problems, irritability, muscle stension, sleep disturbanceb. Often preceded by major life changec. Frequency of occurrence: 5% of North Americans C. Panic Disordersa. Sudden, overwhelming attacks of terrorb. Psychological and physiological symptomsi. Feels like you’re dying (e.g., heart attackc. Attacks last several minutesd. Can lead to social withdrawal and even agoraphobia (extreme fear of public places)i. Because they might have a panic attack in publice. 22% of US have had at least 1 panic attack; 3.5% actually diagnosed with panic disorder D. Obsessive-compulsive disorder (OCD)a. Obsessions: Frequent, intrusive thoughtsb. Compulsions: Behaviors or rituals that one feels driven to performi. Washing, checking lockingc. OCD people sometimes fear what they might have done i. Obsessions produce anxiety which then produce compulsionsd. Occurrence in Americans: 2-3% of the population Mood disorders- Mood disorders: Mental disorders with mood disturbance as their predominant feature- Life time risk of depression (US) -> ~16%A. Major depressive disordera. Sever sadness and a lack of interest in normally pleasurable activitiesb. Feeling of worthlessnessc. Sleep and appetite distrubancesd. Episode lasts at least 2 weeksi. Average episode = 12 weekse. Twice as likely in women as menB. Dysthymiaa. Miler form of depressionb. But it lasts for at least 2 yearsc. Dysthymia is chornic, whereas major depression is acuteC. Bipolar disorder (manic depression)a. An unstable emotional condition characterized by cycles of mania nad depressionb. Maniai. Elevated mood, increased activity, etc.ii. Can conquer the worldc. Much rarer than depression (1.3% of US pop)d. Bipolar VideoSchizophrenia: a disorder characterized by severely abnormal thoughts, perceptions,or consciousness- a devastating disorder- large genetic influence- schizophrenia does not equal multiple personalities!!!!!A. positive symptoms: adding things that aren’t therea. Delusions: false beliefs about reality (e.g., persecution)b. Hallucinations: false sensory perceptions (e.g., voices in your head)c. Disorganized behavior: behavior that does not fit the circumstances (e.g., masturbating in public). B. Negative symptoms: Deficits in functioninga. Ex. Apathy, flat affect, no interest in socializingDissociative Disorders- Dissociative disorders: normal cognitive processes are disjointed & fragmented, creating disruptions in memory, awareness, or personalityo Disruptions can last from minutes to yearso Several types: Dissociative amnesia Dissociative fugue Dissociative identity disorder (DID)- 2+ distinct identities that take over the individual’s behavior- “Multiple personality disorder” (no longer called that)- triggered by childhood abuse? (debatable)- Really RarePersonality Disorders- DSM def: An enduring pattern of inner experience and behavior that deviates markedly form the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment- 14.8 % of the US diagnosed with PD- Controversial, diffictult to diagnose- 3 clusterso Odd/eccentric (3 disorders) Schizotypal eccentric thoughts, speech, dress, behavior Paranoid extremely suspicious and distructful of others Schizoid withdraws from relationships, “loner”o Dramatic/Erratic (4 disorders) Borderline  unstable moods & relationshiops, unpredictable Histrionic seeks attention, overly dramatic, acts as if performing for others Narcissistic exaggerates own importance, manipulative & exploitative, good first impressions/bad relationships Antisocial little empathy or remores, disregards rights of others o Anxious/inhibited (3 disorders) Avoidant extremely socially anxious, afraid of