Psychological Disordera “harmful dysfunction” in which behavior is judged to be:atypical- (not enough in itself)disturbing- (varies with time & culture)maladaptive- (harmful)unjustifiable- (sometimes there’s a

good reason)

Psychological DisordersBio-psycho-social

Perspective*assumes that biological,

sociocultural, and psychological factors combine and interact to produce psychological disorders

Biological(Evolution, individual

genes, brain structures

and chemistry)

Psychological(Stress, trauma,

learned helplessness, mood-related perceptions

and memories)

Sociocultural(Roles, expectations,

definition of normality and disorder)

Psychological Disorders- Etiology

DSM-IV-TR*American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)

*a widely used system for classifying psychological disorders

*presently distributed as DSM-IV-TR (text revision)

*today used as “convenient “convenient shorthand”shorthand” to avoid labeling.

Psychodiagnosis: The Classification of DisordersMultiaxial system5 axes or dimensions

Axis I – Clinical SyndromesAxis II – Personality Disorders or Mental Retardation

Axis III – General Medical Conditions

Axis IV – Psychosocial and Environmental Problems

Axis V – Global Assessment of Functioning

Clinical Syndromes: Anxiety DisordersGeneralized anxiety disorder

“free-floating anxiety”Phobic disorder

Specific focus of fearPanic disorder and agoraphobia

Physical symptoms of anxiety/leading to agoraphobia

Obsessive compulsive disorderObsessionsCompulsions

Etiology of Anxiety Disorders

Biological factorsGenetic predisposition, anxiety sensitivityGABA circuits in the brain

Conditioning and learningAcquired through classical conditioning or

observational learningMaintained through operant conditioning

Cognitive factorsJudgments of perceived threat

PersonalityNeuroticism

StressA precipitator

Clinical Syndromes: Somatoform DisordersSomatization DisorderConversion DisorderHypochondriasis

Etiology Reactive autonomic nervous system Personality factors Cognitive factors The sick role

Clinical Syndromes: Dissociative DisordersDissociative amnesiaDissociative fugueDissociative identity disorder

Etiology severe emotional trauma during childhood

Controversy Media creation? Sybil Repressed memories

Clinical Syndromes: Mood DisordersMajor depressive disorderBipolar disorder (manic-depressive

disorder)Etiology

Age of onset Genetic vulnerability Neuro-chemical factors Cognitive factors – negative thinking Interpersonal roots Precipitating stress

Clinical Syndromes: Schizophrenia

General symptomsDelusions and irrational

thoughtDeterioration of adaptive

behavior - avolitionHallucinations – any

modality but usually auditory

Disturbed emotions – 66%Prognostic factor

Gradual onsetSudden onset

Subtyping of Schizophrenia4 subtypes

Paranoid type – most common subtype - John Nash

Catatonic typeDisorganized typeUndifferentiated type

New model for classificationPositive vs. negative symptoms

Personality Disorders

Anxious-fearful clusterAvoidant, dependent, obsessive-compulsive

Dramatic-impulsive clusterHistrionic, narcissistic, borderline, antisocial

Odd-eccentric clusterSchizoid, schizotypal, paranoid

EtiologyGenetic predispositions, inadequate

socialization in dysfunctional families

Eating DisordersIssues of weightAnorexia nervosa

Criteria and subtypes: restrictive and binge/purgeBulimia nervosaBinge eatingHistory and prevalence

Age onsetEtiology

GeneticsPersonality – perfectionismCultural issues - “perfect” body type and digital

photographFamily roleCognitive factors

Types of Treatment

Types of therapiesInsight therapies

“talk therapy”Behavior therapies

Changing overt behaviorBiomedical therapies

Biological functioning interventions

Who Seeks Treatment?15% of U.S population in a given yearMost common presenting problems

Anxiety and DepressionTreatment seeking for various disorders

Mood disorders Women more than menMedical insuranceEducation levelPsychological Disorders and professional

treatment – Figure 15.3

Who Provides Treatment?

Clinical psychologistsCounseling psychologistsPsychiatristsClinical social workersPsychiatric nursesCounselorsOn-line treatment

Insight Therapies: Psychoanalysis

Sigmund Freud and followersGoal: discover unresolved unconscious

conflicts Free association Dream analysis Interpretation

Resistance and transference

Psychodynamic Therapies

Insight Therapies: Client Centered Therapy

Carl RogersCause: IncongruencyGoal: restructure self-concept to better

correspond to realityTherapeutic Climate

Genuineness Unconditional positive regard Empathy

Therapies Inspiredby Positive PsychologyMartin SeligmanUses theory and research to better

understand the positive, adaptive, creative, and fulfilling aspects of human existencewell-being therapypositive psychotherapy

can be an effective treatment for depression

Behavior TherapiesB.F. Skinner and colleagues

Goal: unlearning maladaptive behavior and learning adaptive ones

Systematic Desensitization – Joseph Wolpe Classical conditioning Anxiety/Fear hierarchy

Aversion therapy Alcoholism, sexual deviance, smoking, etc.

Social skills training Modeling Behavioral rehearsal

Biofeedback

XXX 15.8

Cognitive-Behavioral TherapyAaron Beck

Cognitive therapy Depression and negative thinking

Albert EllisRational-emotive therapy

Goal: to change the way clients thinkDetect and recognize negative thoughtsReality testing

Effectiveness of Behavior TherapiesEfficacy of behavioral interventions for

a variety of disorders

Biomedical TherapiesPsychopharmacotherapy

Antianxiety - Valium, Xanax, BusparAntipsychotic - Thorazine, Mellaril, Haldol

Tardive dyskinesia Atypical antipsychotic – reduce motor effects and other

neurotransmitters Time course

Antidepressant Tricyclics – Elavil, Tofranil Mao inhibitors (MAOIs) - Nardil Selective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil,

Zoloft – side effects Risk of suicide

Mood stabilizers Lithium, Valproic acid

Electroconvulsive therapy (ECT) Transcranial Magnetic Stimulation Deep brain stimulation

Social Thinking

Social Psychology*scientific study of how we think about,

influence, and relate to one another*how individuals affect each other

Social Context*the real, imagined, or symbolic presence of

other people; the activities and interactions that take place among people; the settings in which behavior occurs; and the expectations and social norms governing behavior in a given setting.

Social ThinkingAttribution Theory

*tendency to give a causal explanation for someone’s behavior, often by crediting either the situation or the person’s disposition

Social Thinking*Fundamental Attribution Error

*tendency for observers, when analyzing another’s behavior, to underestimate the impact of the underestimate the impact of the situationsituation and to overestimate the impact of overestimate the impact of personal dispositionpersonal disposition

*dual tendency to overemphasize personal traits while minimizing situational inferences.

***Always try to find a situational explanation for strange or bizarre behavior of others before “blaming” them with dispositional explanations.

et.al. Did the person brake suddenly in front of you because he is a jerk, or because a dog ran out in front of his car?

Social Thinking*Attitude

*belief and feeling that predisposes one to respond in a particular way to objects, people and events

**OUTSIDE INFLUENCES ON WHAT WE SAY AND DO ARE MINIMAL (2002, with most Americans supporting preemptive war in Iraq, most Democrats publicly supported the idea while having private reservations)

** THE ATTITUDE IS SPECIFICALLY RELEVANT TO THE BEHAVIOR (proclaim love while yelling at mate, cherish honesty while cheating on test)

**WE ARE KEENLY AWARE OF OUR ATTITUDES (we mindlessly follow habit or others’ expectations while our attitudes lie dormant)

Social ThinkingOur behavior is affected by our inner attitudes

as well as by external social influences

Internalattitudes

Externalinfluences

Behavior

Social ThinkingFoot-in-the-Door Phenomenon

*tendency for people who have first agreed to a small request to comply later with a larger request

*Social Roles*set of expectations about a social position*defines how those in the position ought to behave*when you adopt a new role (college student, marry, new

job), you strive to follow the social prescriptions. May feel phony at first while you “act” the role.

No one “teaches” you your role.

*Social Roles: involves a person’s knowledge about the sequence of events and actions that are expected of a particular social role.

*Cognitive Dissonance*When we voluntarily undergo

unpleasant experiences.*voluntarily produce discomfort with

ideas that clash with their attitudes and values

*et. al. Republican speaker in a Democratic auditorium

*Cognitive Dissonance Theory*people are motivated to avoid uncomfortable state of

dissonance*must change either one’s behavior or one’s cognitions*et.al. when we become aware that our attitudes and our

actions clash, we can reduce the resulting dissonance by changing our attitudes

Generally speaking, when people’s cognitions and actions are in conflict (a

state of dissonance) they often reduce the conflict by

changing their thinking to fit their behavior.

Social InfluenceConformity

*adapting one’s behavior or thinking/opinions to coincide with a group standard

*used to avoid rejection

Conformity increases whenConformity increases when:

*one is made to feel incompetent or insecure

*the group is unanimous

*one admires the group’s status and attractiveness

*one has made no prior commitment to any response

*others in the group observe one’s behavior

*one’s culture strongly encourages respect for social standards

Yielding to Others: Conformity

Conformity – Solomon Asch (1950s)Group norm behaviorClassic experiment

Group size Group unanimity

ComplianceConforming to requested behavior

Foot-in-door Door-in-the-face

Yielding to Others: ObedienceObedience – Stanley Milgram (1960s)

Controversial landmark experiment 65% gave highest shock level Many variations of basic experiment

“I was just following orders” presence of a dissenter

Behavior in Groups: The Power of the Situation

Social RolesStanford Prison Study – Zimbardo

Behavior in Groups: The Influence of Other People

The Bystander EffectDiffusion of responsibility

Group productivity and social loafingDecision making in groupsGroup Polarization –strengthen group

viewsGroupthink - cohesiveness

Bay of PigsNASA Shuttle disaster

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