PSY2043 Ch15 Lecture Notes

PSY2043 Introduction to Psychology

Ch15 Psychological Disorders

Intended Learning Outcomes

• Know the four criteria that may be used in defining abnormality as well as the characteristics that are considered indicative of normality.
  • Abnormality
    • Deviation from cultural norms 偏离文化规范
    • Deviation from statistical norms 偏离统计常模
    • Maladaptive behavior 行为的适应性（对个人或社会产生不利影响）
    • Personal distress 个人痛苦
  • Nomality
    • Appropriate perception of reality 对现实的正确知觉
    • Ability to exercise voluntary control over behavior 自主控制行为
    • Self-esteem and acceptance 自尊及自我接纳
    • Ability to form affectionate relationships 形成亲密关系的能力
    • Productivity 具有生产力
• Understand the advantages and disadvantages of classifying abnormal behavior into categories.
  • Advantages
    • Aids diagnosis & treatment
    • Enables quick and concise communication
  • Disadvantages
    • Labeling induces us to overlook unique features of person and expect person to conform to classification
    • doesn’t tell us how the symptoms originated or what causes them to continue
    • stigma in many societies
• Know the broad perspectives of the biological, psychoanalytic, behavior, cognitive, and sociocultural models.
  • Biological –　brain disorders
  • Psychoanalytic – unconscious conflicts
  • Behavior – conditioning and reinforcement & learned fear & learned maladaptive behavior
  • Cognitive – maladaptive cognitive process
  • Sociocultural models – social context
  • Vulnerability-stress model – the interaction between a predisposition that make a person vulnerable to a particular health problem and stressful environmental
• Describe four types of anxiety disorders. Understand the development of anxiety disorders from the standpoint of biological, cognitive, behavioral, and psychodynamic theories. Know what research on biological factors has contributed thus far to our understanding of these disorders.
  • Anxiety disorders
    • Generalized anxiety (constant worry and tension)
    • Panic disorders (sudden attacks of overwhelming apprehension)
    • Phobias (irrational fears of specific objects or situations)
    • Obsessive-compulsive disorder
• Describe the two major mood disorders and to compare cognitive-behavior, psychoanalytic, and interpersonal theories of depression.
  • Mood disorders
    • Depressive disorder
    • Bipolar disorder
  • Cognitive theories attribute depression to pessimistic views of the self, the world, and the future and to maladaptive attributional styles.
  • Psychodynamic theories view depression as a reactivation of loss of parental affection in a person who is dependent on external approval and tends to turn anger inward.
  • Interpersonal theories view depression as the result of insecurities about relationships and maladaptive patterns of social interaction.
• Know the defining characteristics of schizophrenia and be able to give examples of each characteristic.
  • Disturbances of thought and attention
    • loosening of associations – word salad
    • delusion
  • Disturbances of perception
    • hallucinations
  • Disturbances of emotional expression
    • express emotions that are inappropriately linked to the situation or to the thought being expressed, such as smiling while speaking of tragic events.
• Be familiar with the research on the causes of schizophrenia; be able to discuss the probable contributions of genetic, biochemical, and psychological factors.
  • Genetic – Schizophrenia clearly is transmitted genetically
  • Biochemical – have problems in dopamine regulation
  • Psychological – Psychosocial factors play important role in overall severity & triggering of new episodes
• Define personality disorders; know the defining characteristics and probable causes of antisocial personalities and borderline personality disorder.
  • Definition – long-standing patterns of maladaptive behavior involving difficulties in coping with stress or solving problems
  • ASPD
    • Biological factors
      • Genetic factors play a role in development of antisocial personality – twin studies confirm genetic component
      • Deficits in executive functions could lead to poor impulse control & difficulty in anticipating consequences
    • Social factors
      • Neglectful & hostile parents may contribute to disorder
    • Personality factors
      • Children with antisocial personalities process information about social interactions in ways that promote aggressive reactions
  • BPD
    • Psychoanalytic theorists argue poorly developed views of self & others stem from poor early relationships with caregivers
    • Others argue deficit in ability to regulate emotions
• Understand the patterns of behavior that constitute autism spectrum disorders. Describe the biological causes of autism spectrum disorders.
  • Diagnose – three types of deficits
    • Social interaction – lack of connection with others
    • Communication – difficulties in communication & speech
    • Activities & interests – preoccupation/routines/rituals
  • Biological causes
    • Genetics
    • Neurological factors – disruption in normal development & organization of the brain

DEFINING ABNORMALITY 变态的定义

Deviation from cultural norms 偏离文化规范

Deviation from statistical norms 偏离统计常模

Maladaptive behavior 适应不良的行为（对个人或社会产生不利影响）

Personal distress 个人痛苦

• Individual’s subjective feelings of distress
  • e.g. anxiety, depression, or agitation 烦躁, or insomnia 失眠, loss of appetite or numerous pains and aches
• Maybe the only symptom to determin disorder

What is normality?

1. 对现实的有效知觉
2. 自主控制行为的能力
3. 自尊及接纳
4. 形成亲密关系的能力
5. 具有生产力

Classifying mental health problems

• Advantages
  • Aids diagnosis & treatment
  • Enables quick and concise communication
• Disadvantages
  • Labeling induces us to overlook unique features of person and expect person to conform to classification
  • doesn’t tell us how the symptoms originated or what causes them to continue
  • stigma in many societies

Perspectives on mental health problems

• Biological perspectives – due to brain disorders
• Psychological perspective – issues in mind functioning
  • Psychoanalytic perspective – unconscious conflicts & defense mechanisms
  • Behavioral perspective – fears become conditioned
  • Cognitive perspective – maladaptive cognitive processes
• Cultural/sociological perspective – social context
• Vulnerability-stress model
  • Interaction between a predisposition, which makes a person vulnerable for developing a particular mental health problem, and stressful environmental conditions encountered by that person
  • 易受性+压力

ANXIETY DISORDERS 焦虑障碍

• Anxiety
  • 4 types of symptoms
    • 1. Physiological 生理 – 心跳加速、肌肉紧绷、冒汗、呼吸急促
      2. Cognitve 认知 – 确信自己要遭重了
      3. Behavioral 行为 – 僵住、动弹不得
      4. Emotional 情绪 – 害怕与恐惧感
  • Generalised anxiety disorder 广泛性焦虑障碍（经常性的担心和紧张）
    • Person experience constant 持续 sense of tension & dread

Panic disorders 惊恐障碍（突然爆发强烈的焦虑）

• Panic attack 惊恐发作 : episode of acute & overwhleming terror
• Panic disorder: diagnosed if panic attacks become frequent & individual worries about having one
• Agoraphobia 广场恐惧症
  • 害怕被困在不安全的地方

Understanding panic disorder and agoraphobia

• 遗传或其他生物上的【易受性】
  • 易患有 panic disorder 的个体可能遗传有“战斗或逃跑过度反应”这种特质
    • 边缘系统受损、神经递质5-HT不足
• 认知–行为论 【压力】
  • 倾向于只关注自己的身体，并将身体的感觉进行消极的解释和以灾难性方式
  • 清楚地记得发病场所 – 导致广场恐惧症
• 易受性–压力模式将上述两个理论整合

Phobias 恐怖症（对特定目标或情景有非理性的害怕）

• 对大多数人并不认为特别危险的刺激/情境产生强烈恐惧，这种恐惧干扰了个人生活
• 通常了解自己是非理性的，但依然会感到焦虑
• 3 broad categories
  • Agoraphobia
  • Specific/simple phobia: fear of simple object/animal/situation
  • Social phobia (social anxiety disorder): 社恐
    • 最常见的有害怕公众场合讲话或者吃东西
    • 通常开始于青少年，如果不加以治疗，往往会成为长期病

Understanding phobias

• Behaviorists: develop from classical & operant conditioning
  • 1. 中性刺激与创伤事件配对，引发焦虑 e.g. 水和溺水
    2. 回避恐惧对象，减轻焦虑
• Freud:
• 行为主义的治疗往往比较成功，精神分析的治疗往往比较失败

Obsessive-compulsive disorder 强迫症 OCD

• Lives dominated by repetitive acts (compulsions) or thoughts (obsessions)
• Obsessions: 持续出现的 unwelcome thoughts
• Compulsions: 无法抗拒地做出 certain acts 来减轻焦虑

Understading obsessive-compulsive disorder

• Cognitivists & behavioralists : 更难 “关闭 “侵入性想法，因为他们倾向于僵化的、道德主义的思维方式
• Gene & Possible dysfunctional neural circuit 基因与可能的功能失调神经回路
• 许多焦虑症可能是生物和心理因素共同作用的结果。
  • 许多焦虑症患者可能都有遗传、神经或生化方面的易焦虑性。

MOOD DISORDERS 心境障碍

Depressive disorder 抑郁障碍：会有一段时间的悲伤、抑郁或平淡情绪；

• 轻微的抑郁症状是对生活压力的正常反应
• 当影响正常生活工作的时候，并持续长达数周的时候，抑郁成为一种疾病
• Prevalence
  • 各国家之间的抑郁症发病率差异很大，从 6% 到 20%
  • 女性的发病率高于男性
• Symptoms
  • Emotional symptoms
    • sadness
    • loss of pleasure
  • Cognitive symptoms
    • Negative views of self
    • Hopelessness
    • Poor concentration and memory; confusion
  • Motivational symptoms
    • Passivity
    • Will not initiate or persist at activities
  • Physicla symptoms
    • Changes in appetite and sleep
    • Fatigue 疲惫
    • Increase in aches and pains 疼痛增加

Bipolar disorder 双相障碍：抑郁期和躁狂期（情绪高涨或激动）之间交替出现，通常在两个极端之间情绪会恢复正常

• 以前叫 manic depreesion 躁狂抑郁症
• 相对不常见，占成年人 2% 或更少
• Manic symptoms often change from joyful exuberance to hostile agitation 欢欣鼓舞到敌意激昂

Understanding mood disorders

• Biological perspective
  • tendency inherited 通常是遗传性的
  • 归因于：遗传和在调节5-羟色胺与正肾上腺素方面的问题
  • 大脑结构和功能异常可能是情绪障碍的前兆和原因，也可能是情绪障碍中对大脑的不良结果
• Cognitive perspective
  • negative thoughts about the self & present & future 对自我、未来、世界的悲观看法
  • Maladaptive attributional styles 适应不良归因风格
• 心理分析观点
  • 依赖外在赞许而且将怒气转向内部的个体，因为丧失亲情的反应重被激起而造成的
• Interpersonal perspective
  • too dependent on opinions & support of others
• Psychosocial factors in bipolar disorders 双相的社会心理因素
  • stressful life events
• Beck’s theory
  • Beck: the father of Cognitive Behavior Therapy
  • 5 principle errors

SCHIZOPHRENIA 精神分裂症

• 通常出现于 late adolescence 或 early adulthood, just when an individual is beginning career and starting a family

Characteristics of schizophrenia

• Disturbance of thought and attention
  • Loosening of association 连结松散 – word salad
• Disturbance of perception
  • Hallucinations
• Disturbance of emotional expression

Motor symptoms and withdrawal from reality

• exhibit bizarre motor activity 表现出怪异的运动活动

Culture and the progression of schizophrenia

Understanding schizophrenia

• Biological perspective
  • 精分可能于生物有密切联系
  • 两种类型的大脑结构缺陷
    • prefrontal cortex smaller & less active 前额叶皮质缩小且不活跃
    • enlarged ventricles 脑室扩大
  • regulation of dopamine 也有问题
• The social & psychological perspective
  • Psychosocial factors play important role in overall severity & triggering of new episodes

PERSONALITY DISORDERS 人格障碍

• Long-standing patterns of maladaptive behavior 长期的适应不良的行为模式

Antisocial personality disorder

Understanding antisocial personality disorder

Boderline personality disorder

Understanding borderline personality disorder

PERVASIVE DEVELOPMENTAL DISORDERS (PDD)

• No Cure

Diagnosis of autism

• 3 types of deficits
  • Social interaction
  • Communication
  • Activities & interests

Asperger’s syndrome and other pervasive develepmental disorders

Unerstanding pervasive developmental disorders