Week 6 LECTURE NOTES:

Psychological Disorders

Psychopathology: Problematic patterns of thought, feeling, or behavior that disrupt an individual's sense of well-being or social or occupational functioning

[Love, work, reality]

Personality: Enduring patterns of thought, feeling, and behavior that are expressed across different circumstances

Normal vs. Abnormal: Where to draw the line?

Psychodynamic:

Neuroses --- the walking wounded

Personality disorders--chronic & disabling; distort reality

Psychoses--severe impairment; out of touch with reality

Perspectives on psychopathology:

Psychodynamic: Unconscious conflicts

Conscious A<-> C --> B

Unconscious A<->C<->A<->C

(conflicts within the unconscious and between unconscious and conscious motives, beliefs lead to disordered behavior-- B should be coming from both conscious & unconscious and the interaction between them--doesn't show up well on the web text, sorry)

Cognitive-behavioral: History of reinforcement B1-->A-->B1, C or

B1-->A-->not B1, C

depending whether affective experience is positive or negative

C-->A--> B

Belief (if I go outside, I will have a panic attack) lead to affect (fear of going outside) which results in behavior (stay inside) which is then seen as effectively "preventing" the feared panic attack.

Biological: Brain/nervous system/malfunction

Brain--> Mind ---> ABC

Systems: Family and society, roles and adaptation

Integrative view:
Diathesis--Stress model

Many sources of vulnerability:
* genetic predisposition, poor parenting, other physical problems, conditioning that has taught maladaptive behaviors

Many sources of stress
* internal conflict, physical illnesses, interpersonal problems, disruptive home situation, negative life events

NOTE: Some disorders seem to have genetic predisposition as a NECESSARY condition (schizophrenia, for example); others (anxiety, depression, especially in milder forms) may appear in just about anyone given sufficient stress.

Typology of Disorders:

Schizophrenia: Severe C disorder leads to disordered B (<1 to 3%)

Genetic vulnerability (+ Stress)

Mood disorders: Disordered AFFECT

Major depression
(5-12% men, 10-26% women)
Dysthymia
Bipolar (< 1%)

Major depression: 90% have severe stressor in 9 months preceding onset of first major depression (NOTE: lots of people have these stressors WITHOUT developing depression). Subsequent episodes, however, become more likely after the first.

Bipolar: Genetic predisposition + stress

Anxiety: Disordered affect

Panic attacks: Severe, acute
(about 80% first attack triggered by negative life event)

Generalized anxiety disorder 2%

Phobias (up to 1/3 population)

Personality disorders

A continuum with normal personality?

This idea is discussed at length in the focus article, including the intruiging notion that personality traits that are extreme in borderline personality (neuroticism) may, when elevated, be a general "vulnerability" for developing a variety of emotional/mental problems under environmental stress

NOTES:
Biological response does not indicate biological cause
Biology affects affect, thought, behavior and vice versa

(Example: grief at news of loved one's death--extreme affective reaction leads body to release natural anaesthetic, causing psychic "numbing" to protect from psychic pain.)

Affect->Biol. response->Affect adjusted

COMORBIDITY:
(Multiple simultaneous problems)

Very common. Especially for anxiety & depression appearing together, and for the personality disorders (as focus reading discusses)