Psychopathology
Psychopathology
Psychopathology
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The Case of Jeffrey Dahmer
— Several months later, Dahmer
picked up a 23-year old man at a
gay bar, had oral sex with him,
drugged him and butchered him.
— Later in the same month, Dahmer
strangled a 24-year old man and
painted his skull after having boiled
his head to remove the skin.
Dahmer told the police that he
saved the skulls of only the most
handsome victims so that he would
not forget them.
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The Case of Jeffrey Dahmer
— In 1991, when he was
arrested, the police found in
Dahmer’s apartment at least
15 dismembered bodies, a
head in the refrigerator and
a heart in the freezer, and a
blue barrel of acid for
leftovers (Matthews, 1992).
— Why would a person like
Dahmer commit such a
deviant act?
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Appropriate perception of reality —fairly
realistic in appraising reactions and capabilities and in
interpreting events
Maladaptive behavior—
psychological dysfunction or
disability with adverse effects on
7 individuals or society
Physically
damaging
Lost touch
with reality Cause
and cannot MALADAPTIVE emotional
control BEHAVIOR suffering or
behavior or harm
thoughts
Severely interfere in
one’s ability to
function in daily life
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Prehistoric times
Demonic possession was thought to cause
psychological disorders. Based on
evidence of trephined skulls, prehistoric
people tried to release the evil spirits by
drilling a hole in the skull.
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Ancient Greece & Rome:
The scientific approach emerged. The
Greek physician Hippocrates sought a
cause within the body. This approach
continued through Roman times with
the writings of the physician Galen.
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Middle Ages:
Return to belief in spiritual
possession and attempts to exorcise
the devil out of the mentally ill. The
mentally ill were thrown into
prisons and poorhouses.
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Renaissance Period:
First hospital to house the
mentally ill was built—St.
Mary’s Hospital in Bethlehem
(London). Attempts to provide
more humane treatment.
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Modern Period:
Era of deinstitutionalization
Invention of antipsychotic
medications made it possible for
people with severe disorders to live
outside institutions.
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y How much of abnormal behavior can be explained
through our biological makeup?
y How important are early childhood experiences and
unconscious motivations in determining our mental
health?
y What is the role of learning in the development of
abnormal behaviors?
y How powerful are thoughts in causing abnormal
behaviors, and can positive thinking be used to
1717 combat irrational beliefs?
Models of Psychopathology
Psychosocial cause Biological
cause
Psychodynamic Behavioral Cognitive
Neuroanatomical
Biochemical
Genetics
Humanistic
Family systems Multicultural
existential
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A Environ-
predisposition mental MENTAL
to develop
illness forces DISORDER
(diathesis) (stressors)
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• Relationship • People exhibit
with parents symptoms they are
Unconscious
• Fixations of unable to understand
oral, anal, • Therapist must make
phallic stages of • Childhood- the patient aware of
psycho-sexual based anxieties unconscious anxieties
development • Repressed
through defense
mechanisms
Childhood
trauma Psychological
Disorders
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Phobias
• Caused by unresolved Oedipal conflict—
fear of the father displaced onto some
other object or situation
Obsessive-compulsive
disorder
• Traced to anal stage, with the urge to soil
or to be aggressive transformed into
compulsive cleanliness
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The case of Anna O.
Anna O. was a bright, attractive young
woman who was perfectly healthy until she
reached 21 years of age. Shortly before her
problems began, her father developed a serious
chronic illness that led to his death. Throughout
his illness, Ann O. had cared for him; she felt it
necessary to spend endless hours at his bedside.
Five months after her father became ill, Ann
noticed that during the day her vision blurred;
and that from time to time she had difficulty
moving her right arm and both legs. Soon,
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additional symptoms appeared.
The case of Anna O.
She began to experience some difficulty
speaking, and her behaviors became very erratic.
Shortly thereafter, she consulted Joseph Breuer.
In a series of treatment sessions, Breuer dealt
with one symptom at a time through hypnosis and
subsequent “talking through,” tracing each
symptom to its hypothetical causation of
circumstances surrounding the death of Anna’s
father. One at a time, her “hysterical” ailments
disappeared, but only after treatment was
administered. Anna O.’s real name was Bertha
24 Pappenheim.
Behavioral models
• Behaviorism stressed the importance of
directly observable behaviors and the
conditions or stimuli that evoked,
reinforced and extinguished them
Obsessive-compulsive
disorder
• Traced to anal stage, with the urge to soil
or to be aggressive transformed into
compulsive cleanliness
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Major Assumptions of
Cognitive Model
Three types of
Man is a thinking People actually
cognition cause
being—his create their own
abnormal
cognitions (i.e., problems (and
behavior: (1)
thoughts and symptoms) by the
causal attributions,
beliefs) influence way they
(2) control beliefs;
behavior and interpret events
(3) dysfunctional
emotions and situations
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assumptions
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Unpleasant
emotional
responses
• The individual’s
belief systems • They result from • Irrational and
produce irrational one’s thoughts about maladaptive
thought patterns an event rather than thoughts
from the event itself
• Lead to anger, • Distortions of
unhappiness, reality
depression, fear,
Cognitions anxiety Psycholog ical
problems
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The individual’s assessment of his own
value and worth
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When the When a
person’s self- person’s
Incongruence
Conditions of
concept is inherent
Standards by
Abnormal
behavior
defined as having potential
which
worth
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Individual as
member of the
family
• A reflection or “symptom” of
Abnormal unhealthy family dynamics, or
behavior poor communication among
family members
Uncontrollable
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Phobias
Panic disorders
Obsessive-compulsive disorder
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• Conversion
Two disorder
forms • Somatization
disorder
• Pain disorder
Additional • Body dysmorphic
categories disorder
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• Hypochondrias
Pain disorder
• The person experiences pain that causes
significant distress and impairment
• Psychological factors have a role in the onset,
maintenance and severity of the pain
• The pain may have temporal relations to
conflict or stress, or may allow the person to
avoid unpleasant activity and to secure
attention
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Pain disorder
• Reports of severe pain may (1) have
no physiological or neurological
basis, (2) be greatly in excess of that
expected with an existing physical
condition, or (3) linger long after a
physical injury has healed
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Hypochondr iasis
• Individuals are preoccupied with fears of
having a serious disease, which persist
despite medical reassurance to the contrary.
• Patients tend to overreact to ordinary
physical sensations or minor abnormalities
(e.g., irregular heartbeat, sweating, sore
spot, occasional coughing)
• Includes fear of having a disease, fear of death
or illness, tendency towards self-observation,
oversensitivity to bodily sensations
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Conversion Disorder
• Loss or disturbance of physical functioning
resembling a physical disorder
• Psychological factors involved in either:
• (a) Initiating or exacerbating the symptoms
• (b) Allowing individual to avoid aversive
activity
• (c) Receiving reinforcements for sick behavior
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Somatization Disorder
• History of vague multiple physical
complaints before the age of 30
• 4 pain symptoms involving at least 4
different sites or functions
• 2 gastrointestinal symptoms
• One sexual symptom
• One pseudoneurologic symptom
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Dissociative disorders
• Disturbances or changes in
memory, consciousness or
identity due to psychological
factors
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Dissociative amnesia
Depersonalization
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• The sudden inability to recall information of a
Dissociative personal nature—not due to forgetfulness or
amnesia other organic conditions—usually of traumatic
or stressful nature
Psychotic
symptoms—
loss of reality-
testing
A long-standing and pervasive
pattern of behavior, thought and feeling
that is highly maladaptive for the
individual and for people around him/her
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Chronic and pervasive mistrust and
suspicion of other people that is
unwarranted and maladaptive
Misinterpret or over-interpret
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situations in line with their suspicions
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Pervasive tendency to interpret actions of
others as deliberately demeaning, malevolent,
threatening, exploiting, or deceiving
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Cold, callous, gains pleasure by
competing with and humiliating anyone
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Low tolerance of frustration and acts
impulsively, often takes chances and
seek thrills with no concern for danger
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üunlawful behavior despite potential for arrest
üdeceitfulness (repeated lying, use of aliases, conning others
for personal profit or pleasure)
ürepeated physical fights or assaults
üreckless disregard for safety of self or others
üirresponsible
ülack of remorse
ücriteria for diagnosis includes: evidence of this behavior
before 15 years of age
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Benchmarks: out-of-control emotions that
cannot be soothed, hypersensitivity to
abandonment, tendency to cling too tightly to
other people, history of hurting oneself
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Problems
shifting
emotions and
unstable
relationships
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Syndrome marked by rapidly shifting moods,
unstable relationships, intense need for
attention and approval
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üalways wants to be center of attention
üinappropriate sexually seductive or provocative
behavior
ürapidly shifting and shallow expression of emotions
üuses physical appearance to draw attention to self
üspeech is dramatic and exaggerated with emotion
üis easily influenced by others or circumstances
üconsiders relationships to be more intimate than they
actually are
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Acting in dramatic
and grandiose
manners, seeking
admiration from
others, shallow in
emotional
expression and
relationships
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Preoccupied with thoughts of own self-importance and
with fantasies of power and success, viewing themselves as
above most others
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Pervasive anxiety, sense of
inadequacy, fear of being
criticized that leads to avoidance
of most social interactions
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Anxious about interpersonal relations
but anxiety stems from a deep need to
be cared for by others rather than a
concern that they will be criticized
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They deny their own thoughts and feelings that
might displease others, submit to even the most
unreasonable demands, frantically cling to others
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üdifficulty making decisions without advice and
reassurance
üneeds others to assume responsibility for most major
areas of life
üdifficulty expressing disagreement with others (fear of
loss of support or approval)
üdifficulty initiating projects or doing things on own
ügoes to excessive lengths to obtain nurturance and
support (volunteers to do things that are unpleasant)
üfeels uncomfortable or helpless when alone
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Pervasive rigidity in one ’ s ac
interpersonal relationships
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Seem grim and austere, tensely in control of
their emotions, lacking spontaneity (Millon,
1981)
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—Fin
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