Psychology Course: Antisocial Personality Disorder

Assessing Psychological Disorders

• Psychological disorders are assessed through observing unusual behavior, potential danger, and atypical presentations.
• Initial evaluation involves a thorough history, criteria for abnormal behavior, societal stereotypes, classification of disorders, and prevalence data.

Historical Perspectives (Medical Model)

• Early models viewed mental illness as demonic possession or divine punishment.
• Treatments included torture, confinement, and even execution.
• Trephination, a surgical procedure, was an early attempt to treat mental illness.
• Medieval diagnoses often used physical examinations like "sink or float" tests.
• The medical model gradually gained traction, promoting compassion and recognizing mental illnesses as diseases. This contrasted with the 18th-century view of demonic possession.

Early Biological Views

• Hippocrates (5th century BC) proposed mental illnesses resembled physical disorders, attributing them to bodily fluids (humors).
• By the late 1800s, medical diagnoses began extending to mental disorders.
• General paresis, a mental deterioration condition, was linked to syphilis.

Psychological Perspectives

• Psychodynamic (psychoanalysis)
• Behavioral
• Cognitive
• Humanistic
• Biological

Psychodynamic Perspective

• Sigmund Freud linked psychological disorders to unresolved childhood conflicts, triggering anxiety and defense mechanisms.
• Neuroses were viewed as extreme defense mechanisms, leading to specific disorders like phobias and depression.

Behavioral Perspective

• Psychological disorders are learned responses, resulting from classical conditioning, operant conditioning, and observational learning.
• This perspective emphasizes the role of the environment in shaping behavior.

Cognitive Perspective

• Maladaptive thought patterns contribute to certain disorders.
• Cognitive distortions are identified to help establish healthier thought patterns.
• This approach focuses on changing negative or self-defeating thought patterns.

Humanistic Perspective

• Disorders result from hindered self-actualization and the search for meaning.
• Conditions of worth can distort self-perception and lead to a negative self-image.

Biological Perspective

• Genetics
• Neurotransmitters
• Health
• Brain abnormalities

Vulnerability/Stress Model

• Everyone possesses a degree of vulnerability.
• Vulnerability stems from biological factors, personality (e.g., low self-esteem), and environment (e.g., poverty, significant loss, war).
• Stressors trigger disorders in vulnerable individuals.

Defining Psychological Disorders

• Psychological disorders involve clinically significant disturbances in cognition, emotion regulation, or behavior.
• Maladaptive behaviors disrupt everyday functioning (social, work, and daily activities).

3 D's of Psychological Disorders

• Deviance: Behaviors that differ from societal norms, recognizing that norms are culturally and historically relative.
• Dysfunctional: Behaviors significantly interfering with daily functioning and relationships.
• Distressing: Subjective suffering or distress experienced by individuals. Many disorders comprise a mix of these factors.
• Diagnoses can involve value judgements alongside scientific criteria.
• Mental disorders and their diagnoses are influenced by cultural values, societal trends, and political forces.

Stereotypes of Psychological Disorders

• Psychological disorders are not inherently incurable.
• People with psychological disorders are not inherently violent or dangerous, though they may be victims of violence, instead.
• The behaviors of people with disorders may not appear substantially different than those of "healthy" individuals.

Classification of Disorders

• The DSM-5 is a system for classifying disorders with both categorical and dimensional elements. This allows a more nuanced approach to diagnosis.

Labelling Psychological Disorders

• Labels, while helpful for communication and treatment, can be arbitrary and reflect value judgments.
• Labeling can stigmatize and negatively influence treatment and perceptions of mental illness.
• The Rosenhan study highlights this potential bias in the diagnosis process.

Legal Considerations

• Legal judgments about mental state can be complex in criminal cases, e.g., competency assessment, legal consequences of mental illness.
• Mental health considerations often arise from crime (e.g., insanity plea).

Prevalence of Disorders

• Diagnoses and numbers vary across studies.
• Increased awareness, refinement of diagnostic criteria, and recognition of drug-related disorders likely contribute to differing prevalence figures.
• Anxiety, substance misuse, and mood disorders are common.

Anxiety Disorders

• Anxiety is a normal state, but disorders involve excessive apprehension, not tied to a specific threat.
• Generalized anxiety disorder, phobias, obsessive-compulsive disorder, and panic disorder are examples.
• Women are affected more frequently than men.

Generalized Anxiety Disorder

• Characterized by chronic, high levels of anxiety without a clear trigger.
• Individuals worry excessively about past mistakes and future uncertainties.
• Symptoms such as trembling, tenseness, and physical distress are common.

Phobic Disorders

• Anxiety is focused on specific objects or situations.
• Marked by persistent and irrational fear of objects or situations that pose no actual danger.
• Fears significantly disrupt a person's daily life.

Panic Disorders

• Involves recurrent, unexpected attacks of overwhelming anxiety.
• Panic attacks involve fear, heart palpitations, and other physical symptoms.
• A heightened risk of severe anxiety disorders exists among smokers.

Mood Disorders

• Two central types are major depressive disorder and bipolar disorder

Major Depressive Disorder

• A widespread mood disorder.
• Women are twice as likely to be diagnosed as men.
• Biological and cultural factors contribute to the discrepancy.
• Major depressive episodes average 5 months but not less than 2 weeks.
• Persistent depressive disorder (dysthymia) is a chronic, less severe form.
• Lifetime prevalence is about 7%.

Bipolar Disorder

• Alternates between periods of mania and depression.
• Mania is characterized by significantly elevated mood, energy, and impulsivity.
• Bipolar disorder has a lifetime prevalence of around 1%.

Etiology of Mood Disorders

• Biological and psychological factors contribute to the development of mood disorders.
• Genetic vulnerability plays a role, with a higher risk in identical than fraternal twins.
• Social cognitive factors, including negative thinking patterns and learned helplessness, also influence the development of mood disorders.

Biological Factors in Mood Disorders

• Genetic factors and neurotransmitter abnormalities are implicated.
• Lower levels of serotonin are associated with depression.
• Norepinephrine is implicated in both depression and mania.
• Lifestyle factors like smoking and diet correlate with mood.

Social Cognitive Factors in Mood Disorders

• Negative thought patterns (cognitive triad) and learned helplessness contribute to depression.
• Rumination is a contributing factor.
• Individuals with depression often display a negative explanatory style which may lead to self-blame and a sense of helplessness.

Somatic Symptom Disorders

• Somatic symptom disorders feature physical symptoms with no clear physical cause.
• Individuals might not be fabricating symptoms but find it difficult to separate genuine from imagined physiological reactions.
• Individuals may gain attention and rewards or avoid stress.
• Conversion disorder involves loss of function without an organic cause.
• Hypochondriac individuals are overly anxious about developing a physical illness.

Dissociative Disorders

• Dissociative disorders involve disruptions in consciousness, memory, or identity.
• Dissociative amnesia, fugue, and identity disorder are examples.

Dissociative Amnesia

• Significant memory loss for important personal information exceeding ordinary forgetting.
• Often triggered by traumatic events.

Dissociative Fugue

• Loss of memory for one's entire life and identity.

Dissociative Identity Disorder

• Coexistence of more than one personality within an individual.
• Each personality may have distinct characteristics, like gender, age, etc.

Schizophrenia

• A disorder characterized by disturbed perceptions, disorganized thinking, and diminished/inappropriate emotions.
• Symptoms of schizophrenia include delusions, irrational thoughts, hallucinations, and disturbed emotions.
• Schizophrenia typically begins during adolescence or early adulthood.

Schizophrenia (Causes and Outcomes)

• Genetic vulnerabilities and structural brain abnormalities appear to be implicated, particularly enlarged ventricles and irregular information transmission.
• Dopamine, glutamate, and other neurotransmitters, as well as neurodevelopmental factors, could also contribute.
• Environmental factors like poverty and expressed emotion from relatives may also influence outcomes.

Personality Disorders

• Personality disorders involve enduring patterns of inflexible traits leading to distress or impairment.
• Three clusters (anxious/fearful, odd/eccentric, and dramatic/impulsive).

Antisocial Personality Disorder

• Marked by impulsive, callous, aggressive, and irresponsible behavior.
• More common in men, affecting approximately 3-4% of the population.
• Symptoms generally emerge before age 15.