Psychology Chapter 29-32 PDF

**Types of Psychological Disorders** 29.1.01 Anxiety Disorders Anxiety disorders are characterized by excessive, uncontrollable fear (about a perceived imminent threat) or worry (about a perceived future threat) that impairs functioning. **Generalized Anxiety Disorder** Excessive and uncontrolla...

**Types of Psychological Disorders** 29.1.01 Anxiety Disorders Anxiety disorders are characterized by excessive, uncontrollable fear (about a perceived imminent threat) or worry (about a perceived future threat) that impairs functioning. **Generalized Anxiety Disorder** Excessive and uncontrollable worry about a range of events (eg, finances, relationships) for more than six months characterizes **generalized anxiety disorder** (GAD). Individuals with GAD anticipate disastrous outcomes for daily events and activities and find it difficult to control their worry. Muscle tension, difficulty concentrating or sleeping, and feeling restless, fatigued, or irritable are all common symptoms of GAD. **Panic Disorder** Panic attacks, which can be associated with several different disorders (eg, panic disorder, posttraumatic stress disorder) are overwhelming surges of anxiety that peak within minutes. A person who is having a panic attack may experience a racing heart, sweating, chills, trembling, breathing difficulties, dizziness, and/or nausea. **Panic disorder** is characterized by repeated, uncontrollable, and unpredictable panic attacks. **Agoraphobia** Individuals with **agoraphobia** have an intense fear of being unable to escape settings (eg, crowds, public transportation) that cause feelings of panic or being trapped. As a result, individuals with agoraphobia avoid such settings and are often afraid to leave their home. Many individuals with agoraphobia experience panic attacks and/or have panic disorder. **Social Anxiety Disorder** An intense fear of interpersonal rejection or humiliation characterizes **social anxiety disorder**. Individuals with social anxiety disorder become extremely anxious in social settings (eg, at school) and may avoid these situations (eg, public speaking, asking someone on a date). **Specific Phobia** **Specific phobia** is characterized by excessive, irrational fear of a specific situation (eg, hiking) or animal/object (eg, bears). Some specific phobias are hypothesized to result from the classical conditioning of fear (Concept 17.1.03) through pairing a negative experience (eg, being charged by a bear while out hiking) with a specific animal/object (eg, a bear) or situation (eg, hiking). 29.1.02 Obsessive-Compulsive Disorder **Obsessive-compulsive disorder** (OCD) is characterized by obsessions and/or compulsions (see Figure 29.1): Obsessions are recurrent, intrusive, distressing thoughts (eg, \"someone is going to harm my child\"). Compulsions are repetitive behaviors or rituals (eg, extensive cleaning, counting, organizing behaviors) that are often intended to neutralize obsessions. The obsessions and/or compulsions must occupy significant time or interfere with functioning for a diagnosis of OCD. Chapter 29: Psychological Disorders 164 **Figure 29.1** Obsessive-compulsive disorder. 29.1.03 Posttraumatic Stress Disorder **Posttraumatic stress disorder** (PTSD) arises from exposure to trauma, an event that resulted or almost resulted in death or serious injury (eg, assault, serious accident, combat). PTSD is characterized by reexperiencing the traumatic event (eg, nightmares, flashbacks), negative thoughts and mood (eg, irritability), avoidance of trauma reminders (eg, avoiding certain events, objects, or people), and hyperarousal (eg, hypervigilance, exaggerated startle response, insomnia, difficulty concentrating). For a diagnosis of PTSD, symptoms must be present for at least one month. 29.1.04 Bipolar Disorder **Bipolar I disorder** is characterized by mania, defined as abnormally elevated or irritable mood and increased energy. During a manic episode, individuals may be talkative, distractible, overconfident, or act impulsively (eg, drive recklessly). They may feel they need less sleep (eg, staying up for several days). To qualify as a manic episode, symptoms must either require hospitalization or persist for at least one week and be severe enough to impair functioning. Many people who have bipolar I disorder also experience major depressive episodes. Major depressive episodes share the same symptoms as major depressive disorder (see Concept 29.1.05), such as feelings of sadness or hopelessness, lack of interest in activities, sleep and appetite disturbances, and frequent thoughts of death or suicide. A collage of a person with his hands in his ears Description automatically generated Chapter 29: Psychological Disorders 165 29.1.05 Depressive Disorders Depressive disorders are characterized by enduring periods of sadness that interfere with a person\'s functioning. One such disorder, **major depressive disorder** (MDD), is characterized by an ongoing period (ie, at least two weeks, but often longer) of depressed mood (severe sadness, hopelessness, or emptiness) and/or a lack of pleasure (anhedonia) or loss of interest in activities. Other symptoms of MDD include changes in appetite (eating more or less); changes in sleep (sleeping more or less); fatigue; low self-worth or guilt; cognitive difficulties (problems with concentration, memory, decision-making); and/or thoughts about death or suicidal ideation. Most people with MDD experience recurrent depressive episodes. 29.1.06 Schizophrenia Schizophrenia spectrum and other psychotic disorders are severe psychological disorders characterized by a loss of contact with reality. The most common psychotic disorder is schizophrenia. A diagnosis of **schizophrenia** requires the presence of several characteristic symptoms for one month or longer, at least one of which must be hallucinations, delusions, or disorganized speech. Schizophrenia typically involves both positive symptoms, which are \"pathological excesses\" (eg, hallucinations, delusions, disorganized speech), and negative symptoms, which are \"pathological deficits\" (eg, apathy, inability to experience pleasure). **Delusions** are fixed, false beliefs that are maintained despite evidence to the contrary (eg, believing that one\'s private thoughts are being broadcast to others), whereas **hallucinations** are false perceptual experiences in the absence of sensory stimulation (eg, seeing things no one else can). Many people with schizophrenia also experience psychomotor symptoms (ie, changes in muscle tone or activity), which can occur either as a symptom of schizophrenia or as a side effect of medication. 29.1.07 Dissociative Disorders Dissociative disorders involve disruptions to memory, consciousness, and/or identity that stem from psychological origins (eg, psychological trauma) as opposed to other medical causes (eg, head injury). For example, after experiencing a trauma, someone with **dissociative amnesia** might forget important autobiographical details, such as their name or marital status. In rare cases, individuals with dissociative amnesia travel from their home and assume a new identity, which is known as a *dissociative fugue*. Another dissociative disorder, **dissociative identity disorder**, is characterized by a person having two or more distinct personalities and the inability to recall important autobiographical information (ie, dissociative amnesia **Neurological Disorders** 29.2.01 Parkinson\'s Disease **Parkinson\'s disease** (PD) is a progressive neurodegenerative disease that is marked by the loss of dopaminergic neurons in the brain\'s substantia nigra (Figure 29.2). Because these neurons are involved in motor movements, PD results in motor abnormalities: resting tremor (often in the upper extremities), muscle rigidity, slowed movement (ie, bradykinesia), postural instability, and shuffling gait. **Figure 29.2** Substantia nigra degeneration in Parkinson\'s disease. PD can be accompanied by non-motor symptoms including cognitive impairment (eg, problems with memory, executive functioning, visuospatial abilities), sleep disturbances, and depressed and/or anxious mood **The Biological Underpinnings of Psychological Disorders** 30.1.01 The Biological Underpinnings of Schizophrenia As Concept 29.1.06 discusses, schizophrenia spectrum and other psychotic disorders (eg, schizophrenia) are severe psychological disorders characterized by a loss of contact with reality. While schizophrenia has a genetic component, there is also evidence that certain environmental factors (eg, prenatal viruses) increase one\'s risk for developing the disorder. Additionally, there are neurological abnormalities associated with schizophrenia, including enlarged ventricles (spaces in the brain containing cerebrospinal fluid) and decreases in the surrounding brain tissue. **Dopamine** has been suggested to play a role in schizophrenia because elevations in the neurotransmitter in certain brain areas have been linked with psychotic symptoms (eg, hallucinations), such as those seen in schizophrenia. Further, many antipsychotic drugs are dopamine [antagonists](javascript:void(0)) that work in part by blocking the action of dopamine. These observations support the dopamine hypothesis of schizophrenia, which directly attributes the disorder\'s psychotic symptoms to the activity of dopaminergic neurons. 30.1.02 The Biological Underpinnings of Depression As Concept 29.1.05 states, depressive disorders (eg, major depressive disorder) are characterized by enduring periods of sadness that interfere with a person\'s functioning. Major depressive disorder has environmental (eg, abuse during childhood) as well as genetic contributing factors. Two monoaminergic neurotransmitters (Concept 4.2.03), **serotonin** and **norepinephrine**, have been implicated in depressive disorders because decreases in these neurotransmitters cause symptoms of depression. Further, medications that elevate levels of serotonin and/or norepinephrine alleviate depressive symptoms for many individuals. These observations support the monoamine hypothesis, which directly attributes depression to a deficit in central serotonergic and/or noradrenergic activity. Some antidepressant medications are [agonists](javascript:void(0)) of one or more of the monoamines. For instance, selective serotonin reuptake inhibitors (SSRIs) [block the reabsorption](javascript:void(0)) of serotonin into the presynaptic neuron (ie, reuptake), prolonging the presence of serotonin in the synapse and thereby increasing its action. Another class of medication, monoamine oxidase inhibitors (MAOIs), inhibit monoamine oxidase, an enzyme that contributes to the breakdown of monoamines. The inhibition of monoamine oxidase increases monoamine concentrations, which increases their action **The Biological Underpinnings of Neurological Disorders** 30.2.01 The Biological Underpinnings of Parkinson\'s Disease As Concept 29.2.01 introduces, Parkinson\'s disease (PD) involves the loss of dopaminergic neurons in the **substantia nigra** (SN), which is a brain structure located in the midbrain. The SN projects axons to the **basal ganglia**, a cluster of nuclei that plays an important role in voluntary movements (Figure 30.1). **Figure 30.1** Basal ganglia and related structures. The basal ganglia contributes to the initiation of desired motor programs and also appears to play a role in the inhibition of competing or unwanted movements. The dopaminergic neurons of the SN modulate these actions. The degeneration of the SN in PD impairs this dopaminergic modulation, which causes the motor symptoms of the disease (see Concept 29.2.01). Some medications used to treat PD (eg, L-dopa) are dopamine [agonists](javascript:void(0)), which mimic or enhance the effects of dopamine. Another treatment for PD, deep-brain stimulation (DBS), involves implanting a device in the brain that sends electrical impulses to a specific area. DBS in portions of the basal ganglia has been shown to relieve some of PD\'s motor symptoms **Treatment Approaches and Techniques** 31.1.01 Treatment Approaches and Techniques **Biomedical versus Biopsychosocial Models** The biomedical model and the biopsychosocial model represent two approaches to conceptualizing how psychological disorders develop and should be treated. The **biomedical approach** (also known as the biomedical model) to psychological disorders suggests that physiological causes (eg, a deficit in a neurotransmitter system) result in psychological symptoms, and therefore, medical treatment (eg, medication) is advised to fix the underlying problem. In contrast, the **biopsychosocial model** of psychological disorders suggests that mental disorders are the result of the combination or interaction between biological (eg, genetics, hormones), psychological (eg, thoughts, behaviors), and social (eg, family dynamics, peer groups) factors. Therefore, a biopsychosocial approach to treating a psychological disorder could involve addressing some or all of these factors. **Types of Treatment** Some psychological disorders are most effectively treated with specific medications or therapeutic techniques. For example, research has shown that because schizophrenia is associated with higher levels of dopamine, it is most effectively treated using antipsychotic medication that blocks the action of dopamine (see Concept 30.1.01). Other psychological disorders are best treated with specific psychotherapeutic techniques. For example, **systematic desensitization** is an effective behavioral (see Lesson 1.2) treatment for specific phobia (see Concept 29.1.01) that pairs relaxation techniques with increasingly distressing stimuli until the client can face the feared animal/object or situation with a diminished fear response. As depicted in Figure 31.1, a therapist using systematic desensitization could help a client with a specific phobia of rats by initially teaching the client relaxation techniques. The client could then use these skills while facing progressive steps over time, such as by first viewing photos of rats; after some time, holding a life-like toy rat; and eventually (and gradually) approaching a live caged rat. Chapter 31: Treatment of Psychological and Neurological Disorders 170 **Figure 31.1** Example of systematic desensitization. **Major Psychotherapeutic Approaches** More broadly, several major psychotherapeutic approaches have been developed based on theoretical perspectives in psychology. One major psychotherapeutic approach is **humanistic psychotherapy** (see humanistic theory in Lesson 1.3), which is a person- or client-centered approach that aims to provide a supportive environment in which clients can grow and change. Humanistic therapists demonstrate unconditional positive regard (ie, acceptance and support, regardless of behavior), empathy (ie, seeing the world from the client\'s perspective), and [active listening](javascript:void(0)) (ie, paraphrasing a client\'s own words and asking clarifying questions). Another major psychotherapeutic approach, **cognitive-behavioral therapy** (CBT), is designed to help individuals replace negative thoughts and behaviors with healthier thoughts and behaviors. For example, a cognitive-behavioral therapist treating an individual with social anxiety (see Concept 29.1.01) could focus on replacing the patient\'s negative thoughts (eg, \"I\'m awkward in social situations\") and avoidant behaviors (eg, eating alone) with more positive thoughts (eg, \"I\'m interesting and a great listener\") and sociable behaviors (eg, eating with others **Major Approaches in Sociology** 32.1.01 Sociology and Society **Sociology** is the scientific study of **society** (also known as social life, the social world, or the social environment); society refers to the patterns of relationships and activities developed by a group of people who share a common way of life. Sociologists examine how humans organize social systems (eg, politics, criminal justice) and create culture (ie, shared languages and customs). When analyzing the relationship between individual actions and the operations of society, sociologists rely on empirical evidence (ie, observations and data) to develop and support their explanations. A few common sociological topics include patterns of group interaction, systems of inequality, and strategies for social change. 32.1.02 Microsociology and Macrosociology Society is a broad and complicated topic to study. To address this complexity, sociology can be divided into two main approaches, microsociology and macrosociology, which each focus on different aspects of social life. The **microsociology** (also known as micro-level) approach examines small-scale social phenomena (eg, community events or workplace dynamics) and interpersonal interactions (eg, communication between teacher and student). Microsociology takes a \"microscopic view\" of society, with a focus on the importance of individual actions that build and shape society. For example, a microsociology approach might focus on communication barriers between physicians and patients to understand the impact of interaction on health outcomes. The other approach to studying society is the **macrosociology** (also known as the macro-level) approach, which focuses on society-wide institutions (eg, healthcare system) and large-scale events (eg, economic recessions, wars) that impact the everyday experiences of individuals. Macrosociology takes a \"bird\'s-eye view\" of society to examine broad patterns, trends, and demographics within the organization of society. For example, a macrosociology approach might focus on how patterns of unemployment and poverty impact the rise of obesity rates. Both micro- and macro-level approaches are seen as distinct perspectives needed to understand the complexities of social life, and within sociology, neither approach is preferred or considered more accurate. Microsociology examines how individual behaviors impact the larger society, and macrosociology examines how larger social institutions shape the lives of individuals (see Figure 32.1 for a comparison between the approaches). **Figure 32.1** Microsociology versus macrosociology. **Sociological Theories** 32.2.01 Functionalism In sociology, a theory is a set of abstract ideas used to explain a wide range of social phenomena such as the development of identity, the emergence of social movements, or the rise of a global economy. Each theory views social life from a particular perspective and is especially relevant for studying certain aspects of society. One macrosociological theory (Lesson 32.1) is **functionalism** (also known as structural functionalism), which compares society to a biological organism. Émile Durkheim proposed that structures of society (Chapter 43 discusses institutions and systems) work together to maintain stability and order (ie, societal balance), similar to the way various organ systems function to maintain homeostasis in an organism. For example, the healthcare system functions to keep people healthy so that they can work and contribute to society, and the education system functions to teach and train people who will, in turn, contribute to society. Each system serves different purposes and is necessary to support society\'s overall order and balance. One application of functionalist theory is to examine different types of social functions (ie, a social institution\'s purpose or contribution to society). Sociologist Robert Merton argued that social institutions have **manifest functions**, which are expected or planned, and **latent functions**, which are unintended. For example, higher education (ie, social institution) is meant to teach students the skills necessary to become functioning citizens in society (ie, manifest function); however, many students also end up meeting potential romantic partners in college (ie, latent function). 32.2.02 Conflict Theory Unlike functionalism\'s focus on balance and order, **conflict theory** views society as a hierarchy of competing groups. According to conflict theory (a macrosociological theory, see Lesson 32.1), tension arises when resources, such as wealth and power (Concept 45.1.05), are unequally distributed throughout society, resulting in the most powerful groups possessing more advantages than others. The development of conflict theory was influenced by Karl Marx, who wrote about societal changes resulting from the capitalist revolution in the nineteenth century. Marx argued that private ownership (ie, individuals and corporations controlling the means of production instead of the government controlling them) in capitalism would increase inequality between the economic classes. The owning class (ie, **bourgeoise**) gains wealth through the exploitation of the working class (ie, **proletariat**). Marx theorized conflict was inevitable when the working class recognized the inequality within capitalism. Conflict theory also asserts that power and privilege (Concept 45.1.05) are incorporated within social institutions (eg, economy, criminal justice) through policies and laws. For example, a conflict theory perspective could be applied to understand the inequality in resources for public schools: property taxes fund public education, and this policy results in higher budgets (ie, more resources) for schools in wealthier neighborhoods and lower budgets (ie, fewer resources) for schools in low-income neighborhoods. 32.2.03 Symbolic Interactionism **Symbolic interactionism** is a microsociological theory (Lesson 32.1) that views society as the product of social interaction. According to symbolic interactionism, meaning can be communicated through the use of **symbols** (ie, any image, object, gesture, or sound that conveys meaning) within social interaction. Chapter 32: Theoretical Approaches in Sociology 177 Symbolic meanings differ by context and culture (see Lesson 34.1) and are not permanent. For example, wearing pants was a symbol of masculinity in the United States through the 1950s, but \"pants\" no longer carry symbolic meaning associated with gender. George Herbert Mead influenced the development of symbolic interactionism and proposed three key principles: Symbolic meaning is created in interaction. Individuals act based on the interpreted meaning of symbols. Differences in symbolic interpretation result in different actions. For example, symbols are used in a chemistry lab to communicate different risks and hazards. A chemistry student learns the meaning of these symbols (ie, visual representation of different properties of the chemical) through *interaction* with the instructor and lab assistants. Individuals take precautions when handling the chemicals based on their *interpretation* of the symbols\' meaning. An individual who is not a chemistry student may interpret the symbols to have *different meanings* (eg, skull and crossbones could symbolize a pirate ship rather than a toxic chemical). 32.2.04 Social Constructionism Similar to symbolic interactionism\'s emphasis on interaction, **social constructionism** is a microsociological theory (Lesson 32.1) focused on the ways societies create ideas and interpret the meaning of reality. A **social construct** is an agreed-upon idea which has been created and supported by a specific social group during a particular time period. Social constructionism proposes that elements of social \"reality\" such as common practices, social systems, and identities are social constructs. Objects (eg, wedding ring), behaviors (eg, wearing clothes), and identity categories (eg, nationality) have meaning only because individuals in society have agreed on that meaning. For example, the monetary value of a dollar bill is not based on the physical (ie, inherent) properties of the paper. However, the dollar has value in society because there is agreement on its worth (ie, social construct), and dollar bills are exchanged for goods based on this shared meaning. 32.2.05 Exchange-Rational Choice **Exchange-rational choice** refers to two micro-level sociological theories (Lesson 32.1), each offering explanations about human decision-making processes. The **rational choice theory** proposes that humans are self-interested (ie, take actions that benefit themselves) and make rational (ie, logical) decisions through an analysis of all possible options to maximize gain and minimize loss. For example, a smoker might weigh the costs and benefits of quitting before deciding to act. Rational choice theory can be applied to this example because the smoker\'s choice about a behavior change is based on a logical analysis of the gains (eg, reduced health risks) and losses (eg, withdrawal symptoms) of smoking cessation, and the decision supports the interests of the individual. **Social exchange theory** (also known as exchange theory) applies rational choice theory to interactions and relationships with others. Exchange theory proposes that interactions between people are based on each person\'s calculation of the benefits (eg, intimacy, support) and costs (eg, time, stress) of the relationship. For example, exchange theory could be useful when studying infidelity in marriages to understand the decision-making process of a spouse leaving or remaining in the relationship. 32.2.06 Feminist Theory In sociology, **feminist theory** describes a variety of theories aimed to explain the differences in power based on gender (ie, gender inequality). Feminist theories argue that the basis for gender inequality, both Chapter 32: Theoretical Approaches in Sociology 178 historically and in contemporary society, is the organization of society into a patriarchal system (ie, men possess most of the power and prestige as defined in Concept 45.1.05). Current feminist theory attempts to address how the patriarchal structure of society negatively impacts all individuals, regardless of gender identity. For example, traditional gender roles within the family (ie, father as provider and mother as nurturer) can lead to the development of distant relationships between fathers and children. Feminist theories include both macro- and micro-level approaches (Lesson 32.1). At the macro-level, feminist theory considers how large-scale social processes maintain gender inequality. For instance, the term *glass ceiling* refers to workplace practices that discriminate against women (eg, less pay, fewer promotions), resulting in the underrepresentation of women in certain fields (eg, surgery) and in leadership positions (eg, CEO). At the micro-level, feminist theory considers how one-on-one interactions also maintain gender inequality through objectification (ie, positioning women as sexual objects) or devaluation (ie, negative or oppressive language towards women). For example, the derogatory phrase \"you throw like a girl\" is aimed to devalue femininity at the micro-level of interaction