PsychologyA Self-Teaching Guide phần 9 doc

The Organic Mental Disorders: When the Nervous System Itself Has Pathology Organic mental disorders are characterized by constellations of signs and symptoms that suggest there is actua

Abnormal Psychology: Exploring Mental Disorders 223

they can attract followers Julius says that he is a visitor to the Earth from an alienworld and has come to spread a message of peace He has written pamphlets and

a history of his world, and he has drawn detailed interstellar maps Everything hesays fits together The points he makes are consistent If his initial premise isgranted, that he is an alien, then he seems to be rational

(a) What is an older name for the disorganized type of schizophrenia?

(b) What disorder, not a kind of schizophrenia, is characterized by an organized, systematic delusional system?

Answers: (a) Hebephrenic schizophrenia; (b) Delusional disorder.

The Personality Disorders: Making Others Suffer

Personality disorders are characterized by maladaptive behavioral traits The

individual’s persistent way of coping with the world is, in the long run, ineffectiveand self-defeating It is important to understand that a personality disorder doesnot, on the surface, appear to be any kind of mental illness The individual is notnecessarily suffering from chronic anxiety or depression Also, the individual isnot psychotic Often, there is not a great deal of personal suffering associated withthese disorders There is sometimes a tendency for the individual with a personal-ity disorder to inflict suffering on others

Three kinds of personality disorders will be identified: (1) narcissistic, (2)

antisocial, and (3) obsessive-compulsive A narcissistic personality disorder

is characterized by self-absorption The individual is in love with himself orherself Such people are described as vain and selfish They are often overlypreoccupied with their appearance They tend to be cold and lacking insympathy

(a) What disorders are characterized by maladaptive behavioral traits?

(b) What disorder is characterized by self-absorption?

Answers: (a) Personality disorders; (b) Narcissistic personality disorder.

The antisocial personality disorder is characterized by a lack of guilt

feel-ings People with this disorder can lie, cheat, steal, and manipulate others without

remorse The word antisocial doesn’t mean they are unfriendly Often, they have a

superficial charm They are antisocial in the sense that they refuse to conform tosociety’s conventions, to its standards and norms of behavior

The obsessive-compulsive personality disorder is characterized by

per-fectionism People with this disorder want order in the environment Everything

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must be in its place Things must be done on schedule Tasks must be completedwithout flaw or error Such individuals find it difficult to just let up a little andenjoy life The obsessive-compulsive personality disorder should not be confusedwith a disorder presented earlier, the obsessive-compulsive disorder The person-ality disorder, as already indicated, is characterized by a need for perfection Onthe other hand, the anxiety disorder is characterized by a need to reduce the anx-iety generated by obsessive ideas

(a) The personality disorder is characterized by a lack of guilt feelings (b) The personality disorder is characterized by perfectionism.

Answers: (a) antisocial; (b) obsessive-compulsive.

The Organic Mental Disorders: When the Nervous System

Itself Has Pathology

Organic mental disorders are characterized by constellations of signs and

symptoms that suggest there is actual damage to the brain and nervous system.This damage may be caused by a genetic tendency, a toxic agent, a vitamin defi-ciency, or an infection In brief, the nervous system itself has pathology (i.e., is

Alcohol amnestic disorder is characterized primarily by memory

difficul-ties It was noted earlier that the word amnesia means “without memory.” Unlike

psychogenic amnesia, the memory problems associated with alcohol amnestic order are general, not specific to the individual’s sense of identity The disorderwas first studied by the Russian neurologist Sergei Korsakoff over one hundred

dis-years ago An older name for the condition is Korsakoff ’s psychosis Alcohol abuse tends to induce a deficiency of thiamine, a B-complex vitamin Some of

the impairment associated with alcohol amnestic disorder is reversible with min therapy On the other hand, some of the impairment is due to the loss of neu-rons linked to the toxic effects of alcohol Impairment associated with destroyedneurons is not reversible

vita-(a) mental disorders are characterized by constellations of signs and toms that suggest there is actual damage to the brain and nervous system.

symp-(b) What is an older name for alcohol amnestic disorder?

Answers: (a) Organic; (b) Korsakoff’s psychosis.

Abnormal Psychology: Exploring Mental Disorders 225

Dementia of the Alzheimer’s type is characterized by a progressive decline

in mental functioning The ability to remember, learn, understand ideas, makedecisions, and control one’s muscles is lost In the latter stages of the disorder the

victim becomes weak and emaciated In clinical work, the term dementia of the

Alzheimer’s type is somewhat preferred over the more popular term Alzheimer’s

disease, because an actual diagnosis based on signs and symptoms alone is difficult.

On the other hand, a post-mortem examination can determine if the degeneration

of neurons in the brain in fact follows the pattern of the actual disease This patternincludes tangles of fibers within nerve cells, the loss of nerve cells within certain

areas of the brain, and amyloid plaques Amyloid plaques are excessive protein

deposits between nerve cells The syndrome was first studied by the German rologist Alois Alzheimer in the early part of the twentieth century

neu-General paresis is characterized by both dementia and paralysis It is linked

to syphilis, a sexually transmitted disease The primary cause of the disorder isdestruction of the brain and nervous system by the corkscrew-shaped bacteriumthat causes syphilis

(a) Dementia of the type is characterized by a progressive decline in mental functioning.

(b) What organic mental disorder is linked to syphilis?

Answers: (a) Alzheimer’s; (b) General paresis.

Viewpoints: Ways to Explain Abnormal Behavior

When an individual’s behavior is abnormal and pathological, as it is in the case ofthe mental disorders, one of the first questions that comes to mind is why We arecurious and want an explanation of the deviant actions

For centuries, a popular explanation of aberrant behavior was demonology,

the view that Satan’s agents had taken possession of the troubled person’s soul.This explanation is not the one favored by psychology and psychiatry Instead,these fields of study tend to subscribe to viewpoints based on an understanding

of natural law Five such viewpoints will be identified: (1) biological, (2) dynamic, (3) learning, (4) humanistic, and (5) sociocultural

psycho-The biological viewpoint assumes that pathological behavior is caused by

an organic factor A genetic tendency, a biochemical imbalance, a brain injury, or

an infection can all play roles in mental disorders For example, there is much

evidence to support the hypothesis that schizophrenia is a biogenetic disorder,

one that is strongly influenced by a genetic tendency This genetic tendency isprobably the principal cause of a difficulty in the way in which the brain employs

dopamine, one of the nervous system’s neurotransmitters (see chapter 3).

The psychodynamic viewpoint assumes that pathological behavior arises

because of repressed emotional conflicts For example, Theresa, a highly

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tional, conventional woman, suffers from agoraphobia Her conscious fear of ing her home territory is a cover, a mask over a forbidden wish She is angry withher husband and is filled with buried resentments The forbidden wish is a desire

leav-to take flight from the marriage

(a) The viewpoint assumes that pathological behavior is caused by an organic factor.

(b) The viewpoint assumes that pathological behavior arises because of repressed emotional conflicts.

Answers: (a) biological; (b) psychodynamic.

The learning viewpoint assumes that pathological behavior is a maladaptive

response to an adverse experience (or a set of related experiences) For example,Quentin suffers from claustrophobia When he was a preschooler, his mother used

to punish him by locking him in a dark closet for an hour or two at a time Hisphobia can be understood as a kind of conditioned reflex (see chapter 6)

The humanistic viewpoint assumes that pathological behavior is a response

to an inability to become self-actualizing For example, Joan suffers from chronicdepression When she was an adolescent she displayed talent in creative writingand won several high-school short story contests She dreamed of a career as anovelist Today, she is divorced with three children, and works as a checker in adiscount store One of the factors in her depression is the frustration associatedwith her inability to make the most of her talents

The sociocultural viewpoint assumes that pathological behavior is a

mal-adaptive response to large, inescapable forces and events arising from the socialworld, the world of other people Such forces include war, economic depression,overcrowded housing, a totalitarian government, and so forth For example, fifty-seven-year-old Lloyd is suffering from a major depressive episode and often thinks

of suicide Once he was worth more than two million dollars in stock Majorreverses in the economy, combined with some impulsive, ill-considered decisions

on his part, wiped out his fortune

It is not necessary to make a choice among the viewpoints and decide which

viewpoint is the correct one The viewpoints overlap and are not mutually

exclu-sive Often the factors associated with two or more viewpoints may interact Inappropriate cases, any of the viewpoints may be useful and applicable

(a) The viewpoint assumes that pathological behavior is a maladaptive response to an adverse experience (or a set or related experiences).

(b) The viewpoint assumes that pathological behavior is a response to an inability to become self-actualizing.

Answers: (a) learning; (b) humanistic.

Abnormal Psychology: Exploring Mental Disorders 227 SELF-TEST

1 One of the following is not a criterion that helps mental health professionals

to identify the presence of a mental disorder.

3 One of the chief features of a generalized anxiety disorder is

a highly specific fears

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8 Self-absorption is a distinguishing feature of

a obsessive-compulsive disorder

b narcissistic personality disorder

c organic mental disorders

d anxiety disorders

9 An older name for alcohol amnestic disorder is

a dementia of the Alzheimer’s type

a The biological viewpoint

b The psychodynamic viewpoint

c The learning viewpoint

d The humanistic viewpoint

ANSWERS TO THE SELF-TEST

1-c 2-d 3-b 4-d 5-b 6-c 7-a 8-b 9-c 10-a

ANSWERS TO THE TRUE-OR-FALSE PREVIEW QUIZ

1 False It takes more than deviation alone for a behavior pattern to be considered logical The chapter lists five additional criteria.

patho-2 True.

3 False Anxiety disorders are characterized by a core of irrational fear.

4 False Dissociative identity disorder (DID), not schizophrenia, is characterized by the presentation to others of two or more selves.

5 True.

KEY TERMS

abnormal behavior acrophobia

agoraphobia alcohol amnestic disorder

Alzheimer’s disease amyloid plaques antisocial personality disorder anxiety disorders

Abnormal Psychology: Exploring Mental Disorders 229

axis biogenetic disorder biological viewpoint bipolar disorder catatonic type chronic worry claustrophobia cognitive distortions conversion disorder cyclothymia

delusional disorder delusions

dementia of the Alzheimer’s type dementia praecox

demonology depersonalization disorder disorganized type

dissociative disorders dissociative identity disorder (DID) dopamine

dysthymia free-floating anxiety general paresis generalized anxiety disorder hallucinations

hebephrenic schizophrenia humanistic viewpoint hypochondriacal disorder (or hypochondriasis) hysteria

illogical behavior inferior personality Korsakoff’s psychosis learning viewpoint

major depressive episode mania

manic-depressive disorder mental disorder

mood disorders multiple personality disorder narcissistic personality disorder negative mood

neurotic anxiety neurotic depression obsessive-compulsive disorder (OCD) obsessive-compulsive personality disorder

organic mental disorders out-of-body experience pain disorder

paranoia paranoid type pathological shyness personality disorders phobic disorders positive mood post-traumatic stress disorder (PTSD) psuedoneurological symptoms psychodynamic viewpoint psychogenic amnesia psychogenic fugue psychotic disorders rational anxiety salient behavior schizophrenia self-defeating behavior self-destructive behavior sign

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social phobia sociocultural viewpoint somatization disorder somatoform disorders specific phobias superior personality

symptom syndrome thiamine undifferentiated type unipolar disorders zoophobia

1 T F The literal meaning of the term psychotherapy is “healing of the mind”

or “healing of the self.”

2 T F The main way that Freud explored the unconscious roots of

mental-emotional problems was with the “digging” tool of operant tioning

condi-3 T F Client-centered therapy is based on the assumption that the troubled

person has powerful inner resources, resources that will help the vidual think and feel better

indi-4 T F Behavior therapy is based on the assumption that mental and

emo-tional problems often arise because of repressed memories and den wishes

forbid-5 T F Antipsychotic agents are drugs that treat mental disorders

character-ized by chronic anxiety

(Answers can be found on page 245.)

As you learned in chapter 14, suffering is usually associated with various mental disorders Mental health professionals seek ways to alleviate this

suffering This chapter presents ways in which therapy—both psychological and biological—can help troubled people cope with life.

ther-• specify some principal features of psychoanalysis;

• describe key aspects of client-centered therapy;

• identify central concepts associated with behavior therapy;

• explain the basic assumption underlying cognitive-behavior therapy;

• state the value of group therapy;

• list basic kinds of psychiatric drugs

Mental disorders are far from hopeless conditions Gone are the days whenmental patients were written off as outcasts and lost members of the human race.Today there are treatments The treatments have varying degrees of effectiveness.Sometimes a given treatment provides dramatic relief More often, a particularpatient will recover slowly, and treatment becomes a prolonged process

Treatment for mental disorders is given in the form of various kinds of

ther-apy Therapy consists of procedures that aim to either cure sick people or

allevi-ate their suffering The term is applied to general medicine as well as to clinicalpsychology and psychiatry In the mental health field there are two basic cate-gories of therapy: psychologically based therapies and biologically based therapies

Psychologically based therapies begin with the assumption that mental

disor-ders are caused by emotional conflicts, maladaptive learning, cognitive errors, orsimilar behavioral processes These therapies recognize that the suffering individ-ual may be free of organic pathology, that there is often nothing objectively wrongwith the brain and nervous system

Psychotherapy is the general term applied to any kind of psychologically

based therapy A presentation of various kinds of psychotherapy constitutes a

prin-cipal portion of this chapter The literal meaning of the term psychotherapy is

“healing of the mind” or “healing of the self.”

Biologically based therapies begin with the assumption that mental

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orders are caused by actual pathology of the brain and nervous system These apies recognize that the suffering individual often has a genetic tendency toward adisorder, an imbalance in neurotransmitters, a hormone problem, an infection, orsimilar difficulties at a biological level.

ther-Drug therapy is the most common form of biologically based therapy It is

characterized by the prescription of certain chemical agents that have been shown

to either eliminate or reduce the severity of symptoms associated with variousmental disorders

(a) What therapies are based on the assumption that mental disorders are caused by tional conflicts, maladaptive learning, cognitive errors, or similar behavioral processes?

emo-(b) What therapies are based on the assumption that mental disorders are caused by actual pathology of the brain and nervous system?

Answers: (a) Psychologically based therapies; (b) Biologically based therapies.

Psychodynamic Therapy: Exploring Unconscious Roots

Psychodynamic therapy is any kind of psychotherapy that attempts to reduce

suffering by exploring the unconscious roots of a mental-emotional problem chodynamic therapy has its origins in Freud’s psychoanalysis Accordingly, adescription of the psychoanalytic process follows

Psy-Free association is the principal “digging” tool used by psychoanalysis.

Free association consists of saying anything that comes to mind without a cern for logic or the appropriateness of the content In classical psychoanalysis,this is accomplished while reclining on a couch The aim of free association is todredge up from the unconscious level a fund of information that can be discussedand understood, with the help of the therapist, at a conscious level In the lastfifteen or twenty minutes of a fifty-minute session, the patient sits up and inter-pretations are made of the memories and ideas obtained by free association

con-An interpretation consists of making sense of content that has been repressed

at the unconscious level Usually the therapist makes the interpretation, but there

is room for discussion The patient should play an active role in modifying theinterpretation If a patient accepts an interpretation that has important meaning,

then the patient often experiences an insight, a sudden burst of understanding It

is believed that insights into the self have therapeutic power

Interpretations are also made of slips of the tongue, dreams, and various kinds

of transference Slips of the tongue are speech errors that reveal a forbidden

wish According to Freud, there are no “innocent” errors They all have

uncon-Therapy: Helping Troubled People 233

scious meaning For example, a wife says to her husband, just before retiring tobed, “I want to kill you.” The husband is taken aback The wife, abashed, says,

“Honey, I don’t know why I said that I meant to say I want to kiss you.” Theinterpretation in this case is that, at the level of the id, there is substantial hostility

toward the husband Slips of the tongue are sometimes called Freudian slips.

(Not all psychologists agree that every slip of the tongue has an unconscious

meaning There are probably so-called Watsonian slips also, errors made because

of a conflict of speech habits.)

(a) What kind of therapy attempts to reduce suffering by exploring the unconscious roots of

a mental-emotional problem?

(b) What is the principal “digging” tool used by psychoanalysis?

(c) An consists of making sense of content that has been repressed at the unconscious level.

(d) According to Freud, are speech errors that reveal a forbidden wish.

Answers: (a) Psychodynamic therapy; (b) Free association; (c) interpretation; (d) slips of the tongue.

The interpretation of dreams is a central feature of psychoanalytic therapy.Freud said that dreams are “the royal road to the unconscious.” He asserted that a

dream has two levels The manifest level is the surface of the dream It is what is

presented to the dreaming subject and what is remembered when the individual

wakes up The latent level is the concealed aspect of the dream, its meaning This

contains a forbidden wish The manifest level is often cast in symbolic form Thesymbols cloak or disguise the hidden content of the dream Like slips of thetongue, the interpretation of a dream is likely to reveal either repressed hostility or

a repressed sexual impulse For example, a fifty-year-old married man dreams that

a young man meets a beautiful stranger in an unfamiliar city and has sexual tions with her An interpretation might suggest that the young man symbolizesthe dreamer’s youthful nature The forbidden wish is perhaps a desire to have sexoutside of the marriage

rela-Patient-initiated transference exists when the patient projects onto the

ther-apist feelings obtained from an unconscious level There are two kinds of

patient-initiated transference A positive transference occurs when the patient sees the

therapist in glowing, magical terms The therapist is a wonder worker; he or shecan do no wrong Sometimes that patient develops a crush on the therapist andthinks he or she is in love

A negative transference occurs when the patient sees the therapist in

nega-tive, derogatory terms The therapist is a jerk; his or her interpretations are stupid

A negative transference often forms toward the completion of therapy when the

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