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PSYC 435 UNIT 10 TO UNIT 13
COMPLETE LATEST VERSION 2024
CHAPTER 10
personality disorder, p. 342 chronic interpersonal difficulties, problems with one’s identity or sense of self, and an inability to function adequately in society - enduring pattern of behavior must be pervasive and inflexible, as well as stable and of long duration - cause either clinically significant distress or impairment in functioning and be manifested in at least two of the following areas: cognition, affectivity, interpersonal functioning, or impulse control.
- Five-factor model of personality: neuroticism (emotional instability), extraversion/introversion , openness to experience (unconventionality), agreeableness/antagonism , and conscientiousness Cluster A : Includes paranoid, schizoid, and schizotypal personality disorders. People with these disorders often seem odd or eccentric, unusual behavior ranging from distrust and suspiciousness to social detachment. Cluster B: Includes histrionic, narcissistic, antisocial, and borderline personality disorders. Individuals with these disorders share a tendency to be dramatic, emotional, and erratic. Cluster C: Includes avoidant, dependent, and obsessive- compulsive personality disorders. In contrast to the other two clusters, people with these disorders often show anxiety and fearfulness. epidemiological study, p. 344 assessed the prevalence of the personality disorders - Epidemiological studies are designed to establish the prevalence (number of cases) of a particular disorder in a very large sample (usually many thousands) of people living in the community
10 and 12 percent of people meet criteria for at least one personality disorder when the time period being asked about is the person’s behavior over the last 2 to 5 years paranoid personality disorder, p. 348 are suspicious and distrustful of others, often reading hidden meanings into ordinary remarks - see themselves as blameless, instead blaming others for their own mistakes and failures—even to the point of ascribing evil motives to others. schizoid personality disorder, p. 349 difficulty forming social relationships and usually lack interest in doing so - tend not to have good friends, with exception of a close relative - unable to express their feelings/seen by others as cold and distant - They often lack social skills and can be classified as loners or introverts, with solitary interests and occupations not all loners/introverts have schizoid personality Neither desires nor enjoys close relationships, including being part of a family - Almost always chooses solitary activities - Has little, if any, interest in having sexual experiences with another person - Takes pleasure in few, if any, activities - Lacks close friends or confidants other than first-degree relatives. schizotypal personality disorder, p. 351 also excessively introverted and have pervasive social and interpersonal deficits. But in addition they have cognitive and perceptual distortions, as well as oddities and eccentricities in their communication and behavior - contact with reality is usually maintained, highly personalized and superstitious thinking is characteristic - often believe that they have magical powers and may engage in magical rituals Ideas of reference (excluding delusions of reference) - Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance,
slow return to a baseline emotional state. Affective instability is also characterized by drastic and rapid shifts from one emotion to another This is combined with a highly unstable self-image or sense of self - chronic feelings of emptiness and have difficulty forming a sense of who they really are - very fearful of abandonment - Self-mutilation Frantic efforts to avoid real or imagined abandonment - A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation - Identity disturbance: markedly and persistently unstable self-image or sense of self - Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior - Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) - Chronic feelings of emptiness - Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) - Transient, stress related paranoid ideation or severe dissociative symptoms - Impulsivity in at least two areas that are potentially self- damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). avoidant personality disorder, p. 364 show extreme social inhibition and introversion, leading to life- long patterns of limited social relationships and reluctance to enter into social interactions. Because of their hypersensitivity to, and fear of, criticism and disapproval, they do not seek out other people, yet they desire affection and are often lonely and bored - Feeling inept and socially inadequate are the two most prevalent and stable features - Avoids occupational activities that involve significant inter- personal contact because of fears of criticism, disapproval, or rejection - Is unwilling to get involved with people unless certain of being liked - Shows restraint within intimate relationships because of the fear of being shamed or ridiculed - Is preoccupied with being criticized or rejected in social situations - Is inhibited in new interpersonal situations because of feelings of inadequacy - Views self as socially inept, personally unappealing, or inferior to others - Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. dependent personality disorder, p. 365 extreme need to be taken care of, which leads to clinging and submissive behavior. They also show acute fear at the possibility of separation or sometimes of simply having to be alone because they see themselves as inept - Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others - Needs others to assume responsibility for most major areas of his or her life - Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.) - Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence - judgment or abilities rather than a lack of motivation or energy) - Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant - Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself - Urgently seeks another relationship as a source of care and support when a close relationship ends - Is unrealistically preoccupied with fears of being left to take care of himself or herself. obsessive-compulsive personality disorder (OCPD), p. 367 Perfectionism and an excessive concern with orderliness and control - Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost - Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met) - Is over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) - Is unable to discard worn-out or worthless objects
even when they have no sentimental value - Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things - Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes - Shows rigidity and stubbornness - Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity). dialectical behavior therapy (DBT), p. 370 Marsha Linehan, is a unique kind of cognitive and behavioral therapy specifically adapted for BPD - patients’ inability to tolerate strong states of negative affect is central to this disorder. One of the primary goals of treatment is to encourage patients to accept this negative affect without engaging in self-destructive or other maladaptive behaviors - based on a clear hierarchy of goals, which prioritizes decreasing suicidal and self-injurious behavior and increasing coping skills. The therapy combines individual and group components as well as phone coaching. psychopathy, p. 372
ideal. This is because many of the symptoms of spe- cific personality disorders are not very precisely defined. A great deal of judgment is needed to know if a person’s behavior meets the standard in each case.
- Many different interviews and self-report measures can be used to assess personality and personality disorders. There is not always high agreement between the diag- noses made with one instrument versus another.
- Classifying personality disorders in a categorical man- ner may not be the best approach. Most researchers today agree that a dimensional approach for assessing personality disorders has many advantages and would be preferable.
- It is difficult to determine the causes of personality dis- orders because most studies to date are retrospective.
- Most people with one personality disorder have at least one more personality disorder as well. This com- plicates research. 10.3 List the three Cluster A personality disorders and describe the key clinical features of each.
- The Cluster A personality disorders are paranoid, schizoid, and schizotypal personality disorder. Indi- viduals with Cluster A disorders seem odd or eccentric.
- Paranoid personality disorder is characterized by sus- piciousness and mistrust. It is equally common in men and women and has a prevalence of around 1 to 2 per- cent. Little is known about the causes of paranoid per- sonality disorder although people with this disorder are at increased risk for schizophrenia.
- People with schizoid personality disorder have little interest in developing social relationships. They are not emotionally expressive. They are viewed by others as being cold and aloof. The lifetime prevalence of schizoid personality disorder is around 1 percent and the disorder is more common in men than women. Not much is known about the causes of schizoid per- sonality disorder, in part because such people have little interest in taking part in research.
- Schizotypal personality disorder has a lifetime preva- lence of around 1 percent. It is thought to be more com- mon in males than females. People with this personality disorder show oddities in their thinking, speech, or behavior. They may have magical thinking or express odd beliefs. Genetic and other biological factors are implicated in schizotypal personality disorder, which is thought to be part of the schizophrenia spectrum. 10.4 Describe the four Cluster B personality disorders and explain what common features they share. and erratic. Little is known about the causes of histri- onic and narcissistic personality disorders.
- Histrionic personality is characterized by excessive attention seeking and high levels of extraversion, as well as theatrical and sometimes seductive behavior. The lifetime prevalence of the disorder is slightly more than 1 percent and it is more common in women than men. This disorder was recommended for deletion in DSM-5, although this did not happen. Many question whether it is a meaningful diagnosis.
- Narcissistic personality disorder involves an exagger- ated sense of self-importance, a need for admiration, and lack of empathy for the feelings of other people. Such people act in very entitled ways. The disorder is thought to be more common in men than women, with a prevalence of just under 1 percent.
- Antisocial personality disorder is characterized by deceitful, aggressive, and irresponsible behavior and a lack of regard for the rights of others. It is much more prevalent in men (around 3 percent) than women (around 1 percent). Many incarcerated people have antisocial personality disorder. Antisocial behavior has its roots in childhood and antisocial traits are thought to be heritable. Many adverse environmental factors (such as low family income, poor parental supervision, or neglect) are also implicated.
- Borderline personality disorder is characterized by emotional instability, fears of abandonment, impulsiv- ity, self-mutilating behavior, and an unstable sense of self. People with BPD have intense and stormy per- sonal relationships. The disorder has a lifetime preva- lence of around 1 to 2 percent. Although many people are taught that borderline personality disorder is more common in women, researchers now believe it is equally common in men and women. Psychosocial causal factors (e.g., childhood adversity) have been identified as increasing the likelihood of developing borderline personality disorder. People with suscepti- ble temperaments or those who are more impulsive and emotional are thought to be most at risk when they experience early maltreatment. 10.5 List the three Cluster C personality disorders and describe the clinical features that are central to each.
- Cluster C disorders are avoidant, dependent, and obsessive-compulsive personality disorder. People with these disorders show fearfulness or tension, as in anxiety-based disorders.
- Children with an inhibited temperament may be at heightened risk for avoidant personality disorder. The disorder is characterized by introversion, social anxiety, and hypersensitivity to criticism or disapproval. Avoid- ant personality disorder is more common in women
- Cluster B includes histrionic, narcissistic, antisocial, and borderline personality disorders; individuals with these disorders share a tendency to be dramatic, emotional, than men and has a prevalence of around 2 to 3 percent. There is substantial overlap between avoidant personal- ity disorder and generalized social phobia.
- People with dependent personality disorder are fear- ful of being alone and believe they need other people to take care of them. They have difficulty making deci- sions and need a lot of reassurance from others. The disorder is more common in women than men with a prevalence slightly under 1 percent. Individuals high on neuroticism and agreeableness, with authoritarian and overprotective parents, may be at heightened risk for dependent personality disorder.
- Obsessive-compulsive personality disorder involves an excessive concern with orderliness and maintaining control. People with this disorder are often perfection- ists and this interferes with their ability to complete projects. They may also be very rigid and have diffi- culty delegating tasks or relaxing in any way. OCD is more common in men than women, with a prevalence of around 2 percent. 10.6 Explain the role that sociocultural factors might play in the prevalence of personality disorders.
CHAPTER 11
addictive behavior, p. 385 behavior based on the pathological need for a substance substance abuse, p. 385 generally involves an excessive use of a substance resulting in (1) potentially hazardous behavior 2) continued use despite a persistent social, psychological, occupational, or health problem. substance dependence, p. 385 usually involves a marked physiological need for increasing amounts of a sub- stance to achieve the desired effects. - individual will show a tolerance for a drug and/or experience withdrawal symptom when the drug is unavailable psychoactive substances, p. 385 alcohol, nicotine, barbiturates, tranquilizers, amphetamines, heroin, Ecstasy, and marijuana. substance-related disorders, p. 385 considered to be disordered when consumed in excessive amounts leading to impairment and other negative consequences tolerance, p. 385 need for increased amounts of a substance to achieve the desired effects—results from biochemical changes in the body that affect the rate of metabolism and elimination of substance from the body. withdrawal, p. 385 refers to physical symptoms such as sweating, tremors, and tension that accompany abstinence from a drug Alcohol Use Disorder A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12 - month period alcohol amnestic disorder, p. 391 memory defect (particularly with regard to recent events), which is sometimes accompanied by falsification of events (confabulation) People with this disorder may not recognize pictures, faces, rooms, and other objects that they have just seen, although they may feel that these people or objects are familiar - treatment with thiamine leads to a reversal alcohol withdrawal delirium, p. 391 those who drink excessively for a long time - usually happens following a prolonged drinking spree when the person enters a state of withdrawal. Slight noises or suddenly moving objects may cause considerable excitement and agitation - The full-blown symptoms include (1) disorientation for time and place, in which, for example, a person may mistake the hospital for a church or jail (2) vivid hallucinations, particularly of small, fast-moving animals like snakes, rats, and roaches; (3) acute fear, in which these animals may change in form, size, or color in terrifying ways; (4) extreme suggestibility, in which a person can be made to see almost any animal if its presence is merely suggested; (5) marked tremors of the hands, tongue, and lips; and (6) other symptoms including perspiration, fever, a rapid and weak heartbeat, a coated tongue, and foul breath. (MCLP), p. 392 “pleasure path- way.” The mesocorticolimbic dopamine pathway - the center of psychoactive drug activation in the brain - made up of neuronal cells in the middle portion of the brain known as the ventral tegmental area - Alcohol produces euphoria by stimulating this area in the brain opium, p. 403 mixture of about 18 chemical substances known as alkaloids
morphine, p. 403 alkaloid present in opium in the largest amount (10– 15 percent) was found to be a bitter- tasting powder that could serve as a powerful sedative and pain reliever heroin, p. 403 if morphine was treated with an inexpensive and readily available chemical called acetic anhydride, it would be converted into another powerful analgesic dopamine theory of addiction, p. 405 suggests that addiction is the result of a dysfunction of the dopamine reward pathway endorphins, p. 405 human body produces its own opium-like substances, called endorphins, in the central nervous system and pituitary gland. Heroin plugs into opiate receptors (taking the place of endorphins), but works much more quickly and intensely, producing the extreme euphoria reward deficiency syndrome, p. 405 suggests addiction more likely to occur in peeps have genetic deviations in components of the reward pathway, leads them to be less satisfied by natural rewards (e.g., from food, sex, drugs, and other pleasurable activities), in turn leads them to overuse drugs and related experiences to adequately stimulate their reward pathway cocaine, p. 406 plant product discovered in ancient times and used ever since - leaves of the coca plant were wrapped around lime and placed inside the cheek to provide a slow release methadone, p. 406 a synthetic narcotic that is related to heroin and is equally addictive physiologically. amphetamine, p. 408 “wonder pills” that helped people stay alert and awake and function temporarily at a level beyond normal caffeine, p. 409 nicotine, p. 409 barbiturates, p. 411 powerful sedatives been available as an aid to falling asleep - they are extremely dangerous drugs associated with both physiological/psychological dependence & lethal overdoses - once widely used by physicians to calm patients and induce sleep. They act as depressants—some- what like alcohol—to slow down the action of the CNS - users can easily ingest fatal over- doses, either intentionally or accidentally. hallucinogens, p.412 are drugs that are thought to induce hallucinations. However, these preparations usually do not in fact “create” sensory images but distort them so that an - individual sees or hears things in different and unusual ways. These drugs are often referred to as psychedelics LSD, p. 412 odorless, color- less, and tasteless drug - discovered by the Swiss chemist Albert Hofmann in 1938 Ecstasy, p. 413 MDMA (3,4-methylenedioxymeth- ylamphetamine), is both a hallucinogen and a stimulant psilocybin, p. 413 obtained from a variety of “sacred” Mexican mushrooms known as Psilocybe mexicana. flashback, p. 413 an involuntary recurrence of perceptual distortions or hallucinations weeks or even months after an individual has taken the drug.
- Although the existence of an “alcoholic personality type” has been disavowed by most theorists, a variety of personality factors apparently play an important role in the development and expression of addictive disorders.
- Sociocultural factors such as attitudes toward alco- hol may predispose individuals to alcohol-related disorders. 11.3 Discuss the treatment of alcohol-related disorders.
- Less than one-third of those with alcohol use disorders receive treatment, because many people with these disorders deny that the problems exist and so may not be motivated to work on them.
- Several approaches to the treatment of chronic substance-related disorders have been developed— for example, medication to deal with withdrawal symptoms and withdrawal delirium, and dietary eval- uation and treatment for malnutrition.
- Psychological therapies such as group therapy and behavioral interventions may be effective for some people with alcohol use disorders. Another source of help is Alcoholics Anonymous; however, the extent of successful outcomes with this program has not been sufficiently studied.
- Most treatment programs require abstinence; however, some research has suggested that some people with alcohol use disorders can learn to control their drink- ing while continuing to drink socially. The controversy surrounding controlled drinking continues. 11.4 List the psychoactive drugs most commonly associated with abuse and dependence.
- Drug use disorders may involve physiological dependence on substances such as opiates—particularly heroin—or barbiturates; however, psychological dependence may also occur with any of the drugs that are commonly used today, for example, marijuana.
- A number of factors are considered important in the etiology of drug use disorders. Some substances, such as alcohol and opiates, stimulate brain centers that produce euphoria—which then becomes a desired goal. 11.5 Describe the commonly used opiates and their effects on the body.
- Opium is a powerful sedative and pain reliever that depresses or slows down the central nervous system. It also causes a state of euphoria and is highly addic- tive, and has been used for centuries. It is known to activate the dopamine reward pathway, or “pleasure pathway,” often leading to addiction and unfortu- nately—at times—to fatal outcomes.
- Opium appears most commonly today in pain reliev- ers such as morphine and codeine, and in illicit drugs like heroin. Methadone is a synthetic narcotic that is often used to treat heroin addiction; it is similarly addictive, but does not produce the same euphoria or impairments. 11.6 Discuss the different types of stimulants and their effects.
- Stimulants stimulate (hence, their name) the action of the central nervous system. As a result, people taking stimulants are “sped up” in their thoughts and behaviors.
- Commonly used stimulants include several illicit drugs, such as cocaine, amphetamines, and metham- phetamine, as well as several legal ones, such as caf- feine and nicotine. 11.7 Describe the effects of sedatives on the brain.
- Like opiates, sedatives also depress, or slow down, the activity of the central nervous system. A major differ- ence is that they produce more sedation and less euphoria, and as such they are commonly used for medicinal purposes to help people to sleep.
- Strong doses of sedatives produce sleep almost imme- diately, and higher doses can lead to paralysis and even death. 11.8 List four different types of hallucinogens.
- Hallucinogens cause people to see or hear things dif- ferently. Some of the most commonly used hallucino- gens include LSD, mescaline, psilocybin, Ecstasy/ MDMA, and marijuana.
- Recent years have seen an increase in the prevalence of synthetic cannabinoids (which mimic the active ingredient in marijuana) and cathinones (which mimic the active ingredients in amphetamines and cocaine). 11.9 Explain whether there are addictive disorders other than alcohol and drugs.
- Although pathological gambling does not involve a chemically addictive substance, it is considered by many to be an addictive disorder because of the personality factors that tend to characterize compulsive gam- blers. Like the substance abuse disorders, pathologi- cal gambling involves behavior maintained by short-term gains despite long-term disruption of an individual’s life. CHAPTER 12 excitement (arousal) phase, p. 422 get sexually aroused and enjoy sexual activity but have a persistent delay, or absence, of orgasm following a normal sexual arousal phase fetishism, p. 426 recurrent, intense sexually arousing fantasies, urges, and behaviors involving the use of some inanimate object or a part of the body not typically found erotic paraphilic disorders, p. 426 recurrent, intense sexually arousing fantasies, sexual urges, or behaviors that generally involve (1) abnormal targets of sexual attraction (e.g., shoes, children), (2) unusual courtship behaviors (e.g., watching others undress without their knowledge, or exposing oneself to others against their wishes), or (3) the desire for pain and suffering of oneself or others. pedophilic disorder, p. 426 intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger). when an adult has recurrent, intense sexual urges or fanta- sies about sexual activity with a prepubertal child; acting on these desires is not necessary for the diagnosis if they cause the pedophile distress transvestic disorder, p. 428 recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviors. exhibitionistic disorder, p. 429 recurrent and intense sexual arousal from the exposure of one’s genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors.
erectile disorder, p. 447 Marked difficulty in obtaining an erection during sexual activity - Marked difficulty in maintaining an erection until the completion of sexual activity - Marked decrease in erectile rigidity. female sexual interest/arousal disorder, p. 447 Lack of, or significantly reduced, sexual interest/arousal, as manifested by at least three of the following male hypoactive sexual desire disorder, p. 449 Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity - acquired or situational rather than lifelong. Typical situational risk factors include depression and relationship stress. delayed ejaculation disorder, p. 452 Marked delay in ejaculation - Marked infrequency or absence of ejaculation female orgasmic disorder, p. 454 diagnosed in women who are readily sexually excitable - show persistent or recurrent delay in or absence of orgasm following a normal sexual excitement phase and who are distressed by this genito-pelvic pain/penetration disorder, p. 454 combines the genital pain of dyspareunia with muscle tension (not muscle spasms) and fear and anxiety related to genital pain or penetrative sexual activity - more likely to have organic than psychological causes. Some examples of physical causes include acute or chronic infections or inflammations of the vagina or internal reproductive organs, vaginal atrophy that occurs with aging, scars from vaginal tearing, or insufficiency of sexual arousal. SUMMARY Explain why it is difficult to define boundaries between normality and psychopathology in the area of variant sexuality.
- Defining boundaries between normality and psychopathology in the area of variant sexuality is very difficult, in part because sociocultural influences on what have been viewed as normal or aberrant sexual practices abound.
- Degeneracy theory and abstinence theory both maintained that sexual activity should only occur for purposes of procreation because wasting semen was harmful; both were very influential for long periods of time in the United States and many other Western cultures and led to very conservative views on heterosexual sexuality.
- In contrast to Western cultures, in the Sambia tribe in Melanesia, homosexuality is practiced by all adoles- cent males in the context of male sexual initiation rites; these males transition to heterosexuality in young adulthood.
- Until rather recently in many Western cultures, homo- sexuality was viewed either as criminal behavior or as a form of mental illness. However, since 1974 homo- sexuality has been considered by mental health pro- fessionals to be a normal sexual variant. 12.2 List and describe four types of paraphilia.
- Paraphilias involve persistent and recurrent patterns of sexual behavior and arousal, lasting at least 6 months, in which unusual objects, rituals, or situations are required for full sexual satisfaction. They occur almost exclusively in males, who often have more than one of them.
- Paraphilias include fetishes (sexual arousal from a nonliving object), transvestic fetishism (sexual arousal from cross-dressing), pedophilia (sexual arousal from children), voyeurism (sexual arousal from observing others naked, undressing, or engaged in sexual activi- ties), exhibitionism (sexual arousal from exposing one’s genitals), frotteurism (sexual arousal from touching or rubbing against a nonconsenting person), sadism (sexual arousal from the physical or psycho logical suffering of another person), and masochism (sexual arousal from suffering at the hands of some- one else). 12.3 Explain the key characteristics of gender dysphoria. Gender dysphoria occurs in children and adults. Childhood gender dysphoria occurs in children who have dysphoria/distress about their biological sex. Most boys who have this disorder grow up to have a homosexual orientation; a much smaller number become transsexuals. Prospective studies of girls who have this disorder have reported similar results. Transsexualism is a very rare disorder in which the person believes that he or she is trapped in the body of the wrong sex and goes through elaborate steps neces- sary to change his or her sex. It is now recognized that there are two distinct types of male-to-female trans- sexuals: homosexual transsexuals and autogynephilic transsexuals, each with different characteristics and developmental antecedents. The only known effective treatment for transsexuals is a sex change operation Although its use remains highly controversial, it does appear to have fairly high success rates when the peo- ple are carefully diagnosed before the surgery as being true transsexuals. 12.4 Describe three primary types of sexual abuse. There are three overlapping categories of sexual abuse: pedophilia, incest, and rape. All three kinds of abuse occur at alarming rates today. Pedophilia is defined as sexual interest in prepubertal children. Incest involves sexual activity between blood relatives. Rape describes sexual activity that occurs under actual or threatened forcible coercion by one person on another. Treatment of sex offenders has not as yet proved highly effective in most cases, although promising research in this area is being conducted. 12.5 Define sexual dysfunction and name three sexual dysfunction disorders. Sexual dysfunction involves impairment either in the desire for sexual gratification or in the ability to achieve it. Dysfunction can occur in the first three of the four phases of the human sexual response: the desire phase, the excitement phase, and orgasm.
- Male hypoactive sexual desire disorder is diagnosed in men when they have little or no interest in sex. In extreme cases they may actually have an aversion to sexual activity.
positive symptoms, p. 466 those that reflect an excess or distortion in a normal repertoire of behavior and experience, such as delusions and hallucinations. Disorganized thinking (as revealed by disorganized speech) is also thought of in this way. schizoaffective disorder, p. 467 person not only has psychotic symptoms that meet criteria for schizophrenia but also has marked changes in mood for a substantial amount of time. (mood disorder) - period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia. schizophreniform disorder, p. 467 schizophrenia-like psychoses that last at least a month but do not last for 6 months and so do not warrant a diagnosis of schizophrenia paranoid schizophrenia, p. 467 clinical picture is dominated by absurd and illogical beliefs that are often highly elaborated and organized into a coherent, though delusional, framework disorganized schizophrenia, p. 467 characterized by dis- organized speech, disorganized behavior, and flat or inappropriate affect catatonic schizophrenia, p. 467 characterized by dis- organized speech, disorganized behavior, and flat or inappropriate affect delusional disorder, like schizophrenia, hold beliefs that are considered false and absurd by those around them. Unlike schizophrenia, however, may otherwise behave quite normally. does not show the gross disorganization and performance deficiencies characteristic of schizophrenia, and general behavioral deterioration is rarely observed in this disorder, even when it proves chronic brief psychotic disorder, p. 468 Brief psychotic dis- order is often triggered by stress - sudden onset of psychotic symptoms or disorganized speech or catatonic behavior. Even though there is often great emotional turmoil, the episode usually lasts only a matter of days Age-Corrected Incidence Rate Incidence is the number of new cases that develop. An age- corrected incidence rate takes into account predicted break- downs for subjects who are not yet beyond the age of risk for developing the disorder. candidate genes, p. 474 genes that are involved in processes that are believed to be aberrant in schizophrenia. An example is the COMT (catechol-O-methyltransferase) gene. This gene is located on chromosome 22 and is involved in dopamine metabolism. As you will soon learn, dopamine is a neurotransmitter that has long been implicated in psycho- sis (impaired reality testing) genome-wide association study (GWAS), p. 474 Study participants provide a sample of DNA and then millions of genetic variants are explored and compared across the two groups (disease/control). By using such an approach, researchers can identify single nucleotide polymorphisms (SNPs—pronounced “snips”), which are sequences of DNA, or other types of genetic variants, that are more frequently found in people with the disorder than without it. endophenotypes, p. 475 discrete, stable, and measurable traits that are thought to be under genetic control. By studying different endophenotypes, researchers hope to get closer to specific genes that might be important in schizophrenia
attenuated psychosis syndrome, p. 480 being perplexed by reality - mild psychotic symptoms that are not severe enough to meet clinical criteria for another full-blown psychotic disorder – thought to be at risk for later psychosis - People also reported losing control over the content of their thoughts or having ideas of being regarded in a negative way by others. prodromal, p. 480 or very early, signs of schizophrenia, dopamine, p. 488 Activity in the dopamine system may play a role in determining how much salience we give to internal and external stimuli. Dysregu- lated dopamine transmission may actually make us pay more attention to and give more significance to stimuli that are not especially relevant or important. glutamate, p. 489 an excitatory neurotransmitter that is widespread in the brain - dysfunction in glutamate transmission might be involved in schizophrenia expressed emotion (EE), p. 491 a measure of the family environment that is based on how a family member speaks about the patient during a private interview with a researcher - three main elements: criticism, hostility, and emotional overinvolvement (EOI). The most important of these is criticism, which reflects dislike or disapproval of the patient. antipsychotics (neuroleptics), p. 496 medications like chlorpromazine (Thorazine) and haloperidol (Haldol), which were among the first to be used to treat psychotic disorders. Antipsychotic medications work by blocking D2 receptors. But, as described earlier, researchers now believe that the most important dopamine abnormality in schizophrenia is occurring presynaptically. This means that cur- rent medications are working downstream from where the real problem may lie. cognitive remediation, p. 499 Using practice and other com- pensatory techniques, researchers are trying to help patients improve some of their neurocognitive deficits (e.g., problems with verbal memory, vigilance, and perfor- mance on card-sorting tasks). The hope is that these improvements will translate into better overall functioning (e.g., conversational skills, self-care, and job skills) perhaps the most powerful conclusion that can be drawn at this stage is that not all patients with schizophrenia need to be treated long term with medications. When patients are motivated to try a period without antipsychotics, medical professionals might do well to support this decision SUMMARY Describe the prevalence of schizophrenia and who is most affected. Schizophrenia affects just under 1 percent of the population. Most cases begin in late adolescence or early adulthood. The disorder begins earlier in men than in women. Overall, the clinical symptoms of schizophrenia tend to be more severe in men than in women. Women also have a better long-term outcome. 13.2 Identify the symptoms of schizophrenia as described in DSM-5. Schizophrenia is the most severe form of mental illness. It is characterized by impairments in many domains. Characteristic symptoms of schizophrenia include hallucinations, delusions, disorganized
