Abnormal Psychology Chapters 8 and 9
Abnormal Psychology Chapters 8 and 9 PSYC 3014
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This 4 page Class Notes was uploaded by Megan Standiford on Thursday March 3, 2016. The Class Notes belongs to PSYC 3014 at Virginia Polytechnic Institute and State University taught by Dr. John Richey in Winter 2016. Since its upload, it has received 22 views. For similar materials see Abnormal Psychology in Psychlogy at Virginia Polytechnic Institute and State University.
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Date Created: 03/03/16
Chapters 8 and 9 Chapter 8 Somatoform Disorders What are they? o Patient complains of bodily symptoms that suggest a medical problem o However, no medical problem is present Differential diagnosis- the process of distinguishing one disorder from another o Malingering Faking symptoms to achieve a goal o Factitious disorder Faking symptoms o Secondary gain- money, attention, relief from an undesirable obligation o How would you differentiate a somatoform disorder from GAD? In a somatoform disorder the patient TRULY BELIEVES they have the disease/medical problem In GAD they do not Hypochondriasis o Patient either believes or very strongly suspects that she/he is sick with a very serious of life threatening illness o Clinical features Minor symptoms or anomalies support and augment this concern Concerns persist despite reassurance of physicians Many doctors visits o Impairment Symptoms can lead to total preoccupation Patient can become invalid/bed-ridden Affects males and females about equally o Onset characteristics Late teens/early 20's Sometimes coincides with witnessing the serious illness/death of a friend or relative Somatization disorder o Physical/bodily problems that do not have an organic basis o Psychological cause is also nonspecific o SSD vs Hypochondriasis SSD= preoccupation with numerous physical symptoms Hypochondriasis= preoccupation with a specific physical disease/illness o Etiology The origins of the disorder are not well understood A combination of High negative affectivity Biased interpretation of symptoms as threatening Conversion disorder o Patient experiences physical/medical symptoms without organic origin o Symptoms are due to a specific event or series of events Factitious disorder o FD by proxy is also called Munchausen's By Proxy Patient feigns or indices a medical condition in another person (usually a child) Body Dysmorphic Disorder o Preoccupation with imagined defect in appearance o Most commonly: facial appearance o Clinical characteristics Patients will often spend many hours scrutinizing their appearance in the mirror Patients will often go to great lengths to change the perceived defect o Differential diagnosis OCD? Reasonably poor insight How is It different? Level of insight "If I touch this, ill get sick" - OCD "I look deformed" - BDD Dissociative Disorders What are dissociative disorders? o Disruption in a persons consciousness, memory or perception Read pg 276 (derealization and depersonalization) 1 or more episodes of inability to recall important personal information Anterograde amnesia o Cannot form new memories Retrograde amnesia o Cannot remember the past Fuge o A state of flight, in the context of dissociative amnesia o Example: A middle aged lawyer unexpectedly disappears and is found working as a taxi driver in New York City. Has no memory of previous life Dissociative identity disorder o Patient manifests 2 or more distinct personalities o Thought to emerge as the result of physical or sexual abuse o The existence of DID is highly controversial o Not the same as schizophrenia Chapter 9 Eating Disorders Over 50% of undergraduate females report being dissatisfied with their bodies o However, not all of these individuals go on to develop an eating disorder 90% of cases are female Can be conceptualized at 2 levels o Manifest/observable A pattern of aberrant/unusual eating behavior o Latent/unobservable Constructs that drive the behavior Anorexia nervosa o DSM 5 Criteria Refusal to maintain body weight at or above 85% of expected weight Intense fear of gaining weight, even though underweight Undue influence of body weight on self-perception For females: absence of > 3 menstrual cycles o 90-95% of patients are females Prevalence ~1-2$ for females and <.03% males o More common in Caucasians o More common in middle and upper SES o Anorexia in men is equally serious o Physical consequences Hair loss Tooth loss Brittle bones Cracked skin Thin/brittle yellow nails Low BP/faintness Even death, due to Heart/kidney failure o Mortality rates Adjusted for prevalence, Anorexia has the highest mortality rate of any disorder o Unique feature Early onset (12-14) has better prognosis Later onset (18-22) has worse prognosis Why? Two different etiologies Late onset subtype: more precipitated by internal, psychological characteristics Early onset subtype: more precipitated by negative life events o According to the DSM 5 A restricting subtype A compensatory subtype Patient fails to maintain consistent body weight Difference between this and bulimia; in bulimia the patient maintains their expected body weight but does engage in purging o One construct that is thought to be causally related: perfectionism o Does the media play a role? Yes o Comorbidity Body dysmorphic disorder How is this different from body dysmorphic disorder? BDD does not have eating symptoms Bulimia Nervosa o DSM 5 Criteria Recurrent episodes of binge eating Eating in <2 hours an amount of food that is "definitely larger" than most people would eat A sense of lack of control over eating during the episode Recurrent, inappropriate compensatory behavior Most often vomiting (purging) Excessive exercise Misuse of laxatives Binges/compensatory behavior >2 times per week; >3 months Self-evaluation is unduly influenced by body shape/weight o How is bulimia different? Compensatory behaviors Relatively normal weight o The magnitude of binge episodes is often underappreciated Can be 5,000-6,000 calories in a single binge o Health consequences of bulimia are different from anorexia Loss of tooth enamel Esophageal cancer o How is bulimia different from anorexia? Body dissatisfaction Impulsivity The inability to resist an urge o Prognosis is better than anorexia Binge eating disorder o Binge eating, but no compensatory behaviors o Typically higher BMI o Different etiology