Abnormal Psych Ch 10-14

active phase of schizophrenia

symptoms are prominent dominated by positive symptoms

A disturbance in thinking characterized by the breakdown of logical associations between thoughts.

thought disorder

•The psychological sense of belonging to one gender while possessing the sexual organs of the other.

transgender identity

Helps control the more flagrant behavior patterns of schizophrenia, such as delusional thinking and hallucinations, and reduces the need for long-term hospitalization. •First-generation antipsychotics associated with increased risk of tardive dyskinesia with long-term use: (involuntary movements of the face, mouth, neck, trunk, or extremities) •Atypical antipsychotics - Second-generation antipsychotics

(biological approach to treating schizophrenia) antipsychotic medication

gender differences of schizophrenia

Compared to women, men: •have slightly higher risk of developing disorder •tend to develop disorder at a younger age •experience greater cognitive impairment •experience more behavioral deficits •do not respond as well to drug therapy

what legitimized aversion therapy for homosexuality

DSM-II

Dr. Bieber did a study with 77 psychiatrists collecting info from over 100 gay men and decided that homosexuality was caused by overbearing mothers and distant, detached fathers, caused the gay man a great deal of distress •Lots of studies like this by psychoanalysts in the first part of the 20th century, from Freud forward •This was the view that became traditionally accepted in psychiatry, written into DSM I and II

Dr. Bieber study of homosexuality

People with schizophrenia often have attentional deficiencies. •Hypervigilance - sensitive to sounds •Eye movement dysfunction - difficulty tracking a target across their field of vision •Greater difficulty filtering out distracting stimuli

attentional deficiencies associated with schizophrenia

hearing voices—is the most common form of hallucination in patients with schizophrenia. Recent evidence suggests that auditory hallucinations may involve inner speech that becomes projected onto external sources.

auditory hallucinations

•decline in testosterone •cardiovascular problems •health issues such as obesity •vascular or nervous disorders •prescription and psychoactive drug use

biological perspective of sexual dysfunction

•Higher-than-average sex drives in men with paraphilias •referred to as hypersexual arousal disorder •higher frequency of sexual fantasies and urges and a shorter refractory period after orgasm by masturbation

biological perspective on paraphilias

male or female, determined by sex chromosomes and anatomy

biological sex

Dopamine Hypothesis •Schizophrenia involves overactivity of dopamine transmission in the brain. Main sources of support: •Antipsychotic drugs (neuroleptics) - inhibit psychotic symptoms by reducing dopamine activity. •Amphetamines - increase concentration of dopamine, may cause symptoms that mimic paranoia.

biochemical factors associated with schizophrenia

Erectile disorder frequently has organic causes - medical treatment is appropriate. •Drugs, such as Viagra •Surgery in some cases •Biological treatments combined with psychological approach work best

biological treatment for sexual dysfunction

•Loss or thinning of gray matter •Abnormal functioning in prefrontal cortex •Typically have abnormally enlarged ventricles in the brain which is a sign of deterioration or loss of brain tissue.

brain abnormalities associated with schizophrenia

•A psychotic disorder lasting from a day to a month that often follows exposure to a major stressor. •Characterized by at least one of the following features: delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior

brief psychotic disorder

Severely impaired cognitive and motor functioning. The individual may: •maintain fixed or rigid posture •be unaware of the environment •exhibit odd gestures and bizarre facial expressions •become unresponsive •show highly excited or wild behavior •slow to a state of stupor •adopt a fixed posture positioned by others (waxy flexibility)

catatonia associated with schizophrenia

Disturbed thought processes -Delusions (fixed false ideas) and thought disorder (disorganized thinking and incoherent speech) Attentional deficiencies -Difficulty attending to relevant stimuli and screening out irrelevant stimuli Perceptual disturbances -Hallucinations (sensory perceptions in the absence of external stimulation) Emotional disturbances -Flat (blunted) or inappropriate emotions Other types of impairments -Confusion about personal identity, lack of volition, excitable behavior or states of stupor, odd gestures or bizarre facial expressions, impaired ability to relate to others, or possible catatonic behavior or gross disturbance in motor activity and orientation in which a person's behavior may slow to a stupor but then abruptly shift to a highly agitated state

clinical features of schizophrenia

Delusions involve disturbed content of thought and false beliefs that remain fixed in spite of a lack of evidence to support them. Common delusions include: •delusions of persecution or paranoia •delusions of reference •delusions of being controlled •delusions of grandeur •thought broadcasting •thought insertion •thought withdrawal

common delusions of schizophrenia

• A pattern of unclear, vague, disruptive, or fragmented communication that is often found among parents and family members of schizophrenia patients.

communication deviance (family theory about schizophrenia)

•referred to as loss of ego boundaries •fail to recognize self as unique individual •confusion about how much of what they experience is part of themselves

confusion about personal identity from schizophrenia

•Applies to people who hold persistent, clearly delusional beliefs, often involving paranoid themes.

delusional disorder

•Disturbances of volition characterized by loss of initiative to pursue goal-directed activities: •most often seen in the residual or chronic state •characterized by apathy and loss of motivation

disturbances of violation due to schizophrenia

when does schizophrenia typically develop

during late adolescence or early adulthood, a time of life when young people are beginning to make their way into the world.

when does someone with schizophrenia experience negative symptoms

during the stable phase

•Nearly 8% of adult males and nearly 20% of adult females reported some form of sexual abuse before the age of 18. •Typical abuser is a relative or step-relative of the child, a family friend, or a neighbor. •Sexual abuse can inflict great psychological harm - anger, anxiety, depression, eating disorders, inappropriate sexual behavior, aggression, drug abuse, suicide, PTSD, low self-esteem, sexual dysfunction, and feelings of detachment.

effects of sexual abuse on children

•Loss of normal affect or emotional expression •Flat affect •Mask - maintaining emotionless facial expression •Exaggerated or inappropriate affect

emotional disturbances associated with schizophrenia

•A sexual dysfunction in males characterized by difficulty in achieving or maintaining erection during sexual activity.

erectile disorder

Delusional beliefs that someone else, usually a person of higher social status such as a movie star or a political figure, is in love with you; also called erotomania.

erotomanic type

Strong and recurrent urges, fantasies, or behaviors of exposing of one's genitals to unsuspecting individuals for the purpose of sexual arousal.

exhibitionism

•A pattern of responding to the schizophrenic family member in a hostile, critical, and unsupportive way. Evidence suggests: •high EE relatives show less empathy, tolerance, and flexibility than low EE relatives •schizophrenia patients from high EE families have greater risk of relapse than those with low EE (more supportive) families

expressed emotion (family theory about schizophrenia)

Learning perspective •Atypical stimuli become conditioned stimuli for sexual arousal as the result of prior pairing with sexual activity •Atypical stimuli may become eroticized by incorporating them within erotic and masturbatory fantasies Psychodynamic perspective •Unresolved castration anxiety from childhood leads to sexual arousal being displaced onto safer objects or activities Multifactorial perspective •Sexual or physical abuse in childhood may corrupt normal sexual arousal patterns Treatment Approaches: Results remain questionable Biomedical treatment •Drugs to help individuals control deviant sexual urges or reduce sexual drives Cognitive-behavioral therapy •Includes aversive conditioning (pairing deviant stimuli with aversive stimuli), covert sensitization (pairing the undesirable behavior with an aversive stimulus in imagination), and nonaversive methods, such as social skills training that helps individuals acquire more adaptive behaviors

factors and treatment approaches for paraphalias

•focusing on practical aspects of everyday living •educating family members about schizophrenia •teaching family how to relate to member with schizophrenia •training family members in communication skills •teaching family members problem-solving and coping skills

family intervention programs to treat schizophrenia

•Strong desire to be a member of the other gender or strongly expressing the belief that one is a member of the other gender (or of some alternative gender) •Strong preferences for playing with members of the other gender and for toys, games, and activities associated with the other gender •Strong feelings of disgust and personal distress about one's sexual anatomy •Strong desires to have physical characteristics (i.e., primary or secondary sexual characteristics) associated with one's experienced gender •Strong preferences for assuming roles of the other gender in make-believe or fantasy play •Strong preferences for wearing clothing typically associated with the other gender and rejection of clothing associated with one's own gender

features of gender dysphoria in childhood

Inflated beliefs about one's own worth, importance, power, knowledge, or identity, or beliefs that one has a special relationship to a deity or to a famous person. Cult leaders who believe they have special mystical powers of enlightenment may have delusional disorders of this type.

grandiose type

what are the three orgasm disorders

female orgasmic disorder delayed ejaculation premature (early) ejaculation

Recurrent, powerful sexual urges, fantasies, or behaviors involving inanimate objects, such as an article of clothing.

fetishism

residual phase of schizophrenia

following the active phase return to prodromal phase some symptoms but not severe or acute

Recurrent, powerful sexual urges, fantasies, or behaviors in which the person becomes sexually aroused by rubbing against or touching a nonconsenting person.

fortteurism

•A psychological disorder in which people experience significant personal distress or impaired functioning as a result of a conflict between their anatomic sex and their gender identity. •Not all people with transgender identity have gender dysphoria or any other diagnosable disorder.

gender dysphoria

Diagnosis applies when there is significant distress associated with having transgender identity. •Often begins in childhood •Associated with depression •Can take different paths

gender dysphoria diagnosis

this is the psychological sense of being female, male, or an alternative gender in most it lines up with biological sex i.e. most are cisgender

gender identity

Evidence that genetics play an important role for the development of schizophrenia: •The closer the genetic relationship between schizophrenia patients and their family members, the greater the likelihood family members will also have schizophrenia. •First-degree relatives of people with schizophrenia have about a tenfold greater risk of developing schizophrenia than do members of the general population.

genetic factor to schizophrenia

•May require medical intervention to determine and treat any underlying physical problems, such as urinary tract infections, that might be causing pain. •Vaginismus - A conditioned reflex involving the involuntary constriction of the vaginal opening.

genital pain disorders

•Applies to women who experience sexual pain and/or difficulty engaging in vaginal intercourse or penetration.

genito-pelvic pain/penetration disorder

Around 1890s medicine/psychiatry put forward a competing view: homosexuality as a form of insanity or psychiatric disorder. •shift was generally considered progressive; a sick person was less blameful than a sinner or criminal •homosexuality still was not accepted in society, most gay and lesbian individuals kept their sexual orientation a secret •in the army during WWII if a man was suspected of being gay, he was arrested and dishonorably discharged •Dr. Irving Bieber was an army psychiatrist, thought treating homosexuality as a crime was cruel and that it should instead be viewed as a psychological disorder

homesexuality treated as a mental disorder

typically interpreted as a derogatory term Was classified as a psychological disorder in DSM I and II 1973 vote to remove homosexuality as a diagnosis from DSM 1987 was removed entirely

homosexuality

•Person seeks sexual gratification by being deprived of oxygen by means of using a noose, plastic bag, chemical, or pressure on the chest during masturbation or sexual act.

hypoxyphilia

what is vaginismus

involuntary muscle spasms that prevent intercourse

what is needed to be diagnosed with a paraphilic disorder

it must •cause personal distress or impairment in important areas of daily functioning, or •involve behaviors either presently or in the past in which satisfaction of the sexual urge involved harm or risk of harm to other people

Delusions of jealousy in which the person may become convinced, without due cause, of the infidelity of his or her partner. The delusional person may misinterpret certain clues as signs of unfaithfulness, such as spots on the bed sheets.

jealous type

•Paraphilias are explained in terms of conditioning and observational learning.

learning theorists on paraphilias

Learning-based interventions have been effective in modifying schizophrenic behavior: •Selective reinforcement of behavior - attention to appropriate behavior and extinction of inappropriate behavior •Token economy - reward for appropriate behavior with tokens •Social skills training - conversational skill and social behavior training

learning-based therapy for treating schizophrenia

dysfunctions are classified according to what 4 catergories

lifelong acquired situational generalized

Exhibitionism Sexual gratification from exposing one's genitals in public Voyeurism Sexual gratification from observing unsuspecting others who are naked, undressing, or engaging in sexual arousal Sexual masochism Sexual gratification associated with the receipt of humiliation or pain Fetishism Sexual attraction to inanimate objects or particular body parts Frotteurism Sexual gratification associated with acts of bumping or rubbing against nonconsenting strangers Sexual sadism Sexual gratification associated with inflicting humiliation or pain on others Transvestic fetishism Sexual gratification associated with cross-dressing Pedophilia Sexual attraction to children

major paraphilias

•persistently have little, if any, desire for sexual activity or may lack sexual or erotic thoughts or fantasies

men with male hypoactive sexual desire disorder

•centers offer housing, and job and educational opportunities • Provide skills training

multiservice rehab centers

•Include features such as lack of emotion or emotional expression, loss of motivation, loss of pleasure in normally pleasant activities, social withdrawal or isolation, and limited output of speech.

negative symptoms of schizophrenia

why was homosexuality removed from the DSM

not more psychologically disturbed than heterosexual individuals does not impair functioning treatments don't work

•Telephone scatologia (obscene phone call) •Necrophilia (corpse) •Partialism (body part) •Zoophilia (animal) •Coprophilia (feces) •Klismaphilia (enema) •Urophilia (urine)

other paraphalias

•Unusual or atypical patterns of sexual attraction that involve sexual arousal in response to atypical stimuli.

paraphilias

what were the 3 historical theories of homosexuality

pathology immaturity normal variation

pathology theory would state, of course, that homosexuality was a disease that differs from normal heterosexual development (arising from some internal defect or external pathological agent). Some thought excessive mothering caused homosexuality. Theories of immaturity would state that homosexual feelings/behaviors at a younger age are somewhat normal, but homosexuality in adults was stunted growth. Theories of normal variation regard homosexuality as a phenomenon that occurs naturally, like left-handedness. It's in line with the contemporary belief that people are "born gay" and discards any notion of homosexuality as something that should be pathologized

pathology/immaturity/normal variation theory on homosexuality

Recurrent and powerful sexual urges or fantasies or behaviors involving sexual activity with children (typically 13 years old or younger).

pedophilia

what are the primary sex characteristics for biological sex

penis/testicles vagina/uterus/ovaries

The most common type of delusional disorder, persecutory delusions, involve themes of being conspired against, followed, cheated, spied on, poisoned or drugged, or otherwise maligned or mistreated. People with these delusions may repeatedly bring legal actions against those whom they perceived to be responsible for their mistreatment, or may even commit acts of violence against them.

persecutory type

•A break with reality, as represented by the appearance of hallucinations and delusional thinking, disturbances in thinking and speech.

positive symptoms of schizophrenia

•Positive symptom involving breakdown in organization, processing and control of thoughts and incoherent speech. •Poverty of speech - slow speech, vague •Neologisms - made-up words •Perseveration - persistent repetition of words •Clanging - stringing together words that rhyme

positive symptoms of schizophrenia involving breakdown in organization, processing, and control of thoughts and incoherent speech

•Schizophrenia affects about 1% of the world's population. •About 1 million people in the United States are treated for schizophrenia each year •About a third require hospitalization

prevalence of schizophrenia

•with sexual interest, desire, or arousal •with orgasmic response •involving pain during sexual intercourse or penetration (in women)

problems associated with sexual dysfunction

Gradual onset of schizophrenic symptoms

prodromal phase of schizophrenia development

•Freud believed that traditional psychoanalysis was ineffective for the treatment of schizophrenia. •Other psychoanalysts adapted psychoanalytic techniques, but no evidence of effectiveness with schizophrenia.

psychodynamic theory about schizophrenia

•Mutually gratifying sexual interactions between partners involving both sadistic and masochistic acts.

sadomasochism

Psychotic behaviors associated with schizophrenia occurring the same time as a major mood disorder

schizoaffective disorder

A chronic debilitating disorder characterized by disturbed behavior, thinking, emotions, and perceptions. •Most disabling psychological disorder •Characterized by psychotic episodes, or breaks from reality •Typically develops in late adolescence or early adulthood

schizophrenia

Most common perceptual disturbance, characterized as sensory perceptions in the absence of external stimuli that become confused with reality. •Auditory hallucinations Most common Command hallucinations •Tactile hallucinations •Somatic hallucinations •Visual, gustatory, and olfactory hallucinations are less common

schizophrenia hallucinations

A psychotic disorder lasting from one to six months in duration, with features that resemble schizophrenia.

schizophreniform disorder

•Self-contained communities •Provide social support •Help find educational opportunities and employment

self help clubs and rehab centers (psychosocial rehab)

•Surgeons construct external genital organs that closely resemble opposite sex •Hormone treatments for development of secondary sex characteristics •Postoperative adjustment more favorable for female-to-male

sex reassignment surgery

Persistent or recurrent problems with sexual interest, arousal, or response.

sexual dysfunctions

•Strong and recurrent sexual urges, fantasies, or behaviors in which the person becomes sexually aroused by being humiliated, bound, flogged, or made to suffer in other ways.

sexual masochism

Whether an individual is sexually attracted to members of the opposite sex, the same-sex, or both Majority of gay, lesbian, and bisexual individuals' gender identity aligns with their biological/anatomical sex

sexual orientation

•Recurrent, powerful sexual urges, fantasies, or behaviors in which the person becomes sexually aroused by inflicting physical or psychological suffering or humiliation on another person.

sexual sadism

•Stereotypical attitudes toward sexuality •Sociocultural beliefs and sexual taboos •Negative beliefs about sexuality

sociocultural perspective on sexual dysfunction

Delusions involving the person's physical or medical condition. People with these delusions may believe that foul odors are emanating from their bodies or that internal parasites are eating away at them.

somatic type

•Self-stimulation exercises with erotic fantasies •Couple therapy •Hormone therapy •Sensate focus exercises - non-demanding sexual contacts

therapeutic approach for low sex drive/arousal

Recurrent and powerful urges, fantasies, or behaviors in which individuals become sexually aroused by cross-dressing. Usually found among heterosexual men Cross-dressing typically done in private May frequent transvestite clubs or become involved in transvestic subculture

transvestism

•Psychoanalysis - Attempts to bring childhood sexual conflicts into awareness so they can be resolved in the light of the individual's adult personality. •Cognitive-behavioral therapy - Includes a number of specific techniques, such as aversion therapy, covert sensitization, and social skills training, to help eliminate paraphilic behaviors and strengthen appropriate sexual behaviors. •Biomedical therapies - SSRIs for obsessive thoughts regarding paraphilic acts and antiandrogen drugs to reduce levels of testosterone in the bloodstream.

treatment of paraphilic disorders

•Most contemporary sex therapists assume sexual dysfunctions can be treated by directly modifying the couple's sexual interactions. •Pioneered by Masters and Johnson (1970), sex therapy uses cognitive-behavioral techniques.

treatment of sexual dysfunction

•When attitude or relationship issues are involved: modification of negative attitudes toward sex •treatment for relationship For female orgasmic dysfunction - directed masturbation For delayed ejaculation in men - increasing sexual stimulation and reducing performance anxiety For early ejaculation in men - stop-and-go technique

treatments for orgasm disorders

•Sevenfold increase in risk of schizophrenia for individuals exposed to influenza in first three months of prenatal development. •Risk of schizophrenia greater in people who are born in the winter and early spring months in the northern hemisphere - with greater risk of flu. •Risk posed by prenatal infections may be limited to mothers with psychiatric disorders.

viral infections and schizophrenia

Strong and recurrent sexual urges, fantasies, or behaviors in which the person becomes sexually aroused by watching unsuspecting people, generally strangers, who are naked, disrobing, or engaging in sexual activity.

voyeurism

•experience either a lack of or greatly reduced level of sexual interest, drive, or arousal

women with female sexual interest/arousal disorder

chronic onset of schizophrenia

•Characterized by slower, more gradual decline in functioning

useful tools for controlling schizophrenia hallucinations

•Cognitive-behavior therapy and drug therapy useful tools to help control hallucinations

causes of schizophrenia hallucinations

•Disturbances in brain chemistry of neurotransmitter dopamine •Auditory hallucinations as a form of inner speech that are attributed to external sources

psychodynamic theorists on paraphilia

•Paraphilias as defenses against leftover castration anxiety from the phallic period of psychosexual development.

acute onset schizophrenia

•Seemingly well-adjusted individual experiences a sudden onset with rapid transformation of personality and behavior.

psychological perspective views sexual dysfunction as developing from one of several pathways including

•a history of sexual trauma or rape •performance anxiety •underlying irrational beliefs and attitudes •relationship problems

not clear whether emotional blunting due to schizophrenia is a disturbance in ability to

•express emotions •report the presence of emotions •experience emotions