Dysfunctional Behaviour

ICD- international classification of diseases and related health problem - in 11th edition
Used worldwide (WHO countries) initially developed as medical manual so scientific. 
Criterea based on real life evidence. Diagnosis number, frequency & severity of symptoms
Freely available. Diagnosis is flexible open to clinician. Looks at axis holistically

DSM- diagnostic and statistical manual of mental disorders. - in 5th edition.
Used in America. Purely developed for mental health. Must buy, not publicly available for free, criterea based on empirical research. 
Looks at each axis (theres 5) induviduall like a check list. So would look at personality disorders then general medical conditions for example.

Behaviour that doesn't fit the 'norm' 
May change over time our throughout different countries and cultures.

Rosenhan and Seligman
Statistical infrenquency- Persons traits, thinking or behaviour classified as abnormal if rare- (but some arent rare but  considered abnormal - depression?)
Deviation from social norms- social norms are a groups expected approved ways of behaviour.
Failure to function adequately- Considered abnormal if unable to cope wiht demands of everyday life- getting up in the monring, Autism, depression, anxiety
Deviation from ideal mental health- Rather than defining abnormality, we define whats normal and everything devaiting from this is regarded as abnormal or 'dsyfunctional behaviour' 
PMA, idependent, able to adapt 

Gender- women seen as more emotional. Men less likely to discuss mental health
Ethnic- African Americans are less likely to be diagnose with depression
Age- Children vunerable more likely to be diagnosed. Elderly under diagnosed as think just old.

Ford and Widiger
266 clinical psychologists responded to study (354 asked)  
1 of 9 case histories. With histronic personality disorder or anti-social personality disorder.
Asked to diagnose , by rating on 7 point scale which patient appeared to have the disorders.

Females misdiagnosed with HPD 46% showing gender bias- as excessive attention seeking, emotional considered a female trait.

Operant conditioning- positively reinforced to act a certain way to create a fear. Negative reinforcement- negative 'occurance' removed. Punishment- punished for a behaviour, wont do again- may start a fear.
Classical conditioning- pair a nuetral stimulus with an unconditioned respnse to create and association causing a conditioned response. example for fear.
Social learning theory- see someone scared we imitate.

 Watson & Rayner
Little albert- classical conditing- to have fear of rats and simillar objects.
Present with rat reached for it and steel bar struck (unconditioned response- natural fear of loud noises)  
Next week, rat present again with loud noise, albert crawled away and cried.
Shown rat on its own 5 days later in a different location- still scared.
One month later- still scared rat and santa. 

Instinct to avoid threat for survival. - snakes, fire, 
Fight or flight 
Imbalance of hormones = more nervous. Genes- are phobias inhertied? Linked to bio?
Amygdala associatied with fear. Over functioning= more fear. - link to brunner.

Genetic Reseach on Twin Studies- Kendler.
MZ- Identical twins
DZ- Non-identical 

Kendler studied concordance rates betweens phobia's with mz and dz twins.

Animal phobias - MZ- 25.9        DZ- 11.0 - genetic influence?
Situational phobias- MZ- 22.2     DZ- 23.7 - more equal, no gentic influence

Are some phobias genetic?

Irrational thought process which is unrealistic = phobias.
Over thinking affects thoughts about past present and future which overall these things change a persons perception 

Clark & Wells Cognitive Model.

Explains what happens to thought processes for social phobics.
Social situation.
-activates assumptions about a situation which are irrational and negative
-Leads to percieved social danger which is unrealistic
- = Cogntive and Somatic Symptoms
- Causes you to process self as social object mentally
- Results in safety behaviours e.g avoidance. 

Systematic Desensitization 10 sessions
Create fear hierarchy, find positive association, start assocation with paired learning of phobia.
So stressful scenario = fearful stimulus. Pair with postive stimulus to create a conditioned response.
Gradual exposure.GIVE EXAMPLES
Flooding- expose to phobia
Aversion Therapy- Unpleasent consequences
Token Economies- Reward 

McGrath
9 year old Lucy
Fear of sudden loud noises - e.g part poppers, firworks
Imagined at home with her toys.
Fear for popping balloons decreased from 7/10 to 3/10

Treats symptoms
Drugs: Anti-depressents: regulate levels of neurotransmitters - seretonin.
Anti-anxiety- slows CNS- valium forces calm.
Anti-Psychotic- Decrease levels of dopamine and seretonin- Ethics - low dopamine= parkinsons.
ECT - shock therapy used for severe depression and schizoprenia. Rarely used. - controversial.
Hormone replacement therapy
Gene Therapy 

Leibowitz
80 patients, DSM diagnosed as social phobics.
Asked no medication 2 weeks prior to trial.
Assed using leibowitz social phobic scale, rate 1-3 how much each statement made them fearful.
4 grps:
- anti-anxiety drugs -matching placebo
-beta blockers -matching placebo

8 weeks better scores anti-anxiety drugs. 

CBT- cognitive behavioural treatment. 8-12 sessions.
-Centres on how induviduals think about themselves & surrounding world
-Thoughts cause emotions so change the thinking changing how you feel and act.
-Designed to change the viscous cycle a negative though can trigger. 
-By Reframing negative positive and develop coping strategies.By breaking them down to: Situation, Thoughts, Actions and Feelings.
-Role play to practice and start practice at home. 

Ost and Westling
Longitudinal
38 patients with DSM diagnosed panic disorder.
CBT used- identify misinterpretation of body symptoms, generate alternative congition in response. e.g heart racing becuase im stressed not due to a heart attack

74% panic free after treatment