Dysfunctional Behaviour


DiagnosisOfDysfuntionalBehaviour - Categorising

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.

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DiagnosisOfDysfuntionalBehav. - DefintionsOfAbnorm

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 

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DiagnosisOfDysfuntionalBehaviour - BiasInDiagnosis

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.

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ExplanationOfDysfunctionalB.- BehaviouralExplanati

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. 

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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?

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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. 

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TreatmentsOfDysfunctionalB- Behavioural

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 

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

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TreatmentsOfDysfunctionalB- Biological

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 

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. 

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TreatmentsOfDysfunctionalB- Cognitive

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
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 

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