,Inhoud
1 Introductie ............................................................................................................................................ 4
1.1 Inleiding ......................................................................................................................................... 4
1.2 Hoe noemen en definiëren we afwijkend gedrag? ....................................................................... 5
1.3 Historische visies op afwijkend gedrag ......................................................................................... 5
1.4 Ethiek in onderzoek ....................................................................................................................... 6
2 Visies op afwijkend gedrag en behandelmethoden ............................................................................. 6
2.1 Inleiding ......................................................................................................................................... 6
2.2 Het biologische perspectief ........................................................................................................... 6
2.3 Het psychologische perspectief..................................................................................................... 8
2.4 Het sociaal-culturele perspectief ................................................................................................ 10
2.5 Het biopsychosociale perspectief: een combinatie van modellen.............................................. 10
2.6 Psychologische behandelmethoden............................................................................................ 10
2.7 Psychotherapie ............................................................................................................................ 10
2.8 Biologisch georiënteerde therapieën .......................................................................................... 11
3 Classificatie en beoordeling van afwijkende emoties, gedachten en gedrag .................................... 12
3.1 Inleiding ....................................................................................................................................... 12
3.2 Classificatie van afwijkende gedragspatronen ............................................................................ 12
3.3 Kenmerken van de DSM .............................................................................................................. 12
3.4 Beoordelingsmethoden ............................................................................................................... 13
4 Stress gerelateerde stoornissen ......................................................................................................... 14
4.1 Inleiding ....................................................................................................................................... 14
4.2 Effecten van stress ...................................................................................................................... 14
4.3 Aanpassingsstoornissen .............................................................................................................. 16
4.4 Traumatische stressstoornissen .................................................................................................. 16
5 Angststoornissen en obsessief-compulsieve stoornis ........................................................................ 17
5.1 Inleiding ....................................................................................................................................... 17
5.2 Angststoornis ............................................................................................................................... 17
5.3 Paniekstoornis ............................................................................................................................. 17
5.4 Fobische stoornissen ................................................................................................................... 18
5.5 Obsessief-compulsieve en verwante stoornissen ....................................................................... 20
5.6 Gegeneraliseerde-angststoornis ................................................................................................. 21
6 Dissociatieve stoornissen, somatische-symptoomstoornis, en verwante stoornissen...................... 22
6.1 Inleiding ....................................................................................................................................... 22
6.2 Dissociatieve stoornissen ............................................................................................................ 22
6.3 Somatisch-symptoomstoornis en verwante stoornissen ............................................................ 24
2
, 6.4 De invloed van psychische factoren op de fysieke gezondheid .................................................. 26
7 Stemmingsstoornissen en suïcide ...................................................................................................... 26
7.1 Inleiding ....................................................................................................................................... 26
7.2 Typen stemmingsstoornissen ...................................................................................................... 26
7.3 Welke factoren spelen een rol bij het ontstaan van een depressieve stoornis? ........................ 29
7.4 Behandeling van stemmingsstoornissen ..................................................................................... 30
7.5 Risicofactoren voor suïcide ......................................................................................................... 32
8 Middelen gerelateerde en verslavingsstoornissen ............................................................................ 33
8.1 Inleiding ....................................................................................................................................... 33
8.2 Aan middelen en verslaving gerelateerde stoornissen ............................................................... 33
8.3 Gebruik en misbruik .................................................................................................................... 34
8.4 Verslavende middelen ................................................................................................................. 34
8.5 Theoretische perspectieven ........................................................................................................ 38
8.6 Behandeling van middel gerelateerde stoornissen ..................................................................... 39
8.7 Training voor terugvalpreventie .................................................................................................. 40
8.8 Gokstoornis ................................................................................................................................. 40
9 Voedings- en eetstoornissen en slaap- waakstoornissen .................................................................. 41
9.1 Inleiding ....................................................................................................................................... 41
9.2 Anorexia nervosa ......................................................................................................................... 41
9.3 Boulimia nervosa ......................................................................................................................... 41
9.4 Eetbuistoornis ............................................................................................................................. 42
9.5 Factoren die bijdragen tot het ontstaan van voedings- en eetbuistoornissen ........................... 42
9.6 Behandeling van anorexia nervosa en boulimia nervosa ............................................................ 43
9.7 Obesitas ....................................................................................................................................... 43
9.8 Slaap-waakstoornissen ................................................................................................................ 44
9.9 Parasomnia .................................................................................................................................. 45
9.10 Behandeling van slaap-waakstoornissen .................................................................................. 46
11 Schizofreniespectrum-stoornissen ................................................................................................... 46
11.1 Inleiding ..................................................................................................................................... 46
11.2 Schizofrenie ............................................................................................................................... 46
11.3 Theoretische perspectieven ...................................................................................................... 49
11.4 Behandeling van schizofrenie.................................................................................................... 50
11.5 Andere schizofreniespectrumstoornissen................................................................................. 52
12 Persoonlijkheidsstoornissen en impulsbeheersingsstoornissen ...................................................... 52
12.1 Inleiding ..................................................................................................................................... 52
12.2 Typen persoonlijkheidsstoornissen ........................................................................................... 52
3
, 12.3 Persoonlijkheidsstoornissen gekenmerkt door vreemd of excentriek gedrag – cluster A ....... 53
12.4 Persoonlijkheidsstoornissen gekenmerkt door dramatisch, emotioneel of wispelturig gedrag –
cluster B ............................................................................................................................................. 54
12.5 Persoonlijkheidsstoornissen gekenmerkt door nerveus of angstig gedrag – cluster C ............ 55
12.6 Problemen met de indeling van persoonlijkheidsstoornissen .................................................. 56
12.7 Theoretische perspectieven ...................................................................................................... 56
12.8 Behandeling van persoonlijkheidsstoornissen .......................................................................... 58
12.9 Impulsbeheersingsstoornissen .................................................................................................. 58
H13 Stoornissen die ontstaan in de kindertijd en adolescentie............................................................ 59
13.1 Normaal en afwijkend gedrag tijdens de adolescentie ............................................................. 59
13.2 Autismespectrumstoornis ......................................................................................................... 60
13.3 Verstandelijke beperking........................................................................................................... 61
13.4 Specifieke leerstoornissen......................................................................................................... 63
13.5 Communicatiestoornissen ......................................................................................................... 63
13.6 Gedragsproblemen .................................................................................................................... 64
13.7 Angst en depressie bij kinderen ................................................................................................ 66
13.8 Zelfdoding bij kinderen en adolescenten .................................................................................. 67
13.9 Eliminatiestoornissen ................................................................................................................ 67
H14 Cognitieve stoornissen en stoornissen die samenhangen met ouder worden ............................. 68
14.1 Neurocognitieve stoornis .......................................................................................................... 68
14.2 Delirium ..................................................................................................................................... 68
14.3 Uitgebreide neurocognitieve stoornis....................................................................................... 69
14.4 Milde neurocognitieve stoornis ................................................................................................ 69
14.5 Psychische stoornissen en ouder worden ................................................................................. 72
1 Introductie
1.1 Inleiding
Psychopathologie is een deelgebied van de psychiatrie en de psychologie die zich bezig houdt met
het beschrijven van psychische stoornissen, oorzaken daarvan en behandelingen daarvoor.
Psychiatrie is het medisch specialisme dat zich richt op de diagnostiek en behandeling van psychische
stoornissen.
Psychische stoornis is het geheel van afwijkende emoties, gedachten of gedragspatronen dat wordt
gekenmerkt door onder andere een storing in het functioneren en (persoonlijk) lijden.
De beschrijving van psychische problemen of stoornissen bevatten specifieke eigenschappen of
kenmerken van deze stoornis. Dit noemen we symptomen.
4
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