Transcript Abnormal Psychology

Abnormal Psychology
A.K.A. Psychological Disorders
Psychological Disorder
1. unusual (deviant from typical behavior in
that culture)
2. causes distress in the person experiencing
the symptoms
3. harmful dysfunction : interferes with life
Early Theories
• Abnormal behavior was evil
spirits trying to get out
• Beatings, burnings, castration,
pulling teeth, removing parts of
intestines, caged like animals,
animal blood transfusions, &
trephining were often used
Medical Model
• 1800s medical model emerges, replaces
“evil” cause of mental illness
• Medical Model: A mental illness needs
to be diagnosed on the basis of its
symptoms and can be treated
• Biopsychosocial approach: today’s
psychologists say that all behavior
(normal or disordered) arises from
interaction of nature & nurture
– Nature: depression & schizophrenia…
– Nurture: eating disorders, phobias…
Perspectives and Disorders
Psychological School/Perspective
Psychoanalytic/Psychodynamic
Cause of the Disorder
Internal, unconscious drives, root in
childhood
Humanistic
Failure to strive to one’s potential or being
out of touch with one’s feelings, being too
sensitive to others’ criticisms/judgments,
lack of positive regard as a child
Behavioral
Reinforcement history, the environment.
At some point the abnormal behavior has
been rewarded or reinforced & is now an
established pattern of behavior
Cognitive
Irrational, illogical, dysfunctional thoughts
or ways of thinking lead us to misperceive
the world (leading to abnormal behavior)
Sociocultural
Biological/Neuroscience
Society & culture help define what is
acceptable behavior
Organic problems, biochemical imbalances,
genetic predispositions (very popular in US
right now)
DSM IV (V is coming…)
• Diagnostic and
Statistical Manual of
Mental Disorders:
the big book of
disorders
• DSM will classify
disorders and
describe the
symptoms
• DSM will NOT explain
the causes or possible
cures
DSM IV
• Axis I
– major disorders (schizophrenia, depression,
dementia, mood, eating, sleep…)
• Axis II
– Developmental & Personality disorders (antisocial,
narcissism, autism, mental retardation…)
• Axis III
– Physical disorders (brain injury, HIV/AIDS…)
• Axis IV
– Assesses the level of psychosocial & environmental
stress the person is experiencing
• Axis V
– Overall assessment of the person’s level of
functioning
Two Major Classifications in the
DSM
Neurotic Disorders
• Distressing but one can
still function in society
and act rationally.
Psychotic Disorders
• Person loses contact
with reality,
experiences distorted
perceptions.
John Wayne Gacy
Anxiety Disorders
• Anxiety Disorders:
characterized by
distressing, persistent
anxiety or dysfunctional
behaviors to reduce
anxiety
• the patient fears
something awful will happen
to them
• They are in a state of
intense apprehension,
uneasiness, uncertainty, or
fear
Generalized Anxiety Disorder
GAD
• An anxiety disorder in which a
person is continuously tense,
apprehensive, & in a state of
autonomic nervous system
arousal
• The patient is constantly tense
and worried, can’t concentrate,
switch from worry to worry and
sleep deprived
• Cannot identify a cause
• 2/3 are women
Phobias
• An anxiety disorder marked by a
persistent, irrational fear and
avoidance of a specific object,
activity, or situation
• Social phobia: intense fear of
being scrutinized by others,
avoid potentially embarrassing
situations (speaking up, going to
parties…)
• Agoraphobia: fear of
situations/places where escape is
difficult when panic strikes
• Phobia List
Phobias
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Top 10 phobias
Fear of snakes
Fear of being buried alive •
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Fear of heights
Fear of being bound/tied up •
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Fear of drowning
•
Fear of public speaking
•
Fear of hell
Fear of cancer
Fear of tornadoes/hurricanes
Fear of fire
What are the following
phobias?
Uxoriphobia
Mikrophobia
Xenophobia
Trichophobia
Nyctophobia
Triskadekaphobia
Panic Disorder
• 1 in 75 people
• An anxiety disorder marked
by a minutes-long episode
of intense dread in which a
person experiences terror
• Will have chest pain, heart
palpitations, dizziness,
choking and other
frightening sensations
• Those who smoke have
double risk of panic
disorder
Obsessive-Compulsive
Disorder
• Persistent unwanted
thoughts (obsessions, ex:
germs, death…) cause
someone to feel the need
(compulsion, ex: checking
locks, in/out of a door…) to
engage in a particular action
• Obsessive thoughts,
compulsive behavior/rituals
• Ex: Obsession about dirt and
germs may lead to compulsive
hand washing
• 2-3%, often in late
teens/early twenties
Post-Traumatic Stress Disorder (PTSD)
• Flashbacks/nightmares following a person’s
involvement in or observation of an
extremely stressful event (accident,
disaster, sexual assault, violence…)
• Memories of the event cause anxiety
– Half of adults will experience at least 1
traumatic event, only 1 in 10 women ptsd,
1 in 20 men
• After 9/11, 8% ptsd, 19% of Vietnam vets
• 1 in 6 Iraq vets have symptoms (1 in 4 some
psych disorder)
• Post-traumatic growth: positive
psychological changes that come from
challenging circumstances
– Greater appreciation for life, priorities…
– Good can come from our worst
experiences
Explaining Anxiety/Fears
• 2 major perspectives to explain anxiety/fear
– Biological, learning (behaviorism)
• Learning (classical & operant conditioning)
– Reinforcement (getting away from the dog reduces your
anxiety=reinforcement)
– Easy to condition fear, hard to extinguish
– Observational Learning (parents transmit fears to
children…)
• Biological
– Ancestors passed on fears of spiders, snakes, heights,
etc. (fearless people likely died)
– Some studies suggests serotonin & glutamate might
influence anxiety
– Brain scans detect elevated activity in certain brain areas
Somatoform Disorders
• Occur when a person
manifests a
psychological
problem through a
physiological
symptoms
• Two types……
Conversion Disorder
• Anxiety/stressful experience is
converted into a physical
problem
• Often related to the stress
they are under
-Ex: blindness, loss of
sensation...
-Ex: you fall off a horse & you
become paralyzed even though
you are not physically injured
Hypochondriasis
• A person interprets
normal physical
sensations as
symptoms of a
disease
• They usually believe
that the minor
issues (headache,
upset stomach) are
indicative are more
severe illnesses
Dissociative Disorders
• These disorders
involve someone
experiencing a
sudden loss of
memory or change in
identity
• Often in response to
overwhelming
stressful event
• Three types….
Psychogenic (Dissociative)
Amnesia
• Mentally blocks out
personal information
• Lose memories of
distant & recent past
• Lose personal identity
• Usually occurs after a
traumatic or stressful
event
• Usually temporary
• Not physical!
Dissociative Fugue
• Dissociative Amnesia &
creating a physical
distance from your
real life
• Last usually only a few
hours or days, rarely
months
Click above to
watch a real life
example
Dissociative Identity Disorder
Click above to see an
explanation of DID
• Used to be known as
Multiple Personality
Disorder
• A rare disorder in
which a person has 2 or
more distinct,
alternating
personalities
• People with DID
commonly have a history
of childhood abuse or
trauma
• Very controversial
Mood Disorders
• Mood Disorders: Characterized by emotional
extremes
• Affects 10% of Americans in a given year
Major Depressive Disorder
• When at least 5 signs last 2 weeks or more (not
caused by drugs or medical condition)
– Lethargic/fatigue/lack of energy
– feelings of worthlessness
– loss of pleasure/interest in activities
– Loss of appetite/overeat
– Lack of sleep/too much sleep
• Survey: 29% hs students, 44% college students
• 13% of adults at some point, 15 million year
• World Health Org- affects 5.8% of men & 9.5%
women in any yr
• 1 in 4 w/ depression is struggling w/ a significant
loss (death, job, relationship)
• #1 reason people seek mental health services
Seasonal Affective Disorder
• Experience symptoms
of depression usually
during the winter
months
– Places with long winter
nights
• Often occurs at the
same time each year
• Treatment: light
therapy,
psychotherapy,
medication
Bipolar Disorder
• Person alternates b/w
hopelessness of depression &
overexcited states of mania
(formally manic depression)
• Mania: hyperactive, wildly
optimistic state
– Overactive, overtalkative, little
sleep, find advice irritating,
exhibit poor judgment (unsafe
sex, reckless spending…)
• 5.7 million Americans
• Many Creatives: Walt Whitman,
Virginia Woolf, Ernest Hemingway,
Mark Twain, Emily Dickinson, Vincent
Van Gogh, Catherine Zeta-Jones,
Jane Pauley
Understanding Mood Disorders
• Women twice as likely to suffer depression
• Bipolar equal among men & women
• Disorders run in families
– More likely if parent or sibling has
– Identical twins 1 in 2 depression, 7 in 10 bipolar
• MRI scans found frontal lobes 7% smaller in people w/ severe
depression
• Neurotransmitters
– Norepinephrine (increases arousal & boosts mood)
• Scarce during depression
• Overabundant during mania
– Serotonin
• Scarce during depression
Social-Cognitive Perspective
• Explanatory Style
– Our way of thinking- how we explain
the events in our lives
– Depressed people tend to blame
themselves, feeding the negative
feelings
– Remember: if you feel down, you
think negatively & remember bad
experiences
Suicide
• Whites twice as likely as African
Americans
• Women more likely to attempt, men
4xs more likely to succeed
• 3 out of 5 suicides in US are
shootings
• More likely among rich, nonreligious,
If someone confides in you, they
single/widowed/divorced
are crying out for help
• 5x greater risk for those who been
depressed
• Alcoholics 100x more likely
• Teen suicides often linked w/ drug
and alcohol abuse
• Gay youth & elderly more likely
• 33,000 Americans/year
• 90% have diagnosable mental disorder
Personality Disorders
• Inflexible & continuous
behavior patterns that
negatively affect people’s
ability to function
• Dominates their
personality
• Let’s Group Them:
– The Dramatic Ones
– The Fearful Ones
– The Odd Ones
Antisocial Personality Disorder
• Lack of conscience &
empathy
• Little regard for
other’s feelings
• No remorse
• View the world as
hostile and look out
only for themselves
• Formerly called
sociopath
• 3% males, 1% females
Borderline Personality Disorder
• Tries to avoid abandonment (real or imagined)
• Pattern of unstable & intense relationships
– Idealize or devalue
• Unstable self-image, feelings of emptiness
• Impulsive
– Spending, sex, substance abuse…
• Recurrent suicidal behavior (threats, cutting…)
• Emotional instability
• Intense anger & trouble controlling it (fights,
temper)
• Paranoid thoughts
• 75% are female, 2% of population
Histrionic Personality Disorder
• Needs to be the center of
attention & feels uncomfortable
when not
• Inappropriate sexual or
provocative behavior
• Uses physical appearance to draw
attention
• Thinks relationships are closer
than they actually are
• Dramatic, theatrical,
exaggerated emotions
• 2-3% of population
Narcissistic Personality Disorder
• Having an exaggerated sense of
self-importance
• Think only other super
important people can
understand them
• Overwhelming need for
admiration
• Patronizing, snobby
• Preoccupied w/ fantasies of
unlimited, success, power,
beauty…
• Lacks empathy
• Arrogant behaviors & attitudes
• Exploits others
• 1% population (more male)
Avoidant Personality Disorder
• Overwhelming feelings of inadequacy
• hypersensitive to what others think
about them & rejection
• Avoids socializing/interacting with
others
• 0.5%-1% of population
Dependent Personality Disorder
• Fear of being separated from
important people in their
lives, become “clingy”
• Difficulty making everyday
decisions
• Feels helpless when alone
• Excessive lengths to get
support from others
• Difficulty disagreeing with
others
• Need others to take charge in
most areas of life
Paranoid Personality Disorder
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Distrustful & suspicious of others
Thinks others’ motives are always bad
Affects every relationship they have
Preoccupied w/ doubts about loyalty of
friends
• Reluctant to confide in others bc think it will
be used against
• Holds grudges
• 0.5%-2.5% of population
Schizoid Personality Disorder
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Detached from social relationships
Doesn’t enjoy close relationships (even family)
Difficulty expressing emotions
Uninterested in sex, activities, relationships
Seems emotionally cold & detached
More common in males
Schizotypal Personality Disorder
• Odd beliefs that differ from cultural norms
– Telepathy, bizarre fantasies
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Unusual perceptual experiences
Suspicious or paranoid
Odd, eccentric, strange behavior/appearance
Lack of close friends
Social anxiety (often associated w/ paranoia)
Less that 3%
Schizophrenic Disorders
• About 1 in every 100 people
are diagnosed with
schizophrenia (24 million
worldwide)
Symptoms of Schizophrenia
1. Disorganized thinking
2. Disturbed Perceptions
3. Inappropriate Emotions
and Actions
Disorganized Thinking
• The thinking of a person with
Schizophrenia is fragmented
and bizarre and distorted with
false beliefs
• Delusions: false beliefs
– Persecution: people are
trying to kill me, watching
me, etc.
• Common for those w/
paranoid tendencies
– Grandeur: I am the Wizard
of Oz, Jesus, etc.
• Disorganized thinking may
come from a breakdown in
selective attention- they
cannot filter out information &
focus on one stimulus
Disturbed Perceptions
• Hallucinations- sensory
experiences without sensory
stimulation
• They see, hear, smell, feel
things that aren’t there
• Most often auditory
hallucinations (horrible insults,
giving orders)
• They seem real!
Inappropriate Emotions & Actions
• Laugh at inappropriate
times, angry for no
apparent reason
• Flat Affect (emotionless
state)
• Senseless, compulsive
acts.
• Catatonia (catatonic
state)
– motionless for hours then
agitated
Onset of Schizophrenia
• Usually as moving into adulthood
– Men: late teens-early 20s
– Women: early-mid 20s
• Positive symptoms
– Hallucinations, exhibit inappropriate
emotions, disorganized talking
– Presence of inappropriate behaviors
• Negative symptoms
– Toneless voices, expressionless
faces, catatonic states
– Absence of appropriate behaviors
Subtypes of Schizophrenia
Disorganized Schizophrenia
• disorganized
speech or
behavior
• flat or
inappropriate
emotion
Paranoid Schizophrenia
• preoccupation
with delusions
or hallucinations
• Somebody is out
to get me!!!!
Catatonic Schizophrenia
• Immobility
• Extreme
negativism
• parrot like
repeating of
another’s speech
and movements
Undifferentiated Schizophrenia
• Many and
varied
Symptoms
Understanding Schizophrenia
• Excess of dopamine receptors (6x)
– Drugs to treat block, cocaine &
amphetamines intensify
• Glutamate research
• Brain area activity (several areas, not just
1)
– Low activity in frontal lobes (reasoning,
planning, problem solving)
– PET scans while hallucinating:
• very active & small thalamus (sensory
relay center), maybe difficult to
filter sensory info & focus attention
• very active amygdala (fear) for
paranoid schizophrenics
• Pregnancy risk factors
– Low birth weight, deprived of oxygen
during delivery, famine
– Flu
Treatment of
Psychological Disorders
• History of treating mental illness was barbaric
• Crusaders like Dorothea Dix changed treatment
(mental hospitals)
• 2 main categories of mental health therapies:
1. Psychotherapy (overcome difficulties & achieve
personal growth)
2. Biomedical therapy (medication or medical
procedure)
• Many psychotherapists say they take an
eclectic approach
– blending different types of therapy depending on the client’s
problem
Psychotherapy
• Psychotherapy: treatment w/
interaction between therapist &
someone seeking to overcome
psychological difficulties or achieve
personal growth
• Freud’s psychoanalysis (repressed
childhood trauma, hypnosis, free
association, dream interpretation)
– Not practiced like Freud anymore but…
• Resistance: blocking memories,
experiences that cause anxiety
• The analyst will interpret behaviors,
dreams, events…in order to promote
insight
• Transference: patient transfers
emotions linked with other
relationships on the analyst (+ or -)
Evaluating Psychotherapy
• Clients and therapists say yes! but that
in itself cannot prove its effectiveness
• Meta-analysis: procedure for
statistically combining results of
different studies
• The verdict: those not undergoing
therapy often improve, but those
undergoing therapy are more likely to
improve
Humanistic Therapy
• Psychoanalytic & Humanistic
therapies are both insight
therapies
– providing new insights to help
better understand motives, boost
self-fulfillment & self-acceptance)
• Focuses on present & future (not
past), conscious motives (not
unconscious), taking responsibility
for feelings & actions, promoting
growth instead of curing illness
(clients not patients)
• Therapists exhibit genuineness,
acceptance, & empathy b/c clients
already have the potential for
growth
Humanistic
• Client-Centered Therapy (Carl Rogers)
– non-directive therapy and listens w/o
judging or interpreting; client is to find
own insights
– Active Listening
• Paraphrase (summarize in your own
words to check understanding)
• Invites clarification (“What might be
an example of that?”)
• Reflect feelings (acknowledge their
feelings & mirror what you are sensing)
– Self-actualization, free-will and
unconditional positive regard
• Gestalt Therapy by Fritz Perls encourage
clients to get in touch with whole self.
Behavioral Therapies
• Behavior therapy: applies learning
principles to eliminate unwanted
behaviors
• Believe can replace learned
behaviors w/ constructive
behaviors
• Counterconditioning: uses classical
conditioning to generate new
responses to stimuli
• Exposure Therapy: expose
people to what they normally
avoid
Behavior: Exposure Therapies
1. Systematic Desensitization (negative to positive)
-associate a nice, relaxed state by exposing people to
things they fear & avoid
-common in treating phobias
2. Aversive Conditioning (positive to negative)
-associates an unpleasant state w/ unwanted behavior
-ex: nausea w/ drinking alcohol, bitter taste w/ nail
biting
Operant Conditioning
• Behavior modification
• Token Economy: get token for desired behavior &
can trade in for privilege or treat
Cognitive Therapy
• Aaron Beck
• Goal: teach people new,
more constructive ways of
thinking
– Negative, self-defeating
thinking
• Rational Emotive Behavior
Therapy (Albert Ellis)
– The way people feel is largely
influenced by how they think
– Change their irrational
thinking
Group Therapy
• Helps people discover that
other have similar problems
– Can be very reassuring
• Family Therapy
– Problem: stressful relationships
– Focused on healing
relationships, not 1 person
– Resolving conflicts
Biomedical Therapies
Psychopharmacology
• Antipsychotics: treats
schizophrenia
– Reduce dopamine activity in
brain
– Haldol, thorazine
• Anti-anxiety: Increases GABA to
decrease brain activity in areas
that relate to anxiety
– Valium, xanax
• Antidepressants & Mood
Elevators: increase serotonin &
norepinephrine activity levels
– Prozac, MAOIs, SSRIs
Brain Stimulation
• ECT (electroconvulsive therapy)
– Extremely effective for those w/ severe
depression (80%) drugs have not worked
– Given anesthetic & muscle relaxer, some
memory loss during treatment period (3
weeks)
– No one really knows why
• Psychosurgery
– Most drastic, least used
• Parkinson’s, Epilepsy, OCD
– Lobotomy
• Very common in 50s & 60s
• not used anymore