Transcript Slide 1

AP Psych Class Announcements:
Psych Quiz Bowl
4/24!!!!!
Let’s get that trophy
back!!!!!
Have you registered
for the AP exam?
Aim: to describe the
symptoms of schizophrenia
and to explain the various
therapies techniques.
Do NOW:
1. What is the difference b/t
behavioral vs. cognitive
therapy?
2. What is
counterconditioning?
Give 2 examples?
HW: study for test
Practice questions
Abnormal Psychology
.
History
• People used to explained mental
illness in terms of demon
possession.
• Trephining was often used
History con’t….
View #36 “Early History of
Mental Illness”
• Phillipe Pinel- took over
Bedlam. He freed patients
from chains and moved
them to sunny rooms and
talked with them.
• The Medical Model was
born- mental problems
were now seen as an illness
that needed to be
diagnosed by its symptoms.
Dorthea Dix
• 18th century
• Fought for improvements in
humane treatment of those
with mental illnesses
• All people should be treated
with dignity
Bio-Psycho-Social Perspective
• Today most clinicians believe that biological,
sociocultural, and psychological factors
combine to produce disorders
What is abnormal?
• Four criteria: Is the behavior
1. atypical or different from the norm?
2. disturbing?
3. maladaptive (harmful or unhealthy)?
4. unjustifiable (i.e. extremely
sad or blue for no
known reason)
How do we label or classify psychological disorders?
The DSM
(Diagnostic Statistical Manual of Mental
Disorders)
The big book of disorders.
• It defines 17 major
categories and classify
disorders and describe the
symptoms.
• DSM will NOT explain the
causes or possible cures.
*changes according to cultural
norms (homosexuality taken off
in 1973)
Questions
• 1. How would you feel upon hearing that
your daughter’s fourth grade teacher was
once briefly admitted to a psychiatric ward?
• 2. Would you rent a room to an
applicant that had listed as prior
address an institution/group home?
• 3. Would you want your co-workers
and boss to know that you are seeing a
psychiatrist and taking prescribed
medication?
Labels: The Result
label
• Although they serve
a purpose for
insurance, they bias
people’s perception
once they have been
labeled.
Affects how
they see
themselves
Changes
other’s
perception
Changes
how others
treat them
http://www.youtube.com/watch?v=WUaXFlANojQ
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.
How Anxious Are You?
• Score the Taylor Manifest Anxiety Scale
A. Anxiety Disorders
• a group of conditions
marked by distressing,
persistent anxiety
symptoms:
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Generalized Anxiety
Panic
Phobias
OCD
PTSD
1. Generalized Anxiety
• They are in a state of
continuously tense,
uneasy, worried that
bad things will happen,
agitated, muscle
tension, sleeplessness
• 2/3 are women
• Many experience panic
attacks
• One can not identify
the source of the
anxiety
You're walking through the park on an ordinary day when suddenly,
without warning, you're stricken with acute fear. The world starts to
spin. Everything around you seems unreal. Your heart beats so hard
that it quakes in your chest, and your throat tightens. Frantic for your
own breath, your mind screams, "Am I having a heart attack? Am I
going crazy?" And, worst of all, "Am I about to die?" The panic keeps
escalating until you feel like you just can't stand it anymore. Then,
finally, it starts to sink away from you. Confused and embarrassed,
you retreat to your car and go home where you know it's safe. You'll
never return to that park again, you think. And then a more fearful
thought pops into your head: "What if this happens again -somewhere else?“
Your body mysteriously triggers the fight-or-flight response when no
danger really exists. Basically, you get the same sensations you might
get if you heard a burglar break into your house in the middle of the
night. Only, nothing nearly that frightening or threatening has actually
occurred.
What is this called?
2. Panic disorder (attacks)
• Symptoms: minutes long episodes of intense
fear (sometimes confused as heart attacks),
heart palpitations, trembling, dizziness,
choking. Suffers begin to fear what they
believe triggered it and can develop phobias
of that place, object or person.
3. Phobias
• Symptoms: anxiety
focused on a specific
object or event; an
irrational fear that
disrupts behavior
Types of Phobias
• 1. Specific- over 700
classified phobias
• 2. Agoraphobia – fear of
leaving one’s home
• 3. Social phobia- fear of
being scrutinized by
others
• *often develop at an
early age
Phobia Matching Game!
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1. ablutophobia
2. amaxophobia
3. cacophobia
4. chaeotophobia
5. chronophobia
6. Coimetrophobia
7. coprastasophobia
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8. lockiophobia
9. placophobia
10. scolionophobia
11. papaphobia
12. arachibutyrophobia
13. triskaidekaphobia
14. epistemophobia
15. gerascophobia
OCD Scale
• Give one point for the following “True” you selected:
• 1,2,4,6,7,8,16,17,18,21
• Give one point for the following “False” you selected:
• 5,9,10,11,12,13,14,19,20,22
• Scores range from 0-20
• Average is 11.15
4. Obsessive-compulsive disorder
• Obsession: a reoccurring
irrational thought
• http://abcnews.go.com/WN
T/video/extreme-afflictionocd-16046438
• *one is driven to repeat
behavior in an attempt to
reduce anxiety that builds
when one does not listen to
the OCD voice or command
• Compulsion: a reoccurring
irrational behavior
• Common OCD’s:
• Germs
Four types of OCD behavior
• 1. the obsession over germs, commonly associated
with OCD.
• 2.the need for things to be in the right place, often in
a manner producing acceptable symmetry.
• 3. doubt, such as feeling like you might have hit a
pedestrian or constantly needing to confirm that an
appliance hasn't been left on.
• 4. disturbing, pressing thoughts that don't go away -uncomfortable sexual urges or the desire to commit
a violent act
5. Post-Traumatic Stress Disorder
• Symptoms: traumatic
events one tends to relive over and over
• Nightmares, social
withdrawal, anxiety or
depression
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Seen in:
soldiers
Rape victims
Victims of natural
disasters
Explaining Anxiety Disorders
• Learning Perspective:
• -general anxiety is linked with
classical conditioning and fear
• -say we generalize (fear of heights
lead to a fear of flying)
• Say behavior is reinforcedescaping situation reduces the
anxiety, therefore, reinforcing the
phobia
• Say much is observational
learning: watch we watch and
parents transmit fears to children
as well.
Biological perspective
• Say we are biologically
predisposed to fear dangers
feared by ancestors (storms,
heights, closed spaces..)
• We seem genetically wired to
certain fears
• Identical twins have identical
or similar fears
• Perhaps it’s their biological
make-up- scans show that the
brain is over aroused in certain
people with GAD, panic and
OCD
B. Somatoform Disorders
• Occur when a person
manifests a
psychological
problem through a
physiological
symptom.
• Two types……
1. Hypochondriasis
• Has frequent
physical complaints
for which medical
doctors are unable
to locate the cause.
• They usually believe
that the minor
issues (headache,
upset stomach) are
indicative are more
severe illnesses.
2. Conversion Disorder
• Report the
existence of severe
physical problems
with no biological
reason.
• Like blindness or
paralysis.
http://www.youtube.
com/watch?v=6Dye0
5tvSoo
C. Dissociative Disorders
• Very controversial!
• These disorders
involve a disruption
in the conscious
process.
• The person has
something so painful
that they dissociate
from it consciously
• Three types….
Questions related to Dissociation:
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1. Have you ever walked in your sleep?
2. Did you have imaginary playmates as a child?
3. Were you physically or sexually abused as a child or adolescent?
4. Have you ever noticed that things are missing from your personal
possessions or where you live?
5. Have you ever noticed that things appear where you live, but you don’t
know where they came from or how they got there (book, jewelry…)
6. Do people ever talk to you as if they know you but you don’t know
them, or only know them faintly?
7. Do you ever speak about yourself as “we” or “us”?
8. Do you ever feel that there is another person or persons inside you?
9. If there is another person inside you, does he or she ever come out and
take control of your body?
1. Psychogenic (dissociative)
Amnesia
• A person cannot
remember things with
no physiological basis
for the disruption in
memory.
• Amnesia is selective
and is retrograde
• NOT organic amnesia.
2. Dissociative Fugue
• People with
psychogenic amnesia
that find themselves
in an unfamiliar
environment.
• Amnesia plus fleeing
one’s home and
starting a new
identity.
3.Dissociative Identity
Disorder
• Used to be known as
Multiple Personality
Disorder.
• A person has several
rather than one
integrated personality.
• People with DID
commonly have a history
of childhood abuse or
trauma.
Common dissociative symptoms:
• 1. depersonalizationhaving the experience
that one’s body does
not belong to
themselves
• 2. self-absorption- sit
staring off in space, not
aware of the passing of
time
• 3. amnesia- find
evidence of having
done things that they
don’t remember
Physiological evidence for DID?
• http://health.discovery.
com/videos/psychweek-2010-eegtest.html
• Watch Tony and his
personalities reveal
themselves during a
therapy session.
• #31
• http://www.youtube.co
m/watch?v=dipFMJckZ
OM&feature=related
• Journal what you feel as
you watch a series of
paintings by Van Gogh.
• Vincent Van Gogh
• What emotions do the
paintings create?
What Do You Know About
Depression?????
• Break into groups and generate your list of the
following:
A.
B.
C.
D.
Types
Symptoms
Causes
Treatments
D. Mood Disorders
• Experience extreme or inappropriate
emotion.
*major depression
*dsythymic depression
*seasonal affective disorder
*bipolar (manic-depressive)
Zung Depression Rating Scale
• Reverse the responses to the following
numbers (1=5, 2=4, 3=3, 4=2, 5=1) :
2, 5, 6, 11, 12, 14, 16, 17, 18 and 20
• Add up all numbers
• 50-59- mild to moderate depression
• 60-69 = moderate to severe depression
• 70 and above severe depression
2. Dysthymic Depression
“Under the radar” type of depression
• Being low or down mood • trouble concentrating
most of the time for over
2 years.
• Irritable
• Low energy, low selfesteem,
• eat too little or too much
• Don’t enjoy things as
much as you used to
1. Major Depression
• A.K.A. unipolar
depression
• Severe symptoms
for at least two
weeks with no
apparent cause.
Symptoms of Major Depression
Withdrawn, feeling hopeless
Not socializing with friends, family
Missing school/work
Insomnia or hypersomnia
Not eating or bathing
suicidal
3. Seasonal Affective
Disorder
• Experience
depression during
the winter months.
• Based not on
temperature, but on
amount of sunlight.
• Treated with light
therapy to decrease
melatonin.
ECT: electroconvulsive
therapy
• “therapy” #37
• Used for Major
Depression
• Suppose one day you wake up feeling oddly
energized and pumped for anything. The world is at
your feet. You can do whatever you set your mind to
and nothing could possibly go wrong. In fact, you're
so full of energy that you decide you don't need to
sleep. Days, perhaps even weeks, go by -- nothing
gets you down and nothing slows you down. But
then, without warning, this feeling starts to wane.
For no reason at all, you begin to feel bogged-down,
depressed or even suicidal. Life is joyless and
meaningless. For weeks you feel absolutely hopeless.
And then, one day you wake up -- ready for anything.
4. Bipolar Disorder
• Involves periods of
depression followed by
episodes of mania
• Mania: hyperactive,
wildly optimistic, flight
of ideas, little sleep,
overly talkative, little
sleep.
• Engage in risky behavior
during the manic
episode.
Mania
• http://www.youtube.co
m/watch?v=p9hbXPVaO
uk&feature=related
• Norephinphrine
is higher then
normal!!!!!!!
• affects approximately
5.7 million adults in the
U.S. (2.6 percent of the
18 and up population)
• http://www.mentalhealthtoday.com/bp/famous_
people.htm
E. Schizophrenia
• Schizo = split mind or a split from reality
• Is a psychotic disorder
Examples:
• http://www.youtube.com/watch?v=uJOT45wX
Erk
Schizophrenia Facts:
• Universally occurs in 1 out of 100
• Strikes b/t the ages of 15-35
• Affects both genders equally
• More prevalent in lower socio-economic
groups
• Slow developing schizophrenia (called chronic
or process) has a much lower chance of
recovering
Recovery rates:
• 1/3 fully recover
• 1/3 in/out of hospitals
• 1/3 never recover
• Sudden onset (called acute or
reactive) has a better recovery
rate
Main Symptoms:
• 1. Hallucinationssensory experiences
(seeing, hearing things)
• http://www.youtube.co
m/watch?v=XC6Px8EJii8
&feature=fvst
2. Delusions
• irrational, fragmented,
bizarre, illogical beliefs
and thoughts.
• Some have paranoid
tendencies leading to
delusions of
persecution.
- Some believe they
are special leading to
delusions of granduer.
3. Inappropriate emotions and
actions
• Laugh at inappropriate
times.
• Flat Effect = zombie-like
state
• Senseless, compulsive
acts.
• Catatonia=motionless
Waxy Flexibility
Positive v. Negative Symptoms
Positive Symptoms:
Negative Symptoms:
Delusions,
hallucinations,
Disorganized thoughts
Flat affect (little
emotion), inability to
feel pleasure, lack of
personal hygiene
Types of Schizophrenia
•
•
•
•
Paranoid – 40%
Undifferentiated – 40%
Catatonic – 8%
Disorganized- 5%
Paranoid Schizophrenia
• preoccupation with
delusions or
hallucinations.
• “Somebody is out to
get me!!!!”
Disorganized Schizophrenia
• disorganized speech or
behavior, or flat or
inappropriate emotion.
• Word Salad:
"Imagine the worst
Systematic, sympathetic
Quite pathetic, apologetic,
paramedic
Your heart is prosthetic"
Heather:
•
http://www.youtube.com/watch?v=k
vdw4b7tC-8&feature=related
Catatonic Schizophrenia
• Flat affect
(emotions)
• Periodic frozen
state
• Parrot-like repeating
of another’s speech
and movements
• http://www.youtube.co
m/watch?v=zAEJJvndms&feature=relate
d
Undifferentiated Schizophrenia
• One has
many and
varied
symptoms
that
doesn’t fit
into any one
category
Schizophrenia:
Brain Abnormalities
• PET scans reveal low activity if the frontal lobe
• Many have enlarged fluid-filled ventricals :
results in less brain matter
• Thalamus is smaller (might account for
lack of selective attention leading to
“word salad”)
Con’t
• Schizophrenics have an excess number (6 X)
receptors for dopamine. Antipsychotic drugs
that try to block dopamine have been
somewhat successful
*Drugs that increase dopamine such as marijuana, cocaine and
amphetamines intensify disorder
Word Salad:
Schizophrenia Review
List all the symptoms of
schizophrenia shown in
this clip of “Gerald”
• http://www.youtube.co
m/watch?v=gGnl8dqEo
PQ
Possible Causes:
Prenatal factors
• Maternal virus during
pregnancy (flu)
• Mother exposed to
teratogens
• Poor nutrition
• Infants of difficult
childbirth
Possible Causes:
genetic
Genetic link: odd are 1 in 2 if one twin has it, 1
in 10 if a sibling does
-1 in 8 odds with
afflicted parent
-1 in 10 with
afflicted sibling
Possible Causes:
Environmental
• If one has a predisposition, then possibly
environmental factors could trigger it such as:
-stress
-family issues
-poor peer relations
-emotional unpredictability
Review:
• On a half sheet of paper:
• List all of the biomedical explanations for
schizophrenia you can recall.
The Rosenhan Study
• Rosenhan’s associates
were faked symptoms of
hearing voices.
• They were ALL admitted
for schizophrenia.
• None were exposed as
imposters.
• They all left diagnosed
with “schizophrenia in
remission.”
• What are some of the
questions raised by this
study?
The 1900’s brought a new reform movement in the United States, a
movement to deinstitutionalize the patients in mental hospitals. Patients
were to be returned to the community, where, with the help of antipsychotic
drugs and community mental health clinics, they would be able to lead
productive lives. Once again, the public’s apparent moral concern with the
treatment of the mentally ills was not matched by financial support. To a
great extent, persons who earlier would have been kept in mental hospitals
are now found in prisons, homeless shelters, nursing homes, and on the
streets, getting little if any treatment.
In 1955 there were about 560,000 persons in mental hospitals in the United
States. In 1997 that number had dropped to about 62,000, some of whom
are there for only short periods of times (2 to 4 weeks) during acute psychotic
episodes, after which they are released back to the community, where it is
expected they will received community-based treatment. Sometimes a
patient is first discharged into a halfway house or group home as part of the
transition from mental hospital to community.
Despite the stereotype, very, very few are violent!!!!
“Guilty by reason of insanity”
• This is a legal term only!!
• Jeffrey Dahmer was judged to be
legally sane at the time he killed and
dismembered 15 individuals.
• This indicates that the jury believed that
Dahmer was able to appreciate the
wrongfulness of his behavior and
control it.
Personality Disorders
• Well-established,
maladaptive
(dysfunctional) ways
of behaving that
negatively affect
people’s ability to
function.
• Dominates their
personality.
Antisocial Personality Disorder
• Typically male
• Shows up at early age,
disregard for laws
• Lack of empathy.
• Little regard for other’s
feelings.
• Lacks conscience
• View the world as
hostile and look out for
themselves.
• Restless and impulsive
Antisocial (aka.sociopath,
psychopath)
• Shows up at early age as: dishonesty, stealing,
delinquency
• As adults many can’t maintain a job or
relationships: act irresponsible, infidelity ….
• High correlation with alcoholism, drug
addiction, promiscuity, frequent relocation
• Combined with high intelligence make
charming, crafty criminals or con-artists
Brains of Antisocials
• Reduced frontal lobe
activity
• Pass lie detectors!!
• Lack the physiological
responses normally
associated with fear!!
• http://www.youtube.co
m/watch?v=oaTfdKYbu
dk
Dependent Personality Disorder
• Rely too much on the
attention and help of
others.
• Unable to make
choices
• Cannot tolerate
being alone,
submissive and
clinging
Histrionic Personality Disorder
• Needs to be the
center of attention.
• Whether acting silly
or dressing
provocatively.
Do you agree with the following?
•
•
•
•
I think I am a special person.
I expect a great deal from other people.
I am envious of other people’s good fortune.
I will never be satisfied until I get all that I
deserve.
• I really like to be the center of attention.
• Do you prefer friends who are weak or
unpopular?
Narcissistic Personality Disorder
• Having an
unwarranted sense
of self-importance.
• Thinking that you
are the center of
the universe.
• Do you agree that with recent
studies that claim that
Facebook encourages
narcisisst, attention-seeking
behavior in this generation?
Rosanne Barr:
• “I hate every human being on earth. I feel
everyone is beneath me and I feel they should
all worship me.”
• Tendencies:
• They love to talk about themselves, believe
that are entitled to the best, very envious,
critical of others, and can fly into fit of rage or
experience depression, shame and self-doubt.
Obsessive –Compulsive
Personality Disorder
• Overly concerned
with certain
thoughts and
performing certain
behaviors.
• Not as extreme as
OCD anxiety.
Borderline Personality
• Unstable self-image, relationships and
emotions……usually females
• DRAMA, DRAMA, DRAMA!!
Avoidant personality
• Hypersensitive to rejection and fears starting
relationships
Schizoid
• Strange behavior, emotionally cold, withdrawn
• 14-22 scale
• Average was 9.6
Psychoanalysis
Free association
therapist: “Tell me about your childhood. Say
whatever comes to your mind”
Resistancepatient: “I don’t really want to talk about my mother.”
Transferencepatient: “Doc, I’m really starting to have feelings for you.”
Humanistic Therapy
Client-centered techniques:
1.active listeningtherapist echoes, reinstates what the
client says
2. unconditional positive regardempathy, genuineness, acceptance
Client-centered therapy
• http://www.youtube.com/watch?v=V_T4B9XA
NCw
Behavioral therapy
• Counterconditioning
1. Exposure therapy- systematic desenstization
Create hierarchy of stressful steps. Teach client to learn
to relax at each step.
Sample hierarchy for one who’s phobia is asking girls’ on a
date:
• 2. aversive therapy:
– To pair something with negative stimuli
Example: antibul with alcohol (makes them sick)
Bed wetter and alarm
3. modeling: have people with Asperger’s
watch someone greet people as they
enter a room, then
must model the behavior.
Behavioral: Operant conditioning
• Pairing desired behavior with rewards
• Token economy
– Ex: one cigarette for each chore completed while
in the psych hospital
Cognitive therapy
• 1. cognitive behavioral therapy Aaron Beck
– One is taught to destroy the ANTs (automatic
negative thoughts) and replace the harmful
behaviors
– Ex of ANTs:
perfectionism, anger, frustration or negative views
of the world
• Rational Emotive therapy (RET) Albert Ellis
Therapist confronts illogical beliefs
http://www.youtube.com/watch?v=v9ezZIkxR74
• Patient: “I am a loser”
• Therapist: “Are you really a loser? At
everything? You’re saying you do NOTHING
well? How logical is this?”
Terms:
• Meta analysis – when you combine the
results of many tests and experiments to
determine the success of a therapy or
medication
• Regression towards the mean- when you start
therapy, you won’t get any worse. You are
now on the way to getting better.
Medications
• Depression
– prozac
Review
1. Systematic desentization
2. Positive regard
3. resistance
4. Transference
5. Cognitive-behavioral
6. Client-centered therapy
7. Modeling
8. RET
9. Aversive conditioning
10. Albert Ellis
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A.
B.
C.
D.
Psychoanalytic
Cognitive
Behavioral
Humanistic