Transcript Abnormal Psychology - Solon City Schools

Abnormal Psychology
A.K.A. Psychological Disorders
Deviant, distressful, dysfunctional patterns
of thoughts, feelings or behaviors
Early Theories
• Abnormal behavior was evil spirits
trying to get out.
• Led to harsh, ineffective remedial
treatments
– Trephining, beatings, burnings, etc.
History of Mental Disorders
• Medical Model (Pinel)–
psychological disorders are
a biologically based…a
“sickness” that needs to be
diagnosed and cured
– Neglects the importance of social
circumstances and psychological
factors.
.
Perspectives and Disorders
Psychological School/Perspective
Psychoanalytic/Psychodynamic
Cause of the Disorder
Internal, unconscious drives
Humanistic
Failure to strive to one’s potential or
being out of touch with one’s feelings.
Behavioral
Reinforcement history, the
environment.
Cognitive
Irrational, dysfunctional thoughts or
ways of thinking.
Sociocultural
Biomedical/Neuroscience
Dysfunctional Society
Organic problems, biochemical
imbalances, genetic predispositions.
History of Mental Disorders
• Biopsychosocial Model– current
approach
– Interaction of nature and nurture
– Influence of culture
DSM IV
• Diagnostic Statistical
Manual of Mental Disorders:
– used to identify and diagnose
disorders
– Diagnoses on observable
patterns of behavior
• Facilitates reliability
– Answer questions from 5 levels
• DSM will NOT explain the
causes or possible cures.
• Criticism: classifys an
excessively broad range of
human behaviors as
psychologically disordered.
Classifying Psychological
Disorders
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
The Rosenhan Study
• Rosenhan’s associates
were Malingering
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?
ADHD
• Symptoms:
– Inattention/distraction
– Hyperactivity
– Impulsivity
• Causes:
– Biological
• Normal but delayed thinning of frontal cerebral
cortex
– Social
• Watching lots of TV as a toddler (correlational)
ADHD
• Assessing:
– Eye Tracking device
• Gender:
– 2-3X more in Boys
• Prevalence:
– 4% of all children
ADHD Treatment
• Treatment
– Biological – assume problem is organic
requires drug treatment therapy
• Stimulant drugs – help calm hyperactivity and
increase focus
– Aderall
– Ritalin
– Behavioral – assume problem behaviors are
the problem and apply operant and
classical conditioning principles
• Token economy –earn token for exhibiting
desired behavior, that can later be exchanged
for privileges or treats
Anxiety Disorders
• Anxiety Disorders - a group of
conditions where the primary
symptoms are persistent or
distressing anxiety or maladaptive
defenses against anxiety.
• Examples:
– Generalized anxiety disorder
– Panic disorder
– Phobias
– Obsessive compulsive disorder
– Post-traumatic stress disorder
Causes of Anxiety Disorders
• Learned Perspective
– Conditioned
• Classically conditioned by associating stimuli (i.e. a
traumatic event) with anxiety.
• Stimulus generalization – fear stimuli that are associated
with the original CS
– Example: Fear all dogs after bitten by Maui
• Reinforcement (operant) – helps maintain phobias and
compulsions after they arise
– Avoiding or escaping stimulus reinforces behavior
– Example: After feeling anxious you go inside your house
which calms you down
– Observational Learning
• Observing others’ fears
– Example: Monkeys transmit fear of snakes to offspring
Causes of Anxiety Disorders
• Biological Perspective
– Natural Selection/evolutionary perspective
• Biological predisposition to fear: spiders, snakes, close spaces, heights,
storms and darkness
• Compulsive acts exaggerate fears that contribute to survival:
– Examples:
» Washing up = ritual hand washing
» Checking boundaries = checking and rechecking locks
– Genes
• High strung temperament
– Anxiety disorders: high correlation in identical twins
– 17 genes expressed with Anxiety
• Neurotransmitters
– Anxiety gene affects brain levels of serotonin
– Too much glutamate: brain’s alarm centers overactive
– Brain
• Anterior Cingulate Cortex monitors actions and checks for errors –
elevated activity in OCD
• Amygdala – fear circuits created in traumatic experiences
Causes of Anxiety Disorders
• Psychoanalytic
Perspective
– Produced by repressed
memories
• Example: Afraid to go out
on dates because sexually
abused by father
Generalized Anxiety Disorder
• GAD - An anxiety disorder
in which a person is
continuously tense,
apprehensive and in a state
of autonomic nervous
system arousal.
– Fearful most of the time
accompanied by heart
palpitations, fatigue, dread,
difficulty concentrating,
sweating, or icy cold hands
– Often accompanied by
depression
– Free Floating – person can’t
identify , deal with or avoid
cause
Panic Disorder
• Panic Disorder - An anxiety
disorder marked by a
minutes-long episode of
intense dread that
something terrible will
happen
– Panic attack - chest pain,
choking, heart palpitations,
trembling, or dizziness
Phobias
• Phobia - irrational fear
causes person to avoid an
activity or situation
– Animals, insects, heights,
blood, closed spaces
– Social Phobia – fear of being
scrutinized by others…avoid
embarrassing social situations
– Agoraphobia – fear of open
spaces…having a panic attack
with no way to escape…may
accompany panic disorder
– Phobia List
Obsessive-compulsive disorder
• OCD - Persistent
• Obsessions – repetitive
thoughts
• Compulsions – repetitive
actions
• Examples – hoarders,
checkers, counters,
cleaners
• Causes
• Evolutionary Exaggerated behaviors of
ancestors – checking
territorial boundaries
• Biological
• insufficient serotonin
• Anterior cingulated cortex
• Learned – anxiety
reduction reinforces
behavior
Post-traumatic Stress Disorder
• PTSD – Flashbacks,
nightmares, withdrawal,
anxiety, insomnia for more than
4 weeks following extremely
stressful event.
– Greater emotional distress the
higher the risk for PTSD
– Cause: Sensitive limbic system
increases vulnerability by flooding
body with stress hormones
• Survival resiliency - ability to survive
dozens of episodes of trauma
• Post-traumatic growth – increased
personal growth due to trauma
Somatoform Disorders
• Somatoform Disorders
- psychological problem
that presents itself
through physical
symptoms
– Examples
• Conversion Disorder
• Hypochondrias
– Cause: socio-cultural
• China report physical
symptoms of psych
distress
• More common in Freud’s
day
Conversion Disorder
• Conversion Disorder –
anxiety is converted to
a physical symptom
with no physiological
basis.
– Examples: blindness or
paralysis.
– 12 teenage girls in
LeRoy, NY report
uncontrollable body
movements, tics and
verbal outbursts
Hypochondriasis
• Hypochondriasis –
normal sensations
are interpreted as a
symptoms of a
dreaded disease
• Patients go from
physician to physician
seeking medical
attention, but fail to
find a biological root.
• Example: Headache=
brain tumor
Dissociative Disorders
• Dissociative Disorders - involve a disruption
to conscious awareness in which a person
experiences a sudden loss of memory or
change in identity, often in response to a
traumatic event
• Two types
– Dissociative Fugue, Dissociative Identity
Disorder
• Symptoms in common
– Memory loss of time periods, events, people
– Distorted perception of people and things
• watch self with sense of attachment
– Blurred sense of identity
Dissociative Fugue
• Conscious awareness is
separated from painful
memories or feelings
• Patients find
themselves in an
unfamiliar environment
with no knowledge of
past life - create
physical distance from
real identity
• Triggered by stress
Dissociative Identity Disorder
• Used to be known as
Multiple Personality
Disorder.
• 2 or more distinct
personalities control
a person’s behavior
• Patients commonly
have a history of
childhood abuse or
trauma.
DID Controversy
AGAINST
1.
2.
3.
4.
Could be extreme version of
our capacity to vary the
“selves” we present in
different situation
Constructive memory –
leading questions may lead
to constructing false
memories of childhood
trauma
Role-playing of fantasyprone patients in response
to leading questions
Outside US disorder is
much less prevalent
FOR
1.
2.
Distinct brain and body
states associated with
differing personalities
Heightened brain activity in
areas associated with
control and inhibition of
traumatic memories
Mood Disorders
• Characterized by emotional extremes
– 2 typical forms
• Major Depressive Disorder
• Bi-polar
• The Common Cold of Psych Disorders
• Inhibits aggression and risk taking, slows us
down
Causes of Mood Disorders
• Biological
– Genes
• Increased risk if have parent or sibling with disorder
• Identical twins
– Major Depression = 1 in 2 chance
– Bipolar = 7 in 10 chance (2 in 10 for Fraternal)
• Linkage analysis – isolating genes across generations
– Not one single gene found
• Heritablity – 35 to 40% in major depression
– Brain
• Less activity in brain during depressed states, more activity during mania
• Left frontal lobe active during positive emotions is inactive during depression
• Hippocampus – vulnerable to stress related damage
– Biochemical
• Norepinephrine – scarce: depression; abundant: mania
• Serotonin – scarce
• Drugs used to block reuptake of norepinephrine and seratonin relieve
symptoms
Causes of Mood Disorders
• Social Cognitive
– Cognition
increased expectations of negative outcomes
Self defeating beliefs
Learned helplessness
Negative explanatory style - tend to explain events in
stable (forever), global (affects everything) and internal
(my fault) terms
• Women : greater emotional memory to recall negative
events, more likely to sense a lack of personal control, and
over think in response to stressful situations
•
•
•
•
– Social
• Stressful life experiences
• Individualistic countries
• Psychoanalytical
– Internalization of anger
Suicide
• Risk highest when
rebounding from
depression
• Higher risk if abuse
alcohol
• Social suggestion
may trigger suicide
• Talk about suicide
Major Depression
• Major Depressive Disorder – at
least 5 signs of depression and
lasts 2 or more weeks
• Signs of depression:
–
–
–
–
lethargy
feelings of worthlessness
loss of interest in family/friends
Loss of interest in activities
• With or without therapy,
episodes usually end
Bipolar Disorder
• Bipolar Disorder – alternating
between depression and mania.
• Mania – euphoric,
hyperactive/high energy, overtalkative, overactive, require
less sleep, take more risks, and
are wildly optimistic state
• Formally manic depression.
Seasonal Affective Disorder
• Seasonal Affective
Disorder Experience
depression during
the winter months.
• Based not on
temperature, but on
amount of sunlight.
• Treated with light
therapy.
Personality Disorders
• Personality Disorders - Wellestablished, maladaptive ways
of behaving that negatively
affect people’s ability to
function.
• 3 clusters
– Anxious/fearful
• Avoidant personality disorder
– Eccentric/Odd
• Schizoid personality disorder
– Impulsive/erratic
• Histrionic personality disorder
• Narcissistic personality disorder
Antisocial Personality Disorder
• Antisocial Personality
Disorder – Lack of
conscience = antisocial
behavior (lying, cheating,
stealing, sexual
promiscuity
• Feel and fear little
• May be aggressive and
ruthless or a clever con
artist
• Usually Male
• Conduct disorder in
children
Causes of Antisocial
Personality Disorder
• Biological
– Little or no physical reaction
• No autonomic nervous system arousal
(low levels of adrenaline)to adverse
events
• May lead to fearless behaviors
– Low levels of stress hormones
– Reduced frontal lobe activity and
tissue
– Genes
– Prone to alcohol and drug addiction
• Social – poverty and family
instability, child abuse
Histrionic Personality Disorder
• Histrionic
Personality Disorder
– attention seeking
behaviors
Narcissistic Personality Disorder
• Narcissistic Personality
Disorder – self
involvement/obsession
with self
• Thinking that you are
the center of the
universe.
Schizoid Personality Disorder
• Schizoid Personality
Disorder – lack of
interest in social
events and
relationships
Avoidant Personality Disorder
• Anxiety personality
disorder
• Lifelong pattern of
feeling very shy,
inadequate, and fear
social rejection.
Schizophrenic Disorders
• Schizophrenia – meaning split mind
and characterized by
1. Disorganized thinking.
2. Disturbed Perceptions
3. Inappropriate Emotions and
Actions
• 2 General Types
– Reactive (acute) schizophrenia –
develops rapidly, but more likely
recovery
– Chronic (process) schizophrenia– slow
to develop and less likely to recover
Disorganized Thinking
• Thinking that is
fragmented, bizarre
and distorted with
false beliefs.
• Speech is fragmented
and full of unrelated
words = word salad
• May be caused by
breakdown in selective
attention –inability to
filter out information.
Delusions (false beliefs)
• Delusions of
Persecution
• Example: “The
police are trying to
get me and take me
to prison”
• Delusions of
Grandeur
• Example: “I am
Jesus and can walk
on water”
Disturbed Perceptions
• hallucinationssensory experiences
without sensory
stimulation.
• Example:
– Hear voices saying
“You are bad and
should burn yourself
with a cigarette”
Inappropriate Emotions and
Actions
• Laugh at
inappropriate times.
• Flat Effect – no
emotion
• Senseless,
compulsive acts.
• Catatoniamotionless Waxy
Flexibility
Positive v. Negative Symptoms
Positive Symptoms
•Presence of
inappropriate symptoms
•Hallucinations,
disorganized thoughts,
delusion, inappropriate
emotions
Negative Symptoms
•Absence of
appropriate ones.
•Toneless voices,
expressionless faces,
mute, rigid bodies
Subtypes of Schizophrenia
• Disorganized - disorganized
speech or behavior, or flat or
inappropriate emotion.
• Paranoid – preoccupation with
delusions or hallucinations,
often with themes of
persecution or grandiosity
• Catatonic – immobility, extreme
negativism, parrot-like
repeating of speech and
movement
• Undifferentiated – many and
varied symptoms
• Residual – Withdrawal after
hallucinations and delusions
have disappeared.
Causes of Schizophrenia
• Brain Abnormalities
– Dopamine Hypothesis – excess dopamine receptors
• May intensify brain signals creating positive symptoms
– Abnormal Brain Activity and Anatomy
• Low brain activity in frontal lobes critical for planning and
reasoning
• Out of synch neurons
• Increased activity in thalamus (hallucinations)
• Increased activity in amygdala (paranoia)
• Enlarged fluid filled areas and shrinkage of
cerebral tissue
– Greater the shrinkage, the more severe the disorder
Causes of Schizophrenia
– Maternal Virus during Pregnancy
• Affects fetal brain development
– Flu epidemics increase risk
– Born during winter and spring months after
fall/winter flu season have greater risk
– Abnormal levels of anti-bodies
• Genetic Factors
– 1 in 10 chance if sibling or parent has
– 6 in 10 in identical twins
• Some genes influence the effects of dopamine
• Some genes affect the production of myelin
Early Warning Signs
• Short attention span and
poor muscle coordination
• Disruptive or withdrawn
behavior
• Birth complications
involving oxygen
deprivation and low birth
weight
• Poor peer relations and
solo play
• Has NOTHING to do with
neglectful childrearing