Transcript "Abnormal" Psychology

"Abnormal" Psychology
Think about it...
450 million people
worldwide suffer from
psychological
disorders
A US government
survey estimates that
15% of the population
are in need of
psychological therapy.
TRUE or FALSE?
1. Very few people are actually affected by psychological disorders.
2. People sometimes forget a very traumatic event as a way of coping
with the psychological stress of the trauma.
3. People whose illnesses are “all in their heads” do not really have
symptoms of disease.
4. Depression is the most common type of psychological disorder.
5. Some people never feel guilty, even when they commit serious
crimes.
What is "normal"?
Are psychological disorders genuine illnesses or socially
defined categories?
What is Abnormal Behavior???
Is abnormal behavior treatable?
Can we prevent abnormality?
What’s Normal?
What’s Abnormal?
How do we decide between these two terms?
Finding a “lucky” seat in an exam.
Being unable to sleep, eat, study, or talk to anyone else for days
after a break-up.
Breaking into cold sweat at the thought of being trapped in an
elevator.
Swearing, throwing pillows, and pounding fists on the wall in
the middle of an argument with a friend or parent.
Refusing to eat solid food for days at a time in order to stay
thin.
Having to engage in a thorough hand-washing after coming
home from a ride on a bus or train.
Believing that the government has agents who are listening in
on telephone conversations.
Drinking a six-pack of beer a day in order to be “sociable” with
friends.
DEVIANCE
- 39% of ppl who
confess to snooping
in their host’s
medicine cabinets
- 30% of ppl who
refuse to sit on a
public toilet seat
- 23% confess to not
flushing all the time
- 10% believe they’ve
seen a ghost
Kanner, 1995
NOT DEVIANT
- 50% of ppl use the
bathroom 6x/day
- 97% write own
name when trying
out a new pen
- 50% regularly sneak
food into movie
theaters
- 57% report having
experienced déjà vu
Kanner, 1995
Questions to consider…
How typical is the behavior of people in general?
Is the behavior maladaptive?
Does the behavior cause the individual emotional
discomfort?
Is the behavior socially unacceptable?
Abnormal is...
Any behavior that differs much from the average
Any behavior that leads to distress (pain), disability
(impaired functioning), or an increased risk of death,
pain, or loss of freedom (DSM definition)
Let people decide for themselves whether they are
troubled?
TYPICALITY
MALADAPIVITY – the behavior impairs an individual’s
ability to function adequately in everyday life; behavior that
is hazardous to the individual or others
EMOTIONAL DISCOMFORT – feelings of helplessness,
hopelessness, suicidal thoughts
SOCIALLY UNACCEPTABLE BEHAVIOR – culture must
be considered (culture-bound syndromes)
*Unjustifiable/disturbing to other people
4 Approaches to
Abnormality
The following can occur alone or an interaction can
contribute towards abnormality
1) Distress
2) Impairment
3) Risk to Self or Other People
4) Socially and Culturally Unacceptable Behavior
Norms vs. Culture
Norms: A society’s Culture: People’s
stated and unstated common history,
rules for proper values, institutions,
conduct.
habits, skills,
technology and
arts.
Would you consider this
normal? Abnormal?
Along the Niger River, men
of the Wodaabe tribe put
on elaborate makeup and
costumes to attract women.
In Western society, the
same behavior would break
behavioral norms and
probably be judged
abnormal
Causes of Abnormality?
Biological
Psychological
Socio-cultural
The Two Models
Medical - psychological disorders are
sickness/diseases
- etiology/prognosis
Bio-psycho-social Model - abnormal behavior has 3
major aspects: biological, psychological, sociological
Biopsychosocial Perspective
Refers to the interaction in which biological, psychological,
and sociocultural factors play a role in the development of
an individual
Diathesis Stress Model
- People are born with a predisposition (or “diathesis”) that
places them at risk for developing a psychological
disorder.
- This vulnerability could be genetic or due to earlier life
experience.
Table 1.1 Causes of Abnormality
Biological
Genetic Inheritance
Medical Conditions
Brain Damage
Exposure to environmental stimuli
Psychological
Traumatic life experiences
Learned associations
Distorted Perceptions
Faulty ways of thinking
Sociocultural
Disturbances in intimate relationships
Problems in extended relationships
Political of social unrest
Discrimination toward one’s social group
Biological Causes
Biological determinants?
•
Use of Medication
•
Brain damage; exposure to toxins
Genetics
•
PD’s do sometimes run in families
•
E.g., MDD
Medical Ailments
Environmental Contributor
Psychological Causes
Disturbances often arise from an emotional,
distressing or troubling life experience
Interpersonal experience
•
Events that take place in interactions w/ other
people
Intrapsychic
•
Those that take place w/in thoughts and feelings
Sociocultural Causes
What does sociocultural mean?
R.D. Laing (1964)
•
“people who refuse to abide by the norms of this
society are psychologically healthier than those
who blindly accept and live by such restrictive
social norms”
Thomas Szasz (1961)
•
“Problems with living” vs. “sick”
•
Trouble stems from a “mismatch b/w personal
needs and society’s ability to meet those needs”
The Human Experience
of Psychological
Disorders
Myths of Mental Illness

Creative people are a little “crazy”

Ppl w/ mental disorders are dangerous

Most older ppl are senile

Criminals are born “bad”

Asthma is caused by emotional problems

Suicidal individuals rarely talk about suicide

People wilth Schizophrenia have multiple personalities
The Human Experience of
Psychological Disorders

Stigma, social reactions
- People treat individuals suffering from a
psychological disorder differently

Why is stigma around PD’s and treatment a
problem??
Social Cognitive Processes

Cues
1) Psychiatric symptoms 2) Social Skill Deficits 3)
Physical appearance 4) Labels

Stereotypes

Prejudice

Discrimination
Why do some psychologists
criticize diagnostic labels?
Classification
DSM- IV- TR
DSM V
Diagnostic and Statistical
Manual of Mental Disorders
(DSM)
First developed in 1952 by American Psychiatric
Association
Many revisions, movement away from the
conceptualization of psychological disorders as
emotional reactions
History of DSM
•
DSM-IV (the 4th ed.) 1994
•
DSM-IV-TR (4th ed., text revision) 2000
- Includes editorial revisions
•
Diagnostic and Statistical Manual of Mental Disorders
- Provides both clinicians and researchers with a
common language for delineating disorders
- This helps professionals with differing backgrounds
understand one another
- This helps create confidence in labeling a ct or pt
•
Published by the American Psychiatric Assoc.
DSM

Concerns in developing the DSM-IV

Reliability

Validity

Base Rates

Social Context
Mental Disorder

What does this term mean to you?

“Clinically Significant”

•
Consistently present over time
•
Dramatically affects daily life
Syndrome
•
Collection of symptoms (observable actions) that
form a definable pattern.
•
Based on client report of thoughts and feelings
Assumptions of the DSM
Medical Model
•
Disorders are viewed as diseases
•
MD’s usually use term “patient” and “mental disorder.”
The latter = neg conotation
Atheoretical Orientation
•
Descriptive, rather than explanatory
•
Describes Sx, not causes
Categorical Approach
Multiaxial System (described next!!!)
NOTE:

Neurosis:

Term referring to
behavior that involves
distressing,
unacceptable symptoms
that are enduring and
lack any physical basis.

Not a modern
diagnostic term

Psychosis:

Term referring to
various forms of
behavior involving a
loss of contact with
reality, such as
delusions (false
beliefs) and
hallucinations (false
perceptions)
The 5 Axes
of the DSM - V
Axis I: Clinical Disorders
Axis II: Personality
Disorders and Mental
Retardation
Axis III: General Medical
Conditions
Axis IV: Psychosocial and
Environmental Problems
Axis V: Global Assessment of
Functioning
Axis I

To be listed on Axis I


Must be primary focus of clinical attention
Typically, an overlay of an otherwise healthy
personality
E.g., substance related disorders; anxiety
disorders, schizophrenia, depression

Axis II

Personality traits that are inflexible and maladaptive

Usually a long standing condition


E.g., Narcissism, OCPD, Borderline
Can an individual have a diagnosis on Axis I and Axis
II?

Example??
Axis III

Physical conditions can be the basis of psychological
problems and should be documented.


E.g., Lyme’s/Bells & Dep Ct.
Also important b/c of medication interaction and
causality
Axis IV

Negative life events

E.g., problem with primary support group


Details: parent died OR falling out with family
All areas of this Axis are stressors which can
contribute towards a dx on Axis I or II
Axis V



An overall judgment of functioning
Consider psychological status, social functioning
(including personal and work relationships)
What’s normal?

65 and Up is generally high functioning
Review
1. Define each of the following terms: phobia, dissociation,
depersonalization, and mania.
2. What are obsessions and compulsions, and how are they
related?
3. What fears are associated with each of the following
phobias: agoraphobia, claustrophobia, and zoophobia?
4. What must occur before a psychologist will make a
diagnosis of major depression?
Adapted from Kessler et al., 2005
Who Seeks
Therapy?
This chart is
based on U.S.
Surveys
Percentages
represent
individuals who
have been in
therapy at some
point in their life
-(Adapted from
Fetto, 2002)
Anxiety Disorders
Generalized Anxiety Disorder
Panic disorder
Phobias
OCD
http://www.youtube.com/watch?v=45PVIo2968E
http://www.youtube.com/watch?v=Rn1OYlYzgm8
PTSD
Mood Disorders
Major Depressive Disorder
Dysthymic disorder
Bipolar Disorder
Other categories
Substance-related
Developmental-related Disorders - mental retardation, pervasive disorders,
ADHD
Age-related and Cognitive Disorders - Dementia, Alzheimer's
Personality Disorders - Histronic, Narcissistic, Paranoid, Schizoid, Schizotypal,
Avoidant, Antisocial, Borderline
Schizophrenia
Somatoform Disorders - Conversion, Body Dysmorphic, Hypchondrias
Dissociative Disorders - Dissociative Amnesia, Diss. Fugue, Depersonalization
Eating Disorders/Impulse Control Disorders - Anorexia, Bulimia, Kleptomania
Sexual Disorders - Pedophilia, Exhibitionism, Fetishism, Sadism/Masochism