Transcript Abnormal Psychology - elizabethmarquardt

ABNORMAL
PSYCHOLOGY
WHAT QUALIFIES AS A DISORDER?
• Unjustifiable (no real and sensible explanation
can be given)
• Maladaptive (prevents individual from living a
normal life)
• Atypical (for the culture a person is in)
• Disturbing (causes individual or others distress)
THINKING ABOUT LABELS
• What is the difference between calling someone “a
schizophrenic” and calling them “a person with
schizophrenia”? Which one would you prefer to be
called?
• If students qualify for a label such as “learning
disability” or “ADHD,” at what age should they be
told about it? Should teachers be told?
CULTURE-BOUND DISORDERS
• Anorexia nervosa and bulimia nervosa are found mostly in Western cultures
• Susto (anxiety and fear of black magic) is found in children in Latin America
• Latah causes uneducated middle-age and elderly women in Malaysia to repeat
others, swear, and do the opposite of what people ask in response to fear brought
on by a specific circumstance
• Amok primarily affects men in the Philippines and parts of Africa. Symptoms begin
with social withdrawal and disconnect from reality, followed by jumping violently,
yelling, and attacking objects and people, and ending with a period of depression
and amnesia of the episode
• Winigo, intense fear of becoming a cannibal, was common among Algonquin
Indian hunters who returned from a hunt empty-handed. Symptoms included
depression, loss of appetite and sleep, and occasionally cannibalism.
ANXIETY DISORDERS
Intense and persistent uneasiness and/or dysfunctional anxiety-reducing
behaviors
GENERALIZED ANXIETY DISORDER
• Symptoms: worry, sleep deprivation, agitation,
trouble concentrating, trembling, twitching,
perspiring, fidgeting
• No identifiable cause for anxiety (difficult to deal
with)
• Affects women more often than men, usually below
age 50, 3.1% of Americans
• Often occurs with depression
• Both can be treated with Effexor and Paxil, a
serotonin reuptake inhibitor
PANIC DISORDER
• Symptoms: panic attacks – episodes of intense fear
accompanied by heart palpitations, shortness of
breath, choking sensations, trembling, or dizziness
• 1.3% of population, smokers have double the risk of
non-smokers
• Often accompanied by agoraphobia (fear of public
spaces) because people fear having a panic attack
in public
PHOBIAS
• Specific phobias (of spiders, clowns, thunderstorms,
etc) may cause maladaptive avoidant behaviors
• Social phobia is a fear of acting awkward or anxious
in front of others, often causes people to avoid
social situations such as eating in public
• Phobias may be learned through conditioning and
are often successfully treated with
counterconditioning or exposure therapy
• Affects 6.8% of population
OBSESSIVE-COMPULSIVE DISORDER
And related disorders: A new category for DSM V, formerly included in
anxiety disorders
OCD
• Symptoms: obsessive thoughts compel repetitive
behavior
• Person generally has insight – recognize that they
have a problem, may feel overwhelmed by
symptoms
• 2-3% of Americans have this, most often develops in
teens and young adults but may be present in
children; lessens with age
COMMON EXAMPLES OF OCD
SYMPTOMS
Obsession
• Concern with
dirt/germs/toxins
• Something terrible
happening
• Symmetry, order, or
exactness
Compulsion (often done a
certain number of times)
• Excessive hand-washing,
bathing, cleaning
• Repeating rituals (checking
locks, stoves, going through
a door)
• Counting things such as
steps taken or words said
OTHER DISORDERS RELATED TO
OCD
• Hoarding disorder (new for DSM-V!) – people feel the
need to save everything and great distress parting
from possessions
• 2-5% population
• Trichotillomania – hair-pulling disorder
• Excoriation – skin-picking disorder
TRAUMA- AND STRESSOR-RELATED
DISORDERS
New category for DSM V!
POSTTRAUMATIC STRESS DISORDER
• DSM IV-TR categorizes it as an anxiety disorder
• Causes: “Exposure to actual or threatened death,
serious injury, or sexual violation” through direct
experience, witnessing an event in person, learning
that it happened to a loved one, or repeated
encounters with details (not through media) of the
event
PTSD
• Symptoms:
• Re-experiencing event in memories or dreams
• Avoidance of memories, thoughts, or similar situations
• Negative cognitions and moods (depression, social
isolation, etc.)
• Arousal (aggression, hyperviligance, etc.)
• 3.5% Americans, up to 25% of those who have seen combat
• Most people who survive a trauma do NOT develop PTSD
LEARNING PERSPECTIVE ON
ANXIETY DISORDERS
• We learn fears through conditioning: people may
overgeneralize a stimulus (fear all storms instead of
just tornadoes)
• Anxiety-reducing behaviors are reinforcing:
someone with a germ obsession may feel calmer
after washing hands and thus wash more frequently
BIOLOGICAL PERSPECTIVE ON
ANXIETY DISORDERS
• Many common phobias and compulsions may be adaptive
in mild form
• Genes may make some predisposed to be anxious/fearful,
sometimes by regulating NTs
• Brain circuits in amygdala influence fear, those in anterior
cingulate cortex, which checks actions for errors, are
especially active in those with OCD
SOMATOFORM DISORDERS
Now called “Somatic Symptom and Related Disorders”
SOMATOFORM DISORDERS
• Soma = body
• People experience physical symptoms (anything
from dizziness or nausea to extreme pain) with no
apparent physical cause
• Generalized complaints such as exhaustion are
more common in cultures where expressing
psychological distress is not the norm
CONVERSION DISORDER
• not as common today as in Freud’s time; patients
“convert” anxiety into a real physical symptom
(including numbness, paralysis, or blindness)
HYPOCHONDRIASIS
• Symptoms: interpret normal physical sensations
(headache or cramp) as signs of terrible disease
(not the same as faking illness!)
• May be reinforced by sympathy/attention from
others
• Many patients try doctor after doctor and refuse to
believe that nothing is wrong
DISSOCIATIVE DISORDERS
“Dissociate” = separate from reality
DISSOCIATIVE DISORDERS
• Very rare
• Difficult to prove
• May develop as a way to protect oneself from
trauma - detach from situation and emotions
DISSOCIATIVE IDENTITY DISORDER
(DID)
• Former called multiple/split personality
• Symptoms: A person’s thoughts, behavior, and
actions are alternately controlled by at least two
different identities with distinct personalities and
mannerisms
• Original personality usually claims to be unaware of
others
• Usually not violent
DISSOCIATIVE AMNESIA
• Complete identity loss due to trauma
DISSOCIATIVE FUGE
• Complete loss of identity
• Patients travel far from home and may turn up in a
faraway city as “John Doe”
CRITICISM OF DISSOCIATIVE
DISORDERS
• DID may be inadvertently manufactured by therapists: most DID patients are
highly susceptible to hypnosis, so if a therapist asks to speak to a different
part of them, they may invent one
• Patient may get so into acting like someone else that they convince
themselves
• Number of reported cases increased from 2 per decade to 20,000 per
decade after it was officially coded a disorder in the DSM
• DID is found almost exclusively in North America
• However, many DID patients do report suffering intense trauma or abuse as
children
MOOD DISORDERS
MAJOR DEPRESSIVE DISORDER
• Affects roughly 6% of men and 10% of women
worldwide in a given year
• Person must have 5 signs of depression that last at
least 2 weeks (not caused by drugs/medical
condition)
• May end on its own or with therapy
• Signs may include
• Lethargy
• Feeling worthless
• Loss of interest in social interaction or previously
enjoyed activities
• Insomnia or hypersomnia
• Poor appetite or overeating
• Difficulty concentrating or making decisions
BIPOLAR DISORDER
• Switching from back and forth from depression to
mania
• Symptoms of mania:
• Hyperactivity
• Feel little need for sleep
• Overconfidence (may lead to poor judgement)
• Creativity/energy
• Generally life-long, can be regulated with
medication
SEASONAL AFFECTIVE DISORDER
• Change in seasons causes change in brain
chemistry
• People experience symptoms of depression in the
winter
PERSONALITY DISORDERS
Inflexible and enduring behavior patterns that impair social functioning
3 CLUSTERS OF PERSONALITY
DISORDERS
• Cluster A: exhibits odd or eccentric behavior;
schizoid, paranoid, schizotypal
• Cluster B: demonstrates impulsive or dramatic
behavior; antisocial, borderline, histrionic, narcissistic
• Cluster C: anxiety-related behaviors; avoidant,
dependent, obsessive-compulsive personality
disorder (different from OCD)
ANTISOCIAL PERSONALITY
DISORDER
• Formerly called psychopaths or sociopaths
• Usually affects men, symptoms show before age 15
• Antisocial individuals:
• Lack regret for actions and compassion for others
• May be highly intelligent and charming
• Often exhibit criminal behavior such as lying, stealing,
or unrestrained sexual behavior
BIOLOGICAL CAUSES OF
ANTISOCIAL BEHAVIOR
• Genetic predisposition to have lower levels of stress
hormones may cause risky and irresponsible
behavior
• Murders have smaller-than-average frontal lobes
• Environmental factors also influence behavior
SCHIZOPHRENIA
“Split mind”, as in “split from reality”
SYMPTOMS
• Delusions – false beliefs; in people with paranoid
tendencies, especially belief that others are out to
get them
• Disorganized thinking – “word salad” describes
sentences that don’t make sense, often including
made-up words (neologisms)
• perhaps because of lack of selective attention
SYMPTOMS
• Hallucinations – false perceptions, most often
auditory and insulting or commanding
• Inappropriate emotions – opposite of what others
display or flat affect – no emotions at all
• Strange actions – excessive, unnecessary
movement or catatonia, no movement for long
periods of time
SYMPTOMS
• Symptoms may be positive (something is added –
hallucinations or active emotions) or negative
(something is absent –flat affect or catatonia)
• Symptoms may develop over time: chronic or
process schizophrenia, less likely to be cured
• Symptoms may begin suddenly after a stressor:
acute or reactive schizophrenia, much more likely to
respond to medication
5 TYPES OF SCHIZOPHRENIA
• Paranoid – concerned with delusions or
hallucinations
• Disorganized – disorganized speech/behavior,
inappropriate emotions
• Catatonic – lack of movement or excessive
meaningless movement, repetition of others’ speech
• Undifferentiated – shows a variety of symptoms
• Residual – social withdrawal, after hallucinations or
delusions are gone
CAUSES: CHEMICAL
• Unusually high levels of dopamine causes positive
symptoms
• Dopamine-blocking drugs help with
hallucinations/delusions and attention
• May cause symptoms similar to Parkinson’s disease
such as hand tremors (Parkinson’s patients do not
have enough dopamine)
• Negative symptoms may be caused by lack of
glutamate
CAUSES
• Neurons in frontal lobe fire out of sync
• Sensory areas light up with hallucinations
• Smaller-than-average thalamus (explains difficulty
filtering sensory input) and cortex, larger-thanaverage fluid filled areas
RISK FACTORS
• Maternal virus during first half of pregnancy can
double or triple risk (1% to 2 or 3%)
• Genetics – if a sibling or parent has schizophrenia,
person has a 10% chance of also having it (60% if an
identical twin that shared the placenta also has it)
• Low birth weight or oxygen deprivation at birth
ORGANIC DISTURBANCE
ORGANIC DISTURBANCE
• Decrease in brain function due to a physical or
biological cause such as head injury, disease, or
substance abuse
• Can be permanent or temporary