Abnormal Psychology and Treatment

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Transcript Abnormal Psychology and Treatment

Abnormal Psychology
Units XII
Defining Psychological Disorders
• What's normal and what's abnormal?
• Psychological Disorders- a harmful dysfunction in
which behavior is judged to be atypical,
disturbing, maladaptive, and unjustifiable
– What is
• Why is it so important to diagnose someone
correctly with a disorder?
• Can you be atypical and not have a disorder?
Defining Psychological Disorders
• The answer is yes
• That is why you must also consider the behavior
to be disturbing
• standards of acceptability vary with different
• one example of how acceptability of disorders
can vary in one culture is:
– from 1952 to Dec. 9, 1973 homosexuality was
considered a disorder in the DSM
– on Dec. 10, 1973 it was not
• later nicotine dependence was added to the DSM
Defining Psychological Disorders
• many clinicians focus on the maladaptive part of the
definition to diagnose someone with a disorder
• for example they see nicotine dependence a disorder
when it becomes self-destructive
• they see a behavior as a possible disorder when it
becomes disabling
• maladaptiveness has become a key element when
defining disorder
• the behaviors must be distressing or disabling or put
one at greatly increased risk of suffering or death
• an intense fear of spiders may be irrational but it does
not impair your life like a disorder
Understanding Psychological Disorders
• in the past people have blamed disorders on
outside forces like the stars, godlike powers, or
evil spirits
• if this was the case, then the cure was simply to
get rid of the outside force
• mad people were often put in zoolike conditions
or given therapies appropriate to a demon
– sometimes beaten, burned, pulling teeth, or even
Understanding Psychological Disorders
• Medical Perspective
• Philippe Pinel of France said madness was not
demon possession but a sickness of the mind
caused by stress and inhumane conditions
• Pinel believed in mortal treatment
– unchaining them, talking with them, and replacing
brutality with gentleness, isolation with activity, and
filth with clean air and sun
• he believed if you boosted their moral you
improved their behavior
Understanding Psychological Disorders
• Medical Perspective
• physicians began to look for ways to treat psychological
disorders through medicine
• this new focus was called the mental health movement
• a mental illness needs to be diagnosed on the basis of
symptoms and cured through therapy
– the therapy may include treatment in a psychiatric hospital
• medical model- concept that diseases have physical
causes that can be diagnosed, treated, and
Understanding Psychological Disorders
• with the medical model being followed,
hospitals started to replace asylums for
dealing with "mad" people
• over time the medical perspective has gained
more and more credibility as doctors are
finding more ways to deal with disorders
through medicine or some form of medical
Understanding Psychological Disorders
• Bio-Psycho-Social Perspective
• today psychologists say that all behavior, whether
called normal or disordered arise from in the
interaction of nature
• to say a person is mental ill is to say the condition is
solely internal
• maybe the issue is a growth blocking influence in the
environment, in the person's current interpretations of
events, or in the person's bad habits and poor social
• evidence of this is that some cultures are culturally
Understanding Psychological Disorders
• Bio-Psycho-Social Perspective
• schizophrenia and depression seem to be worldwide
• anorexia and bulimia seem to only occur in western
• susto which is a fear of black magic seems to only
occur in Latin America
• a fear of social anxiety about one's appearance with a
readiness to blush and a fear of eye contact appears
only in Japan
• they all seem to have similar causes but very different
Understanding Psychological Disorders
• Bio-Psycho-Social Perspective
• Bio-Psycho-Social Perspective- a contemporary
perspective which assumes that biological,
psychological, and sociocultural factors combine
and interact to produce psychological disorders
• they recognize that the body and mind cannot be
• stress and negative emotions can lead to physical
Classifying Psychological Disorders
• classification in science creates order
• in psychology, classification orders and describes
• classification in psychology also looks to predict the
disorders future course, imply appropriate treatment,
and stimulate research into its causes
• the way for classifying psychological disorders is the
American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders(Fourth Edition)
– also called the DSM-IV
• this is a 1994 model that is currently being revised and
will be the DSM-V
Classifying Psychological Disorders
• many people do not like the DSM because it diagnoses
people's problems in terms of their symptoms which
says that it is a mental illness
• they do however still see it as a very practical tool
when diagnosing and treating people with disorders
• health insurance companies require a DSM-IV
diagnosis before they will pay for therapy
• DSM-IV defines 17 major categories of mental disorder
• the DSM-IV describes the disorders and lists their
prevalence without presuming to explain their causes
Classifying Psychological Disorders
• DSM-IV mentions something called neurotic
– a psychological disorder that is usually distressing but
that allows one to think rationally and function
– this term is often considered to be too vague so it is
not used often
• the DSM also talks about psychotic disorders
– a disorder in which a person loses contact with reality,
experiencing irrational ideas and distorted
Classifying Psychological Disorders
• DSM-IV categories must be reliable
– What does this mean?
• some critics say the DSM-IV is too vague and can
bring any kind of behavior within the compass of
• some say that the number of disorder categories
has grown too much- from 60 in the 1950's to
400 today
– 30 percent of adults meet the criteria for at least one
psychiatric ailment
Labeling Psychological Disorders
• once someone is labeled, they are viewed
• labels guide our perceptions and our
interpretations of people
• David Rosenhan conducted a study to test this
– he and seven others went to mental hospital
admissions offices, complaining of hearing voices that
were saying empty, hollow, and thud
– apart from this complaint and giving false names and
occupations, they answered all the questions
Labeling Psychological Disorders
• David Rosenhan's study
– all eight participants were diagnosed as being ill
– until being released on an average of 19 days later,
the patients exhibited no further symptoms
– the clinicians were able to discover the causes of
their disorders after analyzing their life histories
– they said one person was reacting to mixed
emotions about his parents
– even the normal behaviors of the patients, such as
taking notes, were often misinterpreted as
Labeling Psychological Disorders
• Ellen Langer conducted another study where
people rated an interviewee as either normal or
out of the ordinary
– all viewers saw the same tape
– those who watched the unlabeled interviewees
perceived them as normal
– those who watched supposed patients perceived
them as different from most people
• Rosenhan discovered that labels can be useful
but also they can have a life and an influence of
their own
Labeling Psychological Disorders
• the media can often affect people's stereotypes
of disorders
– movies often portray mental health patients as
homicidal or as freaks
• they are also seen as violent or alcoholics
• 9 in 10 people with disorders are in fact not
– they are instead anxious, depressed, or withdrawn
• if used correctly labels can help doctors to
properly treat someone suffering from a mental
Anxiety Disorders
• anxiety is a part of life
• at one time or another, most of us feel enough
anxiety that we fail to make eye contact or we
avoid talking to someone
• for most of us our uneasiness is not intense and
• Anxiety disorder- characterized by distressing,
persistent anxiety or maladaptive behaviors that
reduce anxiety
• all the anxiety disorders combined make anxiety
disorders the most common mental disorders
Anxiety Disorders
• Generalized Anxiety Disorder and Panic Disorder
• GAD- a person is continually tense, apprehensive, and
in a state of autonomic nervous system arousal
• the symptoms of GAD are common but their
persistence is not
• 2/3 of suffers are women
• symptoms: tense, jittery, worried about bad things that
might happen, muscular tension, agitation, and
• the worst part of GAD is that the person cannot
identify and deal with or avoid its cause
Anxiety Disorders
• Panic Disorder- marked by minutes-long episode
of intense dread in which a person experiences
terror and accompanying chest pain, choking, or
other frightening sensations
• it strikes sudden, causes havoc, and disappears
• 1 in 75 people suffer from it
• anxiety escalates into a panic attack
• symptoms: heary palpitations, shortness of
breath, choking sensations, trembling, or
– often thought to be a heart attack
Anxiety Disorders
• Generalized Anxiety Disorder and Panic Disorder
• Panic Disorder
– after several panic attacks people often develop a
panic disorder
– they fear the fear itself and avoid the situations that
caused the panic attack
– smokers are at a higher risk of panic attacks
– often times people with a panic disorder suffer from
• fear or avoidance of situations in which escape might be
difficult or help unavailable when needed
Anxiety Disorders
• Charles Darwin began experiencing panic
attacks after sailing around the world for 5
– he moved to the country, avoided social
gatherings, and traveled only in his wife's
– he saw it as helpful because it allowed him to get
away from the distractions of life and focus on his
Anxiety Disorders
• Phobia- marked by a persistent, irrational fear
and avoidance of a specific object or situation
• many people accept their phobias and live
with them
• some phobias are incapacitating
• sometimes when someone suffers from a fear
of a specific thing, they can avoid that thing
Anxiety Disorders
• Obessive-Compulsive Disorder
• OCD- characterized by unwanted repetitive
thoughts(obsessions) and actions(compulsions)
• we may be obsessed with offensive thoughts that wont
go away or we may be obsessed with ordering,
cleaning, or hoarding
• someone with OCD may recheck a locked door, step
over cracks in the sidewalk, or line up books very
• these actions cross the line from normal to abnormal
when they interfere with the way we live or when they
cause distress
Anxiety Disorders
• Explaining Anxiety Disorders
• anxiety often develops when something bad happens
• anxiety can develop from a classical conditioning of
• when something bad happens, people become
apprehensive when they go back to the place where it
• sometimes fears can be a result of stimulus
– when someone fears height after a fall also fears airplanes
without ever flying in one
Anxiety Disorders
• Explaining Anxiety Disorders
• once phobias and compulsions arise,
reinforcement helps maintain them
– avoiding or escaping the feared situation reduces
anxiety, thus reinforcing the phobic behavior
• we can also learn fear through observational
learning by observing others' fears
Anxiety Disorders
• Explaining Anxiety Disorders
• some people believe our fears have an
evolutionary explanation
– we fear threats faced by our ancestors
• some people believe we do not learn fear but we
actually learn to not be afraid of things
– people during WWII became less afraid of planes
flying over because of the frequent air raids
• some people feel that some people are
genetically predisposed to certain fears and high
Anxiety Disorders
• Explaining Anxiety Disorders
• identical twins often develop similar fears or
• fear-learning experiences can also change how
our brain works by traumatizing it
– some drugs help to get the brain functioning as
close to right as possible
• Schizophrenia
• chronic schizophrenia is considered the cancer of
psychological disorders
• nearly 1 in 100 people will develop schizophrenia
• 24 million people across the world suffer from one of
humanity's most dreaded disorders
• it typically strikes as young people are maturing into
• it knows no national boundaries
• it affects males and females about equally
– men tend to be struck earlier and more severely
• Symptoms of Schizophrenia
• Schizophrenia- a group of severe disorders
characterized by disorganized and delusional
thinking, disturbed perceptions, and
inappropriate emotions and actions
– the term is literally translated to mean split mind
• it does not deal with a multiple personality split
but a split from reality
• symptoms may include disorganized thinking,
disturbed perceptions, and inappropriate
emotions and actions
• Symptoms of Schizophrenia
• the thinking of a person with schizophrenia is
fragmented, bizarre, and distorted by false beliefs
• Delusions- false beliefs, often of persecution or
grandeur, that may accompany psychotic
• Word Salad- created when someone jumps from
one idea to another sometimes within one
• those with paranoid tendencies are prone to
delusions of persecution
• Symptoms of Schizophrenia
• it is thought that disorganized thought result
from a breakdown in selective attention
– giving our undivided attention on one thing when
there are many other possibilities for us to focus on
• schizophrenia sufferers cannot block out other
things to focus on one thing
• they cannot clear their working memory of
distracting info and inhibiting irrelevant material
• Symptoms of Schizophrenia
• a person with schizophrenia may perceive things that are
not there
• hallucinations are usually auditory
• the person may hear voices that make insulting statements
or give orders
• the voices may tell the patient that she is bad or that he
must burn himself
• people may see, feel, taste or smell things that are not
• when the unreal seems real, the perceptions can be
• Symptoms of Schizophrenia
• the emotions of schizophrenia are often inappropriate
• sometimes victims of schizophrenia will lapse into flat
– flat effect- a zombielike state of apparent apathy
• the person may perform senseless, compulsive act,
such as rocking or rubbing an arm
• some exhibit catatonia and will remain motionless for
hours on end and then become agitated
• the symptoms of schizophrenia often prevent a person
from forming relationships
• Symptoms of Schizophrenia
• schizophrenia is a cluster of disorders
• schizophrenia can develop gradually or can
appear suddenly from stress
• when the schizophrenia develops slowly
recovery is doubtful
• men will usually develop schizophrenia on an
average of 4 years earlier than men
• Understanding schizophrenia
• one possible cause of schizophrenia deals with
the neurotransmitter, dopamine
• after examining the brain's of patients after their
death, patients that showed the symptoms of
schizophrenia often had an extreme high level of
• dopamine may intensify brain signals creating
hallucinations and paranoia
• drugs that block dopamine receptors can lessen
the symptoms
• Understanding schizophrenia
• genes could also play a part in schizophrenia
• 1 in 100 are more than likely going to be diagnosed
with schizophrenia
• 1 in 10 among those who have an afflicted sibling or
parent will be diagnosed with schizophrenia
• 1 in 2 that have an identical twin with schizophrenia
will be diagnosed with schizophrenia
• the environment does not seem to affect the chance of
twins being diagnosed with schizophrenia
• Understanding schizophrenia
• physiological factors do not cause
schizophrenia alone
• what scientist do believe is that some of us
are born predisposed to react differently to
psychological triggers of schizophrenia
Mood Disorders
• Mood disorders- psychological disorders
characterized by emotional extremes
• mood disorders come in two principal forms:
1. major depressive
2. bipolar disorder
• we all have felt depressed before
– often times we have felt more depressed during the
darker months than the lighter ones
• we all have felt depressed about the future,
dissatisfied with our lives, or isolated from others
Mood Disorders
• Major Depressive Disorder
• depression is the common cold of psychological
– it is pervasive but not as serious as others
• even though phobias are more common, depression is
the number one reason people seek mental health
• it is the leading cause of disability worldwide
• depression is a response to past and current loss
• to feel bad in reaction to profoundly sad events is to
be in touch with reality
Mood Disorders
• Major Depressive Disorder
• depression is a survival tool
• it slows us down, avoids attracting predators, restrains
futile effort, and evokes support
• the line separating normal downs from major
depression is difficult to draw
• between the temporary blue moods we all experience
and the crushing impact of major depression is a
condition called dysthymic disorder
– a down-in-the-dumps mood that fills most of the day,
nearly every day, for two years or more
Mood Disorders
• Major Depressive Disorder- a person, for no
apparent reason, experiences two or more
weeks of depressed moods, feelings of
worthlessness, and diminished interest or
pleasure in most activities
Mood Disorders
• Bipolar Disorder
• with or without therapy episodes of major
depression usually end, and people will
temporarily return to their normal behavior
• some people rebound to the opposite emotional
extreme of manic episode
– marked by a hyperactive, wildly optimistic state
• mania is like living in fast forward
• alternation between depression and mania
signals biploar disorder
Mood Disorders
• Bipolar Disorder
• during the manic phase of bipolar disorder, the
person is typically overtalkative, overactive,
– they also have little need for sleep, fewer sexual
– can also speak loudly, flighty, and are hard to interrupt
– they will show grandiose optimism and self esteem
– may make reckless investments, go on spending
sprees, and do unsafe things
Mood Disorders
• Bipolar Disorder
• people during the manic phase do not like advice but
they need protection from their own poor judgment
• the energy and free-flowing thinking of mania can fuel
• bipolar is common among creative artists
• creative professionals who rely on emotional
expression and vivid imagery are more prone to bipolar
• bipolar is much less common than depression
• it affects 1 percent of the population
• it affects as many men as women
Mood Disorders
• Explaining mood disorders
• in a depressed mood, we expect our team to lose, our
grades to fall, and our love to fail
• nearly half the time depressed people exhibit
symptoms of another disorder, such as anxiety or drug
or alcohol use
• women are more vulnerable to passive disorders like
depression and anxiety
• men are more vulnerable to active disorders
• when women get sad they often get more sad than
men and when men get mad, they often get more mad
than women
Mood Disorders
• Explaining mood disorders
• in a depressed mood, we expect our team to lose, our
grades to fall, and our love to fail
• nearly half the time depressed people exhibit
symptoms of another disorder, such as anxiety or drug
or alcohol use
• women are more vulnerable to passive disorders like
depression and anxiety
• men are more vulnerable to active disorders
• when women get sad they often get more sad than
men and when men get mad, they often get more mad
than women
Mood Disorders
• Explaining mood disorders
• in North America, today's young adults are three
times as likely as their grandparents to report
having recently suffered depression
• depression is a whole body disorder
– it involves genetic predispositions, biochemical
imbalances, melancholy mood, and negative thougts
• the risk of major depression and bipolar disorder
increases if you have a depressed parent or
Mood Disorders
• Explaining mood disorders
• norepinephrine is overabundant during mania
and scarce during depression
– it increases arousal and boosts mood
• most people with a history of depression are also
habitual smokers
– often times smoking is a way to self medicate
• serotonin is also scarce during depression
– drugs that relieve depression tend to increase
norepinephrine or serotonin supplies by blocking
either their reuptake or their chemical breakdown
Mood Disorders
• Explaining mood disorders
• exercise reduces depression as it increases
• the brains of depressed people have been
found to be less active
• MRI scans have even shown the frontal lobes
to be 7 percent smaller in severly depressed
Dissociative Disorders
• Dissociative Disorders- disorders in which
conscious awareness becomes separated from
previous memories, thoughts, and feelings
• when a situation becomes overwhelmingly
stressful, people are said to dissociate themselves
from it
• dissociative disorders are rare
• the detachment from dissociation can help a
person from becoming overwhelmed from
emotion during a very traumatic event
Dissociative Disorders
• Dissociative identity disorder- a person
exhibits two or more distinct and alternating
– sometimes called multiple personality disorder
• each personality has its own voice and
• the original one usually denies the existence
of the others
Personality Disorders
• Personality disorders- characterized by inflexible
and enduring behavior patterns that impair social
• There are several clusters of personality disorders
– Avoidant personality disorder- fearful sensitivity to
rejection that predisposes someone
– Schizoid Personality disorder- expresses eccentric
behaviors, such as social disengagement
– Histrionic Personality Disorder- exhibits dramatic or
impulsive behaviors
• displays attention getting emotions and tries to gain others'
praise and acceptance
Personality Disorders
• Clusters
– Narcissistic personality disorder- exaggerate their
own importance, aided by success fantasies
• find criticism hard to accept, often reacting with rage or
– Borderline Personality Disorder- have an unstable
identity, unstable relationships, and unstable
Personality Disorders
• the most troubling of the impulsive personality
disorders is antisocial personality disorder
• antisocial personality disorder- the person,
usually a man, exhibits a lack of conscience for
wrongdoing, even toward friends and family
– may be aggressive and ruthless or a clever con artist
– use to be called a sociopath or psychopath
– the lack of conscience can be clearly seen by 15
• will lie, steal, fight, or display unrestrained sexual behavior
• Attention Deficit/Hyperactivity
disorder(ADD/ADHD)- a psychological disorder
marked by the appearance by age 7 of one or
more of three key symptoms: extreme
inattention, hyperactivity, and impulsivity
• 11 percent of American 4 to 17 year olds display
ADD or ADHD key symptoms
• ADHD is diagnosed three times more often in
boys than girls
• Skeptics believe it is being over diagnosed in
some children
Somatic Symptom Disorder and
related disorders
• Somatic symptom disorder- a psychological
disorder in which the symptoms take a bodily
form without apparent physical cause
• These are medically unexplained illnesses
• The complaints may be vomiting, dizziness,
blurred vision, difficulty in swallowing, or
severe or prolonged pain
Somatic Symptom Disorder and
related disorders
• Conversion disorder- a disorder in which a person
experiences very specific genuine physical
symptoms for which no physiological basis can be
• More common in Freud’s day than today
• Anxiety is converted into a physical symptom
• May become paralyzed with no physical reason
• Even though there is no physical reason, the
paralysis is real
Somatic Symptom Disorder and
related disorders
• Illness anxiety disorder- a disorder in which a
person interprets normal physical sensations as
symptoms of a disease
• Formally called hypochondriasis
• Might interpret a headache as a brain tumor
• Sympathy or temporary relief from everyday
demands may reinforce such complaints
• No amount of reassurance by any physician
convinces the patient that the trivial symptoms
do not reflect a serious illness
Causes of schizophrenia
• Dopamine overactivity
• Too much dopamine may intensify brain signals in
schizophrenia, creating positive symptoms such
as hallucinations and paranoia
• Amphetamines and cocaine sometimes intensify
the symptoms of schizophrenia
• Patient’s with schizophrenia may also have
abnormal activity in multiple areas of the brain
• Some may have abnormal behavior in the frontal
lobe, amygdala, or the thalamus
Causes of schizophrenia
• A midpregnancy viral infection that impairs
fetal brain development could also be a cause
• Tests of different cultures with different viral
outbreaks have shown a correlation with viral
infections and the rate of schizophrenia
Causes of schizophrenia
• Genetics can also play a role
• Prenatal viruses and genetic predispositions
do not cause schizophrenia alone
• Family or social factors also play a role
• To study environmental factors researchers
studied the development of high risk children
• They did see 20 percent of those studied to
show a change in social behavior right before
the onset of schizophrenia
Other terms
Social Anxiety Disorder
Posttraumatic Growth