Download Unit 12 - Our Lady of Lourdes High School

Unit 12
Abnormal Psychology
“To study the abnormal is the best
way to understand the normal”
- William James
Defining disorders
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Hard to do from culture to culture
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Hearing voices may make you disturbed in one culture,
may make you a religious figure in others
Mass killing during war time = hero ?
Homosexuality from 1952 – December 9 1973 was viewed
as a mental illness
Patterns of thoughts, feelings or behaviors that are
deviant (different), distressful and dysfunctional
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Harmful dysfunction*
Understanding disorders
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Different perspectives may help explain some
disorders
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1. Medical model
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Philippe Pinel
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Not any type of possession, but a mental sickness
Moral care and treatment
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No more being chained to a wall in filthy conditions
Part of the mental health movement
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Psychopathology needs to be diagnosed on the basis of
symptoms and cured through therapy and treatment
Understanding disorders
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2. Biopsychosocial Approach
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All behaviors, normal or not, come from
interaction of genes and experiences
Not just a matter of being sick, but in the wrong
environment
Different cultures have different prevalence of
disorders
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Environments may attribute or cause the disorders
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Eating disorders, far more prevalent in the West
Biopsychosocial
Psychological Influences
Biological influences
•Stress
•Evolution
•Trauma
•Individual genes
•Learned helplessness
•Brain structure and
chemistry
•Mood related perceptions
and memories
PSYCHOLOGICAL DISORDER
Social Cultural influences
•Roles
•Expectations
•Definitions of normality and disorder
Classifying disorders
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Classifications not only used to describe symptoms
but to predict future courses
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Diagnostic and Statistical Manual of Mental Health
Disorders
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DSM-V
Defines a diagnostic process and 16 syndromes
No explanation of causes
International Classification of Diseases (ICD)
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Covers both medical and psych disorders
16 syndromes of DSM IV under Axis 1
p.566 (Clinical Diagnoses)
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Disorders diagnosed during infancy, childhood and adolescence
Delirium, dementia, amnesia and other cognitive disorders
Mental disorders due to a general medical condition (organic disorders)
Substance related disorders
Schizophrenia and other psychotic disorders
Mood disorders
Anxiety disorders
Somatoform disorders
Factitious disorders (intentionally faked)
Dissociative disorders
Eating disorders
Sexual disorders and gender identity disorders
Sleep disorders
Impulse control disorders not classified elsewhere
Adjustment disorders
Other conditions that may be a focus of clinical attention
DSM-IV
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Gives guidelines for classifications, not
explanations for disorders
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5 Axes that ask questions
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Axis 1 Is a Clinical Syndrome present?
Axis 2 Is a personality disorder/ mental retardation
present?
Axis 3 Is a general medical condition present
(diabetes)?
Axis 4 Are there psychosocial or environmental
problems present (schooling or housing)?
Axis 5 What is the Global Assessment?
Labeling Disorders
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Problems with labels
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Once a label is applied, hard to see past it
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Automatically view that person differently
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Self fulfilling prophecy
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“Gifted”
Beneficial for diagnosis and communicating for
effective treatments
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Anxiety Disorders
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Public speaking, heights, performance
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Distressing, persistent anxiety or maladaptive
behaviors that reduce anxiety
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5 basic disorders
Anxiety Disorders
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1. Generalized Anxiety Disorder
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Continually tense, apprehensive, and in a state of
autonomic nervous system arousal
Mostly women (about 2/3)
A person cannot seem to identify their cause of stress
Often associated with depression/depressed mood
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Jittery, sleep deprived
High blood pressure
Passes with age – very rare by age 50
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Emotions mellow over time
Anxiety Disorders
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2. Panic Disorder
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An Anxiety Tornado
Comes on suddenly and will disappear
Panic Attacks – minutes long intense fear that
something terrible is going to happen
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Can be misperceived as a heart attack
Anxiety Disorders
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3. Phobias
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Irrational fears that causes a person to avoid
some object, activity, or situation
Specific phobias – fear of certain animals, insects,
blood, things
Social phobias – extreme shyness and avoidance
of others. Fear of being judged by others
Afraid of the fear, so avoidance of all things
Anxiety Disorders
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4. Obsessive Compulsive Disorder
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OCD
When behaviors cross the line and persistently interfere
with everyday living and cause distress
Can be extremely debilitating
More common with teens and young adults
Common compulsions – excessive hand washing,
bathing, grooming, rituals, checking locks, windows
Common obsessions – germs, something terrible
happening, symmetry, order, neatness
Anxiety Disorders
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5. Post-traumatic Stress Disorder (PTSD)
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Haunting memories, nightmares, social
withdrawal, jumpy anxiety and or insomnia
The higher the emotional distress during trauma,
the more likely to develop PTSD
Post traumatic growth
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Positive psychological changes as a result of struggling
with extremely challenging circumstances and life crises
Understanding Anxiety
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Learning Perspective
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Fear Conditioning
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Exposure to something that causes harm can lead to
anxiety
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Stimulus generalization –attacked by a dog, afraid of all
dogs
Reinforcement – maintains our phobias after they arise
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Returning to the scene of the crime
Washing hands or going inside to relieve anxiety
Observational Learning
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Watching others fears may cause us to develop our own
Understanding Anxiety
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Biological Perspective
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Natural Selection
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Genes
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We seem to be afraid of the same things that would have caused
harm to our ancestors
Those without these fears would have been more likely to not survive
Fearfulness can run in families (monkeys)
Identical twins often develop similar phobias
Anxiety Gene? Impacting serotonin or glutamate
The Brain
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Over arousal of brain areas involved in impulse control (anterior
cingulate cortex)
Mental hiccups of repeating thoughts
Somatoform Disorders
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Disorder that takes a somatic (bodily) form
without any apparent physical cause
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Vomiting, dizziness, blurred vision/blindness,
difficulty swallowing, prolonged pain
Conversion Disorder – a psychological cause of a
physical ailment
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Limbs going numb without any cause
People don’t seem to mind – indifferent
Hypochondriasis – interpreting normal discomfort
as symptoms of a terrible disease
Dissociative Disorders
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Disorders of consciousness
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Sudden loss of memory
Change in identity
Could be caused by overwhelming stress
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Dissociative fugue – losing memory of yourself
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Dissociate – become separated from painful
memories, thoughts, and feelings
Dissociative Identity Disorder
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2 or more distinct identities are present
alternately controlling the person’s behavior
Each personality has its own voice and
mannerisms
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Jekyll and Hyde
The Hillside Strangler
Used to be called Multiple Personality
Disorder
Understanding DID
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Is it a real disorder or just a an extension of
our capacity to shift our personality?
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Outside the US, not very common diagnosis
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Extreme versions of our self?
Often referred to as being possessed
Creates distinct changes in brain activity, can
it be a different personality?
Mood Disorders
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2 major types
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1. Major Depressive Disorder
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At least 5 signs of depression last two or more weeks
without drugs or medication
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Lethargy
Worthlessness
Loss of interest in family, friends, or activities
Mood Disorders
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Bipolar Disorder
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More than just recovering from bouts of
depression
Extreme mood swings from euphoric, hyperactive
to deep depression
Mania can fuel creativity
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Walt Whitman, Virginia Woolf, Mark Twain, Ernest
Hemingway
Understanding Mood Disorders
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Many behavioral and cognitive changes
occur with depression
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Women are 2x as likely to have depression
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Lethargic and unmotivated
More sensitive to negative happenings
Expect more negative outcomes
These disappear when the mood lifts
Begins in adolescence
Most depressive moods self terminate
Understanding
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Biological Perspective
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Mood disorders run in families
Twin studies
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1 identical twin with a disorder, odds are 1 in 2 that at some time the
other will as well
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Mood disorders are often related to close biological relatives
Neurotransmitters
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Much smaller odds in fraternal
Adoption
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Bipolar – 7/10
Norepinephrine – mood booster absent (too much during manic
state)
Serotonin – also scarce
Brain is slower or inactive in areas during depressed states
Exercise can help boost neurotransmitters and activate brain
areas
Understanding
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Social Cognitive Perspective
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Depression is a whole body disorder
Self defeating beliefs and negative explanatory
style
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Learned helplessness
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Thoughts and moods interact
More common in women than men
Stable, global and internal
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Its going to last forever, everything I do is wrong, its all
my fault
Vicious Cycle of Depression
Negative/Stressful
experience
Cognitive and
behavioral
changes
Negative
explanatory
style
Depressed
mood
Personality Disorders
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Inflexible and enduring patterns of behavior that
impair social functioning
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Avoidant personality disorder
 Anxiety and sensitivity to rejection
Schizoid personality disorder
 Emotionless disengagement
 Rich fantasy life, no desire for connection with others
Histrionic personality disorders
 Impulsive behaviors, attention getting
Narcissistic personality disorders
 Self focused, self inflating
Antisocial Personality Disorder
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Most researched
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Usually male, noticeable before the age of 15
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Formally called psychopaths or sociopaths
Often become criminals
If Antisocial disorder is combined with high
intelligence, it can be very dangerous
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Remorseless criminals, no feeling for victims
Henry Lee Lucas
BTK
Understanding Antisocial
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Twin studies have shown a possible genetic
link
It has been detected in children as young as
3
Reduced activity in frontal lobes
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Where inhibition is located
Passed down through genes? Australia?
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Research does indicate genes AND environment
can correlate with criminal behavior
Schizophrenia
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Almost 1 in 100 people will develop
schizophrenia
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Schizophrenia “split mind”
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Split from reality
Thinking is fragmented, bizarre and distorted by
false beliefs (delusions)
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Paranoid – delusions of persecutions
Breakdown in selective attention – no filter
Schizophrenia
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Perceptions
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Hallucinations
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Seeing, feeling, smelling, tasting things
Most often auditory
Inappropriate emotions and actions
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Crying when others are laughing
Flat affect – having no emotion
Schizophrenia
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Onset
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Usually comes on in early adulthood
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No more in men than women
Cluster of disorders
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Positive symptoms – hallucinations, emotions
Negative – toneless voices, mute, rigid, waxy
flexibility
Schizophrenia
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Subtypes
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Paranoid –
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Disorganized
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Immobility/waxy flexibility
Undifferentiated
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Emotional behavior and speech
Catatonic
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Persecution or grandiosity
Many varied symptoms
Residual
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Withdrawal after hallucinations have disappeared
Schizophrenia
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Brain abnormalities
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Dopamine over activity
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6x the normal level
Intensifies brain signals
Dopamine blockers impact positive symptoms
Abnormal brain anatomy
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Neural signals out of sync
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Activity in the amgydala and thalamus
Enlarged, fluid filled areas in the cerebral tissue
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Shrinkage in other areas
Schizophrenia
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Maternal Virus during pregnancy
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If mom gets the flu at midpoint of pregnancy
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Areas where disease spreads more rapidly
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Viral infections while pregnant do show a
correlation with increased rates of schizophrenia
Schizophrenia
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Genetic Factors
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Adopted children rarely develop the disorder if the
adopted parents have it
Much more likely to develop if it runs in the family
Odds
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1 in 100 develop schizophrenia
1 in 10 if a family member has it (including fraternal
twins)
1 in 2 if an identical twin does
Rates of Disorders
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NIMH estimates 26% of adult Americans
suffer from a diagnosable disorder at some
point during the year
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Generalized Anxiety –
Social Phobias –
Phobia of a specific object –
Mood disorder OCD –
Schizophrenia –
PTSD –
ADHD –
3.1%
6.8
8.7
9.5
1.0
1.1
3.5
4.1
Prevalence
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2x as likely to develop if living under the
poverty line
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Does one cause the other?
75% of disorders appear after 24
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Antisocial most recognizable at youngest age