Download Unit 12 Abnormal Psych Teacher

Myers’ PSYCHOLOGY
For AP
Unit 12
Psychological Disorders
Abnormal Psychology
Ms. Vangelista
Carol Ryff’s Theory of
Mental Well Being
 Well-being is a dynamic concept that includes subjective, social, and psychological
dimensions as well as, health-related behaviors.
 The Ryff Scales of Psychological Well-Being measures multiple facets of one’s well
being including:
 Autonomy - I have confidence in my opinions, even if they are contrary to the
general consensus.
Environmental Mastery - In general, I feel I am in charge of the situation in
which I live.
Personal Growth -I think it is important to have new experiences that challenge
how you think about yourself and the world.
Positive Relations with Others - people would describe me as a giving person,
willing to share my time with others.
Purpose in Life - Some people wander aimlessly through life, but I am not one of
them.
Self-Acceptance - I like most aspects of my personality.
Psychological Disorders
 Psychological Disorder
 a “harmful dysfunction” in which behavior is
judged to be:
 unjustifiable--sometimes there’s a good
reason
 maladaptive--harmful
 atypical--not enough in itself
 disturbing--varies with time and culture
 UMAD!
Considerations…
Cross cultural differences in normative
behavior/social practices…
Japan- hissing is a sign of respecting elders
Among the Karaki of New Guinea – a man is
considered abnormal if he has not engaged in
homosexual behavior before marriage.
Public displays of affection between men and women
in Thailand are unacceptable; men holding hands is
considered friendship; the use of straws is vulgar.
Definitions of “disorder” change in time and space
(location)!
Historical Perspective
 Perceived Causes
 movements of sun or moon
 lunacy--full moon
 evil spirits
 Ancient Treatments
 exorcism, caged like animals, beaten,
burned, castrated, mutilated, blood
replaced with animal’s blood
Psychological Disorders
 Medical Model
 concept that diseases have physical causes
 can be diagnosed, treated, and in most cases,
cured
 assumes that these “mental” illnesses can be
diagnosed on the basis of their symptoms
and cured through therapy, which may
include treatment in a psychiatric hospital
Psychological Disorders
 Bio-Psycho-Social Perspective
 assumes that biological,
sociocultural, and psychological
factors combine and interact to
produce psychological disorders
Psychological Disorders
Psychological
Disorders--Etiology
 DSM-IV
 American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders (Fourth Edition)
 a widely used system for classifying
psychological disorders
 presently distributed as DSM-IV-TR
(text revision)
DSM-V
To be published during the year 2013.
Changes include:
 Mental Retardation will now be classified as Intellectual
Disability
New disorders will include:
Binge Eating Disorder
Hoarding Disorder
Hypersexual Disorder
Somatoform disorder, hypochondriasis, undifferentiated
somatoform disorder and pain disorder combined under
Complex Somatic Symptom Disorder (CSSD)
 For more info visit www.dsm5.com
DSM Continued
You should know the 5 Axis diagnostic criteria
used in the DSM (Table 12.2). These help
doctors determine not only the type of mental
illness a person has, but also some contributing
factors that might need to be dealt with in
order to get the primary mental illness
symptoms under control.
Not only is this important for doctors but also
for insurance companies.
Labelling….Pros and Cons
“Pros” – provide a starting point for
treatment, understanding behavior,
simplifies behavior and communication,
can convey a large amount of information
within the label, standardizes concepts
“Cons” – labelled for life, all or nothing
thinking when using the label,
stigma/stereotyping, civil violations and
lapses in treatment.
Psychological
Disorders- Etiology
 Neurotic Disorder (term seldom used
now)
 usually distressing but that allows one
to think rationally and function socially
 Psychotic Disorder
 person loses contact with reality
 experiences irrational ideas and
distorted perceptions
Anxiety Disorders
 Anxiety Disorders
 distressing, persistent anxiety or
maladaptive behaviors that reduce
anxiety
 Generalized Anxiety Disorder
 person is tense, apprehensive, and in a
state of autonomic nervous system
arousal
GAD Generalized Anxiety
Disorder
Usually if a person is diagnosed with GAD there
is also a comorbid disorder. This means they
have two disorders operating at the same time.
Accompanying GAD is often major depression.
Effective treatment for both is Effexor.
Paxil (same family of drug as Prozac and Zoloft)
serotonin reuptake inhibitor is also used to treat
GAD, social phobia and panic disorder.
Anxiety Disorders
 Panic Disorder
 marked by a minutes-long episode of intense
dread in which a person experiences terror
and accompanying chest pain, choking, or
other frightening sensation
 Agoraphobia (the fear of being in open
spaces or in public) often accompanies Panic
Disorder. They begin to fear going out in fear
of having a panic attack in public and leaves
them suffering in their homes alone.
Anxiety Disorders
 Phobia
 persistent, irrational fear of a specific object
or situation
 one of the most successfully treated
disorders.
 Obsessive-Compulsive Disorder
 unwanted repetitive thoughts (obsessions)
and/or actions (compulsions)
Compulsions
 Can manifest in different ways:
Hoarders – collect things, have a hard time throwing
things away, keep everything for fear of needing it or
losing it.
Checkers – recheck actions they have preformed
over again. Ie. Turn off oven, climb stairs etc usually
# of checks increases with each experience.
Counters – count everything ie. Number of words
people say etc. unimportant to the point of stopping
their daily progress.
Cleaners – clean excessively, a number of times to
relieve anxiety.
OCD vs OCDP
OCD Obsessive Compulsive Disorder – is an
anxiety disorder characterized by obsessive
thoughts with corresponding compulsions.
People with OCD likely to lead lives where strict
routines become essential, repeating tasks over
and over again to find relief from their anxieties.
OCPD Obsessive Compulsive Personality
Disorder is characterized by an obsessive need
for neatness, order, and symmetry. More likely
to be called anal retentive or neat freaks!
Frontal Lobes and
OCD/OCPD
Frontal Lobes are responsible for
judgement and decision making, people
with OCD have overactive frontal lobes
thus, they are controlled by overzealous
decision making. They cannot control
what decisions they should be making, or
they allow their behavior to be ruled by
repetitive and overbearing thoughts.
Anxiety Disorders
 Common and uncommon fears
Anxiety Disorders
Anxiety Disorders
 PET Scan of brain of
person with Obsessive/
Compulsive disorder
 High metabolic activity
(red) in frontal lobe
areas involved with
directing attention
1962 Calhoun Rat Study
 Demonstrated that a high population density causes
abnormal behavior in rat populations.
 Rats lived in overcrowded population for 16 months.
Findings:
Aggression – increase in fighting among males
Submissiveness – non dominating males became submissive
Sexual deviance – non dominant rats didn’t follow rules for
mating.
Nesting abnormalities – females no longer built nests.
High infant mortality
Somatoform Disorders
Not as commonly diagnosed as in the
past.
These are disorders in which symptoms
take a somatic (bodily) form without
apparent physical cause.
One contributing factor may be stress.
(relate stress related symptoms as you
read about somatoform disorders).
Somatoform Disorders
Conversion Disorder – a rare somatoform
disorder in which a person experiences
very specific genuine physical symptoms
for which no physiological basis can be
found.
Hypochondriasis – a somatoform disorder
in which a person interprets normal
physical sensations as symptoms of
disease.
Conversion Disorder
People who suffer from this disorder
generally suffer problems with parts of
their bodies that directly relate to the
stress they are under.
For example, a quarterback may feel
numbness in his throwing hand before the
Grey Cup but may otherwise say he is not
stressed about the big game.
Hypochondriacs
Aren’t people who fake sickness to get
attention. They truly believe they are sick from
illness that doctors haven’t caught yet.
They switch doctors seeking a diagnosis that ill
confirm their condition.
People who fake illness are “melingering” – this
means they avoid trouble or they seek a gain or
gains.
Somatoform Disorders
Con’t
Body Dysmorphic Disorder –
preoccupation with defects in one’s body.
Concern about it becomes excessive.
Pain Disorder – complaints of severe pain
without any particular physical condition;
or malingering.
Somatization Disorder – patients under 30
will exhibit a variety of unexplained
physical symptoms.
Dissociative Disorders
Disorders in which conscious awareness
becomes separated (dissociated) from previous
memories, thoughts and feelings.
Dissociation is not the same as psychosis.
Dissociation involves breaking away from the sense
of self, either losing memory and identity or adding
personalities.
Psychosis involves a break with reality, believing that
are untrue or having hallucinations about things that
are not true.
DID – Dissociative Identity
Disorder
This disorder is characterized by two or more
distinct identities and are said to control the
person’s behavior.
Formerly called Multiple Personality Disorder.
Controversial because claims of patients are
difficult to prove/confirm. Not diagnosed until
later in life when alleged perpetrators died or
there is a loss of evidence. Often only
reported in women.
Dissociative Disorders
Continued
Dissociative Amnesia – Patients suffer
from a complete loss of identity, they
forget who they are due to trauma.
Dissociative Fugue – Patients suffer from
identity loss as in dissociative amnesia,
but these patients also travel away form
home, often showing up ass someone else
in a community far away.
Mood Disorders
 Mood Disorders
 characterized by emotional extremes
 Major Depressive Disorder
 a mood disorder in which 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
Depression
Depression following a traumatic event (death
of a loved one, a major failure, a serious
physical injury) is considered normal.
Depression without a known stressor or causal
event maybe due to biological or psychological
reasons.
Being genetically predisposed to depression
does not mean one is guaranteed to get the
disease. Mitigating environmental circumstances
can help avoid the symptoms of disease.
Dysthymic Disorder
A depressive state lasting more than 2 years (in
children or adolescents it need only last 1 year).
Patients must also present 2 or more of the
following symptoms:
Poor appetite or overeating.
Insomnia (not enough sleeping) or hypersomnia (too
much sleeping).
 Low energy or fatigue.
Low self-esteem.
Feelings of hopelessness.
Poor concentration or difficulty in making decisions.
Suicide, Depression and
Feelings of Loneliness
 Read the Close – Up on page 584.
 5 reasons for loneliness:
Being unattached…no partner, significant other or
breaking up.
Alienation…being misunderstood, feeling different,
having no friends.
Being alone…coming home to an empty house.
Forced isolation…being hospitalized, homebound
having no transportation.
Dislocation…being away from home, new job or
school.
Coping with Loneliness
Rubenstein and Shaver found 4 major
strategies:
Sad passivity-sleeping, drinking, overeating,
watching tv.
Social contact-calling a friend or visiting
someone.
Active solitude-studying, reading, exercising,
going to a movie.
Distractions-spending money, going shopping.
Mood Disorders
 Manic Episode
 a mood disorder marked by a
hyperactive, wildly optimistic state
 Bipolar Disorder
 a mood disorder in which the person
alternates between the hopelessness
and lethargy of depression and the
overexcited state of mania
 formerly called manic-depressive
disorder
Bipolar Disorder
Bipolar Disorder I – classic diagnosis of
disorder – characterized with periods of
inflated mood followed by episodes of
depressive episodes occurring in cycles.
Bipolar Disorder II – milder form of bipolar
disorder in which patients experience at least
one episode of hypomania ( a period of
elevated mood but without psychosis) and at
least one major depressive episode.
Mood DisordersDepression
Mood DisordersDepression
 Canadian depression rates
Mood DisordersSuicide
Mood DisordersBipolar
 PET scans show that brain energy consumption
rises and falls with emotional switches
Depressed state
Manic state
Depressed state
Mood DisordersDepression
 Altering any one
component of
the chemistrycognition-mood
circuit can alter
the others
Mood DisordersDepression
 The vicious
cycle of
depression
can be
broken at
any point
Dissociative
Disorders
 Dissociative Disorders
 conscious awareness becomes separated
(dissociated) from previous memories,
thoughts, and feelings
 Dissociative Identity Disorder
 rare dissociative disorder in which a person
exhibits two or more distinct and alternating
personalities
 formerly called multiple personality disorder
Schizophrenia
 Schizophrenia
 literal translation “split mind”
 a group of severe disorders
characterized by:
 disorganized and delusional thinking
 disturbed perceptions
 inappropriate emotions and actions
Schizophrenia
 Delusions
 false beliefs, often of persecution or grandeur,
that may accompany psychotic disorders
 These are dysfunctions of our cognitive
systems.
 Hallucinations
 sensory experiences without sensory
stimulation
 These are dysfunctions of our perceptual
systems.
Other Striking Symptoms
of Schizophrenia
Loose associations occur in patients with
disorganized schizophrenia as they link
events and memories that don’t seem to
fit together logically.
Neologisms are words that patients
create, usually as part of the “word salad”
symptom. They will make up words that
make no logical sense.
Schizophrenia
Schizophrenia
Paranoid is the most recognizable
Symptoms of Schizophrenia
Positive Symptoms refer to those that are
excessive or in addition to normal behaviors.
Outlandish behavior such as paranoid delusions,
hallucinations, and erratic emotions or behaviors
are typical positive symtoms.
Negative Symptoms refer to those that are
deficient or less than normal behaviors. Flat
affect, social withdrawal, and catatonia are
common negative symptoms.
Schizophrenia
Schizophrenia
Research Findings & Schizophrenia
 People who have schizophrenia have abnormal
brain activity before the onset of symptoms,
showing that schizophrenia may be a developmental
disorder.
 MRI studies show the gray matter in the brains of
people with schizophrenia is markedly dense than
people with no schizophrenia.
 Studies have shown that people who have auditory
hallucinations experience temporal lobe activation,
indicating that they are really hearing voices, even
though the voices are not present.
Personality Disorders
 Personality Disorders
 disorders characterized by inflexible and
enduring behavior patterns that impair
social functioning
 usually without anxiety, depression, or
delusions
Paranoid Personality & Schizoid
Personality Disorder
They differ from schizophrenia only by a matter
of degree.
While people with schizophrenia experience
psychotic episodes when they loose touch with
reality, people with these personality disorders
do not have these extreme experiences. There
behavior is odd, eccentric and disturbing but it
does not impair daily life in the way that
schizophrenia does.
Personality Disorders
 Antisocial Personality Disorder
 disorder in which the person (usually
man) exhibits a lack of conscience for
wrongdoing, even toward friends and
family members
 may be aggressive and ruthless or a
clever con artist
Antisocial Personality
 Psychopath and Sociopath are synonymous. They are
legal terms not used for psychological diagnosis.
 Cleckley describes the characteristics of the antisocial
personality
Superficial charm and high intelligence.
Poise, rationality, absence of neurotic anxiety.
Lack of sense of personal responsibility
Untruthfulness, insincerity, callousness, manipulativeness.
Antisocial behavior without regret or shame.
Poor judgement and failure to learn from experience.
Inability to establish long and lasting relationships.
Lack of insight into personal motivations.
Mood DisordersDepression
 Boys who
were later
convicted of
a crime
showed
relatively low
arousal
Personality Disorders
 PET scans illustrate reduced activation in
a murderer’s frontal cortex
Normal
Murderer
Personality Disorders
Rates of Psychological
Disorders