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Unit 12: Abnormal Psych A.P. Psych Essential Question What is a psychological disorder, what are the causes and symptoms of various psychological disorders, and how do psychologists use the DSM-IV to diagnose them? Day 1 Unit 12 (A): Perspectives on Psychological Disorders Do Now (Discussion) What does it mean to be normal? What separates normal from abnormal? Should we use these labels? Perspectives on Psychological Disorders ➢ Psychologists define disorder as deviant, distressful, and dysfunctional behavior. ➢ The definitions of these words vary over time as well as across cultures. Perspectives on Psychological Disorders ➢ Psychologists use The Medical Model to understand and diagnose psychological disorders. ○ The Medical Model: The concept that psychological diseases/disorders have physical causes. Also, they can be diagnosed based on physical symptoms and treated through therapy and medication. Perspectives on Psychological Disorders ➢ Biopsychosocial Approach: Modern approach stating that disorders are caused by a combination of genetic predisposition, psychological traits, and cultural experiences. Classifying Psychological Disorders How? ➢ Psychologists use the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose disorders based on observable symptoms. Classifying Psychological Disorders Why? ➢ The DSM gives psychologists and insurance companies a common language to use when organizing treatment and insurance plans. Many insurance companies require a DSM diagnosis when considering how much financial assistance to give a patient for their treatment. Labeling Psychological Disorders ➢ There is a lot of controversy surrounding the use of the DSM because it puts labels on people. Labels lead to preconceptions and bias that often create ethical and moral dilemmas such as insanity pleas in serious crime cases. 3 D’s of Psychological Disorders • Deviance • Distress • Dysfunction Classification 5 Axes of DSM-IV: Axis 1: Clinical Disorders Axis 2: Personality Disorders/Mental Retardation Axis 3: Medical Disorders Axis 4: Psychosocial Stressors Axis 5: Global Assessment of Functioning (GAF) (1-100) Code Global Assessment of Functioning (GAF) Scale Description of Functioning 91 - 100 Person has no problems OR has superior functioning in several areas OR is admired and sought after by others due to positive qualities 81 - 90 Person has few or no symptoms. Good functioning in several areas. No more than "everyday" problems or concerns. 71 - 80 Person has symptoms/problems, but they are temporary, expectable reactions to stressors. There is no more than slight impairment in any area of psychological functioning. 61 - 70 Mild symptoms in one area OR difficulty in one of the following: social, occupational, or school functioning. BUT, the person is generally functioning pretty well and has some meaningful interpersonal relationships. 51 - 60 Moderate symptoms OR moderate difficulty in one of the following: social, occupational, or school functioning. 41 - 50 Serious symptoms OR serious impairment in one of the following: social, occupational, or school functioning. 31 - 40 Some impairment in reality testing OR impairment in speech and communication OR serious impairment in several of the following: occupational or school functioning, interpersonal relationships, judgment, thinking, or mood. 21 - 30 Presence of hallucinations or delusions which influence behavior OR serious impairment in ability to communicate with others OR serious impairment in judgment OR inability to function in almost all areas. 11 - 20 There is some danger of harm to self or others OR occasional failure to maintain personal hygiene OR the person is virtually unable to communicate with others due to being incoherent or mute. 1 - 10 Persistent danger of harming self or others OR persistent inability to maintain personal hygiene OR person has made a serious attempt at suicide. Day 2 Unit 12 (B): Anxiety Disorders Do Now (Discussion) ➢ ➢ What is anxiety? ➢ How is it different from worry or fear? Anxiety Disorders Anxiety disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors meant to reduce anxiety. People with anxiety disorders feel persistently and uncontrollably tense and apprehensive, with no apparent cause. Anxiety Disorders ➢ Generalized Anxiety Disorder unexplainable and continuous tenseness and uneasiness. ➢ Panic Disorder - unexplainable sudden episodes of intense dread. ➢ Phobias - irrational and intense fear of a specific object or situation. Anxiety Disorder ➢ Obsessive Compulsive Disorder (OCD) unexplainable repetitive thoughts or actions. ➢ Post-Traumatic Stress Disorder (PTSD) lingering memories, nightmares, and other symptoms after a severely threatening, uncontrollable event. Anxiety Disorders What causes them? ➢ Freud ○ manifestation of mental energy associated with the discharge of repressed impulses ➢ Learning Perspective ○ product of fear conditioning, stimulus generalization, reinforcement of fearful behaviors, and observational learning of others’ fear. Anxiety Disorders ➢ Biological Perspective ○ consider the roles that life-threatening animals, objects, or situations played in natural selection and evolution; genetic inheritance of a high level of emotional reactivity; and abnormal responses in the brain’s fear circuits. Anxiety Disorders http://www.youtube.com/watch?v=_Cr7IomSy8s OCD http://www.youtube.com/watch?v=tPFQMRx2l3Y Dogs and PTSD http://content.time.com/time/video/player/0,32068,6 71301612001_2030797,00.html Top 10 Phobias http://www.youtube.com/watch?v=hsr8JsUr6kU Day 3 Unit 12 (C): Somatoform Disorders Somatoform Disorders Do Now (Discussion) Have you ever felt ill or as though you had a serious medical issue only to find that nothing was wrong with you? Somatoform Disorders Psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause, or “medically unexplained illnesses.” Somatoform disorders are one of the most common problems that result in doctors’ visits. What causes them? Stress is a probable trigger for somatoform disorders. Stress can manifest itself in a somantic (or bodily) form without there being physical causes. People under stress are also more likely to be more bothered by normal bodily sensations, such as a slight headache. Somatoform Disorders and Culture Culture plays a large role in peoples’ physical complaints. In China, for example, psychological explanations for anxiety and depression are less socially acceptable than physical symptoms of distress. According to a cross national survey that screened 90,000 people for major depressive episodes using a standard set of questions 19.2 % of Americans have experienced a depressive episode, while only 6.5% of people in China have. Conversion Disorder A rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found. Anxiety is presumably converted into a physical symptom. Conversion Disorders Conversion disorders, while mystifying, are no less real than physiological disorders. People with conversion disorders who claim to have lost sensation in certain areas have been known to be unaffected by pins being stuck into them. Hypochondriasis A somatoform disorder in which a person interprets normal physical sensations as symptoms of a disease. Day 4 Unit 12 (D): Dissociative Disorders Dissociative Disorders Dissociative Disorders Disorders in which conscious awareness becomes separated or dissociated from previous memories, thoughts, and feelings. What is dissociation? Dissociation occurs when a person’s consciousness is separated from painful memories, feelings, and thoughts. It tends to be caused by extremely stressful situations or in a response to some sort of trauma. Dissociative Identity Disorder (D.I.D.) Dissociative identity disorder is often referred to as multiple personality disorder. A person with D.I.D. will have two or more distinct identities with different personalities. Often the original personality claims to be unaware of the others. What causes D.I.D.? 98-99% percent of individuals with D.I.D. have recognized personal histories of recurring, overpowering, and often lifethreatening disturbances at a sensitive developmental stage of childhood, usually before the age of 9. http://www.youtube.com/watch?v=weLvkZG r9Tw http://www.youtube.com/watch?v=11oD_8jY y0c Is it legitimate? Is D.I.D. a genuine disorder or is it an extension of our normal capacity for personality shifts? Maybe Not Nicholas Spanos asked college students to pretend they were accused murderers being examined by a psychiatrist. When hypnotized, most students expressed a second personality. Maybe Not Nicholas Spanos: Are dissociative identities more extreme versions of selves we present? Are people with D.I.D. simply prone to fantasy and convincing themselves they have other personalities? Most people with D.I.D. are highly hypnotizable;what does this relationship mean? • • • Maybe Not D.I.D. is strangely localized by time and space. After DID was first entered in the DSM,the amount of cases in America skyrocketed. D.I.D. is more rare in Britain than it is in America, and in Japan and India, it is essentially nonexistent. Could it be a cultural phenomenon? Maybe • Handedness sometimes switches with • • personalities Ophthalmologists have detected shifting visual acuity and eye muscle balance with personalities People with D.I.D. have heightened activity in brain areas associated with control and the inhibition or traumatic memories. Day 5 Unit 12 (E): Mood Disorders Do Now 1. I do things slowly. 2. My future seems hopeless. 11. I feel that I am a guilty person who deserves to be punished. 3. It is hard for me to concentrate on reading. 12. I feel like a failure. 4. The pleasure and joy has gone out of my life. 14. My sleep has been disturbed -- too little, too much, or broken sleep. 5. I have difficulty making decisions. 15. I spend time thinking about HOW I might kill myself. 6. I have lost interest in aspects of life that used to be important to me. 7. I feel sad, blue, and unhappy. 8. I am agitated and keep moving around. 9. I feel fatigued. 10. It takes great effort for me to do simple things. 13. I feel lifeless -- more dead than alive. 16. I feel trapped or caught. 17. I feel depressed even when good things happen to me. 18. Without trying to diet, I have lost, or gained, weight. Mood Disorders What are mood disorders? Mood disorders are characterized by emotional extremes. Mood disorders come in two principal forms Major depressive disorder- prolonged hopelessness and lethargy Bipolar disorderaltering between depression and mania (an overexcited, hyperactive state.) Major Depressive Disorder Major depressive disorder is a mood disorder in which a person experiences, in absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities. How common is it? • It is the number one reason people seek • • mental health services 13% of U.S. adults have been plagued by depression at some point In any given year depressive episodes effect 5.8 percent of men and 9.5 percent of women worldwide. What are some main causes? • • • Response to past and current loss. (25% of people diagnosed with depression are struggling with the emotional impact of loss.) Other life events A person’s biology/brain chemistry Bipolar Disorder A mood disorder in which the person alternates between the lethargy of depression and the overexcited state of mania. Depressive phase- fatigue and decreased energy, difficulty concentrating, feeling hopeless or irritable, feeling sad or empty, loss of appetite, loss of interest in daily activities. Manic phase- racing thoughts, elation, little need for sleep, fewer sexual inhibitions. Speech is often loud, flighty, and hard to interrupt. May need protection from poor judgement, but creativity is often True of false? 1. Few behavioral and cognitive changes accompany depression. 2. Depression is widespread 3. Compared with women, men are nearly twice as vulnerable to major depression. 4. Most major depressive episodes so not end without assistance. 5. Stressful events often precede depression 6. With each new generation, depression is striking earlier and affecting more people. Genetic Influences of Mood Disorders • Mood disorders are often genetic • The heritability of major depression is • • about 35-40% Risk goes up if one has a parent or sibling with a mood disorder. Risk goes up even higher if one has an identical twin with a mood disorder The Depressed Brain • Less activity in the brain • The left frontal lobe is likely to be inactive • Frontal lobes tend to be smaller • The hippocampus is vulnerable to stress related • • damage Norepinephrine, which increases arousal and boosts mood, is scarce. Serotonin, which also boosts mood, is scarce as well. The Social-Cognitive Perspective Learned helplessness result in selfdefeating beliefs, and can ultimately result in depression. Women are more susceptible to learned helplessness, which factors into their higher risk for depression. Depression’s Vicious Cycle • When people feel down they are more likely to remember bad experiences and think negatively Abnormal Psychology Schizophrenia “Venture into the mind of a Schizophrenia sufferer. This is made to raise awareness about mental illness. This is how they see and hear the world. Don't turn your back on them just because they're different. Put yourself in their shoes and experience what they experience everyday. Alone but never alone…” Starring Alicia Gall Music By Alexander Kokic-Schmidt HOW MUCH DO YOU KNOW ABOUT SCHIZOPHRENIA? 1. Schizophrenia is caused by poor parenting. True False Don’t know 2. Schizophrenia is caused by street drugs. True False Don’t know 3. People who have schizophrenia are usually violent and dangerous. True False Don’t know 4. People with schizophrenia have multiple or split personalities. True False Don’t know 5. Schizophrenia can be successfully treated. True False Don’t know TRUE & FALSE ANSWERS 1. Schizophrenia is caused by poor parenting-False. The cause of schizophrenia is not known. However, it is definitely an organic (physical, biological) disease and is the fault of no one. 2. Schizophrenia is caused by street drugs-False. Schizophrenia is not caused by street drugs. Some researchers believe, however, that street drugs can precipitate schizophrenia in an individual who has a predisposition to develop the disease. 3. People who have schizophrenia are usually violent and dangerous-False. People who have schizophrenia tend to be vulnerable, fragile people. If violent, the violence is most often directed towards themselves: suicide. 4 People with schizophrenia have multiple or split personalities-False. People with schizophrenia are split from reality, rather than having a multiple or split personality. 5. Schizophrenia can be successfully treated-True. Schizophrenia cannot be cured, but the symptoms can be treated. Schizophrenia “Split Mind” Schizophrenia: Serious mental disorder (psychosis) characterized by thought disturbances, hallucinations, anxiety, emotional withdrawal, and delusions. Psychosis: Disorder that is characterized with a break from reality. delusions: False beliefs of being persecuted (being plotted against), grandiose, or being controlled by others. hallucinations: False sensory perception such as hearing voices or seeing images that are not there. Positive Symptoms Presence of inappropriate behaviors: Delusions Hallucinations Disorganized speech Disorganised or catatonic behavior Negative Symptoms Absence of appropriate behaviors: Flattened affect Anhedonia Patients may fail to experience or express pleasure in things that they once found enjoyable. Reduced speech. Lack of initiative Also called Subtypes of Schizophrenia Categorized by: 1. Disorganized and delusional thinking. 1. Disturbed perceptions. 2. Inappropriate emotions and actions. Theories About the Cause of Schizophrenic Disorders • • The dopamine hypothesis, which is an older theory, is believed to be a biological cause of schizophrenia where high levels of dopamine are found. It is also the most popular theory. o Some of the antipsychotic drugs used to treat the disorder often result in lower levels of dopamine. They often cause negative side effects for the patients such as muscle tremors or stiffness (tardive dyskinesia) Schizophrenia is believed to be genetically influenced o people who are related to someone with schizophrenia tend to have a higher risk of getting it the closer the genetic relationship. (identical twins have 1 in 2 chance, yet the general population is 1 in 100) Environmental • • • • Environmental factors may increase chances of developing schizophrenia in people that already have genetic predisposition. Double binds is when a person is given contradictory messages so they can not make their own rational decisions. Diathesis-stress model is another influence. It can be applied to schizophrenia and other psychological disorders. o Environmental stressors trigger the biological predisposition for the mental illness to release itself. This can explain why some twins both don't have schizophrenia. Schizophrenia affects young people as they mature into adults. It affects men and women equally, but men tend to suffer from it more severely than women. Lesson Activities Divided Minds The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease. Review Do you think schizophrenia is affected by nature or nurture? Why or why not? Give specific examples. Abnormal Psychology Personality Disorders Do Now Personality Disorder Video Defining Personality Disorders: Personality Disorders are maladaptive patterns of behavior that impair social functioning including: 1. Distorted thinking patterns 2. Problematic emotional responses 3. Over or under regulated impulse control 4. Interpersonal difficulties Cluster A- Odd Behavior • All share some of the common symptoms seen in schizophrenia Paranoid Personality Disorder o • Schizoid Personality Disorder o ● Irrational suspicions and mistrust of others Lack of interest in social relationships Schizotypal Personality Disorder ○ odd behavior or thinking Cluster B- Dramatic ● Histrionic Personality Disorder ○ ● Narcissistic Personality Disorder ○ ● Shallow or exaggerated emotions with attention seeking behavior even it is damaging. Grandiosity, need for admiration and lack of empathy Borderline Personality Disorder (video) ○ Unstable relationships, self image, identity, and behavior Cluster B- Dramatic ● ● Symptoms of Antisocial Personality Disorder Antisocial Personality Disorder, sociopath, psychopath ○ 70% more prevalent in men ○ Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest ○ Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure ○ Impulsivity or failure to plan ahead ○ Irritability and aggressiveness, as indicated by repeated physical fights or assaults ○ Reckless disregard for safety of self or others ○ Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations ○ Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another Children with Conduct Disorder probably won't develop antisocial personality disorder, but many people with Cluster B- Dramatic • • • Cause of Antisocial Personality Disorder The main cause of antisocial personality disorder is unknown. Genetic and environmental factors like abuse and abandonment, are believed to contribute to the disorder. Children with Conduct Disorder probably won't develop antisocial personality disorder, but many people with antisocial personality disorder had Conduct Disorder as a child (emotional and behavioral problems) Cluster C- Anxious • • • Avoidant Personality Disorder o social inhibition, feeling inadequate Dependent Personality Disorder o general psychological dependence on others Obsessive Compulsive Personality Disorder o preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency Review http://www.funtrivia.com/playquiz/quiz300 9062272eb8.html http://psychcentral.com/blog/archives/2010 /11/30/personality-disorders-shakeup-indsm-5/ Abnormal Psychology Rates Rates of Psychological Disorders Crime Rates 14.2% 29.6% The prevalence of mental health disorders among females in the juvenile justice system is higher than males. What do you think about this? 14..9% 6.4% 11.9% Students Silenced by Mental Health Stigma Discussion