Download Unit 12: Abnormal Psych

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