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Abnormal Psychology Psychological Disorders A behavior which is judged to be deviant (atypical), distressful, and dysfunctional. Could also be maladaptive and unjustifiable. Early Theories • Abnormal behavior was evil spirits trying to get out. • Trephining was often used. Trephening Early Theories • Another way to deal with the demons was to make the body extremely uncomfortable. History of Mental Disorders • In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill. They were first put in hospitals. Did this mean better treatment? Early Mental Hospitals • They were nothing more than barbaric prisons. •The patients were chained and locked away. •Some hospitals even charged admission for the public to see the “crazies”, just like a zoo. Philippe Pinel • French doctor worked to eliminate the institutional brutality (and declare that these people are sick and “a cure must be found”). Medical Model • Late 1800’s - it was believed that mental illness had a physical (organic) cause. General Paresis and Syphilis examples. But it doesn’t emphasize environmental explanations like stress or upbringing. Many disorders are psychogenic: the origins are psychological. Current Perspectives • Biopsychosocial model: assumes biological, psychological and socio-cultural factors interact to produce specific psychological disorders. Most common view today. Some disorders occur worldwide (schizophrenia) while others are culture-bound (i.e. “anorexia” & “susto” – fear of black magic in Latin America). DSM-V • Diagnostic Statistical Manual of Mental Disorders: the big book of disorders. • DSM will classify disorders and describe the symptoms. • DSM will NOT explain the causes or possible cures. Major Changes in the DSM-V • Autism is now a single condition called “autism spectrum disorder (includes Asperger’s and all forms of autism). • Childhood bipolar disorder has a new name – “Disruptive Mood Dysregulation Disorder.” • ADHD is no longer just a childhood disorder. You can be diagnosed with it as an adult. • Premenstrual dysphoric disorder (PMDD) and binge eating disorder are now official disorders. • Hoarding is now a disorder, NOT a form of OCD. • Subtypes of schizophrenia have been eliminated. Two Major Classifications in the DSM Neurotic Disorders • Distressing but one can still function in society and act rationally. Psychotic Disorders • Person loses contact with reality, experiences distorted perceptions. Danger of Diagnostic Labels • In Rosenhan’s study his associates were faking symptoms of hearing voices. • They were ALL admitted for schizophrenia. • None were exposed as imposters. • They all left diagnosed with schizophrenia in remission. • What did this study show? • 1.) It showed the biasing power of diagnostic labels. Anxiety Disorders • A group of conditions where the primary symptoms are anxiety or defenses against anxiety. • The patient fears something awful will happen to them. • They are in a state of apprehension or nervousness. Generalized Anxiety Disorder (GAD) • Marked by disruptive levels of persistent feelings of apprehension and tenseness. • Symptoms include restlessness, feeling on edge, irritability, sleep disturbance. • 2 out of 3 – women. Panic Disorder • Disorder marked by a minutes-long episode of intense dread (Panic Attack) in which a person experiences terror and accompanying chest pain, choking and other frightening sensations. • Can cause secondary disorders like agoraphobia. Phobias • Marked by disruptive, irrational fears of objects, activities, or situations. • Specific phobias – like arachnophobia. • Social Anxiety Disorder (i.e. Agoraphobia) – fear of public places. Examples of Phobias Name of the phobia: Fear of: Xenophobia Strangers Ophidiophobia Snakes Panaphobia Everything Santa Claustrophobia Stuck in chimneys Numerophobia Numbers Arachnophobia Spiders Murophobia Mice Mikrophobia Germs Obsessive-compulsive disorder • Persistent unwanted thoughts (obsessions) cause someone to feel the need to engage in a particular repetitive action (compulsion) . Common Examples of OCD Common Obsessions: Common Compulsions: Contamination fears of germs, dirt, Washing etc. Imagining having harmed self or others Repeating Imagining losing control of aggressive urges Checking Intrusive sexual thoughts or urges Touching A need to have things "just so" Putting things in order Post-traumatic Stress Disorder (PTSD) • Flashbacks or nightmares following a person’s involvement in an extremely stressful event. • Memories of the event cause anxiety. • War veterans and “shell shock.” Biological Causes of Anxiety Disorders • Heredity or predisposition (twin studies). • Brain function - (fMRI scans of OCD patients show higher anterior cingulate cortex activity). • Evolution – likely to fear situations that posed threat to early humans. Learning Factors and Anxiety Disorders • Conditioning - remember Little Albert? • Observational learning – seeing someone else respond with fear (i.e. a sibling). • Reinforcement – learning to associate emotions with actions and the results that follow those actions. Mood Disorders • Psychological disorders characterized by emotional extremes (i.e. depression, mania, or both). Major Depressive Disorder • Most common disability in the world (6% of men & 10% of women). • Unhappy for at least two weeks with no apparent cause. • Feelings of worthlessness and diminished interest in most activities. • May have suicidal thoughts. Bipolar Disorder • Formally called manic depression. • Involves periods of depression and manic episodes. • Manic episodes may involve long periods of little sleep, racing thoughts, and set impossible goals. • May have bursts of creative energy during manic states (like van Gogh). Famous People with Bipolar Bipolar Brain Postpartum Depression • Depression after childbirth (“baby blues”). • 5% to 10% of women. • Sadness, fatigue, insomnia, reduced libido, etc. • Usually the first few months after giving birth. Seasonal Affective Disorder • Experience depression during the winter months. • Based not on temperature, but on amount of sunlight. SAD's prevalence in the U.S. ranges from 1.4% in Florida to 9.9% in Alaska. Suicide Suicide rates increase with age. Suicide But teen suicide rates increased from 1960 to 1990, but have dropped since 1990. Biological Causes of Mood Disorders • Heredity – twin studies. • Brain function – PET scans have shown lower brain activity during depressed states. • Serotonin and Norepinephrine are lacking during times of depression (Prozac & Zoloft help restore serotonin levels by blocking its reuptake). • Norepinephrine is overabundant during mania. Drugs that alleviate mania, reduce norepinephrine. Social-Cognitive Factors and Mood Disorders • Learned helplessness. • Attributions (explanatory style) – Stable, internal and global. Psychotic Disorders Schizophrenia • Is not one disorder but a group of disorders. • It is not “split personality.” • Typically develops in late adolescence. Schizophrenia • About 1% of people are diagnosed with schizophrenia. Symptoms of Schizophrenia: 1. Disorganized thinking. 2. Disturbed Perceptions. 3. Inappropriate Emotions and Actions. 1.) Disorganized Thinking • The thinking of a person with schizophrenia is fragmented and bizarre. • Disorganized thinking comes from a breakdown in selective attention - they cannot filter out information. • Often causes . . . Delusions (false beliefs) • Delusions of Persecution • Delusions of Grandeur (people are out to get you). (belief that you are more important than you really are). 2.) Disturbed Perceptions • Hallucinations – (usually auditory) is a false perception. 3.) Inappropriate Emotions and Actions • • • • Laugh at inappropriate times. Flat Effect (emotionless). Senseless, compulsive acts. Catatonia - motionless waxy flexibility. Positive vs. Negative Symptoms Positive Symptoms • Presence of inappropriate symptoms Negative Symptoms • Absence of appropriate ones. Types of Schizophrenia Paranoid Schizophrenia • Paranoid and preoccupied with delusions of persecution or grandeur as well as hallucinations. • Always looking over your shoulder like somebody is out to get you! • http://www.youtube.com/watch?v=gGnl8dqEoPQ&feature=results_ main&playnext=1&list=PL135E3BF70B9D590C Catatonic Schizophrenia • Immobility. • Waxy flexibility. • Parroting another’s speech. Disorganized Schizophrenia • Disorganized speech or behavior, or flat or inappropriate emotion. • Clang associations: speaking in rhyme. • “I’m the worst systematic, sympathetic quite pathetic, apologetic, paramedic.“ • Word salad: nonsense talk. • “Because he makes a twirl in life, my box is broken. Help me blue elephant. Isn't lettuce brave? I like electrons, hello.” • Neologisms: made up words that only have meaning to the person using them. • “Is this logomouth here to get me nervous?” Undifferentiated Schizophrenia • Many varied symptoms. • "Undifferentiated schizophrenia" is used as a label for cases of schizophrenia that don't match any of the established types of schizophrenia. Residual Schizophrenia • When the patient no longer displays prominent positive symptoms (i.e. hallucinations). • The person does show some negative symptoms like speaking little or being apathetic. Biological Causes of Schizophrenia • No known single cause. • Possible causes: • Excess of dopamine receptors (6x). • Low activity in frontal lobes. • Genetics (50% chance for identical twins). Biological Causes of Schizophrenia • Possible causes: • Enlarged ventricles (fluid filled spaces) in the brain. • Shrinkage of brain tissue in limbic system. • Prenatal viruses. Psychological Causes of Schizophrenia • There is NO proof that any social or psychological factors “cause” schizophrenia. • We don’t know what role stress or disturbed family communications play. • The just appear to be correlated. Dissociative Disorders Dissociative Disorders • Disorders in which the sense of self has become separated (dissociated) from previous memories, thoughts, or feelings. Dissociative Amnesia • A partial or total forgetting of past experiences, without organic cause. • Usually in reaction to a traumatic event. Organic Amnesia (not a dissociative disorder) • Results from other medical trauma (e.g. a blow to the head, stroke, alcoholism). Dissociative Fugue • A form of dissociative amnesia characterized by physical relocation and the assumption of a new identity with amnesia for the previous identity. (“Traveling amnesia”). •These journeys can last hours, even several days, months or years. Dissociative Identity Disorder (D.I.D.) • Used to be known as Multiple Personality Disorder. • Often confused with schizophrenia. • People with D.I.D. commonly have a history of childhood abuse or trauma. • Unlike schizophrenics, they have 2 or more distinct identities, are not psychotic, and have severe memory lapses. Somatic Symptom Disorders • Disorders in which symptoms take a bodily form without apparent physical cause. • Two types… Illness Anxiety Disorder (Hypochondriasis) • Characterized by imagined symptoms of illness. • They usually believe that the minor issues (headache, upset stomach) are indicative of more severe illnesses. Conversion Disorder • Loss or impairment of some motor or sensory function due to a psychological conflict or stress. • Formerly known as hysteria. • Cambodian refugees. • Killing Fields https://www.youtube.com/watch?v= _jOuqAcgMrA Personality Disorders • Characterized by rigid and lasting behavior patterns that disrupt social functioning. • 3 main clusters: • A.) Related to anxiety • B.) Odd or eccentric behaviors • C.) Dramatic or impulsive behaviors A.) Related to Anxiety • Avoidant Personality Disorder – sensitive about being rejected so relationships become difficult. • Dependent Personality Disorder – are clingy and submissive. Obsessive–Compulsive Personality Disorder • Overly concerned with certain thoughts and performing certain behaviors. • Not as extreme as OCD anxiety disorder. B.) Odd or Eccentric Behaviors • Paranoid Personality Disorder – show deep distrust of other people. • Schizoid Personality Disorder – are detached from social relationships (true hermits). Schizotypal Personality Disorder • Characterized by a need for social isolation, odd behavior and thinking, and often unconventional beliefs. • Some believe they have magical powers (ESP). • Some people believe that schizotypal personality disorder is a mild form of schizophrenia. C.) Dramatic or Impulsive Behaviors • Borderline Personality Disorder (following slides). • Antisocial Personality Disorder (following slides). Borderline Personality Disorder • Characterized by unstable emotions and relationships. People with this disorder are prone to constant mood swings and bouts of anger. Borderline Personality Disorder • They will take their anger out on themselves, causing themselves injury (cutting). Suicidal threats and actions are not uncommon. Antisocial Personality Disorder • Antisocial personality disorder is characterized by a lack of conscience. • Prone to criminal behavior. • No remorse when they hurt others. Antisocial Personality Disorder • Also known as “sociopaths”. Examples would be Charles Manson & Hannibal Lecter. They are often aggressive and are much more concerned with their own needs than the needs of others. Histrionic Personality Disorder • Characterized by a pattern of excessive emotionality and attention seeking. • May act silly or dress provocatively. • These individuals are lively, dramatic, enthusiastic, and flirtatious. Narcissistic Personality Disorder • Having an inflated sense of self-importance. • Thinking that you are the center of the universe. • React to criticism with rage or shame. Personality Disorders https://www.youtube.com/watch?v=4E1JiDFxFGk&list=PL8dPuuaLjXtOPRKzVLY0jJY-uHOH9KVU6&index=34 Other Disorders • Paraphilias (i.e. pedophilia, zoophilia, fetishism). • Impulse Control Disorders. • Eating Disorders. • Substance Use Disorders. • ADHD. • Autism.