Download 2017 Unit 12 Abnormal Psych Class Notes - Lewis

Unit 12:
Abnormal Psychology
This unit encompasses
7-9% of the AP Exam you will ace
next May…that means 7-9
questions will be on this topic.
Therefore, we can only spend 8%
of our time on it -that’s 5
days…barring any snow days, that
is.
This is a probably one of the most
interesting units for students;
however, please keep in mind we
are not self-analyzing!
Artwork by Amber Osterhout
Defining Psychological Disorders
Mental health workers view psychological disorders as
persistently harmful thoughts, feelings, and actions.
Please be very thoughtful when speaking in this section
and only share your own thoughts. Do not share other
people’s stories.
When behavior is deviant,
distressful and dysfunctional
psychiatrists label it as disordered
(Comer, 2004).
BUT! This definition varies by
context/culture because what
“deviates” from the norm,
depends on the culture…so how
should we draw the line between
normality and disorder?
Deviant, Distressful & Dysfunctional
1. Deviant behavior
(walking around
naked) in one culture
may be considered
normal, while in others
it may lead to arrest.
3. And must also be
dysfunctional to be
considered a disorder.
Carol Beckwith
2. Distress accompanies
deviant behavior.
Recall from reading that
Wodaabe tribe men wear
costumes to attract women.
In Western society this might
be considered abnormal.
Psychological Disorders
13 miutes TEDTalk
http://www.ted.com/talks/thomas_insel_toward_a_new_understanding_of_mental_illness
People are fascinated by the exceptional, the unusual,
and the abnormal. This fascination may be caused by
two reasons:
1.
2.
During various moments
we feel, think, and act like
an abnormal individual.
Psychological disorders
may bring unexplained
physical symptoms,
irrational fears, and
suicidal thoughts.
Understanding Psychological
Disorders…a little history.
Ancient Treatments of psychological disorders
include trephination, exorcism, being caged like
animals, being beaten, burned, castrated,
mutilated, or transfused with animal’s blood.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)
So then came
the Medical Model
George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago
Philippe Pinel (1745-1826) from France, insisted that
madness was not due to demonic possession, but an
ailment of the mind.
Criticism? This model fails to recognize the effect of
social and psychological factors…
nature nurture nature nurture….
Still we began classifying
psychological disorders…
• Diagnostic and Statistical Manual of
Mental Disorders (DSM)
–Latest DSM-5
–
http://psychcentral.com/blog/archives/2013/05/18/dsm-5-released-the-big-changes/
• International Classification of
Diseases (ICD-10)
• Find in your book some of the
criticisms of the DSM?
In your book you will read about classifying
psychological disorders using the
axes…however!
BUT! Guess what!!!
Multi-axial system has been eliminated. The
rationalization was that it “Removes artificial
distinctions” between medical and mental
disorders.
1. Three major sections of the DSM-5
I. Introduction and clear information on how to use the
DSM.
II. Provides information and categorical diagnoses.
III. Section III provides self-assessment tools, as well as
categories that require more research.
2. Section II – Disorders
Organization of chapters is designed to demonstrate
how disorders are related to one another.
Throughout the entire manual, disorders are framed in
age, gender, developmental characteristics.
DSM-5 has approximately the same number of
conditions as DSM-IV.
3. The Big Changes in Specific Disorders
Go to http://psychcentral.com/blog/archives/2013/05/18/dsm-5-releasedthe-big-changes/
Today we consider the
Biopsychosocial Approach to
Psychological
Disorders
As you read and take notes, try to identify each type of
contribution, biological- psychological and social- to
psychological health or disorder.
Review the 5 cases.
Labeling Psychological Disorders
• Rosenhan’s study
– 7 went to hospitals, pretended to hear voices and were
diagnosed with disorders- causes were found in their
histories…
• Power of labels
– Preconception can stigmatize
• Stereotypes of the mentally ill
– Are people with disorders are more likely to be victims of
violence than perpetrators?
• Self-fulfilling prophecy If you are told someone is a
certain way, do you treat them differently and thus…?
• However, they do help healthcare professionals to
communicate.
Ramifications and Legality of
Labeling
• While they do help healthcare professionals to
communicate….certain labels, like “Insanity,” raise
moral and ethical questions about how society should
treat people who have disorders and have committed
crimes.
Be sure to
read the box
at the top of
p 569
(Unabomber-young illness and
unknown causes, inside the serial
killer, for students at home: 2/20
https://www.youtube.com/watch?v=wGfbAEi5Byk
Anxiety Disorders
Generalized Anxiety Disorder
Videos IF interested
http://www.bing.com/videos/search?q=psychology+today+generalized+anxiety+disorder&qs=n&form=QBVR&pq=psychology+today+
generalized+anxiety+disorder&sc=0-22&sp=-1&sk=#view=detail&mid=5AE98B96C631F1FFED255AE98B96C631F1FFED25
Symptoms
1. Persistent and
uncontrollable
tenseness and
apprehension.
2. Autonomic
arousal.
3. Inability to identify or avoid the cause of
certain feelings, this is an anxiety which
Freud labeled free floating.
Panic Disorder
A person experiences
sudden episodes of
intense dread
Described as an “anxiety
tornado.”
– 1 person in 75 with disorder
can experience sudden
escalations into a panic
attack
– Smokers have 2X the risk
Phobias are marked by persistent and irrational fear(s)
of an object(s) or situation(s) that disrupt(s) behavior.
Agoraphobia
Acrophobia
Claustrophobia
Hemophobia
Social phobia
Phobia of open places.
Phobia of heights.
Phobia of closed spaces.
Phobia of blood.
Shyness to an extreme
Nice chart illustrating the difference between fear and phobia on p 571
Crash Course: https://www.youtube.com/watch?v=aX7jnVXXG5o
Obsessive-Compulsive Disorder
https://www.youtube.com/watch?v=44DCWslbsNM with JNicholson
Persistence of unwanted thoughts (obsessions)
and urges to engage in senseless rituals
(compulsions) that cause distress.
What has Brain Imaging shown?
A PET scan of the brain of a person with
Obsessive-Compulsive Disorder (OCD) shows
high metabolic activity (red) in the frontal lobe
areas that are involved with directing
attention.
Obsession or Compulsion?
Obsession or Compulsion?
Obsession or Compulsion?
Post-Traumatic Stress Disorder
\
• Recurring (4 or more weeks) haunting memories or
nightmares, numbed social withdrawal, jumpy
anxiety, insomnia: PTSD
– Other names “shellshock” or “battle fatigue”
– Not just due to a war situation
• Kidnap victims
• Rape victims
• Torture victims
• Post-traumatic
growth
– Reporting increased appreciation for life, etc. p574
– https://www.youtube.com/watch?v=X6AYmzunPlQ
(TEDTalks PTSD after Iraq 11 minutes)
Perspectives…
Learning VS Biological
The Learning Perspective
Learning theorists suggest two specific learning
processes which contribute to anxiety:
1. Fear conditioning leads to anxiety. This
anxiety then becomes associated with
other objects or events (stimulus
generalization).
2. Reinforcement maintains our phobias
and compulsions when we avoid or
escape the feared situation to reduce
anxiety.
3. Observation Investigators believe that
fear responses are reinforced through
observational learning. Young
monkeys develop fear when they
watch other monkeys who are afraid
of snakes.
On the other hand…
The Biological Perspective considers
• Natural selection
– has led our ancestors to learn to fear snakes, spiders, and other
animals. Therefore, fear preserves the species.
• Genes
– Twin studies suggest that our genes may be partly
responsible for developing fears and anxiety. Twins are
more likely to share phobias.
– Anxiety gene
• The Brain
– Anterior cingulate cortex (pictured)
– Too much glutamate makes the brain’s alarm centers
overactive
Video Break?
Activity?
• Crash Courses:
– 28 and 29
–
–
https://www.youtube.com/watch?v=
wuhJ-GkRRQc
https://www.youtube.com/watch?v=aX
7jnVXXG5o
• 11 min PTSD video
•
•
http://www.bing.com/videos/sea
rch?q=iraq+tedtalk&&view=deta
il&mid=97D49B07AED70A5C3B
4897D49B07AED70A5C3B48&F
ORM=VRDGAR
(TEDTalks PTSD after Iraq 9
minutes)
• Somatoform disorder
– Somatic (body)
– Symptoms mimic a physical disease or injury.
– Medical test results are either normal or do not
explain the person’s symptoms.
–Conversion disorder
– One type of somatoform disorder is conversion
disorder in which very specific genuine physical
symptoms exist for which no physiological basis can
be found.
–Hypochondriasis
– is a somatoform disorder in which a person interprets
normal physical sensations as symptoms of a disease.
Dissociative Disorders
Dissociative Disorders
Conscious awareness becomes separated
(dissociated) from previous memories, thoughts, and
feelings.
Symptoms
1. Having a sense of
being unreal.
2. Being separated from
the body.
3. Watching yourself as
if in a movie.
Dissociative Identity Disorder (DID)
HBO documentary
http://www.youtube.com/watch?v=B0LNyXsErb8 start at 26:38 police officer
A disorder in which a person exhibits two or
more distinct and alternating personalities,
formerly called multiple personality disorder.
What is “fugue state?” If you don’t know…p577
Chris Sizemore (DID)
DID Critics
Critics argue that the diagnosis of DID
increased in the late 20th century. DID has
not been found in other countries.
Critics’ Arguments
1. Role-playing by people open to a
therapist’s suggestion.
2. Learned response that reinforces
reductions in anxiety.
Mood Disorders
• Emotional extremes of mood disorders come in
two principle forms
–Bipolar disorder
• Formerly called manic-depressive disorder. An
alternation between depression and mania signals
bipolar disorder.
–Major depressive disorder
• Depression is the “common cold” of psychological
disorders. In a year, 5.8% of men and 9.5% of
women report depression worldwide (WHO, 2002).
Bipolar Disorder
–Mania (manic)
• Overtalkative, overactive, elated, little
need for sleep, etc.
–Bipolar disorder and creativity
Major Depressive Disorder
• Major depressive disorder
– Major depressive disorder occurs
when signs of depression last two
weeks or more and are not caused
by drugs or medical conditions.
– Lethargy
– Feelings of worthlessness
– Loss of interest in family and
friends
– Loss of interest in activities
Suicide
The most severe form of behavioral response to
depression is suicide. Each year some 1 million
people commit suicide worldwide.
Comparative Suicide Rates
• National Differences: Britain, Italy & Spain’s rates are little
more than half that of the US, Canada and Australia. Austria
& Finland are double.
• Racial Differences: In the US, whites are 2x as likely than
blacks.
• Gender Differences: Women are more likely to attempt, men
are more likely to succeed.
• Age Differences: Rates increase dramatically in late
adulthood, especially among men.
• Other: Rates are higher among the rich and those who are
single, widowed or divorced. In the last 60 years, the global
rate of annual suicide rose from 10 to 18 per 100,000. In 2006
in the US, suicide per 100,000: 11.1 (or 33,300 people).
Do we have time for a
Reading Quiz?!?
• Maybe next time!
Understanding Mood Disorders
• Many behavioral and cognitive changes
accompany depression
• Depression is widespread
• Compared with men, women are nearly twice
as vulnerable to major depression
• Most major depressive episodes self-terminate
• Stressful events related to work, marriage and
close relationships often precede depression
• With each new generation, depression is
striking earlier and affecting more people
Understanding Mood Disorders
The Biological Perspective
• Genetic Influences
– Mood disorders run in families
• Heritability
• What is “linkage analysis?” p.584
• The Depressed Brain
– Hippocampus (memory and emotion) is
vulnerable to stress-related damage
• Biochemical Influences
– Norepinephrine and serotonin (both scarce
when depressed)
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Social-Cognitive Perspective
• Negative Thoughts and Moods Interact
– “A recipe for severe depression is preexisting
pessimism encountering failure.” ~Seligman
– Self-defeating beliefs
• Learned helplessness
– Explanatory style
• Bad things seems more stable, global, internal
explanations (self-blaming)
– Cause versus indictor of depression?
• Eg speedometer reads 70 mph but doesn’t cause it!
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
‘Negative emotions contribute to physical
illness, and physical abnormalities
contribute to negative emotions…we are
mind embodied.”
Crash Course (30):
https://www.youtube.com/watch?v=ZwMlHkWKDwM
Last section:
Schizophrenia &
Personality Disorders
Artwork by Amber Osterhout whose brother suffered from mental illness.
Symptoms of Schizophrenia
• Schizophrenia (split mind)
–Not multiple personalities
Some of the art in this section, including this one, was
created by a person suffering from schizophrenia.
She would draw what she was seeing on the walls.
Symptoms of Schizophrenia
Disorganized Thinking
• Disorganized thinking
• The literal translation is “split mind” which refers to a
split from reality. A group of severe disorders
characterized by the following:
– Delusions
• Delusions of persecution (paranoid)\Word
Salad
– Breakdown in selective attention may cause
disorganized thinking, fragmented or bizarre
thoughts
Symptoms of Schizophrenia
Disturbed Perceptions
• TEDTalks 15 minutes must see
http://www.ted.com/talks/elyn_saks_seeing_mental_illness?language=en
• Disturbed perceptions
–Hallucinations
• hearing voices
• seeing people or things
that are not present
Symptoms of Schizophrenia
Inappropriate Emotions and Actions
• Inappropriate
Emotions
–Flat affect
• Inappropriate
Actions
–Catatonia
–Disruptive social
behavior
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Onset and Development
• Statistics on schizophrenia TE rt. p591 (read
with class)
•Onset of the disease
•Positive versus negative symptoms
–Positive symptoms: the presence of
inappropriate behaviors (hallucinations,
disorganized or delusional talking)
–Negative symptoms: the absence of
appropriate behaviors (expressionless
faces, rigid bodies)
•Chronic (process) schizophrenia (Slow
onset)
•Acute (reactive) schizophrenia (Rapid
onset)
Understanding Schizophrenia
Brain Abnormalities
• Abnormal Brain Activity and Anatomy
–Dopamine Overactivity
–Frontal lobe and core brain activity
–Fluid filled
areas of the
brain
Understanding Schizophrenia
Includes studying Genetic Factors
• Be sure to read about genetic
predisposition and especially twin
studies
• What does the research say
about genetics and
environmental
influences?
Psychological Factors
• Possible warning signs
– Mother severely schizophrenic
– Birth complications (low weight/oxygen deprivation)
– Separation from parents
– Short attention span
– Poor muscle coordination
– Disruptive or withdrawn behavior
– Emotional unpredictability
– Poor peer relations and solo play
– Crash Course (32):
https://www.youtube.com/watch?v=uxktavpRdzU
Personality Disorders
Personality Disorders
• Clusters
– Anxiety cluster
• Eg. Fear of rejection
– Eccentric cluster
• Eg. emotionlessness
– Dramatic/impulsive cluster
• Eg. Narcissistic Personality Disorder
Antisocial Personality Disorder
A disorder in which the person (usually men)
exhibits a lack of conscience for wrongdoing, even
toward friends and family members. Formerly, this
person was called a sociopath or psychopath.
Symptoms May Include:
• Lack of empathy or affection.
• No regard for right and wrong.
• Using charm or wit to manipulate
others.
• Intimidation of others.
•Violent or aggressive behavior.
Jeffrey Dahmer
Antisocial Personality Disorder
Some have trouble
functioning
normally in
society: trouble
with relationships
and with the law.
Others are very
successful and
mimicking emotion
and general
deception.
Ted Bundy
Understanding Antisocial
Personality Disorder
Like mood disorders and
schizophrenia, antisocial
personality disorder has
biological and
psychological reasons.
Youngsters, before
committing a crime,
respond with lower levels
of stress hormones than
others do at their age.
Understanding Antisocial
Personality Disorder
PET scans of 41 murderers revealed reduced
activity in the frontal lobes. In a follow-up study,
repeat offenders had 11% less frontal lobe activity
(Raine et al., 1999; 2000).
Courtesy of Adrian Raine,
University of Southern California
Normal
Murderer
Rates of Disorder
Rates of Disorder
• Mental health statistics
• Influence of poverty- doubles- but which came first?
• Please read and re-read p599-600
Crash Course (34):
https://www.youtube.com/watch?v=4E1JiDFxFGk
PsychSim: Losing Touch with Reality:
http://bcs.worthpublishers.com/WebPub/Psychology/psychsim5/PsychSim5%20Tutorials/Losing%20Touc
h%20with%20Reality/LosingTouchWithReality.htm
The End
If interested there is a “Did you
know” section following this slide…
…and the next unit is more
optimistic!
Did you know…?
The Brain and Disorders
• Did you know (from your reading) that
individuals diagnosed with ADHA experience a
normal but delayed thinning of the frontal
cerebral cortex?
The Brain and Disorders
• Did you know (from reading your text) that
severely depressed individuals are especially
likely to show reduced brain activity in the
LEFT FRONTAL lobe?
The BRAIN and Disorders
• Did you know (from your reading) that among
schizophrenia patients, the fluid-filled areas
of the brain are abnormally large and the
thalamus is abnormally small?
The BRAIN and Disorders
• Did you know (from your reading of the text)
that Tardive Dyskinesia is often associated
with long-term use of drugs that occupy
certain dopamine receptors?
The BRAIN and Disorders
• Remember from reading, LITHIUM has been
found to be especially effective in the
treatment of Bipolar Disorder.
The Brain and Disorders
• Did you know (from your reading of your text)
that D-cycloserine helps relieve symptoms of
OCD?
•
http://www.steveseay.com/ocd-d-cycloserine-medication-treatment/
The Brain and Disorders
• What provides some of the benefits of
Electroconvulsive Therapy without triggering
seizures or memory loss?
• Repetitive Transcranial Magnetic Stimulation
(rTMS).
Movie time…
• https://www.facebook.com/natalie.m.pate?fre
f=ts
The End
http://www.bing.com/videos/search?q=a+beautiful+mind+video+ect&FORM=VIRE1#view=detail&mid=B5D3D4CE7990F3A637B2B5D3D4CE7990F3A637B2
• Thoughts?
• Transition: treatment through viruses
http://www.bing.com/videos/search?q=TE
D+Talks+PTSD&Form=VQFRVP#view=det
ail&mid=35D1C09A0D62D407738435D1C0
9A0D62D4077384 (TEDTalks first 9 min
approx)
•
http://www.bing.com/videos/search?q=a+beautiful+mind+video+ect&FORM=VIRE1#view=detail&mid=B5D3D4CE7990F3A637B2B5D3D4CE7990F3A
637B2 Movie clip Insulin Shock Treatment.
Sites in which you may interested
1.
2.
3.
4.
5.
6.
For Students TEDTalks
http://www.ted.com/talks/thomas_insel_toward_a_new_unde
rstanding_of_mental_illness
DSM5 site http://www.dsm5.org/Pages/Default.aspx
Check out the “UN-DSM” at www.viastrengths.org (ref:p. 567)
Unabomber
http://www.bing.com/videos/search?q=Theodore+Kaczynski&
FORM=HDRSC3#view=detail&mid=682A4412FA00ED7DC720
682A4412FA00ED7DC720 )
Stereotyping and the mentally ill
http://thinkprogress.org/health/2012/12/17/1346201/are-peoplewith-mental-illnesses-more-prone-to-violence/
TEDTalks by person who suffers from PANIC
https://www.youtube.com/watch?v=S8FNcOBkhN4
The End
Really this time….