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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….