Download Abnormal Psychology

CS 8: The SW examine how psychological disorders
are diagnosed, classified and treated
Class Activity

 Students will get in groups of four and develop a
definition for “psychological disorder”
 Be specific, identify criteria for the line between
normality and abnormality
Who has a mental disorder?

 The World Health
Organization (WHO,
2008) reports
approximately 450
million people suffer
from a mental or
behavior disorder
Perspectives on Psychological
Disorders

Psychological Disorder:
Deviant, distressful, and dysfunctional
patterns of thoughts, feelings or behaviors
MUDA

Four attributes of a psychological
disorder
Maladaptive
Unjustifiable
Disturbing
Atypical
www.ghaps.org
Maladaptive

An exaggeration of normal,
acceptable behaviors
Destructive to oneself or others
www.ghaps.org
Unjustifiable

A behavior which does not have a
rational basis
www.ghaps.org
Disturbing

A behavior which is troublesome to
other people
www.ghaps.org
Atypical

A behavior so different from other
people’s behavior that it violates a
norm
Norms vary from culture to culture
www.ghaps.org
Cultural Connections

Hissing is a polite way to show respect for
superiors in Japan
Among the Karaki of New Guinea, a man is
considered abnormal if he has not engaged in
homosexual activity before marriage
Public displays of affection between men and
women in Thailand are unacceptable
 Men holding hand is considered a sign of friendship
 Using straws is considered vulgar
Cultural Connection

 Statistically speaking, any behavior is atypical if it is NOT
exhibited by 68% of the people in a particular group or
culture
 What behaviors would be considered normal if we followed this
definition of abnormality?
 Who would suffer discrimination?
 Religious practices
 Ways of life would be abnormal? Single-parent households?
Two-parent households?
 What ethnic groups would be considered abnormal?
 Styles of dress, music preferences, post-high school choices?
ADHD

US: Controversy with ADHD
(ADHD) Attention-deficit hyperactivity
disorder:
 A psychological disorder marked by the
appearance by age 7 of one or more of three
key symptoms: Extreme inattention,
hyperactivity and impulsivity
“The Devil Made Me Do It”

Middle Ages:
Trephination
Understanding Psychological
Disorder

The Medical Model:
The concept that diseases, in this case
psychological disorders, have physical
causes that can be diagnosed, treated and
in most cases, cured often through
treatment
The Biopsychosocial
Approach

Psychological Influences:
Stress
Trauma
Learned Helplessness
Mood-Related Perceptions
and Memories
Biological Influences:
Evolution
Individual Genes
Brain Structure and
Chemistry
Psychological
Disorder
Social-Cultural Influences:
Roles
Expectations
Def. of Normality and
Disorder
Classifying Psychological
Disorder

DSM-IV-TR:
The American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders; a widely used system
for classifying psychological disorders
(2000)
How are psychological disorders
diagnosed?

Five “Axis” diagnostic criteria used in
DSM
Helps doctors determine not only the type of
mental illness a person has, but also some
contributing factors that probably need to be
dealt with in order to get the primary mental
illness symptoms under control
“Axis” Five

 Axis I: Is a clinical syndrome present?
 Axis II: Is a personality disorder or mental
retardation present?
 Axis III: Is a General Medical Condition, such as
diabetes, hypertension, or arthritis, also present?
 Axis IV: Are psychosocial or environmental
problems, such as school or housing issues, also
present?
 Axis V: What is the Global Assessment of this
person’s functioning?
 http://faculty.fortlewis.edu/burke_b/Abnormal/Abnormalmultiaxial.htm
Labeling Psychological Disorders

Insurance companies and DSM
Ask Yourself

 How would you draw a line between sending
disturbed criminals to prisons or to mental hospitals?
Would the person’s history (child abuse) influences
your decisions?
 What is the biopsychosocial perspective and why is
it important in our understanding of psychological
disorders?
Critical Thinking

 Does well being refer to the absence of a disorder?
 Are people mentally sound if they do not suffer from
anxiety, depression, or other forms of psychological
symptomology?
 What characteristics mark psychological well-being?
Carol D. Ryff

Psychologist who argues we must
define mental health in terms of
positive
Six Core Dimensions of
Well-Being

 Self-Acceptance: A person not only has a positive
attitude toward the self the self but accepts multiple
aspects of the self-good and bad, past, present, and
future
 Positive relations with other people: Healthy people
have warm, satisfying, and trusting interpersonal
relationships
 Autonomy: The person is independent, selfdetermining, and self-controlled
Six Core Dimensions of
Well-Being

 Environmental Mastery: The healthy are able to
choose or create contexts that are supportive of
personal needs or values
 Purpose in life: The person has both goals and a
sense of directedness
 Personal growth: Healthy people see themselves as
growing and expanding
Insanity or Hospital?

Anxiety Disorders

 At some point we all become anxious; speaking in front of
an audience, playing a big game. Usually these feelings go
away after event is over
 For some, they do not
Anxiety Disorder:
Marked by distressing, persistent anxiety
or dysfunctional anxiety reducing
behaviors
Anxiety Disorder

 Generalized Anxiety Disorder:
 Person is continually tense, apprehensive and in a state of
autonomic nervous system arousal
 Jittery, agitated and sleep-derived
 Panic Disorder:
 Marked by unpredictable minutes-long episodes of intense
dread in which a person experiences terror and
accompanying chest pain, choking or other frightening
sensations
 1 in 75 people
 Panic Attack: minute long episode of intense fear that something
horrible is about to happen
 Smokers Double risk
Anxiety Disorder

 Phobias:
 An anxiety disorder marked by a persistent, irrational
fear and avoidance of a specific object, activity, or
situation
 Social phobias: animals, insects, heights, etc (may hide
in fear)
 Agoraphobia: Fear or avoidance of situations
 Obsessive-Compulsive Disorder:
 An anxiety disorder characterized by unwanted
repetitive thoughts (obsessions) and/or actions
(compulsions)
Anxiety Disorders

 Post-Traumatic Stress Disorder:
 Characterized by haunting memories, nightmares,
social withdrawal, jumpy anxiety, and/or insomnia
that lingers for four weeks or more after a traumatic
experience
 Post-Traumatic Growth:
 Positive psychological changes as a result of
struggling with extremely challenging circumstances
and life crisis
Critical Thinking

 Today 24- hour news channels show up-to-dateminute coverage of war and disaster. People can
watch violence as it happens. While it represents
advance in TV journalism, it exposes everyday
people to experiences that could lead to PTSD
 http://www.youtube.com/watch?v=-mNFqqB6EPU
 http://www.youtube.com/watch?v=umatZvJnvFM
 http://www.youtube.com/watch?v=3aEvzuA4f0c
Critical Thinking

 How does view trauma on TV affect people who haven’t
experienced the tragedy or conflict firsthand?
 Can people develop PTSD vicariously? How different are
experiences with PTSD from those who developed it
vicariously compared to those who developed it through
firsthand experience with trauma?
 How did coverage of the events of September 11, 2001
attacks and Hurricane Katrina affect the viewing public?
 Were lessons learned from coverage of the first Gulf War
applied to coverage of the Iraq War? Why or Why not?
Understanding Anxiety Disorder

 The Learning Perspective:
 Fear Conditioning
 Observational Learning
 The Biological Perspective:
 Natural Selection
 Genes
 The Brain: Anterior Cingulate Cortex
Critical Thinking

 Can you recall a fear you have learned? What role
was played by fear conditioning and by
observational learning?
 How do generalized anxiety disorder, panic
disorder, phobias, obsessive-compulsive disorder
and post-traumatic stress disorder differ?
Somatoform Disorders

Often people come to the doctor’s office with
“medically unexplained illnesses”
Somatoform Disorder:
Psychological disorder in which the
symptoms take a somatic (bodily) form
without apparent physical cause
Somatoform Disorders

Conversion Disorder:
 A rare somatoform disorder in which a person
experiences very specific genuine physical
symptoms for which no physiological basis can be
found
Hypochondriasis:
 A somatoform disorder in which a person
interprets normal physical sensations as
symptoms of a disease
Other Somatoform Disorders

 Body Dysmorphic Disorder
 Pain Disorder
 Somatization Disorder
 P/T under 30 will exhibit a variety of unexplained physical
symptoms
Ask Yourself

 Describe a time when you have fretted needlessly
over a normal bodily sensation?
 In your own words, what does somatoform mean?
Dissociative Disorders

 Disorders in which conscious awareness becomes
separated (dissociated) from previous memories,
thoughts, and feelings
 Disorder of the consciousness
 A person appears to experience a sudden loss of memory or
change in identity in response to an overwhelmingly
stressful situation
 “I was not myself at the time”
 Driving in a car and driving to some unintended location
while your mind was preoccupied elsewhere
Dissociative Identity Disorder

DID:
A rare dissociative disorder in which
a person exhibits two or more
distinct and alternating personalities.
Formerly called multiple personality disorder
Dissociative Disorder

 Dissociative Amnesia:
 Patients suffer from a complete loss of identify. They
forget who they are due to a trauma
 Dissociative Fugue:
 Patients suffer the identity loss as in dissociative
amnesia, but these patients also travel away from
home, often showing up as a “John/Jane Doe” in
another community far away
Understanding
Dissociative Identity Disorder

 Outside US, DID is rare
 Other countries it is viewed as “possessed”
 Britain considers it an “American Fad”
 India and Japan do not recognize
 Included under umbrella of post-traumatic disorders
 Symptoms are ways of dealing with anxiety
Chris Sizemore

 “The Three Faces of Eve” gave early visibility to
what is now called DID
 http://www.youtube.com/watch?v=SOxxf8zJt9M
 14:10-25:29
Ask Yourself

 In a normal way, do you ever flip between displays
of different aspects of your personality?
 The psychoanalytic and learning perspectives argue
that dissociative identity disorder symptoms are
ways of dealing with anxiety. How do their
explanations differ?
Mood Disorders

Psychological disorders characterized by emotional
extremes
Two Principle Forms
1) Major depressive disorder: prolonged
hopelessness and lethargy
2) Bipolar Disorder: A person alternates
between depression and mania, an
overexcited, hyperactive state
Mood Disorders

Seasonal Affective Disorder
Postpartum Depression
Major Depressive Disorder

 Major Depressive Disorder:
 Mood disorder in which a person experiences in the
absence of drugs or a medical conditions, two or more
weeks of significantly, depressed moods, feelings of
worthlessness, and diminished interest or pleasure in
most activities
Bipolar Disorder

Mania:
 A mood disorder marked by a hyperactive, wildly
optimistic state
 Bipolar Disorder:
 A mood disorder in which the person alternates
between the hopelessness and lethargy of depression
and the overexcited state of mania
 Walt Whiman, Virginia Woolf, Samuel Clemens (Mark
Twain), and Ernest Hemingway
Bipolar Disorder

 Bipolar Disorder I: The classic diagnosis of this disorder.
Patients experience periods of inflated mood
followed by depressive episodes occurring in cycles
 Bipolar Disorder II: A milder form; patients
experience at least one episode of hypomania and at
least one major depressive episode
Understanding Mood Disorders

Help students see that depression following a
traumatic even (death of a loved one, failure,
serious physical injury) are considered
normal. Depression without a known stressor
or causal event may be due to biological or
psychological reasons.
Understanding Mood Disorders

 Many behavior 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
Class Activity

 SW divide into groups and create a continuum of the
different types of moods (depression on one extreme and
mania on the other)
 Come up with at least five different levels of mood between
the two extremes
 Could groups come to a consensus about what the different
types of moods were called? Why or why not?
 What were the different names they came up with for each
type of mood?
EX:
Depression------------------------------------------------------Mania
The Biological Perspective

Genetic Influences:
 Emotions are “postcards from our genes”
 The risk of major depression and bipolar disorders
increases if you have a parent or sibling with the disorder
Linkage Analysis:
 Linkage studies seek to identify abnormal genes in
family members suffering a disorder
Important to Remember

Being genetically predisposed to a condition such
as depression does not mean one if guaranteed to
get the disease
It is important to take into account
environment
Suicide

Struggling with questions of life’s purpose
and these feelings are normal. Any indication
of someone contemplating suicide should be
taken seriously
Suicide

National Differences: Europe; most suicide prone
people
Racial Differences: Whites are nearly twice as
likely
Gender Differences: Women twice more likely
than men
Age Differences and Trends: In late adulthood,
rates increase among men
What reasons do people give for
being lonely?

Being unattached
Alienation
Being Alone
Forced Isolation
Dislocation
Help is Available

National Hopeline Network
1-800-784-2433
National Suicide Prevention Lifeline
1-800-273-8255
Open 24 Hours a Day/ 7 Days a week
The Depressed Brain

People with severe depression have shown
their frontal lobes 7% smaller than normal
Hippocampus is vulnerable to stressrelated damage
Biochemical Influences

 Norepinephrine:
 Increases arousal and boots mood
 Scarce during depression and overabundant during mania
 Serotonin:
 Scarce during depression
 Drugs that relieve depression are Prozac, Zoloft and Paxil
 Exercise increases serotonin
The Social-Cognitive Perspective

Self-defeating beliefs and a negative
explanatory style feed depression’s
vicious cycle
Depression Vicious Cycle

1.
2.
3.
4.
Stressful Experiences
Negative Explanatory Style
Depressed Mood
Cognitive and Behavioral Changes
Test Yourself

What does it mean to say that
“depression is the common cold of
psychological disorders”?
Schizophrenia

If depression is the common cold or
psychological disorders, schizophrenia is
the cancer
 Nearly 1 in 100 people will develop schizophrenia
 Approximately 24 million across the world suffer from
this disease
 http://www.youtube.com/watch?v=UTUMt05_nCI
Schizophrenia

Children as young as 12 have developed
symptoms of schizophrenia
 The onset of the disorder typically occurs during the
late teen and early adult years
 Full-Blown psychotic episodes (where patients lose
touch with reality) may not occur until the patient is
out on his or her own, away from family and friends
who have supported that person in the past
Symptoms of Schizophrenia

 “Split Mind”
 It refers to not a multi-personality, but to a split from
reality that shows itself in disorganized thinking,
disturbed perceptions and inappropriate emotions
and actions
Symptoms of Schizophrenia

 “This morning, when I was at Hillside, I was making a
movie. I was surrounded by movie stars…I’m Mary
Poppins. Is this room painted blue to get me upset? My
grandmother died four weeks after my eighteenth
birthday”.
 Fragmented, bizarre, and often distorted by false beliefs
Symptoms

 Delusions:
 False beliefs
 Dysfunction of our cognitive systems
 Those with paranoid tendencies are particularly prone
to delusions of persecution
 Selective Attention
Disturbed Perceptions

 Hallucinations
 False perceptions
 Dysfunction of our perceptual systems
 Seeing, feeling, tasting, smelling things that are not
there
Inappropriate Emotions and Actions

 Emotions are split off from reality
 Laughing at funeral
 Cry when others laugh or anger for no apparent reason
 Others my become emotionless state of flat affect
 Motor behavior may also be inappropriate
 Senseless, compulsive acts such as continually rocking or
rubbing an arm
Onset and Development of
Schizophrenia

For some, it may appear suddenly
(reaction to stress)
Others, it may appear gradually
Social Inadequacy
 Socioeconomic levels
Onset and Development of
Schizophrenia

 Cluster of disorders
 Subtypes share common features
 Positive Symptoms:
 Hallucinations, talk in disorganized deluded ways and
exhibit inappropriate laughter, tears or rage
 Negative Symptoms:
 Toneless voices, expressionless faces or mute, and rigid
bodies
Positive and Negative

 Positive Symptoms refer to those that are in excessive or
in addition to normal behavior (outlandish)
 Negative Symptoms refer to those that are deficient or less
than normal behaviors (flat affect)
Onset and Development of
Schizophrenia

 When it is slow developing (chronic), recovery is
doubtful
 When developed rapidly (acute), recovery is much
more likely
Understand Schizophrenia

 Brain Abnormalities:
 Dopamine Overactivity
 Abnormal Brain Activity and Anatomy
 Multiple brain areas: Frontal lobes, decline of brain waves,
out-of-sync neurons, increased activity in amygdala, fluid
filled areas, shrinkage of cerebral tissue, smaller than
normal cortex, thalamus
 Maternal Virus during pregnancy
 Flus, viral disease, Hemisphere, season
 Genetic Factor
 Psychological Factor
Write about It

 Do you think the media accurately portrays the
behavior of people suffering from schizophrenia?
Why or why not?
 How do researchers believe that biological and
environmental factors interact in the onset of
schizophrenia?
Personality Disorder

Some dysfunctional behavior patterns impair
people’s social functioning without depression or
delusions
Personality Disorders:
 Psychological disorders characterized by
inflexible and enduring behavior patterns that
impair social functioning
Differences

Paranoid Personality Disorder and Schizoid
Personality Disorder are different from
schizophrenia only by a matter of degree. While
people with schizophrenia experience psychotic
episodes when they lose touch with reality, people
with these personality disorders do not have these
extreme experiences. Their behavior is odd, eccentric
and disturbing, but it does not impair daily life in
the way that schizophrenia does
Personality Disorders

 Clusters of personality disorders:
 One cluster of these disorders expresses anxiety, such as fearful
sensitivity to rejection that predisposes the withdraw avoidant
personality disorder
 Second cluster expresses eccentric behavior such as emotionless
disengagement of schizoid personality disorder
 Third cluster exhibits dramatic or impulsive behaviors, such as
attention-getting histrionic personality disorder and the selffocused and self-inflating narcissistic personality disorder
Antisocial Personality
Disorder

A personality disorder in which the person
(usually a man) exhibits a lack of conscience
for wrongdoing, even toward friends and
family members. May be aggressive and
ruthless or a clever con artist.
Antisocial Personality Disorder

 While all serial killers are antisocial, not all those with
antisocial disorder are serial killers.
 Harvey Cleckley identifies the following characteristics of
antisocial personality disorders:








Superficial charm and high intelligence
Poise, rationality, absence of neurotic anxiety
Lack of sense of personal responsibility
Untruthfulness, insincerity, callousness, manipulativeness
Antisocial behavior without regret or shame
Poor judgment and failure to learn from experience
Inability to establish lasting, close r/t with others
Lack of insight into personal motivations
Understanding Antisocial
Personality Disorder

 Genetic Influence:
 Andrian Raine (1999, 2005)
 Reduced activity in frontal lobes, an area in cortex that
helps control impulses
 11% less frontal lobe tissue than normal
 Respond less to facial displays of others’ distress
Rates of Psychological Disorders

 The U.S. National Institute of Mental Health
estimates 26% of adult Americans “suffer from a
diagnosable mental disorder in a given year”
 WHO:




US has highest rate
Immigrants have better than average mental health
Minority born in US are at a greater risk
Those at most risk: Poverty, cross ethnic and cross
gender lines
Critical Thinking

 Blue text psy book:
 P 485 1-4 (Min of 3 sentence responses for each)