Download Abnormal Psychology

Abnormal Psychology and
Treatment
Calendar for this Unit
• Art or Music, and Mental Illness—Sign up for
your day—Week 1: Diagnose and Week 2: Treat
• Vocabulary—Chapter 16 Due Friday!
• Vocabulary—Chapter 17 Due Next Friday!
• Mental Illness and Treatment Role Play
– Groups of 3 (patient, therapist, narrator)
– 5 sources
– Have fun—props, puppets, drama, etc.
Q--What is normal?
Defining Abnormality
• 1/7 Americans and 1/10 Worldwide—Why?
• Is it an illness?
– Yes! Schizophrenia vs. Type 1 Diabetes
• DSM IV TR—Designed to diagnose—not treat!
• Abnormality
– Maladaptive
– Disturbing to others
– Atypical
– Irrational
Defining Abnormality
• Insanity is a legal term
• Causes of Abnormality—Mobile Survey/Notes
– Psychoanalytic
– Humanistic
– Behavioral
– Cognitive*
– Sociocultural
– Biomedical
– Eclectic*
Psychoanalytic
• Cause of mental illness--Internal, Unconscious
Conflicts mostly stemming from childhood
• Freud, Horney, Erikson, Adler, and Jung
Humanistic
• Cause of mental illness--Failure to strive
toward one’s potential— self actualization or
being out of touch with one’s true feelings
• Maslow and Rogers
Behavioral
• Cause of mental illness—reinforcement
history and the environment
• Skinner, Watson, and Bandura
Cognitive
• Cause of mental illness—irrational,
dysfunctional thoughts or maladaptive ways
of thinking
Sociocultural
• Cause of mental illness—Dysfunctional
society; not you but the society that you live
in
Biomedical
• Cause of mental illness—organic problems,
biochemical imbalances, genetic
predispositions
• Psychiatrists
Eclectic
• Clinical psychologists do not tend to subscribe
to just one perspective, but instead utilize
many and accept and use ideas from a
number of perspective
Sybil—Scenes 1,2,3
• What aspects of abnormality are
displayed?
• What perspective of mental illness best
explains Sybil’s problems?
Types of Disorders
•
•
•
•
•
•
•
Intern Syndrome????
Anxiety
Somatoform
Dissociative
Mood or Affective
Schizophrenic
Personality
Anxiety
Disorders
Simple or
Specific Phobia
Claustrophobia
Arachnophobia
Agoraphobia
Social Phobia
Anxiety Disorders
GAD
Panic Disorder
• Generalized Anxiety
Disorder
• Constant Low Level
Anxiety
• http://www.webmd.
com/video/generaliz
ed-anxiety-disorder
• Acute /Instense
Anxiety
ANXIETY
DISORDERS
OCD—Obsessive
Compulsive
Disorder
•Germs
•Medical Issues
•Symmetry
•Cleanliness
•Numbers
•And more!
Look at Checklist!
http://www.brainph
ysics.com/screener.p
hp
http://www.webmd.com/vid
eo/teen-with-ocd
ANXIETY DISORDERS
• PTSD—
• Post Traumatic Stress
Disorder
•Caused by trauma
from war, rape,
accidents, etc.
•Symptoms—
Flashbacks
Nightmares
Severe Anxiety
Drug Abuse
Causes of Anxiety
• Psychoanalytic—unresolved, internal conflicts
between ID, Ego, and Superego
– EX.—ID wishing to rid yourself of a bad parent and the
Superego saying that it is wrong to have such a wish
• Behaviorists—anxiety is learned
– EX.--classical conditioning of phobias
• Cognitive—dysfunctional, irrational thinking
– EX.—setting too high of standards for yourself
Sybil—Scenes 4,5,6
• What examples of anxiety did you see?
• If you were going to diagnose Sybil with an
anxiety disorder, what would it be?
• What is the most probable cause for Sybil’s
anxiety?
Somatoform
Disorders
Psychological
problem manifests
in a physical way
Somatization
Hypochondriasis
Conversion
Psychophysical
Munchausen
Munchausen by
Proxy
Causes of Somatoform
• Psychodynamic or psychoanalytic—unresolved
conflicts that cannot be resolved
• Behaviorists—have been reinforced for being
sick or for their behavior either through an
actual reward or the removal of something
unpleasant
• Cognitive—don’t know how to positively get
attention
Dissociative Disorders—disruption in
cognition
Psychogenic Amnesia
• No organic or
physical basis
• Selective, Localized,
Generalized
• Fugue
DID
• Dissociative Identity
Disorder
• AKA—multiple
personality disorder
Causes of Dissociative Disorders
• Psychoanalytic—extremely traumatic events
have been repressed and the split
consciousness results
• Behaviorists—patients find dissociating
rewarding because they don’t have to think
about the trauma. Amnesia is “easier” than
dealing with it
• Very rare and many question legitimacy
• E. Loftus would question it—why?
Sybil—Scene 7, 10, 11
• What signs of somatoform disorders did Sybil
and/or her mom show of a somatoform
disorder?
• What is the likely cause of the mother’s
somatoform behavior?
• What signs does Sybil show of DID?
• What is the likely cause of the disorder?
Mood or Affective Disorders
• Major Depression—aka:
Unipolar Depression
• DSM says you have to:
– depressed more than 2
weeks
– Absence of clear reason
– Loss of Appetite
– Fatigue
– Change in sleep
– Lack of interest
– Feelings of worthlessnes
• Seasonal Affective
Disorder--SAD
• Bipolar Depression—aka:
Manic-Depression
• Depressed episodes are
similar to major
depression
• Manic episodes
– High energy
– Heightened sense of
confidence & power
– Anxious/Irritable
– Risky Behavior
– Don’t think about negative
consequences
Causes of Mood Disorders
• Psychoanalysts –anger
directed inward, loss
during early stages,
overly punitive
superego
• Behaviorists—brings
some amount of
reinforcement such as
attention or sympathy
• Aaron Beck (cognitive)
caused by unreasonably
negative ideas about
themselves, world, and
future— Cognitive Triad
• Cognitive psychologists
would also look at
attributions—
pessimism, internal,
external, global, specific
Causes of Mood Disorders
• Martin Seligman—
Learned Helplessness
• Shocked Dogs
• Relate to humans?!?
– Unable to fix the
situation, so they give up
• Biological—
• low levels of serotonin
and or norepinephrine
and unipolar
• More receptors for
acetylcholine and
bipolar
• Genetic Component—
run in families
• Types of Schizophrenia
Schizophrenia
Most severe mental
illness
Disorder characterized
by:
Disturbed thoughts,
behaviors, movement
Hallucinations
Delusions—persecution
and grandeur
Disorganized thoughts
and speech—word
salad, clang associations
– Paranoid
• Delusions of persecution
– Disorganized
• Clang association (+ symp.)
• Neologisms (+ symp.)
• Innappropriate Affect
– Flat Affect (neg. symp.)
– Catatonic (negative symp.)
• Waxy flexibility (neg. symp.)
– Undifferentiated
• Disorganized thinking
Schizophrenia Simulator
• http://www.janssen.com/mindstorm_video.ht
ml
Causes of Schizophrenia
• Genetic—if a close family member has
schizophrenia, then you are more likely to
suffer—5th chromosome abnormality (bio)
– Twin Studies—Monozygotic vs. Dizygotic
• Dopamine Hypothesis—more dopamine (bio)
• Enlarged ventricles—takes away frontal lobe
development in late teen years, early 20s (bio)
• Double Bind parent??? (cognitive, sociocultural)
• Diathesis-Stress Model—environmental stressors
activate genetic predispositions (bio/)
• Drug use (bio)
Sybil—Scenes 19,20, 21
• What symptoms of depression does Sybil or
one of her personalities display?
• What is the cause of her depression?
• What symptoms of schizophrenia does Hattie
display?
• What do you think caused her schizophrenia?
Personality
Disorders
Histrionic
Paranoid
Dependent
Anti-social
Narcissistic—DSM?
Compulsive
Obsessive
Passive-Aggressive
Schizoid/Avoidant
Borderline
• Personality Disorders are
characterized by a
maladaptive way in
behaving that seems to be
imbedded in the
personality during
development
Causes of Personality Disorders
• Psychoanalytic—unresolved conflict between the
id and superego
• Behavioral—some maladaptive aspect of the
personality has been reinforced
• Sociocultural—dysfunctional society has caused
personality flaws
• Cognitive—maladaptive thinking cause
personality flaw
• Humanistic—personality flaw developed by
conflict between ideal self and real self
Other Mental Illnesses in the DSM-IV-TR
• Paraphillias—sexual disorders
– Pedophillia, zoophillia, fetish, voyeur, masochist,
sadist
• Anorexia-Nervosa and Bulemia
– Loss of 15% of body mass, fear of food, distorted body
image
• Substance Use Disorder—
– Substance dependence—addiction
• ADHD???
– Overdiagnosed
• Autism
– Less social and emotional contact, language delayed,
and don’t seek parent assistance
Sybil—Scenes 26, 27, 28
• Does Sybil suffer from any personality
disorders? If so, why do you think she
developed it?
• Does her dad seem to suffer from a
personality disorder? If so, why do you think it
developed?
Caution!!!!!!!!
• Is it a good idea to label people as depressed
or as a hypochondriac? Is there really a
benefit to giving a person a label?
• Rosenhan—Who’s Crazy Here Anyway?
– Discuss with a neighbor what Rosenhan concluded
and what info we can take from his study!
– Clinical Psychologists more likely to label—
Counseling Psychologists not so much!
History of Treatment
•
•
•
•
Trephining
Enlightenment—Dorothea Dix
Deinstitutionalization
Preventative Efforts
– Primary—reduce socieatal problems
– Secondary—work with at risk persons
– Tertiary—keep mental illness from getting worse
• Finish Sybil—29, 31
Treatment Options
Psychoanalytic
Humanistic
Behavioral
Cognitive*
Sociocultural
Biomedical
Eclectic*
• What type of therapy do
you think Dr. Wilbur uses
with Sybil?
• Do you think it was
ethical/appropriate for Dr.
Wilbur to get so close to
Sybil?
http://abcnews.go.com/GMA/video/charlie-sheennot-bipolar-bi-winning-13017875
Patient: Charlie Sheen
Diagnosis:______________
Treatment Proposal:_____________________
http://abcnews.go.com/GMA/video/lindsay-lohanspeaks-out-13026910
Patient: Lindsay Lohan
Diagnosis: ___________________
Treatment Proposal:____________________
Patient: Marshall Bruce Mathers III aka
Eminem, Slim Shady
Diagnosis:____________
Treatment Proposal:____________
Psychoanalytic
• Must bring repressed
memories and conflict
with id/superego to the
surface so ego and
conscious can deal with
it.
• If you do the work, you
won’t have symptom
substitution
• Hypnosis
• Free Association
– Role play!
• Dream Analysis
– Manifest vs. Latent
• Resistance
• Transference
– Countertransference
• Dr. Wilbur—Example
• Psychodynamic--Insight
Humanistic
• Must help CLIENT
remove roadblocks to
self actualization and
resolve incongruence
between real self and
ideal self in a nondirective way
• Need for unconditional
positive regard
• Carl Rogers—I’m OK,
You’re OK
• Active Listening
– Role Play!
• Free Will vs.
Determinism
• Client Centered or
Person Centered
Therapy
• Modeling Congruence
Other Types of Humanist Therapies
• Existential Therapy
– Life is worthwhile
– Has purpose
– Don’t Worry, Be Happy!
• Gestalt Therapy
–
–
–
–
–
Much more directive
Empty Chair Technique
WHOLE selves
Integrate self into one
Who would be in your
empty chair and what
would you say to them?
Behavioral
• Must counter condition
the patient in a more
adaptive way
• Mary Cover Jones—
Counter Conditioning
• Joseph Wolpe—
Systematic
Desentization
– Relaxation
• Flooding
– In vivo vs. Convert
– Extinguishing Fear
• Aversive Conditioning
• Token Economy
• Biofeedback
Anxiety Hierarchy—Systematic
Desensitization
• in vivo vs. covert
desensitization
Most
Anxiety
Provoking
Least Anxiety Provoking
Cognitive
• Must fix maladaptive
thinking in a directive way
• Fix unhealthy
attributional styles and
replace it with more
effective attributions
• Aaron Beck—Cognitive
Therapy—Cognitive Triad
• Cognitive Behavioral
Therapy or CBT
• Rational Emotive
Behavioral Therapy or
RBET
• Albert Ellis
Role Play with someone in
class to get rid of an
irrational belief they
have!
Sociocultural
• Most help patient by
fixing his/her
environment—ie—
family, friends,
workplace, etc.
• YOU don’t exist in a
vacuum
•
•
•
•
•
Family Therapy
Couples Counseling
Group Therapy
AA/NA
Self Help Groups
Biological or Somatic Therapies
• Treating mental illness
from a biological
approach like you
would any illness
• Psychiatrists
• Family MDs
• Other MDs
• NOT typically
Psychologists
• Medicine
• Psychosurgery
– Lesioning vs. Lobotomy
• Diet/Exercise
• ECT/Shock Therapy
Psychopharmacology or
Chemotherapy
– Anti Depressants—
increase serotonin
activity
• Tricyclics
• MAOIs
• SSRIs
– Prozac
– Anti Anxiety
• Barbiturates
– Miltown
• Benzodiazapines
– Valium and Xanax
Mood Stabilizers—
Lithium—Heavy Metal
Treat Bipolar
Anti Psychotics-Schizophrenia
• Thorazine
• Haldol
– Side Effects:
» Tardive
Dyskenia
A Beautiful Mind
• Insulin Shock Therapy Scene—Scene 15
Eclectic
• Using a variety of
• Write here!
approaches to help your
patient/client
• What combo would you
prefer to use?
Types of Therapists
• Psychiatrists—MD
– Only therapist type that
can prescribe medicine
– Favor biomedical and
not as well trained in
psychotherapy
• Psychoanalysts
– Freudian Methods
• Clinical Psychologists
– PhDs--Diagnose
• Counseling
Psychologists
– Masters in Family
Therapy--JEFF
– Deal with less serious
issues
How Effective is Therapy???
Very Effective
Not Very Effective
Outdated studies indicate that 66% of people get better with
therapy or without therapy! However, new research indicates
that even if people who get better are not seeking formal
counseling, they are seeking therapy in less formal ways!
Schizophrenia FRQ—Stand Up Review!
• Often misunderstood, schizophrenia is a psychological
disorder affecting one percent of the population. In
treating the disorder, psychologists work to identify its
nature and origins.
– Identitify two characteristics used to diagnose
schizophrenia
– Discuss a research finding that supports a genetic basis for
schizophrenia
– What is the dopamine hypothesis regarding the origins of
schizophrenia?
– Describe how medications used to treat schizophrenia
affect the actions of neurotransmitters at the synapse.
– Identify a risk inherent in the treatment of schizophrenia.
– People often times confuse schizophrenia with DID
(Dissociative Identity Disorder). Identify two characteristics
that differeniate DID from Schizophrenia.