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Abnormal Psychology
A.K.A. Psychological Disorders
A “harmful dysfunction” in which behavior is
judged to be atypical, disturbing,
maladaptive and unjustifiable.
Early Theories
• Abnormal behavior was evil
spirits trying to get out.
• Trephining was often used.
Perspectives and Disorders
Psychological School/Perspective
Psychoanalytic/Psychodynamic
Cause of the Disorder
Internal, unconscious drives
Humanistic
Failure to strive to one’s potential or
being out of touch with one’s feelings.
Behavioral
Reinforcement history, the
environment.
Cognitive
Irrational, dysfunctional thoughts or
ways of thinking.
Sociocultural
Biomedical/Neuroscience
Dysfunctional Society
Organic problems, biochemical
imbalances, genetic predispositions.
Criteria for Mental Illness
Statistical Infrequency
How observed behavior compares in frequency to that of others (rare in occurrence)
Deviation from the Norm
Doing the opposite of the majority of people in a given situation
Personal Distress
Person appears to be distress/reports distress
Impaired Functioning
Person struggles to operate in society/accomplish daily routines are tough
DSM IV
• 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.
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.
John Wayne Gacy
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 intense
apprehension, uneasiness,
uncertainty, or fear.
• 80% are females
• Most common mental illness
• Survey Activity
Phobias
• A person experiences
sudden episodes of
intense dread.
• Must be an irrational
fear.
• Phobia List
Generalized Anxiety Disorder
GAD
• An anxiety disorder in
which a person is
continuously tense,
apprehensive and in a
state of autonomic
nervous system arousal.
• The patient is constantly
tense and worried, feels
inadequate, is
oversensitive, can’t
concentrate and suffers
from insomnia.
Panic Disorder
• An anxiety disorder
marked by a minuteslong episode of
intense dread in which
a person experiences
terror and
accompanying chest
pain, choking and
other frightening
sensations.
Obsessive-compulsive disorder
• Persistent unwanted thoughts
(obsessions) cause someone to
feel the need (compulsion) to
engage in a particular action.
• Obsession about dirt and germs
may lead to compulsive hand
washing.
• https://www.youtube.com/watch
?v=LODLxY-KdfE
OCD- Obsessive Compulsive
Disorder
• Patient knows its illogical
• Very debilitating/consumes
life
• Contaminators
• Checker
• Counter
• Ritualizer
• Orderer
Hoarding disorder
• Intense need/desire for
objects associated with
intense fear of parting
with the possessions.
• https://www.youtube.c
om/watch?v=MzV4Vc
MG7nc
Body Dysmorphic Disorder
Intense pre-occupation with a perceived
defect on the body that is not
observable to others.
– Imagined ugliness
– Head specifically:
Hair/Nose/Lips/Eyes
– Patient may have
had/demanded
multiple corrective
surgeries!
Post-traumatic Stress Disorder
a.k.a. PTSD
• Following exposure to an
actual or threshold
traumatic event, person
experiences intense
feelings of fear and
distress days, weeks, or
months after the trauma.
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Natural disasters
Car accidents
Rape
Combat
Symptoms of PTSD
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Flashbacks
Nightmares
Insomnia
Depressed mood
Irritable/Angry
Hypervigilant/Increased startle
Alcohol dependence
Suicide risk
PBS ‘A Soldiers Heart’
In 2015 1.7 soldiers and veterans died
everyday of suicide
This is a very touching clip from a documentary.
Please take notes as you watch.
http://www.pbs.org/wgbh/pages/frontline/sho
ws/heart/view/
Somatoform/Somatic
Disorders
• Pathological concern
for ones body and
bodily functions,
usually in the
absence of any
identifiable medical
condition.
Somatic Symptom Disorder:
Hypochondriasis
• Has frequent
physical complaints
for which medical
doctors are unable
to locate the cause.
• They usually believe
that the minor
issues (headache,
upset stomach) are
indicative are more
severe illnesses.
Conversion Disorder
Pol Pot
• Report the existence of
severe physical problems
with no biological reason.
• People don’t know they’re
okay.
• Like blindness or paralysis.
• Seems to begin as a
response to periods of
intense stress
https://www.youtube.com/wa
tch?v=6Dye05tvSoo
Dissociative Disorders
• A group of disorders
that presents with
periods of profound
separation from the
self!... Not Psychotic
• Caused by intense
and repeated stress
Psychogenic(Dissociative) Amnesia
• A person will forget parts of
their past following a stressful
event.
– Localized: Unable to recall
details for a particular
event or brief period of
time.
– Generalized: Unable to
recall all details from a
person’s past.
– Continuous: Unable to recall
details from a specific event
forward to the present.
Dissociative Fugue
• People with
psychogenic amnesia
that find themselves
in an unfamiliar
environment.
Dissociative Identity Disorder
• Used to be known as
Multiple Personality
Disorder.
• Person will present with
2 or more clearly
distinct personas!
(Distinct handwriting,
speech, body language,
beliefs, even allergies…
smoking… addition…)
D.I.D
• Caused by:
– Women are 9x’s more likely to have this disorder!!
Severe and repeated sexual abuse as a child. Memories
repressed over time!
• Symptoms:
– May appear in childhood! Usually as a teen or early
adult! “Missing time”
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•
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Shift due to emotional stressor
Shift is a physical and emotional experience
Shift will last minutes… to WEEKS!
Personas are fragmented of the host… specific memories and
feelings from the past
D.I.D
• Alter personas
– Host- out the most! Presents in
therapy! Unaware of Alters
– Child- Most common. Age is
when abused
– Protector- Helper the Host. May
cut to give punishment to the
host
– Opposite gender- Male in female
– Persecutory- Kill the body!
Abuser
D.I.D
• Persona relations:
– Isolating: Host has no idea the Alters exist. Amnesia
when Alters are out
– Co-Conscious: Alters know of the Host and the other
Alters! Will talk to each other inside the Hosts mind.
Alters are always aware of the environmental
context.
• Treatment:
– Goal is to RE-INTERGRATE Host with all of its Alters!
Talk therapy… Journaling!
Mood Disorders
• A group of disorders that present with deep
and profound disturbances of one’s feelings
and emotional state.
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Affect more women then men
15 to 20% of society
Does seem to run in families
Drop in Serotonin for sure! Other chemicals
suspected
Major Depression
• A.K.A. unipolar
depression
• Unhappy for at least
two weeks with no
apparent cause.
• Depression is the
common cold of
psychological
disorders.
Depression: Low Mood Plus…
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Sleep (Insomnia/Hyposomnia)
Interest (Stop favorite activities)
Guilt/Very low self-esteem
Energy (Unmotivated)
Concentration (Very Poor)
Appetite (Weight gain/weight loss)
Psychomotor (Agitated/Lethargic)
Suicidal thoughts
Mania
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Very Impulsive
High-risk behavior
Feelings of Euphoria
Increased self-worth
Little sleep
Racing thoughts racing speech
Some psychosis
Bipolar Disorder
• Present with altering
states of depression (5
symptoms) and period of
mania (3 symptoms)
• Formally manic
depression.
– BPI: Classic case!
Depression and mania
– BPII: Depression and
hypo-mania!
– Treat with Lithium
Seasonal Affective Disorder
• Experience
depression during
the winter months.
• Based not on
temperature, but on
amount of sunlight.
• Treated with light
therapy.
Personality Disorders
• Long lasting and pervasive
trouble with one’s sense of
self/personality!
• Very controversial
• We share 5 main traits…
OCEAN
• Long term stress as a child
causes some traits to become
mal-adaptive and deviant in
their expression.
• They LEARNED to act this way
• Later they act this way in ALL situations and
with ALL people
• There are 3 clusters of Personality disorders
– Cynical and Irrational
– Dramatic and Erratic
– Tense and Over controlling
Cluster A: Cynical and Irrational
• Paranoid
• Schizoid
• Schizotypal
Paranoid Personality Disorder
• Paranoid personality
disorder is
characterized by a
distrust of others
and a constant
suspicion that people
around you have
sinister motives.
Paranoid Personality Disorder
• They search for hidden meanings in
everything and read hostile intentions into
the actions of others.
•They are quick to challenge the loyalties of
friends and loved ones and often appear cold
and distant to others. They usually shift
blame to others and tend to carry long
grudges.
Schizoid Personality Disorder
• People with schizoid
personality disorder
avoid relationships
and do not show
much emotion
They genuinely prefer to be alone and do
not secretly wish for popularity.
Schizoid Personality Disorder
• They tend to seek jobs that require
little social contact
Their social skills are often weak and they
do not show a need for attention or
acceptance
They are perceived as humorless and
distant and often are termed "loners."
Schizotypal Personality Disorder
• characterized by a need for social
isolation, odd behavior and thinking, and
often unconventional beliefs such as
being convinced of having extra sensory
abilities.
• Some people believe that schizotypal
personality disorder is a mild form of
schizophrenia.
Cluster B: Dramatic and Erratic
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Narcissistic
Antisocial
Histrionic
Borderline
Antisocial Personality Disorder
• Lack of empathy.
• Little regard for
other’s feelings.
• View the world as
hostile and look out
for themselves.
The Grinch- Antisocial Case Study
• https://www.youtube.c
om/watch?v=rEOmeLyF
brg&list=PL81C8C21394
E2A94D&index=6
Histrionic Personality Disorder
• Needs to be the
center of attention.
• Whether acting silly
or dressing
provocatively.
Borderline Personality Disorder
• characterized by mood instability and
poor self-image
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
Suicidal threats and actions
are not uncommon
They are quick to anger when their
expectations are not met.
Narcissistic Personality Disorder
• Having an
unwarranted sense
of self-importance.
• Thinking that you
are the center of
the universe.
Cluster C: Tense and Over Controlling
• Avoidant
• Dependent
• Compulsive
Avoidant personality disorder
• characterized by a pervasive pattern of
social inhibition, feelings of inadequacy,
and extreme sensitivity to negative
evaluation.
• consider themselves to be socially inept
or personally unappealing, and avoid
social interaction for fear of being
ridiculed or humiliated.
Dependent Personality Disorder
• Rely too much on the
attention and help of
others.
Obsessive –Compulsive
Personality Disorder
• Overly concerned
with certain
thoughts and
performing certain
behaviors.
• Not as extreme as
OCD anxiety.
Adrian Monk- Case Study
• https://www.youtube.c
om/watch?v=0s6fTrSnoI
w&list=PL81C8C21394E
2A94D&index=8
Schizophrenic Disorders
• A group of disorders in
which the patients
experience a profound
break from reality.
(Psychosis: A break
from Reality)
Stats
• About 1 in every 100 people are diagnosed
with schizophrenia.
• Onset is in the late teens to early 30’s!
• Disease is chronic! Death rate is higher due to
accidents and suicides.
Causes
• Genes: May have some susceptible to
Schizophrenia
• Stress: May help trigger the gene!! Research is
sketchy!
• Dopamine Hypothesis: People with
Schizophrenia have higher levels in their
brains; L-DOPA does cause symptoms similar
to Schizophrenia in people who take it for
prolonged period!
Symptoms of Schizophrenia
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•
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Delusions
Hallucinations
Negative Symptoms
Disorganized Speech
Abnormal Behavior
Disorganized Thinking
• The thinking of a
person with
Schizophrenia is
fragmented and
bizarre and distorted
with false beliefs.
• Disorganized thinking
comes from a
breakdown in selective
attention.- they
cannot filter out
information.
Delusions (false beliefs)
• Delusions of
Persecution
• Delusions of
Grandeur
Disturbed Perceptions
• hallucinationssensory experiences
without sensory
stimulation.
Inappropriate Emotions and
Actions
• Laugh at
inappropriate times.
• Flat Effect
• Senseless,
compulsive acts.
• Catatoniamotionless Waxy
Flexibility
Shock and Awe
Positive v. Negative Symptoms
Positive Symptoms
•Presence of
inappropriate symptoms
Negative Symptoms
•Absence of
appropriate ones.
Other Disorders
• Paraphilias
(pedophilia,
zoophilia,
hybristophilia)
• Fetishism
• sadist, masochist
• Eating Disorders
• Substance use
disorders
• ADHD
The Rosenhan Study
• Rosenhan’s associates
were Malingering
symptoms of hearing
voices.
• They were ALL admitted
for schizophrenia.
• None were exposed as
imposters.
• They all left diagnosed
with schizophrenia in
remission.
Therapy
• It used to be that if
someone exhibited
abnormal behavior,
they were
institutionalized.
• Because of new drugs
and better therapy,
the U.S. went to a
policy of
deinstitutionalization.
Psychoanalytic Therapy
• Psychoanalysis
(manifest and latent
content through….
hypnosis free
association, dream,
interpretation).
• Unconscious
• Transference
• Other therapies will
result in symptom
substitution.
Humanistic Therapy
• Client-Centered Therapy
by Carl Rogers
• These are non-directive
therapies and use active
listening.
• Self-actualization, freewill and unconditional
positive regard.
• Gestalt Therapy by Fritz
Perls encourage clients to
get in touch with whole
self.
Behavioral Therapies
Counterconditioning
• Classical Conditioning
1. Aversive Conditioning
2. Systematic
desensitization
3. Flooding
Operant Conditioning
• Token Economy
Cognitive Therapy
• Change the way we
view the world
(change our
schemas)
• Aaron Beck
• Albert Ellis and
Rational Emotive
Therapy
Somatic Therapies
Psychopharmacology
• Antipsychotics
(thorazine, haldol)
• Anti-anxiety (valium,
barbiturates, Xanax)
• Mood Disorders
(serotonin reuptake
inhibitors)
• Bipolar (lithium)
Somatic Therapy
• Electroconvulsive
Therapy (ECT)- for
depression.
• Psychosurgury
1. Prefontal lobotomy
Group Therapy
• Also called psychotherapy
or cognitive behavioral
therapy
• Helps with interpersonal
relationships
• Can be used for substance
abuse, anger
management, etc.