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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. – – – – Natural disasters Car accidents Rape Combat Symptoms of PTSD • • • • • • • • 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” • • • • 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. – – – – 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… • • • • • • • • 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 • • • • • • • 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 • • • • 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 • • • • • 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.