Download Neurodevelopmental disorders

Abnormal Behavior
or
Psychological
Disorders
Content as per College Board
Abnormal Behavior 7-9 %
What is Normal?
In a small group of 3-5
students, determine what
you would call “normal”
Not who, what is normal?
What is well-being?
 In this same group, identify what is
psychological order or well-being.
 Is it just an absence of a disorder?
 Is it more like that which makes a
person healthy?
 List 3-5 characteristics that make a
person have “well-being”
Well being
 Self acceptance
 Positive relations with others
 Autonomy
 Environmental mastery
 Purpose in life
 Personal growth
 Carol Ryff
 Myers’ Teachers Guide
What is a disorder?
 There is no one absolute definition of
psychological disorders
 A continuum exists between mental
health and pathology
 Some proposed definitions may
include: (from sample textbooks)
 A psychological disorder can be defined as a
pattern of behaviors or psychological symptoms
that cause significant personal distress and/or
impairs the ability to function in one or more
important areas of life.
 A syndrome marked by a clinically significant
disturbance in an individual’s cognition, emotion
regulation or behavior. (adapted from American
Psychiatric Association, 2013)
From the DSM 5
 A mental disorder is a syndrome characterized by
clinically significant disturbance in an individual’s
cognition, emotion regulation, or behavior that reflects
a dysfunction in the psychological, biological or
developmental processes underlying mental
functioning.
 Mental disorders are usually associated with
significant distress or disability in social, occupational,
or other important activities.
 2013
From the DSM 5
 An expectable or culturally approved response to a
common stressor or loss, such as the death of a loved
one, is not a mental disorder.
 Socially deviant behavior (e.g., political, religious or
sexual) and conflicts that are primarily between the
individual and society are not mental disorders unless
the deviance or conflict results from dysfunction in the
individual, as described above.
 2013
NOTE:
 Sanity and Insanity are legal definitions
 A person accused of a crime can acknowledge
that they committed the crime, but argue that
they are not responsible for it because of their
mental illness, by pleading "not guilty by
reason of insanity.”
Just FYI. . .
 Although a defense known as "diminished capacity"
bears some resemblance to the "reason of insanity"
defense (in that both examine the mental competence
of the defendant), there are important differences. The
most fundamental of these is that, while "reason of
insanity" is a full defense to a crime -- that is, pleading
"reason of insanity" is the equivalent of pleading "not
guilty" -- "diminished capacity" is merely pleading to a
lesser crime.
 One of the most famous recent uses of the insanity
defense came in United States v. Hinckley, concerning
the assassination attempt against then-President
Ronald Reagan.
Also, FYI. . .
The history of "not guilty by reason of insanity"
The insanity defense reflects a compromise on the part of society
and the law. On the one hand, society believes that criminals should
be punished for their crimes; on the other hand, society believes that
people who are ill should receive treatment for their illness. The
insanity defense is the compromise: basically, it reflects society's
belief that the law should not punish defendants who are mentally
incapable of controlling their conduct.
In the 18th century, the legal standards for the insanity defense were
varied. Some courts looked to whether the defendant could
distinguish between good and evil, while others asked whether the
defendant "did not know what he did." By the 19th century, it was
generally accepted that insanity was a question of fact, which was left
to the jury to decide.
The M'Naghten rule -- not knowing right
from wrong
The first famous legal test for insanity came in 1843, in the M'Naghten case.
Englishman Daniel M'Naghten shot and killed the secretary of the British Prime
Minister, believing that the Prime Minister was conspiring against him. The court
acquitted M'Naghten "by reason of insanity," and he was placed in a mental institution
for the rest of his life. However, the case caused a public uproar, and Queen Victoria
ordered the court to develop a stricter test for insanity.
The "M'Naghten rule" was a standard to be applied by the jury, after hearing medical
testimony from prosecution and defense experts. The rule created a presumption of
sanity, unless the defense proved "at the time of committing the act, the accused was
laboring under such a defect of reason, from disease of the mind, as not to know the
nature and quality of the act he was doing or, if he did know it, that he did not know
what he was doing was wrong."
The M'Naghten rule became the standard for insanity in the United States and the
United Kingdom, and is still the standard for insanity in almost half of the states.
In your small group,
 Review and discuss the provided assignment, “What is
Disordered Behavior?”
 Record your thoughts upon discussion with group
members.
 Turn in a copy for each group member.
 We will discuss this in 5-7 minutes.
Who suffers from disorders?
 Diathesis-Stress Model-The diathesis, or
predisposition, interacts with the subsequent stress
response of an individual.
 Stress refers to a life event or series of events that
disrupt a person’s psychological equilibrium and
potentially serves as a catalyst to the development of
a disorder.
 Sometimes referred to as the stress-vulnerability
model- explanation of disorder that assumes a
biological sensitivity (vulnerability) to a certain
disorder will result in the development of that
disorder under the right conditions of environmental
or emotional stress
Historical Perspectives on
Abnormal Behavior
 The ancient world
 Greece
 Hippocrates- (460-377 BCE) believed that mental
illness was the result of natural, as opposed to
supernatural causes
 Galen – (130-200 BCE) divided the causes of mental
disorders into physical and psychological causes
 China
 Chung Ching- (200CE) stated that both organ
pathologies and stressful psychological events were
causes of mental disorders
The Middle Ages (5001500 CE)
 Europe- abnormal behavior was viewed
as a demonic possession. Treatment
might include prayer, laying on of hands
and/or exorcism performed by the
clergy. Possibly witch hunts?
 Islamic Countries-known for humane
hospitals for mentally ill (Baghdad 792
CE).
The Renaissance- brings reemergence of
the scientific approach to mental illness
 Teresa of Avila (1515-1582 CE) a
Spanish nun established a conceptual
framework that suggests the mind can be
sick
 Johann Weyer (1515-1588 CE) of
Germany used scientific skepticism to
refute the concept of demonic
possession
Humanitarian Reforms
th
of 18th-19 centuries
 Philippe Pinel (France)-pioneered compassionate
medical model for the treatment of the mentally ill
 William Tuke (England)- introduced trained nurses for
the mentally ill
 Benjamin Rush (United States) founder of American
psychiatry and established hospitals for the mentally ill
 Dorothea Dix (United States) advocated for reforms to
allow for humane treatment of mentally ill in
institutional settings
Deinstitutionalization
 Occurred due to scientific advances of
the 20th century
 Psychopharmacology
 Medical advances including imaging
devices (CT, MRI, PET)
 Release of patients back into their usual
community using out- patient care

Historical perspective from: TOPSS Unit Lesson Plan
Modes or Perspectives of
Psychological Disorders
Psychological Models
 Psychodynamic
(Psychoanalytic)explains disordered
behavior as the result of
repressing one’s
threatening thoughts,
memories, concerns in
the unconscious mind
 Sigmund Freud
 Carl Jung
 Alfred Adler
 Erik Erikson
The Biopsychological
Perspective
 Emphasizes that mental
illness should be
diagnosed on the basis
of its symptoms and
cured through medical
intervention
 Relates to genetic
predisposition,
abnormalities in brain
structure and
biochemistry
 Medical Doctors (M.D.)
The Behavioral Model
 Learning perspective
emphasizes
inappropriate behaviors
might have been
reinforced and thus
reoccurred
 Observational learning
and modeling may play
a role
 John B. Watson
 B. F. Skinner
 Albert Bandura
The Cognitive Model
 Emphasizes the
irrational, illogical
and/or maladaptive
thought process or
thinking patterns
 Aaron Beck
 Albert Ellis
The Biopsychosocial
Model

Biological, psychological
(psychodynamic, behaviorist
and cognitive) and
sociocultural influences
interact to cause the various
forms of disorders
 This view has become an
influential way to view the
connection between mind
and body
Ciccarelli and White, AP Edition
Psychology
TOPSS Unit Lesson Plan
Others?
Evolutionary?
Social Cultural?
The DSM-5
The fifth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-5) was published in May 2013 with revisions to the
criteria for the diagnosis and classifications of mental disorders. In
the interest of fairness and to allow time for publishers to integrate
such changes into pertinent sections of AP Psychology textbooks,
the College Board has made the following decisions regarding
upcoming AP Psychology Exams:
Beginning with the 2015 AP Psychology Exam, all terminology,
criteria and classifications referred to among multiple-choice and
free-response items will adhere to the new fifth edition of the
Diagnostic and Statistical Manual (DSM-5).
The DSM-5
 Published by the American
Psychiatric Association
 Widely used diagnostic
system for the United States
 Provides a set of criteria to
make assessments
 International Classification
of Diseases (ICD)
 ICD published by World
Health Organization
DSM 5 has removed the multiaxial system
 Axes I, II and III are all
listed on a single axis
which includes all mental
disorders as well as
personality disorders and
intellectual disabilities as
well as other medical
diagnosis
 Reference: APA, FRQ
about DSM-5
 Axis V (Global
Assessment of
Functioning) was used to
determine medical
necessity for treatment.
 A single GAF score may
not convey information to
adequately assess
functioning.
 Section III of DSM
provides separate
assessments for severity
and disability in regard to
functioning
Consequences of labeling
Refer to the Rosenhan Study
 Positive:
 Negative:
Specific
Diagnostic
Categories
Neurodevelopmental
Disorders
Neurodevelopmental
Disorders
 Neurodevelopmental disorders are impairments of
the growth and development of the brain or central
nervous system. A narrower use of the term refers to
a disorder of brain function that affects emotion,
learning ability, self-control and memory and that
unfolds as the individual grows.
 Neurodevelopmental disorders are associated with
widely varying degrees of difficulty which may have
significant mental, emotional, physical, and economic
consequences for individuals, and in turn their families
and society in general.
Neurodevelopmental
Disorders
 Intellectual disabilities
 Intellectual Disabilities:
 Diagnostic criteria for intellectual disability emphasize the
need for an assessment of both cognitive capacity (IQ)
and adaptive functioning
 The term “mental retardation” was used in the DSM IV,
however, intellectual disability has become more
commonly used in the past two decades
 Global Developmental Development Delay:
 Language Disorder:
 Speech Sound Disorder:
 Social Communication Disorder (combines expressive
and mixed receptive – expressive language disorders):
Neurodevelopment
Disorders
 Autism Spectrum Disorder:
 This is new to the DSM 5 and reflect scientific
consensus four previously separate disorders are
actually a single condition
 ASD is characterized by 1) deficits in social
communication and social interaction and 2) restricted
repetitive behaviors, interest and activities
Neurodevelopmental
Disorders
 Attention-Deficit/Hyperactivity Disorder (ADHD):
 This was added to the neurodevelopmental disorders
chapter to reflect brain development correlates with
ADHD and the DSM 5 elimination of diagnosis of
those first made in infancy, childhood or adolescence
 DSM 5 uses the same 18 symptoms used in DSM-4 and
continues to be divided into two symptoms domains
(inattention and hyperactivity/impulsivity)
Neurodevelopmental
Disorders
 Specific Learning Disorders:
 This combines the diagnosis of reading, mathematics
disorders and disorder of written expression
Motor Disorders:
Developmental Coordination Disorder
Stereotypic Movement Disorder
Tic Disorders
Tourette’s Disorder
Persistent (Chronic) Motor or Vocal Tic Disorder
Provisional Tic Disorder
Neurocognitive
Disorders
Neurocognitive Disorders
 The criteria for these disorders are based on defined
cognitive domains
 The domains as defined by the DSM 5 along with
guidelines for clinical thresholds, form the basis on
which neurocognitive disorders are diagnosed
 Cognitive domains:
 Complex attention
 Executive function
Cognitive Domains
 Complex attention (sustained, divided, selective attention,
processing speed)
 Executive Function (planning, decision making, working
memory, responding to feedback, error correcting)
 Learning and memory( immediate, short term, long term
memory)
 Language (expressive and receptive)
 Perceptual –motor (visual perceptive, perceptual motor)
 Social Cognitive (recognition of emotion, theory of mind)
Examples (but not
limited to)
 Delirium
 Alzheimer’s disease
 Traumatic brain injury
 Substance/medication use
 HIV infection
 Parkinson’s disease
 Huntington’s disease
Schizophrenia
Spectrum and
Other Psychotic
Disorders
Schizophrenic Disorders
 A psychological disorder characterized by delusions,
hallucination, disorganized speech and/or diminished
or inappropriate emotional expression
 Literally translated, schizophrenia means “split
mind,” as in split from reality
 Myers’ Psychology for AP
Schizophrenia Spectrum and Other
Psychotic Disorders
 In the DSM 5, two Criterion A symptoms are required
for any diagnosis of schizophrenia
 Delusions
 Hallucinations
 Disorganized speech
 (At least one of these positive symptoms is necessary
for a reliable diagnosis)
 Grossly disorganized or catatonic behavior
 Negative symptoms (diminished emotional behavior)
 Simulated Schizophrenia:
https://www.youtube.com/watch?v=dkB2CGL769o
Schizophrenia subtypes
 Subtypes of schizophrenia have been eliminated
(paranoid, disorganized, catatonic, undifferentiated and
residual)
https://www.youtube.com/watch?v=48YJMOcykvc
 DSM 5 includes in this category:
 Schizotypal (Personality) Disorder
 Delusional Disorder
 Brief Psychotic Disorder
 Schizophrenia
 Schizoaffective Disorder
Bipolar and
Related
Disorders
Bipolar Disorder
 A mood disorder in which a person alternates between
the hopelessness and lethargy of depression and the
overexcited state of mania
 Long ago referred to as manic - depression
Bipolar and Related
Disorder

Bipolar I Disorder – for a diagnosis, it is necessary to meet the following
criteria for a manic episode. The manic episode may have been preceded
by and may be followed by hypomanic or depressive episode

During the period of mood disturbance and increased activity, three (or
more) of the following are present (representing a change from usual
behavior)

Inflated self-esteem or grandiosity

Decreased need for sleep

More talkative

Flight of ideas

Distractibility

Increased in goal directed activity or psychomotor agitation

Excessive involvement in activities that might have painful
consequences
Bipolar Disorders

The major depressive episode includes five or more of the
following symptoms

Depressed mood for most of the day

Marked diminished interest or pleasure in all (or almost all)
activities

Significant weight loss or weight gain

Insomnia or hypersomnia

Psychomotor agitation or retardation

Fatigue or loss of energy

Feeling of worthlessness or excessive or inappropriate guilt

Diminished ability to think or concentrate

Recurrent thoughts of death or suicide ideation
Bipolar Disorders
 Bipolar II- a categorization for individuals with a past
history of a major depressive disorder who meet all of
the criteria for hypomania except duration
 Cyclothymic disorder-disorder that has too few
symptoms of hypomania to meet the full criteria
Depressive
Disorders
Depressive Disorders
 A mood disorder in which a person experiences, in the
absence of drugs or another medical condition, two or
more weeks of five or more symptoms, at least one of
which must be either 1) depressed mood or 2) loss of
interest or pleasure.
 Myers’ Psychology for AP
Diagnosis Of Depression
 The DSM 5 classifies major depressive disorder as the
presence of at least five of the following symptoms
over a two-week period.
 Symptoms must cause near daily distress or
impairment and not be attributed to substance use or
another medical or mental illness
 Myers’ Psychology for AP
Signs

Depressed mood most of the day

Markedly diminished interest or pleasure in activities most of the day

Significant weight loss or gain when not dieting, or significant decrease or
increase in appetite

Insomnia or sleeping too much

Physical agitation or lethargy

Fatigue or loss of energy

Feeling worthless or excessive or inappropriate guilt

Problems in thinking, concentrating or making decisions

Recurrent thoughts of death and suicide
Included in the category of
Depressive Disorders
 Disruptive Mood Dysregulation Disorder
 Major Depressive Disorder, Single and Recurrent
Episodes
 Persistent Depressive Disorder (Dysthymia)
Anxiety Disorders
Anxiety Disorders
 Psychological disorders characterized by distressing,
persistent anxiety or maladaptive behaviors that
reduce anxiety
 Myers’ Psychology for AP
Specific Anxiety Disorders
 Panic Disorder- Recurrent and unexpected
panic attacks are severe and involve feelings
of terror and physiological involvement.
 Generalized Anxiety Disorder- characterized
by persistent high levels of anxiety and
excessive worry with symptoms present for
at least 6 months; more persistent than panic
disorder
Specific Anxiety Disorders
 Phobia – a persistent, unrealistic, irrational fear of specific
objects or situations. Exposure to a feared stimulus produces
intense panic or fear, anxiety dissipates when the phobic
situation is not confronted
 No longer is there a requirement that individual over the age is
18 recognize that their anxiety is excessive or unreasonable
 Duration of symptoms to 6 month is extended to all ages
 Examples:
 Specific phobias
 Agoraphobia
 Social Anxiety Disorder (Social Phobia)
Other Examples
 Separation Anxiety Disorder- previously classified as
a developmental disorder, in DSM 5, classified as an
anxiety disorder. The DSM 5 indicates a possibility of
adult onset, with an added duration criterion as
“typically lasting for 6 months or more.”
 Selective Mutism- previously classified as a
developmental disorder, now it is classified as an
anxiety disorder given that a large majority of children
with selective mutism are anxious.
 Highlights of Changes from DSM IV TR to DSM 5
Changed from DSM IV
to DSM 5
 Classified separately in the DSM 5
 Obsessive Compulsive Disorder
 Posttraumatic Stress Disorder
ObsessiveCompulsive and
Related
Disorders
Obsessive-Compulsive
Disorder
 A disorder characterized by unwanted repetitive thoughts
(obsessions) and/or actions (compulsions)
 Reported obsessions: concerns are dirt, germs, toxins,
something terrible happening (fire, death, illness),
symmetry, order or exactness
 Reported compulsions: excessive hand washing, bathing,
tooth brushing, grooming, repeated rituals, checking doors,
locks, appliances, car brakes, homework)
 These thoughts cross the line between normality and
abnormality when they persistently interfere with our
daily living and cause distress
 Myers’ Psychology for AP
Obsessive-Compulsive
and Related Disorders
 Obsessive-Compulsive Disorders
 Body Dysmorphic Disorder
 Hoarding Disorder
 Trichotillomania (Hair-pulling disorder)
 Excoriation (Skin Picking) Disorder
https://app.discoveryeducation.com/learn/videos/18
71337F-EF55-4D19-A74B1C8863FCB873?hasLocalHost=false
Trauma and
Stressor Related
Disorders
 Trauma and stressor-related disorders include
disorders in which exposure to a traumatic or stressful
event is listed explicitly as a diagnostic criterion.
 These include:
 Reactive Attachment Disorder
 Disinhibited Social Engagement Disorder
Posttraumatic Stress Disorder (PTSD)
Acute Stress Disorder
 Adjustment Disorders.
PTSD
 A disorder characterized by haunting memories,
nightmares, social withdrawal, jumpy anxiety,
numbness of feeling and/or insomnia that linger for
four weeks or more after a traumatic experience
 Symptoms have been reported by survivors of
accidents, disasters, violent sexual assault, terrorist
attacks, natural disasters, war and the like.
 https://app.discoveryeducation.com/learn/videos/97
5FADD8-5074-4F72-8EFBA12C7E1CEAE8?hasLocalHost=false
Somatic
Symptom and
Related
Disorders
Somatic Symptom and Related
Disorders Disorders
 Somatic symptom disorder and other disorders with
prominent somatic symptoms constitute a new category in
DSM-5.
 A psychological disorder in which the symptoms take on a
somatic (bodily) form without apparent physical cause
 Myers’ Psychology for AP
 All of the disorders in this area share a common feature:
the prominence of somatic symptoms associated with
significant distress and impairment.
 DSM 5 Library
Examples
 Somatic Symptom Disorder (A psychological
disorder in which the symptoms take on a somatic
(bodily) form without apparent physical cause)
 Illness Anxiety Disorder (Hypochondriasis has been
eliminated as a disorder)
 Conversion Disorder (a disorder in which a person
experiences very specific genuine physical symptoms
for which no physiological basis can be found)
 Factitious Disorder (Previously Munchausen
Syndrome)
 Myers’ Psychology for AP
Dissociative Disorders
Dissociative Disorders
 Disorders in which conscious awareness
becomes separated (dissociated) from
previous memories, thoughts and
feelings
Dissociative Disorders
 Dissociative amnesia- involves partial or total loss of
important personal information (memory) that may
occur after a stressful or psychologically traumatic
event. There is no organic cause.
 Dissociative fugue has been eliminated from DSM 5
Dissociative Disorders
 Depersonalization/Derealization Disorder- most
common dissociative disorder that is characterized
by feeling of unreality concerning the self and the
environment. Characterized by intensity of
symptoms and anxiety provoked by symptoms
 Dissociative Identity Disorder (DID)- formerly
called Multiple Personality Disorder.
2 or more distinct personalities that alternately control
the person’s behaveor with memory impairment.
https://www.youtube.com/watch?v=YXuG2zI39yA
Feeding and
Eating Disorders
Feeding and Eating
Disorders
 Feeding and eating disorders are characterized
by a persistent disturbance of eating or eatingrelated behavior that results in the altered
consumption or absorption of food and that
significantly impairs physical health or
psychosocial functioning.
Feeding and Eating
Disorders
 Pica -persistent eating of nonnutritive, nonfood
substances over a period of one month, no age
restriction
 Rumination Disorder - repeated regurgitation of food
over a period of at least 1 month. Food may be rechewed, re-swallowed or spit out
 Avoidant/Restrictive Food Intake Disorder – a
disturbance as manifested by persistent failure to meet
appropriate nutritional and/or energy needs
 DSM 5

Feeding and Eating
Disorders
Anorexia Nervosa – an eating disorder in which a person
(usually an adolescent female) maintains a starvation diet
despite being significantly (15% or more) underweight
 Bulimia Nervosa – an eating disorder in which a person
alternates binge eating (usually high calorie foods) with
purging (by vomiting or laxative use), excessive exercising
or fasting
 Binge Eating Disorder – significant binge-eating episodes,
following distress, disgust or guilt but without
compensatory purging or fasting that marks bulimia
nervosa
 Myers’ Psychology for AP
Personality Disorders
Personality Disorders
 Characterized by long standing, chronic, inflexible,
maladaptive patterns of perception, thought and
behavior that seriously impair an individual’s ability
for function personally or socially
 Usually recognized by the time a person reaches
adolescence
 As a group, these disorders are among the least
reliably judged
Clusters
 Cluster A: Paranoid, Schizoid and Schizotypal (Odd
or Eccentric Behaviors)
 Cluster B: Antisocial, Borderline, Histrionic and
Narcissistic (Dramatic or Erratic Behaviors)
 Cluster C: Obsessive-Compulsive, Avoidant and
Dependent (Anxious or Fearful Behaviors)
Personality Disorders
 Narcissistic personality disorder- marked by a
grandiose sense of self-importance and
preoccupation with fantasies of success or power.
Individual is in constant need of attention or
admiration and has inappropriate reactions to
criticism
Personality Disorders
 Antisocial personality disorder – marked by long
standing pattern of irresponsible behavior that hurts
others without causing feelings of guilt or remorse
 Individual does not experience shame or intense
emotion of any kind.
 Violation of social norms, may include criminal acts
 Some studies detect early signs of antisocial
behavior in children as young as 3-6 years old
The Big Picture: Perspectives in Studying
Personality, Abnormal Behaviors and Treatment

Draw a graphic of your choosing (flower, fish, balloons, whatever)

Somewhere on your graphic, identify, define and list names associated
with the 6 current perspectives in psychology (listed below)

behavioral, biological, cognitive, evolutionary, humanistic,
psychodynamic/psychoanalytic

Predict how each perspective would explain development of personality.

Analyze (Predict) how each perspective would explain the development of
a disordered behavior.

Evaluate a list of major treatment orientations for each perspective used in
therapy.

Note To Teacher: This may be a preview or review of content.
Suggested Activities
Student Project: Encounters with the Mentally Ill
Multimedia Project for the Introduction of Psychological Disorders
Movies and Mental Illness
Your Suggestions?
From the Office of Teaching Resources in Psychology
(OTRP)
APA Div. 2
Society for the Teaching of Psychology
Films Illustrating Psychopathology OTRP Danny
Wedding
Using Film to Teach Psychology Elizabeth M. Nelson