Download Abnormal psychology slides

Abnormal Behavior *
A psychological disorder,
causing distress, disability, or
dysfunction. Defined
symptomatically by the DSM.
Biopsychosocial Model *
Key
concept is
Interaction.
biological factors
• come from the body
• e.g., genes;
neurotransmitters
social factors
• come from
society and
culture
• e.g.,
socioeconomic
status,
homelessness,
abuse
psychological
factors
• come from the
individual
• e.g., patterns of
negative
thinking; stress
responses
Statistics on Disorders
•
•
•
•
•
•
•
•
•
1 in 4 affected each year
Each year prevalence: 18.1% anxiety disorders;
1% schizophrenia; 4.4% alcohol use disorder
More lower SES
Mentally ill stigmatized
Many disorders comorbid.
Comorbid = more than one disorder at a time
Most severe disorders in a small group of people
6% of population have 3 or more disorders
DSM *
•
•
•
•
Diagnostic and Statistical Manual
American Psychiatric Association
Currently DSM-5
Common language and standard criteria
for classifying mental disorders
•
•
•
•
Controversies include:
Cultural bias (e.g. sexual disorders)
Medical rather than behavioral model
Diagnosing, e.g. ADHD, autism.
Diagnosing Disorder: The DSM
• The DSM
organizes
disorders by
category. Within
a diagnostic
category,
clinicians may
also identify
specifiers and
rate severity.
Categories of Disorders include:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Obsessive Compulsive and Related Disorders
Neurodevelopmental Disorders
Dissociative disorders
Substance Related and Addictive Disorders
Depressive Disorders
Bipolar and related disorders
Schizophrenia spectrum and other psychotic disorders
Anxiety Disorders
Somatic Symptom and Related Disorders
Trauma and Stressor-Related Disorders
Feeding and Eating Disorders
Sexual Dysfunction
Personality Disorders
Autism Spectrum Disorders
Neurocognitive Disorders
Anxiety Disorders
• Anxiety – irrational fear, dread, or
agitation; physiological arousal
• 1. Phobias: unreasonable fear; avoidance
•
a. Specific phobia – clearly defined
object or situation, e.g. dogs
•
b. Social phobia – extreme shyness
or discomfort in social situations
• 2. Panic Disorder *
•
Sudden attacks of terror leading to
behavioral changes & physical symptoms
Phobias
• An anxiety disorder characterized by intense fear of specific situations or
objects.
• The individual knows the fear is irrational.
• Common phobias include animals, heights, closed places, needles
• Social phobias
– An irrational fear and avoidance of any social or performance situation
in which one might embarrass or humiliate oneself in front of others
Shaking, blushing, sweating, or appearing clumsy, foolish, or
incompetent
– Most common type of anxiety disorder
– Ricky Williams
Phobias
• Specific phobias- A marked fear of a specific object
or situation.
– Phobic items include (ordered by frequency of
occurrence):
Situational phobias (elevators, airplanes, enclosed
places, tunnels)
Fear of natural environment (storms or water)
Animal phobias (dogs, snakes, insects, or mice)
Blood injection-injury phobia (fear of seeing blood or
receiving an injection
Panic Disorder
• An anxiety disorder marked by unpredictable
minutes-long episodes of intense fear and other
frightening sensations (heart pounding,
shortness of breath, choking sensations,
dizziness)
• Visit doctors and emergency rooms quite frequently
• Person is often left with fear of having another
panic attack
• Can lead to agoraphobia-intense fear of being
in a situation from which no escape is possible
if the person experienced a panic attack.
• Post Traumatic Stress Disorder *
• Obsessive Compulsive Disorder *
•
a. Obsessions *
•
•
•
Repetitive, distressing or
frightening thoughts
b. Compulsions *
Repetitive behaviors
(an attempt to calm the thoughts)
• OCD love poem
• Examples of obsessions:
– Concern for order and constancy
– Cleanliness (body or living space)
– Forbidden sexual thoughts
• Examples of compulsions:
– Hand washing
– Checking
– Collecting
– Repeating behaviors (in and out of a door)
– Arranging things
– Cleaning
Etiology of Anxiety Disorders
• Biological factors
– Genetic predisposition
– GABA circuits in the brain
• Conditioning and learning
– Acquired through classical conditioning
– Maintained through operant conditioning
• Cognitive factors
– Judgments of perceived threat
• Stress—a precipitator
Figure 13.4 Conditioning as an explanation for phobias
Figure 13.3 Twin studies of anxiety disorders
Dissociative Disorders
Disorders in which, under unbearable stress,
consciousness becomes dissociated from a
person’s identity, her/his memories of important
personal events, or both
• Types of Dissociative Disorders:
– Dissociative Amnesia: retrograde forgetting of
autobiographical info
– Dissociative Fugue: forgets…and leaves old life
– Depersonalization Disorder: everything’s surreal
– Dissociative Identity Disorder
Copyright © 2011 Pearson Education, Inc.
All rights reserved.
Dissociative Disorders
• Disorders which, under unbearable stress, consciousness
becomes dissociated from a person’s identity or her/his
memories of important personal events, or both
• Dissociative Amnesia
– A complete or partial loss of the ability to recall personal
information or identify past experiences
– Cannot be attributed to forgetfulness or substance abuse.
– Often caused by traumatic experience or
– A situation creating unbearable anxiety causing the person to
escape by “forgetting”
• Victims of 9-11 tragedy were discovered in mental hospital months
later with dissociative amnesia
• Brought to hospitals with no identification and couldn’t recall it
– Sufferers forget name, age, address, and may not recognize
parents, family or friends
– Do not forget how to carry out routine tasks
– basic personality remains intact
WWB
Copyright © Allyn & Bacon 2006
Dissociative Identity Disorder *
• 2 or more distinct personalities in the
same person
• Memory disruption regarding the “alter”
• Rare
• Some psychologists don’t believe the
disorder really exists
• NOT the same as Schizophrenia
Schizophrenia
A severe psychological disorder characterized by loss of contact with
reality, hallucinations, delusions, inappropriate or flat affect, some
disturbance in thinking, social withdrawal, and/or other bizarre behavior
• Positive Symptoms
(added)
– Hallucinations
– Delusions
– Derailment
– Inappropriate affect
WWB
• Negative Symptoms
(loss of deficiency)
– Social Withdrawal
– Apathy
– Loss of motivation
– Lack of goal-directed
behavior
– Very limited speech
– Slow movements
– Poor hygiene
– Poor problem-solving
– Distorted sense of time
Copyright © Allyn & Bacon 2006
Schizophrenia *
Video – Gerald
• Psychosis: loss of contact with reality
• Positive symptoms – hallucinations, delusions,
inappropriate affect, disorganized speech and
behavior
• Negative symptoms – social withdrawal,
deterioration of adaptive behavior, flat affect,
poor problem solving abilities
• Cognitive symptoms – problems with focus,
memory, problem-solving; control
Symptoms of Schizophrenia
• Delusions and irrational thought
– Delusions are false beliefs that are maintained
even though they are clearly out of touch with
reality.
• Distorted perceptions (Hallucinations)
– Sensory perceptions that occur in the absence of
real stimulus. Usually auditory.
• Disturbed emotions
– Some show a flattening of emotion.
– Some show inappropriate emotional responses.
Brain Abnormalities in Schizophrenia
• Several abnormalities in brain structure and function
have been found
– Low levels of neural activity in the frontal lobes
– Defects in neural circuitry of the cerebral cortex and limbic
system
– Reduced volume in hippocampus, amygdala, thalamus, and
frontal lobes
– Abnormal lateralization of brain functions slow communications
between left and right hemispheres
– Abnormal dopamine activity is common
• May result from cocaine abuse
– Medication effective in reducing symptoms of schizophrenia
block dopamine action
– One third who take these medications do not show improvement
WWB
Copyright © Allyn & Bacon 2006
Etiology of Schizophrenia
•
•
•
•
•
•
Genetic vulnerability
Neurochemical factors
Structural abnormalities of the brain
The neurodevelopmental hypothesis
Expressed emotion
Precipitating stress
Possible Causes of Schizophrenia *
•
•
•
•
•
•
•
•
Genes – runs in families
Brain– loss of neurons; enlarged ventricles
Neurotransmitters – e.g. excess dopamine
Poverty, malnutrition, disease
Prenatal damage – e.g. viruses
Stress
Substance Abuse may trigger
Interactions between items above
Causes of Schizophrenia
• Genetic vulnerability
– Evidence suggests heredity plays a role
– Identical twins concordance rates-48%
– Offspring of two schizophrenic parents has
about a 46% probability of developing the
condition.
WWB
Copyright © Allyn & Bacon 2006
Causes of Schizophrenia
• Effects of Prenatal environment
– Malnutrition
– Prenatal viral infections and birth
complications
• Effects of the family environment
– Results of research shows that a degree of
disorganized communication at home that
does not harm most children may have
damaging effects on those genetically
predisposed to schizophrenia
Depressive Disorders *
• Major depressive disorder *
• Low mood (despair) - withdrawal, loss of interest
& pleasure; eating & sleeping disturbance Video
•
•
•
•
•
More than 2 weeks
Impaired functioning
Twice as many women
May have psychotic features
Suicidal thoughts or attempts
Risk Factors for Suicide *
•
•
•
•
•
•
•
•
Diagnosable psychiatric disorder
Male, esp. older and physically ill
Method (guns succeed more than pills)
Prior attempts, family history, exposure
History of being abused
Incarceration
High risk behavior
Adolescence 2% attempt
Suicide and Race, Gender, and Age
• Mood disorders, schizophrenia, and substance abuse are major risk
factors for suicide in all age groups
• Suicide risk increases when exposed to troubling life stressor
• Suicidal behavior runs in families
• 30,000-31,000 suicides are reported annually in the U.S.
• Suicide rates far lower for white and African American women than men
• Older Americans are at far greater risk than young people
• 90% of individual who commit suicide leave clues
– Verbally – “you won’t be seeing me again”
– Behavioral – giving away most valued possessions
– Taking unnecessary risks
– Showing personality changes
– Losing interest in favorite activities
• Warning signs should be taken seriously
• Encourage them to get professional help or call 24-hour hotline
WWB
Copyright © Allyn & Bacon 2006
• Bipolar and related disorders * Video
• Mood & energy swings from low
(depression) to high (mania); near normal
in between
• Mania *
• Exceptional energy,
enthusiasm, agitation,
irritability, reckless
behavior.
Causes of Mood Disorders
Neurological Correlates
– Heredity and abnormal brain structure and chemistry
Abnormal levels of serotonin linked to depression and
suicide
Neurotransmitter abnormalities may reflect genetic
variations
Heritability of depressive disorder is 70%, environment
30%
– Twins of those diagnosed with bipolar disorder:
50% of identical twins also diagnosed
7% of fraternal twins also diagnosed
Personality Disorders *
• Inflexible patterns of thinking, feeling or
relating to others
• These patterns cause problems in
personal, social & work situations.
• Inability to understand needs of others
• Three “clusters”
• A) Odd, eccentric
• B) Dramatic/erratic, BPD Video
• C) Anxious/inhibited
Personality Disorders
Characteristics of personality disorders
 Extremely difficult to get along with
 Unstable work and social histories
 Know their behavior causes problems, yet seem unable to
change
 Blame other people or situations for their problems
 Treatment options are few
– Most seek treatment by legal authorities or family members
– Seldom engage in self-reflection essential for success
 Psychological and behavioral factors that lead to a personality
disorder diagnosis may be resolved to some degree or become
less severe over time
Personality Disorders
• Three clusters
– Dramatic, Emotional: Histrionic
Narcissistic
Antisocial
Borderline
– Anxious, Fearful: Avoidant
Dependent
Obsessive-Compulsive
Odd, Eccentric:
Paranoid
Schizoid
Schizotypal
Antisocial Personality Disorder *
• Pervasive pattern of violating the rights of
others
• 3x more males
• Alcohol, drug abuse
• Egocentric, impulsive
• Lie, cheat, steal, criminal behavior
• Biological and environmental factors
Personality Disorder
• Antisocial Personality Disorder
– Most troubling and heavily researched
personality disorder
– Disregards rights, feelings; manipulates, etc.
without remorse
– Aggressive, irresponsible, reckless, willing to
break the law
– Breaks the law, lies, cheats, exploits, and fails
to hold jobs
– Typically a male, whose lack of conscience
becomes plain before age 15
Somatic Symptom Disorders *
• Substantial physical symptoms
• May have no documented illness or may
have a real illness with “overreaction”.
• Stress-related
• More females
• Distressing and disruptive
• Contrast with illness anxiety disorder –
exaggerated “normal” physical sensations and
no real physical illness.