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Abnormal Psychology (Chapter 18) Lecture Outline: “Abnormality” and diagnosis Anxiety Disorders Dissociative Disorders On the sheet of paper, list three things you are afraid of Abnormality • Behavior is statistically unusual, nonadaptive, labeled “abnormal”, or has perceptual/cognitive distortion • Historical examples of abnormal behavior: – psychosis: demon possession, syphillis – mentally retarded individuals & midgets were “court-jesters” – Salem witch trials: girls may have ingested Salem witch trial Models of abnormality • Psychodynamic: Intrapsychic conflict – e.g., sexual abuse and conversion disorder • Humanistic: Oversensitivity to others – e.g., alcoholism for social anxiety • Behavioral: Reinforcement/Punishment – e.g., snake bite leads to snake phobia • Cognitive: Distorted thinking – e.g., negative thoughts and depression • Medical: Physiological imbalance Diagnosis: DSM-IV • Diagnostic and Statistical Manual, 4th Ed. (APA, 1994) • Axis I: Clinical syndromes/ Mental disorders • Axis II: Personality and Disorders • Axis III: General Medical Conditions • Axis IV: Psychosocial and Environmental Problems • Axis V: GAF Scale (1:low to 100:high) Anxiety Disorders Symptoms of Anxiety • Symptoms of anxiety: – Mood: tension, apprehension and panic – Cognitive: catastrophe, concentration – Somatic: Sweat, pulse, dizzy, pounding – Motor: Tics, bite nails, pace, fidget • Case examples of clients with anxiety disorders, with emphasis on panic disorder (video #92) Case example: Social phobia "I couldn't go on dates or to parties. For a while, I couldn't even go to class. My sophomore year of college I had to come home for a semester." "My fear would happen in any social situation. I would be anxious before I even left the house, and it would escalate as I got closer to class, a party, or whatever. I would feel sick to my stomach--it almost felt like I had the flu. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else." "When I would walk into a room full of people, I'd turn red and it would feel like everybody's eyes were on me. Iwas too embarrassed to stand off in a corner by myself, but I couldn't think of anything to say to anybody. I felt so clumsy, I couldn't wait to get out." Specific kinds of anxiety disorders • Phobias: Simple, social, and agoraphobia • Panic Disorder: Bouts of intense and uncontrollable anxiety • Generalized anxiety disorder: Chronic • Stress Disorder: PTSD • Obsessive-Compulsive Disorder – obsession: unwanted impulses or thoughts – compulsion: uncontrolled repetitive act Etiology (Cause) of Anxiety • Psychodynamic: External threats – guilt after id-superego struggle • Learning theory: Classical conditioning – sexual anxiety after unprotected sex • Cognitive: Anxious cognitions – public speaking catastrophes • Humanistic-Existential: “A” gets a “B” • Physiological: Autonomic reactivity Who were the lambs, Clarice? Dissociative Disorders • Dissociative amnesia: Memory loss for specific events or people • Fugue: Total memory loss after stress, relocation and starting a new life • Dissociative Identity Disorder (MPD) – two or more identities that coexist – associated with child trauma such as abuse – abused children “leave their bodies” – hearing voices