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AP Psych Class Announcements: Psych Quiz Bowl 4/24!!!!! Let’s get that trophy back!!!!! Have you registered for the AP exam? Aim: to describe the symptoms of schizophrenia and to explain the various therapies techniques. Do NOW: 1. What is the difference b/t behavioral vs. cognitive therapy? 2. What is counterconditioning? Give 2 examples? HW: study for test Practice questions Abnormal Psychology . History • People used to explained mental illness in terms of demon possession. • Trephining was often used History con’t…. View #36 “Early History of Mental Illness” • Phillipe Pinel- took over Bedlam. He freed patients from chains and moved them to sunny rooms and talked with them. • The Medical Model was born- mental problems were now seen as an illness that needed to be diagnosed by its symptoms. Dorthea Dix • 18th century • Fought for improvements in humane treatment of those with mental illnesses • All people should be treated with dignity Bio-Psycho-Social Perspective • Today most clinicians believe that biological, sociocultural, and psychological factors combine to produce disorders What is abnormal? • Four criteria: Is the behavior 1. atypical or different from the norm? 2. disturbing? 3. maladaptive (harmful or unhealthy)? 4. unjustifiable (i.e. extremely sad or blue for no known reason) How do we label or classify psychological disorders? The DSM (Diagnostic Statistical Manual of Mental Disorders) The big book of disorders. • It defines 17 major categories and classify disorders and describe the symptoms. • DSM will NOT explain the causes or possible cures. *changes according to cultural norms (homosexuality taken off in 1973) Questions • 1. How would you feel upon hearing that your daughter’s fourth grade teacher was once briefly admitted to a psychiatric ward? • 2. Would you rent a room to an applicant that had listed as prior address an institution/group home? • 3. Would you want your co-workers and boss to know that you are seeing a psychiatrist and taking prescribed medication? Labels: The Result label • Although they serve a purpose for insurance, they bias people’s perception once they have been labeled. Affects how they see themselves Changes other’s perception Changes how others treat them http://www.youtube.com/watch?v=WUaXFlANojQ 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. How Anxious Are You? • Score the Taylor Manifest Anxiety Scale A. Anxiety Disorders • a group of conditions marked by distressing, persistent anxiety symptoms: • • • • • Generalized Anxiety Panic Phobias OCD PTSD 1. Generalized Anxiety • They are in a state of continuously tense, uneasy, worried that bad things will happen, agitated, muscle tension, sleeplessness • 2/3 are women • Many experience panic attacks • One can not identify the source of the anxiety You're walking through the park on an ordinary day when suddenly, without warning, you're stricken with acute fear. The world starts to spin. Everything around you seems unreal. Your heart beats so hard that it quakes in your chest, and your throat tightens. Frantic for your own breath, your mind screams, "Am I having a heart attack? Am I going crazy?" And, worst of all, "Am I about to die?" The panic keeps escalating until you feel like you just can't stand it anymore. Then, finally, it starts to sink away from you. Confused and embarrassed, you retreat to your car and go home where you know it's safe. You'll never return to that park again, you think. And then a more fearful thought pops into your head: "What if this happens again -somewhere else?“ Your body mysteriously triggers the fight-or-flight response when no danger really exists. Basically, you get the same sensations you might get if you heard a burglar break into your house in the middle of the night. Only, nothing nearly that frightening or threatening has actually occurred. What is this called? 2. Panic disorder (attacks) • Symptoms: minutes long episodes of intense fear (sometimes confused as heart attacks), heart palpitations, trembling, dizziness, choking. Suffers begin to fear what they believe triggered it and can develop phobias of that place, object or person. 3. Phobias • Symptoms: anxiety focused on a specific object or event; an irrational fear that disrupts behavior Types of Phobias • 1. Specific- over 700 classified phobias • 2. Agoraphobia – fear of leaving one’s home • 3. Social phobia- fear of being scrutinized by others • *often develop at an early age Phobia Matching Game! • • • • • • • 1. ablutophobia 2. amaxophobia 3. cacophobia 4. chaeotophobia 5. chronophobia 6. Coimetrophobia 7. coprastasophobia • • • • • • • • 8. lockiophobia 9. placophobia 10. scolionophobia 11. papaphobia 12. arachibutyrophobia 13. triskaidekaphobia 14. epistemophobia 15. gerascophobia OCD Scale • Give one point for the following “True” you selected: • 1,2,4,6,7,8,16,17,18,21 • Give one point for the following “False” you selected: • 5,9,10,11,12,13,14,19,20,22 • Scores range from 0-20 • Average is 11.15 4. Obsessive-compulsive disorder • Obsession: a reoccurring irrational thought • http://abcnews.go.com/WN T/video/extreme-afflictionocd-16046438 • *one is driven to repeat behavior in an attempt to reduce anxiety that builds when one does not listen to the OCD voice or command • Compulsion: a reoccurring irrational behavior • Common OCD’s: • Germs Four types of OCD behavior • 1. the obsession over germs, commonly associated with OCD. • 2.the need for things to be in the right place, often in a manner producing acceptable symmetry. • 3. doubt, such as feeling like you might have hit a pedestrian or constantly needing to confirm that an appliance hasn't been left on. • 4. disturbing, pressing thoughts that don't go away -uncomfortable sexual urges or the desire to commit a violent act 5. Post-Traumatic Stress Disorder • Symptoms: traumatic events one tends to relive over and over • Nightmares, social withdrawal, anxiety or depression • • • • Seen in: soldiers Rape victims Victims of natural disasters Explaining Anxiety Disorders • Learning Perspective: • -general anxiety is linked with classical conditioning and fear • -say we generalize (fear of heights lead to a fear of flying) • Say behavior is reinforcedescaping situation reduces the anxiety, therefore, reinforcing the phobia • Say much is observational learning: watch we watch and parents transmit fears to children as well. Biological perspective • Say we are biologically predisposed to fear dangers feared by ancestors (storms, heights, closed spaces..) • We seem genetically wired to certain fears • Identical twins have identical or similar fears • Perhaps it’s their biological make-up- scans show that the brain is over aroused in certain people with GAD, panic and OCD B. Somatoform Disorders • Occur when a person manifests a psychological problem through a physiological symptom. • Two types…… 1. 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. 2. Conversion Disorder • Report the existence of severe physical problems with no biological reason. • Like blindness or paralysis. http://www.youtube. com/watch?v=6Dye0 5tvSoo C. Dissociative Disorders • Very controversial! • These disorders involve a disruption in the conscious process. • The person has something so painful that they dissociate from it consciously • Three types…. Questions related to Dissociation: • • • • • • • • • 1. Have you ever walked in your sleep? 2. Did you have imaginary playmates as a child? 3. Were you physically or sexually abused as a child or adolescent? 4. Have you ever noticed that things are missing from your personal possessions or where you live? 5. Have you ever noticed that things appear where you live, but you don’t know where they came from or how they got there (book, jewelry…) 6. Do people ever talk to you as if they know you but you don’t know them, or only know them faintly? 7. Do you ever speak about yourself as “we” or “us”? 8. Do you ever feel that there is another person or persons inside you? 9. If there is another person inside you, does he or she ever come out and take control of your body? 1. Psychogenic (dissociative) Amnesia • A person cannot remember things with no physiological basis for the disruption in memory. • Amnesia is selective and is retrograde • NOT organic amnesia. 2. Dissociative Fugue • People with psychogenic amnesia that find themselves in an unfamiliar environment. • Amnesia plus fleeing one’s home and starting a new identity. 3.Dissociative Identity Disorder • Used to be known as Multiple Personality Disorder. • A person has several rather than one integrated personality. • People with DID commonly have a history of childhood abuse or trauma. Common dissociative symptoms: • 1. depersonalizationhaving the experience that one’s body does not belong to themselves • 2. self-absorption- sit staring off in space, not aware of the passing of time • 3. amnesia- find evidence of having done things that they don’t remember Physiological evidence for DID? • http://health.discovery. com/videos/psychweek-2010-eegtest.html • Watch Tony and his personalities reveal themselves during a therapy session. • #31 • http://www.youtube.co m/watch?v=dipFMJckZ OM&feature=related • Journal what you feel as you watch a series of paintings by Van Gogh. • Vincent Van Gogh • What emotions do the paintings create? What Do You Know About Depression????? • Break into groups and generate your list of the following: A. B. C. D. Types Symptoms Causes Treatments D. Mood Disorders • Experience extreme or inappropriate emotion. *major depression *dsythymic depression *seasonal affective disorder *bipolar (manic-depressive) Zung Depression Rating Scale • Reverse the responses to the following numbers (1=5, 2=4, 3=3, 4=2, 5=1) : 2, 5, 6, 11, 12, 14, 16, 17, 18 and 20 • Add up all numbers • 50-59- mild to moderate depression • 60-69 = moderate to severe depression • 70 and above severe depression 2. Dysthymic Depression “Under the radar” type of depression • Being low or down mood • trouble concentrating most of the time for over 2 years. • Irritable • Low energy, low selfesteem, • eat too little or too much • Don’t enjoy things as much as you used to 1. Major Depression • A.K.A. unipolar depression • Severe symptoms for at least two weeks with no apparent cause. Symptoms of Major Depression Withdrawn, feeling hopeless Not socializing with friends, family Missing school/work Insomnia or hypersomnia Not eating or bathing suicidal 3. Seasonal Affective Disorder • Experience depression during the winter months. • Based not on temperature, but on amount of sunlight. • Treated with light therapy to decrease melatonin. ECT: electroconvulsive therapy • “therapy” #37 • Used for Major Depression • Suppose one day you wake up feeling oddly energized and pumped for anything. The world is at your feet. You can do whatever you set your mind to and nothing could possibly go wrong. In fact, you're so full of energy that you decide you don't need to sleep. Days, perhaps even weeks, go by -- nothing gets you down and nothing slows you down. But then, without warning, this feeling starts to wane. For no reason at all, you begin to feel bogged-down, depressed or even suicidal. Life is joyless and meaningless. For weeks you feel absolutely hopeless. And then, one day you wake up -- ready for anything. 4. Bipolar Disorder • Involves periods of depression followed by episodes of mania • Mania: hyperactive, wildly optimistic, flight of ideas, little sleep, overly talkative, little sleep. • Engage in risky behavior during the manic episode. Mania • http://www.youtube.co m/watch?v=p9hbXPVaO uk&feature=related • Norephinphrine is higher then normal!!!!!!! • affects approximately 5.7 million adults in the U.S. (2.6 percent of the 18 and up population) • http://www.mentalhealthtoday.com/bp/famous_ people.htm E. Schizophrenia • Schizo = split mind or a split from reality • Is a psychotic disorder Examples: • http://www.youtube.com/watch?v=uJOT45wX Erk Schizophrenia Facts: • Universally occurs in 1 out of 100 • Strikes b/t the ages of 15-35 • Affects both genders equally • More prevalent in lower socio-economic groups • Slow developing schizophrenia (called chronic or process) has a much lower chance of recovering Recovery rates: • 1/3 fully recover • 1/3 in/out of hospitals • 1/3 never recover • Sudden onset (called acute or reactive) has a better recovery rate Main Symptoms: • 1. Hallucinationssensory experiences (seeing, hearing things) • http://www.youtube.co m/watch?v=XC6Px8EJii8 &feature=fvst 2. Delusions • irrational, fragmented, bizarre, illogical beliefs and thoughts. • Some have paranoid tendencies leading to delusions of persecution. - Some believe they are special leading to delusions of granduer. 3. Inappropriate emotions and actions • Laugh at inappropriate times. • Flat Effect = zombie-like state • Senseless, compulsive acts. • Catatonia=motionless Waxy Flexibility Positive v. Negative Symptoms Positive Symptoms: Negative Symptoms: Delusions, hallucinations, Disorganized thoughts Flat affect (little emotion), inability to feel pleasure, lack of personal hygiene Types of Schizophrenia • • • • Paranoid – 40% Undifferentiated – 40% Catatonic – 8% Disorganized- 5% Paranoid Schizophrenia • preoccupation with delusions or hallucinations. • “Somebody is out to get me!!!!” Disorganized Schizophrenia • disorganized speech or behavior, or flat or inappropriate emotion. • Word Salad: "Imagine the worst Systematic, sympathetic Quite pathetic, apologetic, paramedic Your heart is prosthetic" Heather: • http://www.youtube.com/watch?v=k vdw4b7tC-8&feature=related Catatonic Schizophrenia • Flat affect (emotions) • Periodic frozen state • Parrot-like repeating of another’s speech and movements • http://www.youtube.co m/watch?v=zAEJJvndms&feature=relate d Undifferentiated Schizophrenia • One has many and varied symptoms that doesn’t fit into any one category Schizophrenia: Brain Abnormalities • PET scans reveal low activity if the frontal lobe • Many have enlarged fluid-filled ventricals : results in less brain matter • Thalamus is smaller (might account for lack of selective attention leading to “word salad”) Con’t • Schizophrenics have an excess number (6 X) receptors for dopamine. Antipsychotic drugs that try to block dopamine have been somewhat successful *Drugs that increase dopamine such as marijuana, cocaine and amphetamines intensify disorder Word Salad: Schizophrenia Review List all the symptoms of schizophrenia shown in this clip of “Gerald” • http://www.youtube.co m/watch?v=gGnl8dqEo PQ Possible Causes: Prenatal factors • Maternal virus during pregnancy (flu) • Mother exposed to teratogens • Poor nutrition • Infants of difficult childbirth Possible Causes: genetic Genetic link: odd are 1 in 2 if one twin has it, 1 in 10 if a sibling does -1 in 8 odds with afflicted parent -1 in 10 with afflicted sibling Possible Causes: Environmental • If one has a predisposition, then possibly environmental factors could trigger it such as: -stress -family issues -poor peer relations -emotional unpredictability Review: • On a half sheet of paper: • List all of the biomedical explanations for schizophrenia you can recall. The Rosenhan Study • Rosenhan’s associates were faked symptoms of hearing voices. • They were ALL admitted for schizophrenia. • None were exposed as imposters. • They all left diagnosed with “schizophrenia in remission.” • What are some of the questions raised by this study? The 1900’s brought a new reform movement in the United States, a movement to deinstitutionalize the patients in mental hospitals. Patients were to be returned to the community, where, with the help of antipsychotic drugs and community mental health clinics, they would be able to lead productive lives. Once again, the public’s apparent moral concern with the treatment of the mentally ills was not matched by financial support. To a great extent, persons who earlier would have been kept in mental hospitals are now found in prisons, homeless shelters, nursing homes, and on the streets, getting little if any treatment. In 1955 there were about 560,000 persons in mental hospitals in the United States. In 1997 that number had dropped to about 62,000, some of whom are there for only short periods of times (2 to 4 weeks) during acute psychotic episodes, after which they are released back to the community, where it is expected they will received community-based treatment. Sometimes a patient is first discharged into a halfway house or group home as part of the transition from mental hospital to community. Despite the stereotype, very, very few are violent!!!! “Guilty by reason of insanity” • This is a legal term only!! • Jeffrey Dahmer was judged to be legally sane at the time he killed and dismembered 15 individuals. • This indicates that the jury believed that Dahmer was able to appreciate the wrongfulness of his behavior and control it. Personality Disorders • Well-established, maladaptive (dysfunctional) ways of behaving that negatively affect people’s ability to function. • Dominates their personality. Antisocial Personality Disorder • Typically male • Shows up at early age, disregard for laws • Lack of empathy. • Little regard for other’s feelings. • Lacks conscience • View the world as hostile and look out for themselves. • Restless and impulsive Antisocial (aka.sociopath, psychopath) • Shows up at early age as: dishonesty, stealing, delinquency • As adults many can’t maintain a job or relationships: act irresponsible, infidelity …. • High correlation with alcoholism, drug addiction, promiscuity, frequent relocation • Combined with high intelligence make charming, crafty criminals or con-artists Brains of Antisocials • Reduced frontal lobe activity • Pass lie detectors!! • Lack the physiological responses normally associated with fear!! • http://www.youtube.co m/watch?v=oaTfdKYbu dk Dependent Personality Disorder • Rely too much on the attention and help of others. • Unable to make choices • Cannot tolerate being alone, submissive and clinging Histrionic Personality Disorder • Needs to be the center of attention. • Whether acting silly or dressing provocatively. Do you agree with the following? • • • • I think I am a special person. I expect a great deal from other people. I am envious of other people’s good fortune. I will never be satisfied until I get all that I deserve. • I really like to be the center of attention. • Do you prefer friends who are weak or unpopular? Narcissistic Personality Disorder • Having an unwarranted sense of self-importance. • Thinking that you are the center of the universe. • Do you agree that with recent studies that claim that Facebook encourages narcisisst, attention-seeking behavior in this generation? Rosanne Barr: • “I hate every human being on earth. I feel everyone is beneath me and I feel they should all worship me.” • Tendencies: • They love to talk about themselves, believe that are entitled to the best, very envious, critical of others, and can fly into fit of rage or experience depression, shame and self-doubt. Obsessive –Compulsive Personality Disorder • Overly concerned with certain thoughts and performing certain behaviors. • Not as extreme as OCD anxiety. Borderline Personality • Unstable self-image, relationships and emotions……usually females • DRAMA, DRAMA, DRAMA!! Avoidant personality • Hypersensitive to rejection and fears starting relationships Schizoid • Strange behavior, emotionally cold, withdrawn • 14-22 scale • Average was 9.6 Psychoanalysis Free association therapist: “Tell me about your childhood. Say whatever comes to your mind” Resistancepatient: “I don’t really want to talk about my mother.” Transferencepatient: “Doc, I’m really starting to have feelings for you.” Humanistic Therapy Client-centered techniques: 1.active listeningtherapist echoes, reinstates what the client says 2. unconditional positive regardempathy, genuineness, acceptance Client-centered therapy • http://www.youtube.com/watch?v=V_T4B9XA NCw Behavioral therapy • Counterconditioning 1. Exposure therapy- systematic desenstization Create hierarchy of stressful steps. Teach client to learn to relax at each step. Sample hierarchy for one who’s phobia is asking girls’ on a date: • 2. aversive therapy: – To pair something with negative stimuli Example: antibul with alcohol (makes them sick) Bed wetter and alarm 3. modeling: have people with Asperger’s watch someone greet people as they enter a room, then must model the behavior. Behavioral: Operant conditioning • Pairing desired behavior with rewards • Token economy – Ex: one cigarette for each chore completed while in the psych hospital Cognitive therapy • 1. cognitive behavioral therapy Aaron Beck – One is taught to destroy the ANTs (automatic negative thoughts) and replace the harmful behaviors – Ex of ANTs: perfectionism, anger, frustration or negative views of the world • Rational Emotive therapy (RET) Albert Ellis Therapist confronts illogical beliefs http://www.youtube.com/watch?v=v9ezZIkxR74 • Patient: “I am a loser” • Therapist: “Are you really a loser? At everything? You’re saying you do NOTHING well? How logical is this?” Terms: • Meta analysis – when you combine the results of many tests and experiments to determine the success of a therapy or medication • Regression towards the mean- when you start therapy, you won’t get any worse. You are now on the way to getting better. Medications • Depression – prozac Review 1. Systematic desentization 2. Positive regard 3. resistance 4. Transference 5. Cognitive-behavioral 6. Client-centered therapy 7. Modeling 8. RET 9. Aversive conditioning 10. Albert Ellis • • • • A. B. C. D. Psychoanalytic Cognitive Behavioral Humanistic