Download Abnormal Psychology

Abnormal Psychology
Psychological Disorders
How common are they?
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1994: Michigan Institute for Social Research
 Nearly ½ of people age 15-54 have
experienced at least one bout with psych
disorder
 Psych disorders peak between ages 25 and 34
 Only 1 out of 4 ever receive help
 Many are mild, thus recover without help
 Most common disorders
 Major depressive episode, alcohol
dependence, social phobia, simple phobia
Psych Disorders in the U.S. ….
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Psych disorders are often culturally based…
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Examples p. 8
Michigan study…
¼ of Americans met criteria for mental illness
within prior year
 ¼ of those had serious disorder
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U.S. posed to rank #1 in mental illness…
So what is a mental illness and what criteria
qualify somehow as mentally ill…?
What is Abnormal Psych??
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Abnormal Psychology
 Study
of people who suffer from
psychological disorders
 Behavior and or thoughts
 From depression, substance abuse,
learning difficulties to schizophrenia and
bipolar disorder
What constitutes Abnormal?
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4 Criteria to characterize as abnormal
Unjustifiable (irrational) : can’t justify /
doesn’t make sense
 Maladaptive: Harmful / disturbing to the
individual
 Atypical (unusual): not shared by members of
population
 Disturbing (irrational): Disturbing to others
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All or most not required to be diagnosed
OR…..
“Deviant, Distressful, Dysfunctional”
DSM-V
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Diagnostic and Statistical Manual of Mental
Disorders
Resource to diagnose patients (only)
 Symptoms of everything considered to be
psychological disorder
 16 clinical syndromes
 Weakness: assumption / labeling of mental
illness based on symptoms…
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Rosenhan Study
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Dangers of labeling patients with disorders
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8 participants who faked symptoms
All acted completely normal except for
testifying to hearing voices (3 words)
All diagnosed with Schizophrenia and
discharged as “Schizophrenia in remission”
Average stay in institutions- 18 days
Perspectives on Psych Disorders…
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Psychoanalytic theorists
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Behaviorists
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Maladaptive ways of thinking
Humanistic theorists
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History of reinforcement (Environment)
Cognitive theorists
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Unconscious conflicts
A person’s feelings, self-esteem, self-concept
Biomedical theorists
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Hormonal / neurotransmitter imbalances, brain
structure, genetic abnormalities
An Eclectic Approach
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Specific fields are not exclusive to their
theories
Consider any/ all theories as potential
influence to a specific illness
6 Major Types of Disorders…
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Anxiety Disorders
Somatoform disorders (psych issue causes
physiological problem)
Dissociative disorders (disruption in
conscious processes)
Mood / affective disorders (extreme /
inappropriate emotions)
Schizophrenic disorders: (Disordered,
distorted thinking)
Personality Disorders: (Maladaptive
behavior that affects functioning)
Don’t Get Paranoid…
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Intern’s Syndrome
 Tendency to see in oneself the characteristics of a
disorder one is studying.
Anxiety Disorders
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When do we classify it as a disorder?
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Distressing, persistent anxiety or maladaptive
behaviors to reduce anxiety
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Heart palpitations, sweaty palms, dizziness, ringing in
ears, muscular tension, sleeplessness....
Types of Anxiety Disorders
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Generalized Anxiety Disorder (GAD)
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Constant low-level anxiety (nervousness)
2/3 are women
Patient can’t identify its cause and thus can’t
deal with or avoid it.
Often accompanied by depression
Tense, jittery, muscular tension, agitation,
sleeplessness, difficulty concentrating
(fidgeting, twitching, trembling)
Panic Disorders
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Acute episodes of intense anxiety without
provocation (panic attack)
Tend to increase in frequency (minutes
long)
1 in 75 (smokers 2-4 x more likely)
Heart palpitations, shortness of breath,
choking sensations, trembling, dizziness…
“feels like a heart attack”
Charles Darwin (age 28)
Phobias
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Focuses anxiety on a specific object,
activity or situation.
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Irrational fear that disrupts behavior
Identify these phobias:
Agoraphobia
 Social phobia
 Androphobia
 Coulrophobia
 Cynophobia
 Didaskaleinophobia
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Obsessive-Compulsive Disorder
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OCD
Persistent obsessive (uncontrollable)
thoughts lead to compulsive (uncontrollable)
actions
Obsession creates anxiety / reduced by
compulsive behavior
Cleanliness, security, symmetry, organization
Often late teens, early twenties (2-3%)
Howard Hughes
Post-Traumatic Stress Disorder
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PTSD
Cause: experiencing / witnessing a traumatic event
(fear, helplessness, horror)
Nightmares, flashbacks, social withdrawal, insomnia
Combat veterans, disaster or accident survivors,
sexual assault victims, 2/3 of prostitutes
Basic trust erodes, sense of hopelessness
15% of Vietnam vets (45% for heavy combat)
1 in 6 Iraqi combat infantry veterans
Theories Explaining Anxiety Disorders
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Brainstorm with a partner.
How would the Psychoanalytic theorist
explain the cause of anxiety disorders?
Create an example.
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Unconscious conflict
Conflict of id, ego, superego
Anxiety disorder is the outward manifestation
of an internal, unconscious conflict
Theories Explaining Anxiety Disorders
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How would the behavioral theorist
explain the cause of anxiety disorders?
Learned response: Classical, or Operant
learning
Provide an example for each. (Pick a
specific anxiety disorder for the example.)
Chronically anxious, ulcer-prone rats by
unpredictable electric shock
Theories Explaining Anxiety Disorders
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How would the cognitive theorist
explain the cause of anxiety disorders?
Dysfunctional , maladaptive ways of
thinking
Example:
GAD the result of unreasonably high
standards set for oneself: thus constant
anxiety from impossibility of meeting goals
Theories Explaining Anxiety Disorders
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Biological Perspective
Natural Selection
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Genetic predisposition
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Fear of spiders, snakes, storms, heights etc.
increase survival (genetic)
Twin studies (together and apart)
The Brain
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OCD: Anterior cingulate cortex: monitors
actions, checks for errors (hyperactive regionlike a hiccup…)
Theories Explaining Anxiety Disorders
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Two biggest perspectives today:
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Behavioral (learning) and biological
Mood Disorders
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Experiencing extreme or inappropriate
emotions.
 Two
major forms:
 Major
depression (unipolar depression)
 Bipolar Disorder (manic depression)
Major Depressive Disorder
“common cold” of psychological disorders
 Biggest cause of therapy (mental health services)
 2 weeks or more (with absence of clear
reason)
 Fatigue, loss of appetite, feelings of
worthlessness, hopelessness,
disinterestedness, changed sleeping
patterns
 SAD: Seasonal-Affective Disorder
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Facts about Major Depressive Disorder
Women are nearly 2 x more likely to have it
 Leading cause of disability worldwide (5.8 %
of men, 10.5% of women)
 Most major depressive episodes selfterminate
 Stressful events often precede depression
 Rate is increasing with each new generation
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Bipolar Disorder
Depressed and manic episodes (alternate)
 Depression- typical characteristics
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(1% of pop. , equal between genders, yrs. 20-30)
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Manic- high energy (and often highly illogical)
 Overly
active, elated, outspoken, little to no
inhibition
 Often reckless, poor judgment
 Mild cases can produce creative genius
“Famous Folks with Disorders”
Depression
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Abraham Lincoln
Winston Churchill
Meriwether Lewis
Emily Dickenson
Isaac Newton
Mozart
Woody Allen
Buzz Aldrin
Drew Carey
Harrison Ford
Beyonce Knowles
Bipolar
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Walt Whitman
Ernest Hemingway
Virginia Wolf
Mark Twain
Edgar Allen Poe
Kurt Cobain
Mel Gibson
Ozzy Osbourne
Robert Downey Jr.
Explaining Mood Disorders
Biological Perspective
 Whole-body
disorder
 Genetic predispositions (runs in families),
biochemical imbalances
 Neurotransmission
 Norepinephrine
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(increases arousal, mood)
Too little = depression
Too much = mania
 Serotonin
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Too little = depression (Prozac, Zoloft, Paxil) / Exercise!
Explaining Mood Disorders
Social-Cognitive Perspective
 Aaron Beck: Cognitive Triad
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Depression stems from unreasonably negative ideas about
oneself, one’s setting and one’s future
(Thus depression is mostly cognition based, not mood
based)
Martin Seligman
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(Cognitive-Behavioral)
Learned Helplessness (prior events convince a person
of the inability to control future) = passivity and
depression
More prevalent in Western societies
 Epidemic hopelessness due to individualism and decline
of commitment to family and religion
Explanatory Styles and Depression
The Social-Cognitive Dilemma
Chicken and Egg Argument
 Does learned hopelessness, self-defeating
beliefs and negative explanatory styles
cause depression, or does depression
cause them…???
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Multiple Factors Must be Considered
Depression’s Vicious Cycle
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Characteristics, factors of depression tend
to promote each other in a wicked cycle…
 helplessness,
lethargy, sorrow, isolation,
dismissal, failure
Somatoform Disorders
“soma” = body
 Psychological problem manifested in a
physiological symptom (IOW: physical problem
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without a physical cause)
Common among those claiming disability
Two major disorders:
hypochondriasis: imagined or exaggerated illnesses (no
medical cause)
 Conversion disorder: involves motor or sensory
problems with no biological explanation / cause
 Conversion blindness, conversion paralysis
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Explaining Somatoform
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Psychoanalytic
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Outward manifestations of unconscious
conflict
Behaviorists
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Reinforcement for behavior (can’t work or
sympathy / attention)
Clinical Distinction…
Somatoform patient: unconscious of
psychological causes (does not seek to
maintain role of patient)
 factitious patient: Consciously creating the
symptoms, …prolonging role of patient
 Malingering patient: consciously creating
symptoms,…end goal (often financial)
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Dissociative Disorders
Disruption in conscious processes (lose
identity)
Usually from traumatic event
Famous films: Sybil, Three Faces of Eve,
Dr. Jekyll and Mr. Hyde
Types of Dissociative Disorders
Psychogenic Amnesia: Amnesia with no
physiological basis
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biologically induced amnesia = organic
amnesia)
Fugue = Psychogenic Amnesia +
unfamiliar environment (fugue = flight /
loss of identity and flee)
Types of Dissociative Disorders
Dissociative Identity Disorder (DID)
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AKA Multiple Personality Disorder
Usually from traumatic event / overwhelming
stress (high % report child abuse)
often at young age (3-5 years)
Self-protection / coping mechanism
Distinctive identities for different events
(toddler to adult)
Norm- 3-6 identities (2 to qualify)
Almost entirely confined to N. America
Very controversial as medical diagnosis
Explaining Dissociative Disorders
Psychoanalytic theorist:
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Extremely traumatic event so repressed that
causes split in consciousness
Behaviorist
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putting event out of mind is reinforcing (to
feel better)
Schizophrenia
Schizophrenia
 Disordered
/ distorted thinking
Breakdown in selective attention (Can’t filter
out information)
► Disturbed
perceptions
 Delusions: beliefs that have no basis in reality
►Delusions
of persecution = paranoia
►Delusions of grandeur = greatness
 Hallucinations: Perceptions in the absence of
sensory stimulation
► Inappropriate
actions / emotions
Things to consider…
► Most
severe of psych disorders
► Usually starts in late teens / early twenties
► 1 out of every 100 people have
Schizophrenia
Types of Schizophrenia
Disorganized Schizophrenia
 Paranoid Schizophrenia
 Catatonic Schizophrenia
 Undifferentiated Schizophrenia
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Acute vs. Chronic Schizophrenia
 What’s the difference?
 Acute: Abrupt display of symptoms- can be short
duration and never return or become long term issue
 Chronic: Long-term struggle with Schizophrenia
Disorganized Schizophrenia
► Odd
use of language (Word Salad =
fragmented speech
 Neologisms:
made up words
 Clang associations: string together nonsense words
that rhyme
► Inappropriate
effect:
Laugh in sorrowful setting
Flat effect: no emotional response at all
Paranoid Schizophrenia
► Delusions
of persecution
► “out to get me”
Catatonic Schizophrenia
► Engage
in odd movements
► Remain motionless for hours (odd positions
/ poses / Waxy flexibility
► parrot-like repeating of speech, movement
Undifferentiated Schizophrenia
► Disordered
thinking, but no symptoms of
other types of Schizophrenia
Schizophrenic Symptoms: 2 Types
Positive Symptoms
► Excesses in behavior,
thought, mood
Negative Symptoms
► Deficits, such as flat
effect, or catatonia.
(Absence of normal
behavior)
Explaining Schizophrenia
► Biological
 Dopamine hypothesis
►Excessive
levels)
levels = Schizophrenia (average 6x normal
 Enlarged brain ventricles
 Genetic predispositions
 Abnormality of 5th chromosome
► Social-Cognitive
 Double binds: contradictory messages =
distorted ways of thinking
Personality Disorders
(Notes = Dark Green)
 Enduring, maladaptive behavior
that negatively affects one’s
ability to function.
 Usually less serious than other
disorders. (But there are
exceptions..)
 Nurture and nature based
Personality Disorder
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Antisocial disorder (most serious)
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No regard for others’ feelings / world as hostile / look
out for oneself / absence of conscience
No fear, no shame
Most cases are not violent, however…
• serial criminals, serial killers (worst case)
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Electric shock: no increased anxiety in anticipation
Causes: Both Biological and Psychological
• Nurture influential: hero or villain…
More Personality Disorders
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Borderline Personality
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Dependant personality disorder
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Self-love, grandiose self-importance, entitlement, failed
relationships, “”narcissistic paradox”
Histrionic Disorder: (center of attention)
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Feel persecuted, very distrustful
Narcissistic Disorder
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Overly dependant on attention, help from others
Paranoid Personality Disorder
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Disorder of emotions (intense instability) self-mutilation
Severe anxiety, depression
Overly dramatic behavior
Obsessive-Compulsive Disorder
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Overly concerned with thoughts and behaviors
Other Personality Disorders
 Eating
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Personality Disorders
Anorexia Nervosa, Bulimia
 Substance
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Abuse Disorder (Addictions)
Drugs, alcohol
 Developmental
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Disorders
Autism, Attention deficit / hyperactivity
disorder (ADHD)
Other Personality Disorders
 Paraphilia:
sexual attraction to things not
normally seen as sexual (object, person,
activity) Examples below:
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Pedophilia / children
Zoophilia / animals
Fetish (objects, shoes, feet etc.)
 More
common in men
Remember…
 Personality
disorders are more minor than
other disorders ( in thought and behavior)
 Example
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Paranoid personality disorder
• Suspicion of persecution, but not the delusions,
hallucinations of the Paranoid Schizophrenic
Mental Disorders by Nation