Download RATE each of these people using the following scale

Chapter 17
Abnormal Behavior: Deviance and Disorder
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Key Questions

How is normality defined, and what are the major psychological
disorders?

What is a personality disorder?

What are the most common sexual disorders?

What problems result when a person suffers high levels of
anxiety?

How do psychologists explain anxiety-based disorders?

Is psychiatric labeling damaging?

What role does the concept of insanity play in criminal trials?
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Catch-22 (Page 557)
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Facts on Psychopathology

During their lifetimes, 1 out of every 100 people will become so
severely disturbed as to require hospitalization

Some 3-6% of the aged suffer from organic psychoses

In any given week, 7% of the population is experiencing an
anxiety-related disorder

1 out of every 8 school-aged children is seriously maladjusted

10-20% or more of all adults will suffer a major depression in
their lifetime

Each year over 2 million people in North America are admitted
or readmitted for psychiatric treatment in hospitals
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Andy Wilf Selfportraits
The self-portraits shown here
were painted by Andy Wilf
between 1978 and 1981. During
that time, Wilf is said to have
increasingly abused drugs and
alcohol. This dramatic series of
images is a record of his selfdestructive descent into a private
hell. The third painting shows a
shrouded skull-and foretells the
artists fate.
Wilf died of a drug overdose
early in 1982. Drug abuse is but
one of the many
psychopathologies, or “problems
in living,” psychologists seek to
alleviate
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What is Normal?

Psychopathology:

Scientific study of mental, emotional, and
behavioral disorders
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What is Normal? (cont.)

Subjective Discomfort:


Statistical Abnormality:


Feelings of anxiety, depression, or emotional distress
Having extreme scores on some dimension, such as intelligence,
anxiety, or depression
Social Nonconformity:

Disobeying societal standards for normal conduct; usually leads to
destructive or self-destructive behavior
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Fig. 17.1 The number of people displaying a personal characteristic may help define what is statistically
abnormal. Social non-conformity does not automatically indicate psychopathology.
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Does social nonconformity
automatically
indicate
psychopathology?
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What is Normal? (cont.)

Situational Context:

Social situation, behavioral setting, or general circumstances
in which an action takes place


Is it normal to walk around strangers naked? If you are in a
locker room and in the shower area, yes!
Cultural Relativity:

Judgments are made relative to the values of one’s culture
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The Politics of “Madness”

Page 560
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Shades of Abnormality

Bob is a very intelligent, 25 year
old member of a religious
organization that is based on
Buddhism. Bob's working for
this organization caused
considerable conflict between
him and his parents, who are
devout Catholics. Recently Bob
experiences acute spells of
nausea and fatigue that prevent
him from working and which
have forced him to return home
to live with his parents. Various
medical tests are being
conducted, but as yet no physical
causes of his problems have been
found.

RATE each of these people
using the following scale:
1 = Basically O.K. Psychotherapy is
not necessary.
2 = Mild disturbance. Psychotherapy
should be considered.
3 = Significant disturbance.
Psychotherapy is definitely required.
4 = Severe disturbance. Hospitalize!
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Shades of Abnormality

Jim was vice president of the
freshman class at a local college
and played on the school's
football team. Later that year he
dropped out of these activities
and gradually became more and
more withdrawn from friends
and family. Neglecting to shave
and shower, he began to look
dirty and unhealthy. He spent
most of his time alone in his
room and sometimes complained
to his parents that he heard
voices in the curtains and in the
closet. In his sophomore year he
dropped out of school entirely.
With increasing anxiety and
agitation, he began to worry that
the "Nazis" were plotting to kill
his family and kidnap him.

RATE each of these people
using the following scale:
1 = Basically O.K. Psychotherapy is
not necessary.
2 = Mild disturbance. Psychotherapy
should be considered.
3 = Significant disturbance.
Psychotherapy is definitely required.
4 = Severe disturbance. Hospitalize!
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Shades of Abnormality

Mary is a 30 year old musician
who is very dedicated and
successful in her work as a
teacher in a local high school and
as a part-time member of local
musical groups. Since her
marriage five years ago, which
ended in divorce after six
months, she has dated very few
men. She often worries that her
time is "running out" for
establishing a good relationship
with a man, getting married, and
raising a family. Her friends tell
her that she gets way too anxious
around men, and that she needs
to relax a little in general

RATE each of these people
using the following scale:
1 = Basically O.K. Psychotherapy is
not necessary.
2 = Mild disturbance. Psychotherapy
should be considered.
3 = Significant disturbance.
Psychotherapy is definitely required.
4 = Severe disturbance. Hospitalize!
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Shades of Abnormality

Larry, a homosexual who has
lived for three years with a man
he met in graduate school, works
as a psychologist in a large
hospital. Although competent in
his work, he often feels strained
by the pressures of his
demanding position. An added
source of tension on the job is his
not being able to confide in all
his co-workers about his private
life. Most of his leisure activities
are with good friends who
belong to the gay subculture

RATE each of these people
using the following scale:
1 = Basically O.K. Psychotherapy is
not necessary.
2 = Mild disturbance. Psychotherapy
should be considered.
3 = Significant disturbance.
Psychotherapy is definitely required.
4 = Severe disturbance. Hospitalize!
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Clarifying and Defining Abnormal Behavior
(Mental Illness)

Maladaptive Behavior:


Behavior that makes it difficult to function, to
adapt to the environment, and to meet everyday
demands
Table 17-1

Levels of functioning (page 561)
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Clarifying and Defining Abnormal Behavior
(Mental Illness)

Mental Disorder:


Significant impairment in psychological functioning
Those with mental illness lose the ability to
adequately control thoughts, behaviors, or
feelings
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Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

Psychological problems
can be grouped into broad
categories.

DSM-IV is not the only system
for classifying mental disorders.
Nevertheless, most activities in
mental health settings-from
diagnosis to therapy to billing of
insurance companies- are
influenced by the DSM. DSM-IV
is both a scientific document and
a social one. Major disorders are
well-documented problems.
Some problems, however, have
little to do with “mental
illness.” Instead, they are
primarily socially disapproved
behaviors.
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Diagnostic and Statistical Manual of Mental Disorders (DSMIV)

Major DSM-IV Categories

Page 563-564
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Clarifying and Defining Abnormal Behavior
(Mental Illness)

Psychotic Disorder:


Severe psychiatric disorder characterized by hallucinations and
delusions, social withdrawal, and a move away from reality
Organic Mental Disorder:


(cont.)
Mental or emotional problem caused by brain pathology (i.e.,
brain injuries or diseases)
Substance Related Disorders:

Abuse or dependence on a mind- or mood-altering drug, like
alcohol or cocaine

Person cannot stop using the substance and may suffer
withdrawal symptoms if they do
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Fig. 17.2 This MRI scan of a human
brain (viewed from the top) reveals a
tumor (dark spot). Mental disorders
sometimes have organic causes of this
sort. However, in many instances no
organic damage can be found.
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© Scott Camazine/Photo Researchers
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Clarifying and Defining Abnormal Behavior (Mental Illness)
(cont.)

Mood Disorder:


Disturbances in mood or emotions, like depression or mania
Anxiety Disorder:

Feelings of fear, apprehension, anxiety, and behavior
distortions
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© Bettmann/CORBIS
The Mad Hatter, from Lewis Carroll’s Alice’s Adventures in Wonderland. History provides numerous examples
of psychosis caused by toxic chemicals. Carroll’s Mad Hatter character is modeled after an occupational disease
of the eighteenth and nineteenth centuries. In that era, hatmakers were heavily exposed to mercury used in the
preparation of felt. Consequently, many suffered brain damage and became psychotic, or “mad” (Kety, 1979).
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Alice in Wonderland

Video (Johnny Depp)

Video (Disney)
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Clarifying and Defining Abnormal Behavior (Mental
Illness) (cont.)

Somatoform Disorder:


Dissociative Disorder:


Physical symptoms that mimic disease or injury
(blindness, anesthesia) for which there is no
identifiable physical cause
Temporary amnesia, multiple identity, or
depersonalization (like being in a dream world, feeling
like a robot, feeling like you are outside of your body)
Personality Disorder:

Deeply ingrained, unhealthy, maladaptive personality
patterns
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Clarifying and Defining Abnormal Behavior
(Mental Illness) (cont.)

Sexual and Gender Identity Disorder:


Problems with sexual identity, deviant sexual behavior, or
sexual adjustment
Neurosis:

Archaic; once used to refer to anxiety, somatoform, and
dissociative disorders, also used to refer to some kinds of
depression
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Personality Disorders:
Blueprints for Maladjusted

Paranoid person
Overly suspicious, mistrusting

Narcissistic person
Pre-occupied with their own self-importance. Absorbed in fantasies of
power, wealth, brilliance, beauty, and love

Borderline
Very unstable relationships, erratic emotions, self-damaging behavior,
impulsive

Histrionic

Overly dramatic, attention seekers, easily angered, seductive, vain,
shallow and manipulative

TABLE 17-5 (Page 568)
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Personality Disorders

Borderline


Narcissistic


Girl Interrupted
There Will be Blood
Histrionic

Gone With The Wind
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Let’s Have A Party

Imagine a party where all the people had a personality
disorder
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General Risk Factors for
Contracting Mental Illness

Social Conditions: Poverty, homelessness, overcrowding, stressful
living conditions

Family Factors: Parents who are immature, mentally ill, abusive, or
criminal; poor child discipline; severe marital or relationship
problems

Psychological Factors: Low intelligence, stress, learning disorders

Biological Factors: Genetic defects or inherited vulnerabilities; poor
prenatal care, head injuries, exposure to toxins, chronic physical
illness, or disability
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Focus on a Controversy

Are the Mentally Ill Prone to Violence?

Jeffrey Dahmer

Page 565
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Personality Disorders: Antisocial Personality
Disorder (APD)

Antisocial Personality Disorder:

A person who lacks a conscience (superego?); typically
emotionally shallow, impulsive, selfish, and
manipulative toward others

Oftentimes called psychopaths or sociopaths

Many are delinquents or criminals, but many are NOT
crazed murderers displayed on television
Create a good first impression and are often charming
Cheat their way through life (e.g., Dr. Michael Swango,
Scott Peterson)


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APD: Causes and
Treatments

Possible Causes:



Childhood history of emotional deprivation, neglect, and
physical abuse
Underarousal of the brain
Very difficult to effectively treat; will likely lie, charm, and
manipulate their way through therapy
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Antisocial Personality
Disorder
CINEMA EDUCATION

Michael Swango

Clockwork Orange

The Joker

Ted Bundy
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© Robert Hare
Fig. 17.3 Using PET scans, Canadian psychologist Robert Hare found that the normally functioning brain (left)
lights up with activity when a person sees emotion-laden words such as “maggot” or “cancer.” But the brain
of a psychopath (right) remains inactive, especially in areas associated with feelings and self-control. When Dr.
Hare showed the bottom image to several neurologists, one asked, “Is this person from Mars?” (Images
courtesy of Robert Hare.)
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Anxiety-Based Disorders

Anxiety:


Feelings of apprehension, dread, or uneasiness
Adjustment Disorders:

When ordinary stress causes emotional disturbance
and pushes people beyond their ability to effectively
cope

Usually suffer sleep disturbances, irritability, and depression

Examples: Grief reactions, lengthy physical illness,
unemployment
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Anxiety-Based Disorders
(cont.)

Generalized Anxiety Disorder (GAD):


Duration of at least six months of chronic, unrealistic, or
excessive anxiety
Free-Floating Anxiety:

Anxiety that is very general and persuasive
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Anxiety Neurosis

Worksheet (Page 125)

Anxiety Neurosis
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Panic Disorders

Panic Disorder (without Agoraphobia):




A chronic state of anxiety with brief moments of
sudden, intense, unexpected panic (panic attack)
Panic Attack: Feels like one is having a heart attack, going to die,
or is going insane
Symptoms include vertigo, chest pain, choking, fear of losing
control
Panic Disorder (with Agoraphobia):

Panic attacks and sudden anxiety still occur, but with
agoraphobia
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Agoraphobia

Agoraphobia (with Panic Disorder):

Intense, irrational fear that a panic attack will occur
in a public place or in an unfamiliar situation




Intense fear of leaving the house or entering unfamiliar
situations
Can be very crippling
Literally means fear of open places or market (agora)
Agoraphobia (without Panic Disorder):

Fear that something extremely embarrassing will
happen away from home or in an unfamiliar situation
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Specific Phobias

Irrational, persistent fears, anxiety, and avoidance that focus on
specific objects, activities, or situations

People with phobias realize that their fears are unreasonable and
excessive, but they cannot control them

Examples: (Table 17-7 page 573)

Animal type: Fear of a specific type

Natural environment: Fear of heights, storms, ocean…

Blood, injection, injury: Fear of blood, injections, treatments

Situational: Fear of situations, airplanes, elevators, enclosed spaces

Other: Fear of other situations that lead to choking, vomiting, sick
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Social Phobia

Intense, irrational fear of being observed, evaluated,
humiliated, or embarrassed by others (e.g., shyness, eating,
or speaking in public)

Celebrities with Anxiety Disorders
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Phobia

Worksheet (Page 126)

Phobias
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Obsessive-Compulsive
Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)


Extreme preoccupation with certain thoughts and compulsive
performance of certain behaviors
Obsession:

Recurring images or thoughts that a person cannot prevent




Cause anxiety and extreme discomfort
Enter into consciousness against the person’s will
Most common: Being dirty, wondering if you performed an action
(turned off the stove), or violence (hit by a car)
Compulsion:

Irrational acts that person feels compelled to repeat against his/her
will


Help to control anxiety created by obsessions
Checkers and cleaners
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Obsessive-Compulsive
Disorder (OCD)
Cinema Education

The Odd Couple

Matchstick Men

As Good As It Gets
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OCD & Profile of a Neurotic

Worksheet(129-131)


Obsession/Compulsion and Hysteria
The Case of A.H./Profile of a Neurotic
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Stress Disorders

Occur when stresses outside range of normal human
experience cause major emotional disturbance


Acute Stress Disorder:


Symptoms: Reliving traumatic event repeatedly, avoiding
stimuli associated with the event, and numbing of emotions
Psychological disturbance lasting up to one month following
stresses from a traumatic event
Post Traumatic Stress Disorder (PTSD):

Lasts more than one month after the traumatic event has
occurred; may last for years


Typically associated with combat and violent crimes (rape,
assault, etc.)
Terrorist attacks on September 11th, 2001, likely led to an
increase of PTSD
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Dissociative Disorders

Dissociative Amnesia:


Inability to recall one’s name, address, or past
Dissociative Fugue:

Sudden travel away from home and confusion about personal
identity
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Dissociative Identity Disorder
(DID)

Dissociative Identity Disorder (DID):

Person has two or more distinct, separate
identities or personality states; previously
known as Multiple Personality Disorder




“Sybil” or “The Three Faces of Eve” are good examples
Often begins with horrific childhood experiences (e.g., abuse,
molestation, etc.)
Therapy often makes use of hypnosis
Goal: Integrate and fuse identities into single, stable personality
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Dissociate Identity Disorder
(DID)

Sybil

3 Faces of Eve

Fight Club
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Somatoform Disorders

Hypochondriasis:

Person is preoccupied with having a serious
illness or disease



Interpret normal sensations and bodily signs as proof that they
have a terrible disease
No physical disorder can be found
Somatization Disorder:

Person expresses anxieties through numerous
physical complaints

Many doctors are consulted but no organic or physical causes are
found
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Somatoform Disorders (cont.)

Pain Disorder:

Pain that has no identifiable organic, physical cause


Appears to have psychological origin
Conversion Disorder:

Severe emotional conflicts are “converted” into physical
symptoms or a physical disability

Caused by anxiety or emotional distress but not by physical
causes
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Fig. 16.4 (left) “Glove” anesthesia is a conversion reaction involving loss of feeling in areas of the hand that
would be covered by a glove (a). If the anesthesia were physically caused, it would follow the pattern shown in (b).
(right) To test for organic paralysis of the arm, an examiner can suddenly extend the arm, stretching the muscles. A
conversion reaction is indicated if the arm pulls back involuntarily. (Adapted from Weintraub, 1983.)
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Theoretical Causes of Anxiety
Disorders: Psychodynamic

Psychodynamic (Freud):

Anxiety caused by conflicts among id, ego, and
superego

Forbidden id impulses for sex or aggression are trying to break
into consciousness and thus influence behavior; person fears
doing something crazy or forbidden

Superego creates guilt in response to these impulses

Ego gets overwhelmed and uses defense mechanisms to cope
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Other Theoretical Causes of
Anxiety Disorders

Humanistic:


Existential:


Unrealistic self-image conflicts with real self-image
Anxiety reflects loss of meaning in one’s life
Behavioristic:

Anxiety symptoms and behaviors are learned, like
everything else

Conditioned emotional responses that generalize to new
situations
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More Theoretical Causes of
Anxiety Disorders

Avoidance Learning:


When making a particular response delays or
prevents the onset of a painful or unpleasant
stimulus
Anxiety Reduction Hypothesis:

When reward of immediate relief from anxiety
perpetuates self-defeating avoidance behaviors
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Cognitive Approach

Cognitive:

When distorted thinking causes people to
magnify ordinary threats and failures, leading to
anxiety and distress
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Insanity

Insanity:

A legal term; refers to an inability to manage one’s affairs or to be
aware of the consequences of one’s actions





Those judged insane (by a court of law) are not held legally
accountable for their actions
Can be involuntarily committed to a psychiatric hospital
Some movements today are trying to abolish the insanity plea and
defense; desire to make everyone accountable for their actions
How accurate is the judgment of insanity?
Expert Witness:

Person recognized by a court of law as being qualified to give expert
testimony on a specific topic

May be psychologist, psychiatrist, and so on
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Insanity

Insanity Defense: Person was incapable of knowing
right from wrong while committing a crime

M’Naghten Rule: Standard for judging legal insanity
in English common law



Must understand wrongfulness of actions to be held
responsible for them
If suffering from mental disease preventing person from
knowing right from wrong, can be deemed insane
Taking of a life due to insanity is not murder

Irresistible Impulse: Uncontrollable urge to act

Diminished Capacity: Temporary loss of ability to
control actions or to know right from wrong
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Psychology and the Law

The “Twinkie Defense”
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Panic Disorder

Part A read (Page 203-206)

Part B complete using Part A (Page 207-208)
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