Download Unit 8, Abnormal Psychology

Abnormal Psychology
Psychological Disorders
Chapter 14
1
Defining Psychological Disorders
Mental health workers view psychological
disorders as persistently harmful thoughts,
feelings, and actions.
When behavior is deviant, distressful, and
dysfunctional psychiatrists and psychologists
label it as disordered (Comer, 2004).
Intern’s Syndrome - diagnose yourself or
those around you while studying a particular
disorder
2
Deviant, Distressful & Dysfunctional
 Maladaptive
Carol Beckwith
1. Deviant behavior
(going naked) in one
culture may be
considered normal,
while in others it may
lead to arrest.
2. Deviant behavior must
accompany distress.
3. If a behavior is
dysfunctional it is
clearly a disorder.
In the Wodaabe tribe men
wear costumes to attract
women. In Western society
this would be considered
abnormal.
3
Abnormality
 Statistically rare
 Deviant from social norms
 Situational context - the social or environmental
setting of a person’s behavior.
 Subjective discomfort - emotional distress
or emotional pain.
 Maladaptive - anything that does not allow a
person to function within or adapt to the
stresses and everyday demands of life.
Abnormality vs. Insanity
 Insanity is a legal term
 The insanity defense is used to argue that a
mentally ill person should not be held
responsible for his or her actions.
 Not everyone diagnosed with a mental
disorder would be able to claim insanity –
that designation is determined by judges
and juries.
 Not defined in DSM-IV-TR
Understanding Psychological Disorders
Ancient Treatments of psychological
disorders include trephination, exorcism,
being caged like animals, being beaten,
burned, castrated, mutilated, or transfused
with animal’s blood.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)
6
Medical Perspective
Philippe Pinel (1745-1826) from France,
insisted that madness was not due to demonic
possession, but an ailment of the mind.
George Wesley Bellows, Dancer in a Madhouse, 1907. © 1997 The Art Institute of Chicago
Dance in the madhouse.
7
Medical Model
When physicians discovered that syphilis led to
mental disorders, they started using medical
models to review the physical causes of these
disorders.
1.
2.
3.
4.
Etiology: Cause and development of the
disorder.
Diagnosis: Identifying (symptoms) and
distinguishing one disease from another.
Treatment: Treating a disorder in a
psychiatric hospital.
Prognosis: Forecast about the disorder.
8
Biopsychosocial Perspective
9
DSM IV
 Diagnostic Statistical
Manual of Mental
Disorders: the big book
of disorders.
 Operational definitions
of each disorder
 DSM will classify
disorders and describe
the symptoms.
 DSM will NOT explain
the causes or possible
cures.
 400 psychological
disorders compared to
60 in 1950’s
10
Goals of DSM
1.
2.
Describe (400) disorders.
Determine how prevalent the
disorder is.
Disorders outlined by DSM-IV are reliable.
Therefore, diagnoses by different
professionals are similar.
Others criticize DSM-IV for “putting any
kind of behavior within the compass of
psychiatry.”
11
Labeling Psychological Disorders
1.
Critics of the DSM-IV argue that labels may
stigmatize individuals.
2. David Rosenhan “pseudopatient” study 1970
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, 1995. Cornell University
Press.
Asylum baseball team (labeling)
12
Labeling Psychological Disorders
Elaine Thompson/ AP Photo
3. Labels may be helpful
for healthcare
professionals when
communicating with
one another and
establishing therapy.
4. “Insanity” labels raise
moral and ethical
questions about how
society should treat
people who have
disorders and have
committed crimes
(STIGMA)
Theodore Kaczynski
(Unabomber)
13
Anxiety Disorders
 A group of conditions
where the primary
symptoms are anxiety
or defenses against
anxiety.
 the patient fears
something awful will
happen to them.
 They are in a state of
intense apprehension,
uneasiness,
uncertainty, or fear.
 Important that their
behavior is maladaptive
14
Phobias
 A person experiences
sudden episodes of
intense dread.
 Must be a deep seated,
irrational fear.
 3 Basic Categories
 Specific
 Social
 Agoraphobia
 Phobia List
15
Generalized Anxiety Disorder
GAD
 An anxiety disorder in which
a person is continuously
tense, apprehensive and in a
state of autonomic nervous
system arousal.
 The patient is constantly
tense and worried, feels
inadequate, is oversensitive,
can’t concentrate and
suffers from insomnia.
 No specific stimulus
 Free Floating
16
Panic Disorder
 An anxiety disorder marked
by a minutes-long episode of
intense dread in which a
person experiences terror and
accompanying chest pain,
choking and other frightening
sensations.
 Can be recurrent; unexpected
 Symptoms: chest pain, muscle
tightness, numbness and
dizziness
17
Obsessive-compulsive disorder
 Persistent unwanted
thoughts (obsessions)
cause someone to feel the
need (compulsion) to
engage in a particular
action.
 Interfere with everyday
living and cause the person
distress
 Example: Obsession about
dirt and germs may lead to
compulsive hand washing.
18
Obsessive-Compulsive Disorder
19
Post-Traumatic Stress Disorder
Four or more weeks of the following
symptoms constitute post-traumatic stress
disorder (PTSD) after a deeply troubling
event:
1. Haunting memories
2. Nightmares
3. Social withdrawal
Bettmann/ Corbis
4. Jumpy anxiety
5. Sleep problems
20
Resilience to PTSD
Only about 10% of women and 20% of men
react to traumatic situations and develop
PTSD.
Survivor Resilience- Holocaust survivors show
remarkable resilience against traumatic
situations.
Post-traumatic Growth- All major religions of
the world suggest that surviving a trauma
leads to the growth of an individual and a new
positive view on life.
21
Somatoform Disorders
 Occur when a
person manifests a
psychological
problem through a
physiological
symptom without a
physiological cause
 Two types……
22
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.
23
Body Dysmorphic Disorder
 Intense anxiety about
perceived physical
deformity or defect
 Flaw is usually minor or
imagined
 Western Civilization
and its effect…
Dissociative Disorders
 These disorders involve
a disruption in the
conscious process.
 Separated from previous
memories, thoughts, and
feelings in response to a
stressful situation
25
Dissociative Identity Disorder
 Used to be known as
Multiple Personality
Disorder.
 A person exhibits two
or more distinct and
alternating
personalities
 May not know about one
another
 People with DID
commonly have a history
of childhood abuse or
trauma.
26
DID Critics
Critics argue that the diagnosis of DID
increased in the late 20th century. DID has
not been found in other countries.
Critics’ Arguments
1.
Role-playing by people open to a
therapist’s suggestion.
2. Learned response that reinforces
reductions in anxiety.
Psychoanalytic Viewpoint – protect us against a painful memory
27
Mood Disorders
 Experience extreme or inappropriate
emotion.
 Also known as Affective Disorders
28
Major Depression
 A.K.A. unipolar depression
 Unhappy for at least two
weeks with no apparent
cause.
 Sadness, hopelessness and
worthlessness, loss of
energy, changes in appetite
and sleep
 Depression is the “common
cold” of psychological
disorders.
 5.8% Men vs. 9.5% Women 29
Theory of Depression
Gender differences
Women get sadder, men get madder.
30
Neurotransmitters & Depression
•A reduction of
norepinephrine and
serotonin has been
found in depression.
•Drugs that alleviate
mania reduce
norepinephrine.
Pre-synaptic
Neuron
Norepinephrine
Serotonin
Post-synaptic
Neuron
31
The Depressed Brain & Genetic Influences
PET scans show that brain energy consumption
rises and falls with manic and depressive
episodes. (Left Frontal Lobe)
Identical Twins- 1 in 2 will have depressive
disorder; 7 in 10 will have bipolar disorder
32
Bipolar Disorder
 Formally manic
depression.
 Involves periods of
depression and manic
episodes.
 Manic episodes involve
feelings of high energy,
euphoria, inflated self
esteem
 but they tend to differ a
lot…some get confident
and some get irritable
 Engage in risky behavior
during the manic episode.
33
Bipolar Disorder
Many great writers, poets, and composers
suffered from bipolar disorder. During their
manic phase creativity surged, but not during
their depressed phase.
Hemingway
Earl Theissen/ Hulton Getty Pictures Library
Clemens
The Granger Collection
Wolfe
George C. Beresford/ Hulton Getty Pictures Library
Bettmann/ Corbis
Whitman
34
Personality Disorders
 Well-established,
maladaptive ways of
behaving that
negatively affect
people’s ability to
function.
 Dominates their
personality.
 Hard to tell apart
and treat
35
Antisocial Personality Disorder
 Lack of empathy.
 Little regard for other’s
feelings.
 View the world as hostile
and look out for
themselves.
 Manipulative, rebellious,
hurtful
 Sociopath/ (psychopath)
 Conduct Disorder
36
Understanding Antisocial
Personality Disorder
PET scans of 41 murderers revealed reduced
activity in the frontal lobes. In a follow-up
study repeat offenders had 11% less frontal
lobe activity compared to normals (Raine et al.,
1999; 2000).
Murderer
Courtesy of Adrian Raine,
University of Southern California
Normal
37
Histrionic Personality Disorder
 Needs to be the center
of attention and a
tendency toward highly
emotional behavior.
 Whether acting silly or
dressing provocatively.
 Needs reassurance they
are worth something 38
Narcissistic Personality Disorder
 Having an unwarranted
sense of selfimportance and an
extreme preoccupation
with themselves.
 Thinking that you are
the center of the
universe.
 Needs reassurance they
are better
39
Paranoid Personality Disorder
 Persistent suspicion
marked by the
chronic sense of
being observed and
persecuted
 Highly suspicious of
others
Borderline Personality Disorder
 Sudden and intense rages,
deep insecurity and fear of
abandonment, and general
instability in relationships
 Impulsive
 High suicide risk group
41
Schizophrenic Disorders
 If depression is the common cold
of psychological disorders,
schizophrenia is the cancer.
 About 1 in every 100 people are
diagnosed with schizophrenia.
 Schizophrenia strikes young
people as they mature into
adults.

It affects men and women equally,
but men suffer from it more
severely than women.
 Symptoms of Schizophrenia
1. Disorganized thinking.
2. Disturbed Perceptions
3. Inappropriate Emotions and
Actions
42
Disorganized Thinking
 The thinking of a
person with
Schizophrenia is
fragmented and bizarre
and distorted with
false beliefs.
 Word Salad
 Disorganized thinking
comes from a
breakdown in selective
attention.- they cannot
filter out information.
43
Disturbed Perceptions
 hallucinationssensory experiences
without sensory
stimulation.
 Usually auditory
 They do not exist!
44
Disturbed Perceptions
 Delusions- false beliefs
 Delusions of Persecution
or Paranoia
 Delusions of Grandeur
 Delusions of Reference
 Beautiful Mind
45
Inappropriate Emotions and
Actions
 Apathy
 Laugh at inappropriate times.
 may laugh at the news of someone dying
 Flat Effect- show no emotion at all
 Catatonia
 motionless Waxy Flexibility
 senseless, compulsive acts.
 may continually rub an arm, rock a chair,
or remain motionless for hours
46
Types of Schizophrenia
47
Positive and Negative Symptoms
Positive Symptoms
Schizophrenics have inappropriate symptoms
(hallucinations, disorganized thinking, deluded ways)
that are not present in normal individuals.
(presence)
Negative Symptoms
Schizophrenics also have an absence of appropriate
symptoms (apathy, expressionless faces, rigid bodies)
that are present in normal individuals.
(absence)
48
Subtypes
49
Understanding Schizophrenia:
Biological Model
Schizophrenia is a disease of the brain
exhibited by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found
that schizophrenic patients express higher
levels of dopamine D4 receptors in the brain.
50
Abnormal Brain Activity
Brain scans show abnormal activity in the
frontal cortex, thalamus, and amygdala of
schizophrenic patients. Adolescent
schizophrenic patients also have brain lesions.
Paul Thompson and Arthur W. Toga, UCLA Laboratory of
Neuro
Imaging and Judith L. Rapport, National Institute of
Mental Health
51
Abnormal Brain Morphology
Schizophrenia patients may exhibit
morphological changes in the brain like
enlargement of fluid-filled ventricles.
Effects frontal lobes and temporal lobes
Both Photos: Courtesy of Daniel R. Weinberger,
M.D., NIH-NIMH/ NSC
52
Genetic Factors
The likelihood of an individual suffering
from schizophrenia is 50% if their identical
twin has the disease (Gottesman, 1991).
0
10
20
30
40
50
Identical
Both parents
46x
Fraternal
One parent
6x
Sibling
Nephew or niece
Unrelated
53
Genetic Factors
The following shows the prevalence of
schizophrenia in identical twins as seen in
different countries. Averages out to about
1 in 2
54
Warning Signs
Early warning signs of schizophrenia include:
1.
A mother’s long lasting schizophrenia.
2.
Birth complications, oxygen deprivation and low-birth
weight.
3.
Short attention span and poor muscle coordination.
4.
Disruptive and withdrawn behavior.
5.
Emotional unpredictability.
6.
Poor peer relations and solo play.
55