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Abnormal Psychology Abnormal Psychology: study of behavior & mental processes connected with emotional distress or impairment in functioning Psychological Disorders • About half of Americans will meet the criteria for a DSM-IV disorder at some time in life • By age 75, the lifetime probability of a(n)… • Anxiety disorder (including phobias) = 32% • Mood disorder (including depression) = 28% • Impulse control = 25% • Alcohol abuse = 15% • Drug abuse = 9% • Median age of onset is earlier for anxiety disorders and impulse control (11 years) than for substance abuse disorders (20 years) and mood disorders (30 years) • Half of all cases start by 14 years and ¾ of cases start by 24 years Psychological Disorders • Rates of mental illness have flattened in the past 15 years after steadily rising from the 1950s • More people are seeking treatment 41% of those having a disorder went for treatment in the prior year which is up from 25% a decade ago • Younger adults are more likely to seek prompt care, so the stigma of mental illness is waning • Because schizophrenia, autism, and some other severe disorders were not surveyed, the researchers conclude that he prevalence of psychological disorders is even higher than their statistics suggest Historical Perspectives on Abnormal Behavior – Old Beliefs • Perceived Causes – Movements of sun or moon (lunacy = full moon) – Evil spirits, demonic possession • Ancient Treatments – Exorcism, caged like animals, beaten/burned, castrated, mutilated, blood replaced with animal’s blood, trephening Trephening = cut hole in head to let out evil spirit Historical Perspectives on Abnormal Behavior • In the 1800s, disturbed people no longer thought of as “madmen” but as “mentally ill” • Early mental hospitals – Barbaric prisons – Patients chained & locked away – Charged admission to see “crazies” © Bettmann/CORBIS Fig. 16.5 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). Historical Perspectives on Abnormal Behavior – 18th & 19th Centuries • Philippe Pinel (France) – Compassionate model for treatment – humane hospital in Paris • William Tuke (England) – Trained nurses for mentally ill, change public attitudes • Benjamin Rush (U.S.) – Founder of American psychiatry – Encouraged humane treatment, establishment of hospitals It’s All a Matter of Degree Epidemiology v. Etiology • Epidemiology is the study of diseases in populations of humans or other animals, specifically how, when and where they occur. – Epidemiological studies can never prove causation – Incidence = new cases of a condition which occur during a specified period – Prevalence = cases (both new and existing) of a condition observed at a point in time or during a period of time. • Etiology is the study of the origins and causes of disease Rosenhan’s “Labeling” Study • How does being “labeled” affect one’s treatment by others? • Had 7 confederates admitted to mental hospitals, labeled as schizophrenic • The confederates were told not to show any unusual behaviors at all, but be completely normal • Normal events/behaviors were perceived as irregular and abnormal by hospital staff • Rosenhan reasoned that labels were so powerful that they profoundly affected the way information was processed & perceived Practical Approach for Identifying Abnormality • What is the content of the behavior? – I stop bathing – I shower 37 times every day • What is the sociocultural context in which the behavior occurs? – We are expected to not smell – We are expected to show up to work on time • What are the consequences of the behavior for that person and for others? – People avoid me – I get fired from my job What is “Abnormal”? • • • • Maladaptive or harmful to individual Disturbing to others Atypical or uncommon Unjustifiable – does not make sense, irrational Psych disorders must cause significant personal distress and impair the ability to function in one or more areas of life Psychological Disorders- Etiology • Neurotic disorder (term seldom used now) – usually distressing but that allows one to think rationally and function socially – Freud saw the neurotic disorders as ways of dealing with anxiety • Psychotic disorder – person loses contact with reality – experiences irrational ideas and distorted perceptions Psychological Disorders- Etiology • Organic Mental Disorder: mental or emotional problem caused by brain pathology (injury, disease) • Substance Related Disorders: abuse or dependence on a mind- or mood-altering drug, like alcohol or cocaine – Person cannot stop using the substance & suffer withdrawal symptoms of they do How are psychological disorders diagnosed? • Interviews, self-reports • Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. known as DSM-IV • Published by the American Psychiatric Association • Provides set of criteria, but does NOT identify causes or treatments The DSM-IV defines symptoms & diagnoses using hierarchy (Five Axes) Axis 1: Adult psychological disorders (depression, schizophrenia, etc.) Axis 2: Developmental disorders (mental retardation, learning disability), personality disorders Axis 3: Medical conditions Axis 4: Social and environmental sources of stress (loss of job, death of loved one, divorce) Axis 5: Global Assessment of Functioning (GAF) score Scale ranges from 1 to 100 Score of 100 = unimpaired Score of 1 = severe dysfunction The DSM-IV defines symptoms & diagnoses using hierarchy (Five Axes) Axis 1: Alcohol dependence Axis 2: Dependent personality disorder Axis 3: Diabetes Axis 4: Death of spouse, unemployment Axis 5: GAF = 60 (moderate symptoms, occasional panic attacks, difficulty in school/work/social functioning) Perspective Biological (Biomedical) Causes of Disorder Organic problems (i.e. brain functioning), biochemical imbalances (neurotransmitters), heredity Psychoanalytic Unconscious conflicts & impulses stemming from childhood Humanistic Failure to strive to one’s potential, out of touch with one’s feelings Perspective Cognitive Behavioral (Learning) Sociocultural Causes of Disorder Irrational, dysfunctional thoughts or thought processes Abnormal behaviors are observed and/or reinforced Dysfunctional society (i.e. society’s pressure to be thin or powerful, gender socialization, etc.) Biopsychosocial Model Assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Biological (Evolution, individual genes, brain structures and chemistry) Sociocultural (Roles, expectations, definition of normality and disorder) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) FYI… • Intern’s syndrome tendency to see self as having symptoms & characteristics of disorder that one is learning • Comorbidity disorders can occur together (depression is sometimes comorbid with an anxiety disorder) Categories of Disorders • • • • • • • Anxiety Somatoform Dissociative Mood Personality Schizophrenic Sexual & Gender Identity • Eating • Substance Abuse • Etc.