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Myers’ Psychology for AP* David G. Myers PowerPoint Presentation Slides by Kent Korek Germantown High School Additions to PP by Loretta Merlino Worth Publishers, © 2010 *AP is a trademark registered and/or owned by the College Board, which was not involved in the production of, and does not endorse, this product. Unit 12: Abnormal Psychology Objective • I will be able to identify and apply information about psychological disorders on individual and group assignments. Introduction-Essential Questions: • How do we define psychological disorders? • How should we classify psychological disorders? • What makes a thought or behavior abnormal/ a psychological disorder? Perspectives on Psychological Disorders Unit Overview-Essential Questions: What are • • • • • • • • Perspectives on Psychological Disorders Anxiety Disorders Somatic Symptom Disorders Dissociative Disorders Mood Disorders Schizophrenia Personality Disorders Rates of Disorder Click on the any of the above hyperlinks to go to that section in the presentation. What do you think would classify a behavior/though as a “Psychological Disorder” How should we define psychological disorders? Leave a space where there are spaces provided • 1.ongoing patterns of thoughts, feelings and actions that are • 2. deviant From what? _________________Context helps to determine this__________________ • 3. distressful (to who________________) and • 4. maladaptive/dysfunctional (how?____________________) Do psychological disorders change over time and why? Homosexuality dropped by the APA in 1973 Defining Psychological Disorders • Psychological disorders • Definition varies by context/culture (Ex. Koro-China and SE Asia) • Attention deficit hyperactivity disorder (ADHD)-lets read-563 Understanding Psychological Disorders The Medical Model Middle Ages-devil, possession-treatment: beatings, burning, castration, exorcism, trephination, pulling teeth, cauterizing the clitoris, transfusions of animal blood Understanding Psychological Disorders The Medical Model *Philippe Pinel (1745 to 1826), France: reformer, saw as sickness of mind caused by severe stresses and inhumane conditions His cures: unchaining, talking, boosting moral By 1800s discovery of syphilis brain infection led to further reform, hospital replaces asylums, cures/treatments sought, led to • *Medical model – Mental illness ( also called psychopathology) diagnosed according to symptoms and cured through therapy and treatment, including in psychiatric hospitals Understanding Psychological Disorders The Biopsychosocial Approach emerges • Medical Model was not sufficient The Biopsychosocial Approach to Psychological Disorders Classifying Psychological Disorders Diagnostic and Statistical Manual of Mental Disorders – DSM: description of symptoms and courses of disorders-does not give treatment –DSM-5 in 2013 • International Classification of Diseases (ICD-10) Classifying Psychological Disorders P. 566-Axes No Longer Used-IGNORE Criticisms of the DSM • 60 disorder categories in 1950 to 400 today • # of adults diagnosed expanded, 26 % at any given year and 46 % in their lifetime • More children being diagnosed, tripled to 6,000,000since the 1990s • Increase in disorders and people diagnosed since 1950. Overall, it is helpful in diagnosing Labeling Psychological Disorders-criticizms • Rosenhan’s study (p 567-568) • Power of labels-what do you think this power is? –Preconception can stigmatize • Insanity label-should they be hospitalized or jailed? • Stereotypes of the mentally ill (Silence of the Lambs) • Self-fulfilling prophecy Disorders Stated in College Board, AP Psychology Standards • anxiety disorders • • • • • • • • • • • trauma- and stressor-related disorders obsessive-compulsive and related disorders depressive disorders Bipolar and related disorders dissociative disorders personality disorders schizophrenia spectrum and other psychotic disorders somatic symptom and related disorders Feeding and eating disorders neurodevelopmental disorders Neurocognitive disorders Anxiety Disorders Anxiety Disorders • Anxiety disorders – Generalized anxiety disorder – Panic disorder – Phobia – Separation Anxiety Disorder Related Disorders: – Obsessive-compulsive disorder – Post-traumatic stress disorder (PTSD) Anxiety Disorders • Generalized anxiety disorder – 2/3 women – Symptoms are…, and often accompanied by depressed mood, disabling – Person can not deal with this because they cannot pinpoint the cause of their anxiety, frequently feel nervous – Free floating anxiety was the Term used by Freud Anxiety Disorders • Panic disorder –Panic attacks (similar symptoms as being in fight or flight stage of the sympathetic NS); no event precedes attack –1 in 75 persons Anxiety Disorders-Copy Entire Slide A. Phobias (1.specific and 2.social anxiety disorder-previously social phobia) – Specific phobia (snakes, heights, etc… Agoraphobia (is a specific phobia) =open/public spaces, stays in house due to panic atttacks, fears being unable to escape -Social anxiety disorder(situations in which one could embarrass oneself) B. Separation Anxiety Disorder –onset before or after 18 Phobias-p. 571 Phobias-p 571 Obsessive-Compulsive Disorder OCD(copy slide) • Obsessive-compulsive disorder – An obsession (repetitive thoughts) versus a compulsion(repetative actions) – Checkers (check) – Hand washers OCD (copy slide) • More common among teens/young adults • As one ages, symptoms may improve Obsessive-Compulsive Disorder-p. 572 Obsessive-Compulsive Disorder-p. 572 Obsessive-Compulsive Disorder-p. 572 Obsessive-Compulsive Disorder Obsessive-Compulsive Disorder New OCD Related Disorders (involve • • • • repetitive behaviors and anxiety) Hoarding disorder Excoriation (skin picking) Trichotillomania (hair pulling) Body dysmorphic disorder (focus on imagined or slight flaws-results in checking self in mirror, compulsive exercise, frequent plastic surgery) Post-Traumatic Stress Disorder (under Traumaand Stressor-Related Disorders) 1. Post-traumatic stress disorder • – PTSD – “shellshock” or “battle fatigue” – In one study of 104,000 returning from Iraq/ Afghanistan, 1 in 4 PSTD – Not just due to a war situation – Can get from observing others being Victimized, or hearing about it -anxiety, depression, flashbacks - May suffer from other Psychopathologies (co-morbitity) Post-traumatic growth (suffering has transforming power) 2. Reactive Attachment Disorderand 3. Disinhibited social engagement disorder (similar to ADHD symptoms) Both due to social neglect Understanding Anxiety Disorders The Learning Perspective (copy slide) • Fear conditioning (Leave space after each term): 1. Classical Conditioning –Stimulus generalization 2. Reinforcement (Operant Conditioning) 3. Observational learning Understanding Anxiety Disorders The Biological Perspective • Natural selectionAfraid of things that can harm us (preparedness hypothesis) -obsessive acts protect (checking, washing) • Genes – Anxiety gene, some are predisposed to anxiety (twins reared apart have similar phobias) – Glutamate, neurotransmitter, regulated by genes; too much glutamate leads to over activity in brain’s alarm centers • The Brain – Anterior cingulate cortex that monitors actions and checks for errors, hyperactive in those with OCD Somatic Symptom Disorders (Previously Somatoform Disorders) Somatic Symptom Disorders copy all of this: • Somatic Symptom disorders (manifesting a psychological problem through a physical disorder) Somatic=body – 1. Conversion disorder-very specific physical symptoms (paralysis) -no physiological reason; no sense of urgency from one who suffers – 2. Illness Anxiety Disorder (previously hypochondriasis)-interprets normal physical sensations as disease-goes to doctors for it, talks about it, etc… – 3. Factitious Disorder to self (aka Munchausen) =simulate, or cause symptoms of an illness and/or injury to self, or Factitious Disorder to others Dissociative Disorders Dissociative Disorders (copy slide) • Dissociative disorders-rare; change in consciousness-who we are- often due to extremely stressful situations • Dissociate =to become separated 1. Dissociative (aka-psychogenic) Amnesia (leave space for notes) With or without dissociative fugue/psychogenic fugue Dissociative Identity Disorder 2.Dissociative identity disorder (DID) – Two or more distinct personalities, can be observed or self reported (a.k.a., Multiple personality disorder) – Chris Sizemore, born 1927 22 personalitiesshe observed two violent deaths early on Dissociative identity disorder (DID) • • • • • • Many DID patients suffered from severe sexual/physical abuse as children (set on fire by parents, used in child pornography, sexual abuse) Rates: 2 diagnosed in North America per decade, 1930 to 1960 1980 first code for DID in DSM, 20,000 cases Displayed personalities also mushroomed from 3 to 12 More prevalent in North America Rare in Britain Non-existent India and Japan Understanding Dissociative Identity Disorder (copy) • Genuine disorder or not? • DID rates (increase in) lead some to believe it is: Therapist’s creation • Differences from culture to culture are too great Mood Disorders Mood Disorders (Copy slide) Mood disorders (a.k.a Affective Disorders) 1.Major depressive disorder (a.k.a Unipolar Depression) (leave 6 spaces here) 2. Disruptive mood deregulation disorder (similar to bipolar but for children to age 18) 3. Seasonal Affective Disorder change in daylight hours in winter/spring causes circadian rhythm disturbance , sleep less due to serotonin changes-serotonin impacted by sun light-treatment phototherapy (boosts serotonin levels in brain) 4. Premenstrual dysphoric disorder Bipolar disorder (formally, Manic Depressive Disorder-now under Bipolar and Related Disorders) (leave 5 spaces here) Major Depressive Disorder (copy entire slide) • Major depressive disorder (must be present for more than 2 wks; can be due to clear incident-family deathor no known reason/incident) • Most common mood Disorder -the “common cold” of disorders – Lethargic – Feelings of worthlessness – Loss of interest in family and friends, Activities -little interest in eating or overeating Major Depressive Disorder-P. 585 Suicide and Depression Common for people who commit suicide to have talked about it Women attempt suicide more often than do men, but men more likely to die from attempts due to more lethal means Suicide is one of the most common causes of death among young people Suicide is attempted NOT only by people who are depressed. Understanding Mood Disorders • Women more vulnerable to major depression than men • Most major depressive episodes selfterminate • Stressful events related to work, marriage and close relationships often precede depression • With each new generation, depression comes earlier and affects more people Bipolar Disorder (copy entire slide) • Bipolar Disorder=Mania & Depression –Mania (manic) • Overtalkative, overactive, elated, little need for sleep, risky behaviors, invincible….. “What goes up, must come down” – Men and women affected equally Understanding Mood Disorders-p. 582 Understanding Mood Disorders The Biological Perspective • Genetic Influences – Mood disorders run in families • Heritability (1 in 2 that identical twin of one with mood disorder will be affected) • Overall hereditability is 35 to 40% Linkage analysis (analyze genes for genetic causes of illness or disorders) : with depression, many genes at work with environmental factors to put people at risk) Understanding Mood Disorders The Biological Perspective • The depressed brain: Less brain activity during depression More during manic state Hippocampus, brain’s memory-processing center, linked with emotions circuits and vulnerable to stress related damage Biochemical influences-two neurotransmitters involved: Norepinephrine (increases arousal and boosts moods) is low during depression and high during mania Serotonin (mood, hunger, sleep, arousal) scarce during depression- REMEMBER THIS AS THE MAIN MOOD/DEPRESSION Neurotransmitter Understanding Mood Disorders The Biological Perspective-p 586 Understanding Mood Disorders The Social-Cognitive Perspective • Negative Thoughts and Moods Interact – Self-defeating beliefs • Learned helplessness (Martin Seligman) • Over thinking (to ruminate) – Explanatory style (how one explains events in one’s life) view (Seligman-dog research)that is: • Stable (‘this prob. Will last forever”), global (“it will effect all I do.”), internal explanations (all my fault) – Seligman (key figure) feels depression is common among young Westerners due to rise of individualization and decline in commitment to religion young people to take personal responsibility for failure Understanding Mood Disorders Explanatory Style Understanding Mood Disorders The Social-Cognitive Perspective Depression’s Vicious Cycle: – 1. Stressful experience results in – 2. Negative explanatory style, results in – 3. Depressed mood, results in – 4. Cognitive and behavioral changes, results in the cycle repeating (number 1) Understanding Mood Disorders The Vicious Cycle of Depression -p.589 Biopsychosocial Approach to Depression-pg. 465 Schizophrenia Spectrum and Other Psychotic Disorders No Longer Different Types of Schizophrenia-p. 591 No longer in DSM 5 (DO NOT NEED TO KNOW) Schizophrenia (symptoms) • Schizophrenia (split mind)-split from reality, with 1.disorganized thinking (Delusions), 2. disturbed perceptions (Hallucinations) and 3. inappropriate emotions/actions • It is a psychotic (break from reality) disorder with irrationality and lost contact with reality – Not multiple personalities Symptoms of Schizophrenia Disorganized Thinking (copy slide) 1. Disorganized thinking –Delusions • Delusions of persecution (others out to get me/recording me-paranoid) • Word Salad • Delusions of Granduer (I am Jesus) –Breakdown in selective attention Symptoms of Schizophrenia Disturbed Perceptions (Copy Slide) 2. Disturbed perceptions= Hallucinations(visual= seeing things not there, or verbal=hearing Voices= is most common) (copy slide)Symptoms of Schizophrenia 3.Inappropriate Emotions and Actions Inappropriate Emotions – Flat affect (lack of emotions)verses heightened emotions Inappropriate Actions – Catatonia/catatonic= no movement Can have Waxy flexibility (leave space) or -constant senseless emotion – Disruptive social behavior (I’ll explain) Schizophrenia Spectrum and Other Psychotic Disorders • Schizoaffective Disorder= Schizophrenia with a mood disorder • Delusional Disorder (not due to other disorder): nonbizzare =could be possibleboyfriend cheating; a friend is a government agent, etc…(or)bizarre=someone replaced heart with a battery • Catatonia= catatonic –can be due to medical condition or other disorder Onset and Development (copy *) • Statistics on schizophrenia: 1 in 100 people; 24 million across the world • *Onset –entering into adulthood, all cultures, slightly more often in men (struck younger) • *Positive (hallucinations, disorganized speech, laughing, tears or rage)versus negative symptoms (toneless voices, expressionless, mute, rigid bodies) • *Positive symptoms= presence of inappropriate behaviors • *Negative Symptoms=absence of appropriate behaviors • *Chronic (aka-process) schizophrenia=slow onset: recovery doubtful • *Acute (aka-reactive) schizophrenia=sudden onset: recovery more likely Understanding Schizophrenia Brain Abnormalities (copy all) • *Dopamine Overactivity/hypothesis-have excess D4 dopamine receptors; this intensifies brain signals and creates positive symptoms (hallucinations and paranoia) – *Dopamine blocking drugs lesson symptoms *Drugs that increase dopamine (stimulants) intensify Symptoms *dopamine overactivity over reaction to irrelevant stimuli Understanding Schizophrenia Brain Abnormalities • Abnormal Brain Activity and Anatomy –Frontal lobe and core brain activity –Fluid filled areas of the brain Understanding Schizophrenia Brain Abnormalities • *Low activity in frontal lobe (reasoning, planning, problem solving) • *Thalamus (filters sensory signals and sends to cortex)-when hallucinating activity seen here • *amygdala (fear processing center)-increased activity seen for people with paranoia Understanding Schizophrenia Brain Abnormalities • Maternal Virus During Pregnancy Studies show: –*Possible Influence of the flu during pregnancy Understanding Schizophrenia Genetic Factors (copy slide) • *6 in 10 chance for identical twins due to shared placenta • *Child whose parent has it , has increased risk • *Genetic predisposition and the Diathesis-Stress Model/ Vulnerably Stress Hypothesis= Environmental stressors can provide circumstances that trigger the disorder; explains why not all Identical twins share disorder Understanding Schizophrenia Psychological Factors • Possible warning signs – Mother severely schizophrenic – Birth complications (low weight/oxygen deprivation during birth) – Separation from parents – Short attention span – Poor muscle coordination – Disruptive or withdrawn behavior – Emotional unpredictability – Poor peer relations and solo play Personality Disorders Personality Disorders • Personality disorders=disruptive, inflexible, enduring behavior patterns that impair social functioning – Anxiety cluster: *Dependent (very needy) *Obsessive Compulsive (order and control, perfectionist) *Avoidant (oversensitive to criticism avoids social situations) - Eccentric cluster: *Paranoid (others out to get them) *Schizoid (No social relationships) – Dramatic/impulsive cluster: *Histrionic (center of attention, dramatic, emotionally shallow) *Narcissistic (exaggerated belief of importance, arrogant) Personality Disorders *Antisocial personality disorder –Previously Sociopath or psychopath Understanding Antisocial personality disorder • *Typically male • *Lack of consciousness for wrongdoing, even towards family and friends, apparent by age 15 (in non adults, it is called Conduct Disorder): *Lies, steals, fights, unrestrained sexual behavior; Half of these children become antisocial adults *Antisocial personalities feel and fear little WHY??? Pp. 597-598 *Differences in the brains frontal lobe that controls aggressive/impulsive behavior Neurodevelopmental Disorders Neurodevelopmental Disorders 1. Intellectual Disability (name change from mental retardation)=IQ below 70 and impaired functioning 2. Communication Disorders (speech and communication issues) • expressive or receptive language issues • speech sound disorder • fluency disorder (stuttering) • social communication disorder (difficulties in the social uses of verbal and nonverbal communication) 3. Autism Spectrum Disorder 1. deficits in social communication and interaction 2. repetitive behaviors, interests, and activities (likes routines) 3. heightened perception of senses 4. Attention-Deficit/Hyperactivity Disorder inattention and hyperactivity/impulsivity 5. Specific Learning Disorder (reading-includes dyslexia-, writing, math) 6. Motor Disorders= developmental coordination disorder, stereotypic movement disorder (ex-hand waving or head banging), Tourette’s disorder (motor or vocal tics) Neurocognitive Disorders-minor or major (dementia=decline in mental functioning- due to different causes, such as Alzheimer's) Feeding and Eating disorders Pica (eats non food ), Rumination Disorder (throws up and re-chew/eats), Anorexia (starve), Bulimia (binge/purge), Bing Eating Disorder (binge/guilt), Restrictive Food Intake Disorder (don’t fear weight gain and don’t have distorted body image (may fear choking, dislike food’s texture, etc…) Rates of Disorder Rates of Disorder • Mental health statistics • Influence of poverty (chicken and egg debate), crosses ethnic and gender lines • Phobias and antisocial by age 10 • Other disorders by early 20s The End Definition Slides Psychological Disorder = deviant (from the norm), distressful, and dysfunctional patterns of thoughts, feelings, or behaviors. Attention-deficit Hyperactivity Disorder (ADHD) = a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms; extreme inattention, hyperactivity, and impulsivity. Medical Model = the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured often through treatment in a hospital. DSM-V = the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013)-a widely used system for classifying psychological disorders. Anxiety Disorders = psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. Generalized Anxiety Disorder = an anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal. Panic Disorder = an anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations. Phobia = an anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation. Obsessive-compulsive Disorder (OCD) = an anxiety related disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions). Post-traumatic Stress Disorder (PTSD) = an anxiety related disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience. Post-traumatic Growth = positive psychological changes as a result of struggling with extremely challenging circumstances and life crises. Somatic Symptom Disorders (Formerly Somatoform Disorders) = psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause. Conversion Disorder = a rare somatic symptom disorder in which a person experiences very specific genuine physical symptoms for which no psychological basis can be found. Illness Anxiety Disorder (Formerly Hypochondriasis) = a somatic symptom disorder in which a person interprets normal physical sensations as symptoms of the disease. Dissociative Disorders = disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Dissociative Identity Disorder (DID) = a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder. Mood Disorders = psychological disorders characterized by emotional extremes. Major Depressive Disorder = a mood disorder in which a person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities. Mania = a mood disorder marked by a hyperactive, wildly optimistic state. Bipolar Disorder = a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. (formerly called manicdepressive disorder.) Schizophrenia = a severe disorder characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions. Delusions = false beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Personality Disorders = psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning. Antisocial Personality Disorder = a personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.