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Abnormal Psychology A.K.A. Psychological Disorders A “harmful dysfunction” in which behavior is judged to be maladaptive, unjustifiable, atypical or disturbing. 1 MUDA • A mnemonic device used to remember the four attributes of a psychological disorder – Maladaptive – Unjustifiable – Disturbing – Atypical 2 Maladaptive • An exaggeration of normal, acceptable behaviors • Destructive to oneself or others 3 Unjustifiable • A behavior which does not have a rational basis 4 Disturbing • A behavior which is troublesome to other people 5 Atypical • A behavior so different from other people’s behavior that it violates a norm • Norms vary from culture to culture 6 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) 7 History of Mental Disorders • In the 1800’s, disturbed people were no longer thought of as madmen, but as mentally ill. They were first put in hospitals. Did this mean better treatment? 8 Early Mental Hospitals • They were nothing more than barbaric prisons. •The patients were chained and locked away. •Some hospitals even charged admission for the public to see the “crazies”, just like a zoo. 9 Philippe Pinel • Pinel said “take the chains off and declare that these people are sick” “a cure must be found!!!” 10 Perspectives and Disorders Psychological School/Perspective Psychoanalytic/Psychodynamic Cause of the Disorder Internal, unconscious drives Humanistic Failure to strive to one’s potential or being out of touch with one’s feelings. Behavioral Reinforcement history, the environment. Cognitive Irrational, dysfunctional thoughts or ways of thinking. Sociocultural Biomedical/Neuroscience Dysfunctional Society Organic problems, biochemical imbalances, genetic predispositions. 11 Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to classify, and describe psychological symptoms of the disorders. It does not explain causes or possible cures. The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s. 12 Multiaxial Classification Axis I Axis II Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Is a Personality Disorder or Mental Retardation present? Is a General Medical Condition (diabetes, Axis III hypertension or arthritis etc) also present? Are Psychosocial or Environmental Problems Axis IV (school or housing issues) also present? What is the Global Assessment of the person’s Axis V functioning? 13 Multiaxial Classification Note 16 syndromes in Axis I 14 Multiaxial Classification Note Global Assessment for Axis V 15 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.” 16 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. 17 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. 18 Panic Disorder • An anxiety disorder marked by a minuteslong episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations. 19 Phobia Marked by a persistent and irrational fear of an object or situation that disrupts behavior. 20 Phobias • A person experiences sudden episodes of intense dread. • Must be an irrational fear. • Phobia List 21 Kinds of Phobias Agoraphobia Acrophobia Claustrophobia Hemophobia Phobia of open places. Phobia of heights. Phobia of closed spaces. Phobia of blood. 22 Obsessive-compulsive disorder • Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action. • Obsession about dirt and germs may lead to compulsive hand washing. 23 Obsessive-Compulsive Disorder Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress. 24 Post-Traumatic Stress Disorder Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD): 1. Haunting memories 2. Nightmares 3. Social withdrawal Bettmann/ Corbis 4. Jumpy anxiety 5. Sleep problems 25 Somatoform Disorders • Occur when a person manifests a psychological problem through a physiological symptom. 26 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. 27 Dissociative Disorders • These disorders involve a disruption in the conscious process. • Three types…. 28 Dissociative Amnesia • A person cannot remember things with no physiological basis for the disruption in memory. • Retrograde Amnesia • NOT organic amnesia. • Organic amnesia can be retrograde or antrograde. 29 Dissociative Fugue • People with psychogenic amnesia that find themselves in an unfamiliar environment. 30 Dissociative Identity Disorder • Used to be known as Multiple Personality Disorder. • A person has several rather than one integrated personality. • People with DID commonly have a history of childhood abuse or trauma. 31 Mood Disorders • Experience extreme or inappropriate emotion. 32 Mood Disorders 1. Major depressive disorder 2. Bipolar disorder 3. Seasonal Affective Disorder 4. Post- Partum Depression 33 Major Depression • Depressed for at least two weeks with no apparent cause. 34 Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. 1. 2. 3. 4. Signs include: Lethargy and fatigue Feelings of worthlessness Loss of interest in family & friends Loss of interest in activities 35 Bipolar Disorder • Formally manic depression. • Involves periods of depression and manic episodes. • Manic episodes involve feelings of high energy (but they tend to differ a lot…some get confident and some get irritable). • Engage in risky behavior during the manic episode. 36 Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Depressive Symptoms Manic Symptoms Gloomy Elation Withdrawn Euphoria Inability to make decisions Tired Slowness of thought Desire for action Hyperactive Multiple ideas 37 Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Earl Theissen/ Hulton Getty Pictures Library The Granger Collection Wolfe George C. Beresford/ Hulton Getty Pictures Library Bettmann/ Corbis Whitman Clemens Hemingway 38 Seasonal Affective Disorder • Experience depression during the winter months. • Based not on temperature, but on amount of sunlight. • Treated with light therapy. 39 Desiree Navarro/ Getty Images 40 Post-partum depression Depression Cycle 1. Negative stressful events. 2. Pessimistic explanatory style. 3. Hopeless depressed state. 4. These hamper the way the individual thinks and acts, fueling personal rejection. 41 Schizophrenic Disorders The literal translation is “split mind.” A group of severe disorders characterized by the following: Symptoms of Schizophrenia 1. Disorganized thinking. 2. Disturbed Perceptions 3. Inappropriate Emotions and Innappropraite Actions 42 Disorganized Thinking • The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs. • Disorganized thinking comes from a breakdown in selective attention.they cannot filter 43 out information. Delusions (false beliefs) • Delusions of Persecution • Delusions of Grandeur 44 Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” (Sheehan, 1982) Other forms of delusions delusions of This monologue illustratesinclude, fragmented, bizarre persecution is following me”) or thinking with (“someone distorted beliefs called delusions grandeur (“I am a king”). (“I’m Mary Poppins”). 45 Disturbed Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory. L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg 46 Inappropriate Emotions and Actions • Laugh at inappropriate times. • Flat Affect • Senseless, compulsive acts. • Word Salad • Catatoniamotionless Waxy Flexibility 47 Subtypes of Schizophrenia Schizophrenia is a cluster of disorders. These subtypes share some features, but there are other symptoms that differentiate these subtypes. 48 Disorganized Schizophrenia • disorganized speech or behavior, or flat or inappropriate emotion. • Clang associations • "Imagine the worst Systematic, sympathetic Quite pathetic, apologetic, paramedic Your heart is prosthetic" 49 Paranoid Schizophrenia • preoccupation with delusions or hallucinations. • Somebody is out to get me!!!! 50 Catatonic Schizophrenia • Flat effect • Waxy Flexibility • parrot like repeating of another’s speech and movements 51 Undifferentiated Schizophrenia • Many and varied Symptoms. 52 Understanding Schizophrenia 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. 53 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 54 Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC 55 Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development. 56 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 Fraternal One parent Sibling Nephew or niece Unrelated 57 Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983). Courtesy of Genain Family Genain Sisters The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. 58 Personality Disorders Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. 59 Antisocial Personality Disorder • Lack of empathy. • Little regard for other’s feelings. • View the world as hostile and look out for themselves. 60 Antisocial Personality Disorder A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath. 61 Dependent Personality Disorder • Rely too much on the attention and help of others. 62 Histrionic Personality Disorder • Needs to be the center of attention. • Whether acting silly or dressing provocatively. 63 Narcissistic Personality Disorder • Having an unwarranted sense of selfimportance. • Thinking that you are the center of the universe. 64 Schizoid Personality Disorder • People with schizoid personality disorder avoid relationships and do not show much emotion They genuinely prefer to be alone and do not secretly wish for popularity. 65 Borderline Personality Disorder • characterized by mood instability and poor self-image People with this disorder are prone to constant mood swings and bouts of anger. 66 Borderline Personality Disorder • they will take their anger out on themselves, causing themselves injury Suicidal threats and actions are not uncommon They are quick to anger when their expectations are not met. 67 Other Disorders • Paraphilias (pedophilia, zoophilia, etc) • Fetishism • Sadist, Masochist • Eating Disorders • Substance use disorders • ADHD 68