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Abnormal Behavior or Psychological Disorders Content as per College Board Abnormal Behavior 7-9 % What is Normal? In a small group of 3-5 students, determine what you would call “normal” Not who, what is normal? What is well-being? In this same group, identify what is psychological order or well-being. Is it just an absence of a disorder? Is it more like that which makes a person healthy? List 3-5 characteristics that make a person have “well-being” Well being Self acceptance Positive relations with others Autonomy Environmental mastery Purpose in life Personal growth ****As defined by Carol Ryff What is a disorder? There is no one absolute definition of psychological disorders A continuum exists between mental health and pathology Some proposed definitions include: NOTE: Sanity and Insanity are legal definitions American Psychiatric Association A psychological disorder can be defined as a pattern of behaviors or psychological symptoms that cause significant personal distress and/or impairs the ability to function in one or more important areas of life. In your small group, Review and discuss the provided assignment. “What is Disordered Behavior?” Record your thoughts upon discussion. We will discuss this in 5-7 minutes. PBJ Who suffers from disorders? Ideas? (no p in pb and j) Diathesis-Stress Model Historical Perspectives on Abnormal Behavior The ancient world Greece Hippocrates Galen China Chung Ching The Middle Ages Europe Islamic Countries The Renaissance Teresa of Avila Johann Weyer and Reginald Scot Humanitarian Reforms th of 18th-19 centuries Philippe Pinel William Tuke Benjamin Rush Dorothea Dix Deinstitutionalization Occurred due to scientific advances of the 20th century MRI, PET Psychopharmacology Release of patients back into their usual community using out- patient care Modes or Perspectives of Psychological Disorders The Biopsychological Perspective The Psychoanalytical Model The Behavioral Model The Cognitive Model The Biopsychosocial Model Others? The DSM-V On Amazon.com $117 Available on Kindle The DSM-V Published by the American Psychiatric Association Widely used diagnostic system Provides a set of criteria to make assessments DSM Axes Axis 1- 16 major categories of disorders Axis 2 – personality disorders and developmental disorders (mental retardation) Axis 3 medical conditions Axis 4 - recent social and environmental stressors Axis 5 – Global Assessment of Functioning (GAF) See handout The positive and negative consequences of labeling Refer to the Rosenhan Study Anxiety Disorders Anxiety Disorders Occurs when overwhelming anxiety disrupts social or occupational functioning or produces significant distress Manifestations of anxiety: Cognitive Behavioral- Somatic- Specific Anxiety Disorders Specific Anxiety Disorders Panic Disorder- Recurrent and unexpected panic attacks are severe and involve feelings of terror and physiological involvement. Generalized Anxiety Disorder- characterized by persistent high levels of anxiety and excessive worry with symptoms present for at least 6 months; more persistent than panic disorder Specific Anxiety Disorders Phobia – a persistent, unrealistic, irrational fear of specific objects or situations. Exposure to a feared stimulus produces intense panic or fear, anxiety dissipates when the phobic situation is not confronted Examples Three subcategories: Simple phobias Agoraphobia Social Phobias Specific Anxiety Disorders Obsessive-Compulsive Disorders (OCD) Involves patterns of obsessions (thoughts, images or impulses that are recurrent or persistent despite a person’s efforts to suppress them) Involves patters of compulsions (repetitive, purposeful, but undesired acts performed in a ritualized manner in response to an obsession) Examples Persons with the disorder acknowledge the senselessness of the behavior, but when anxiety rises, the ritualized behavior relieves tension Examples PTSD 10 mins OCD 6 mins EtiologyCauses or explanation of disorder Etiology of anxiety disorders The learning perspective (behavioral) The cognitive perspective The biological perspective Somatoform Disorders Somatoform Disorders Characterized by complaints of physical symptoms that have no organic or physiological explanation They are psychologically based Symptoms are not considered voluntary or under conscious control Somatoform Disorders Specific somatoform disorders Somatization Disorder – characterized by multiple physical complaints with no organic explanation with onset prior to age 30. Conversion Disorder- specific physical complaints (paralysis of legs, blindness) Patients strongly believe there is impairment, but may show less distress than with a real loss. Hypocondriasis- characterized by persistent preoccupation with one’s health and physical condition, despite the fact that genuine symptoms are lacking Examples Body Dysmorphic Disorder http://www.youtube.com/watch?v=iAuc2xAM7- 8&feature=related Etiology The behavioral perspective These disorders constitute only 5% of all disorders treated with decreased incidence due to diagnosis advancements. Dissociative Disorders Dissociative Disorders Characterized by disturbances or changes in memory, consciousness or identity due to psychological factors Dissociative Disorders Dissociative amnesia- involves partial or total loss of important personal information (memory) that may occur after a stressful or psychologically traumatic event. There is no organic cause. Dissociative fugue- occurs when the individual suffers confusion over personal identity (memory) and often assumes a partial or completely new identity. It is accompanied by unexpected travel away from home. Dissociative Disorders Depersonalization Disorder- most common dissociative disorder that is characterized by feeling of unreality concerning the self and the environment. Characterized by intensity of symptoms and anxiety provoked by symptoms Dissociative Identity Disorder (DID)- formerly called Multiple Personality Disorder Kim Nobles 5 mins Oprah DID Psych Exchange DID This is a rare, dramatic and controversial disorder. Characterized by two or more distinct personalities within one person. Original personality is unaware of other personalities, but the other personalities are aware of each other. Each personality maintains its own identity, name and distinctive behavior. Diagnosis is controversial, some say it is really PTSD Explaining DID Dissociation is a relatively common response to traumatic experiences People with DID have experiences that are more extreme, frequent and disrupt daily functioning Some psychologist say this is a diagnostic fad. Examples Amnesia David 4 mins Fugue Reading “Joe” or John Doe DID male sufferer 4 mins Personality Disorders Personality Disorders Characterized by long standing, chronic, inflexible, maladaptive patterns of perception, thought and behavior that seriously impair an individual’s ability for function personally or socially Usually recognized by the time a person reaches adolescence As a group, these disorders are among the least reliably judged and are questioned as to their existence Clusters Cluster A: Paranoid, Schizoid and Schizotypal (Odd or Eccentric Behaviors) Cluster B: Antisocial, Borderline, Histrionic and Narcissistic (Dramatic or Erratic Behaviors) Cluster C: Obsessive-Compulsive, Avoidant and Dependent (Anxious or Fearful Behaviors) Personality Disorders Narcissistic personality disorder- marked by a grandiose sense of self-importance and preoccupation with fantasies of success or power. Individual is in constant need of attention or admiration and has inappropriate reactions to criticism Personality Disorders Antisocial personality disorder – marked by long standing pattern of irresponsible behavior that hurts others without causing feelings of guilt or remorse Individual does not experience shame or intense emotion of any kind. Violation of social norms, may include criminal acts Some studies detect early signs of antisocial behavior in children as young as 3-6 years old Explaining antisocial personality disorders Biological perspective suggests a biological vulnerability. May be related to low level of autonomic system arousal May show a fearlessness Biopsychosocial perspective suggests that if fearlessness is channeled in productive ways, heroism or adventurism may result. Personality Disorders Boarderline Personlity Disorder Histrionic Personality Disorder 5 mins Antisocial personality disorder Mood (Affective) Disorders Affective Disorders Mood disorders have significant and chronic disruption in mood as the predominant symptom Impaired cognitive, behavioral, and physical functioning Differentiated from normal moods on the basis of duration, intensity and absence of cause Prevalence: most common of all psychological disorders affecting 12 million Americans a year. More common in women. Greatest risk between ages 15-24 and 35-44. Affective Disorders Unipolar depression or clinical depression- one major mood or affect that is low. Behavioral symptoms- dejected, unsmiling, downcast demeanor, slow movement and speech, tearfulness and spontaneous crying and loss of interest or pleasure in one’s usual activity Emotional symptoms involve feelings of sadness, hopelessness and guilt while feeling emotionally disconnected Cognitive symptoms- difficulty thinking, concentrating, and remembering. Global negativity and pessimism. Suicidal thought and preoccupation with death Physical symptoms- changes in appetite (weight loss or gain) sleep disturbances, vague aches and pains, loss of energy or restlessness Other Depressed Mood Disorders Dysthymic Disorder- involves chronic, low grade feelings of depression that produces subjective discomfort but does not seriously impair one’s ability to function Seasonal Affective Disorder (SAD)- involves episodes of depression which typically recur in fall and winter and alleviate in summer and spring Bipolar Disorder Bipolar Disorder Characterized by alternating episodes of major depression and mania Previously referred to as manic -depression Prevalence and course: Annually about 2 million Americans suffer from bipolar disorder Onset typically in the early 20s Affects men and women at the same rate Responds favorable to drug therapy (lithium) Bipolar Disorder Depression has been defined. Mania includes: Emotional symptoms include euphoria, expansiveness and excitement Behavioral symptoms include out-of-character energy or activity, frenzied, disorganized activity, rapid-fire speech, spending sprees, illegal activities, disrupted sleep patterns Cognitive symptoms include wildly inflated self- esteem, grandiosity, easily distractibility, irritability, verbal abusiveness Cyclothymic Disorder Milder but chronic form of bipolar disorder involves moderate but frequent mood swings. People with the disorder are perceived as extremely moody, unpredictable and inconsistent Examples Bipolar 5 mins Maurice Bernard 3 mins SAD 5 mins Explaining affective disorders The biopsychological perspective The behavioral perspective The cognitive perspective The biopsychosocial perspective Developmental Disorders Developmental Disorders These disorders encompass a wide variety of psychological problems that involve disturbances in acquisition of cognitive, language, motor or social skills. Many symptoms may be behavioral oddities that require little attention and may disappear without intervention while some are more serious disorders. Developmental Disorders Autistic Disorders Developmental Skills Disorders Attention Deficit Disorder Hyperactivity Disorder TED TALK Temple Grandin 20 mins Schizophrenia Schizophrenia A group of severe disorders characterized by the breakdown of personality functioning, withdrawal from reality, distorted emotions and disturbed thoughts. Originally a vague general description that led to over diagnosis NOT “split personality” one personality that is shattered; split is from reality Onset in late teen or early 20s, early diagnosis key to successful treatment Schizophrenia DSM-IV indicates the following symptoms: Delusions Hallucinations Marked disturbances of speech, affect or thinking Deterioration from former functioning level Symptoms last at least 6 months and are currently present for one month Another classification system Positive symptoms- an Delusions excess or distortion of Hallucinations normal functioning Severely disorganized thought process, speech or behavior Disturbances involving extremely high or low activity levels of motor activity or odd movements and gestures Another classification system Negative Symptoms- restriction or reduction of normal functioning Flat affect, showing little emotion Inability to feel pleasure Lack of motivation Lack of meaningful speech Cessation of personal hygiene Types of schizophrenia Paranoid Schizophrenia- involves strongly held delusions of persecution or grandeur. Onset tends to be later in life (in the 30s). Rarely exhibits disorganized behavior, but may act upon delusions. Disorganized Schizophrenia- inappropriate behavior and affect including odd movements and disconnected emotional states. Incoherent language (word salad) Types of Schizophrenia Catatonic Schizophrenia- frozen rigid or excitable motor behavior. Maintains postures for hours. Undifferentiated Schizophrenia- has mixed set of symptoms. It involves thought disorders and features from other types of schizophrenia. Course of Schizophrenia Typically occurs in men younger than 25 and women between 25 and 45. Men and women equally affected. 1-2% of the world’s population Present in all cultures. Gradual onset- some changes in previous behavior noted by others (social withdrawal) Sudden onset- symptom free then symptoms present Better prognosis for recovery Promodal phase, active phase, residual phase “Rule of Thirds” Next slide Rule of Thirds One-third- patients recover One-third-patients are helped with medication but retain some symptoms One-third- patients are not helped by drug therapy and retain symptoms as a chronic condition Explaining Schizophrenia In the Biopsychological Perspective Genetic factors (studies within families and twin and adoption studies) Abnormal Brain Chemistry (some studies implicate dopamine and dopamine blocking drugs reduce the symptoms, particularly the positive ones) Prenatal Viral Infection-based cause (mother suffers from seasonal influenza during 2nd trimester) Abnormal brain structure (abnormalities in the frontal lobe, temporal lobe and basal ganglia and/or fluid-filled ventricles) Currently Researchers have not been able to find a single cause of schizophrenia. Schizophrenia may be viewed as a complex, chronic mental illness affecting people in different ways. Secret Life of the Brain A PBS series that is widely available for a relatively low cost. The segment on “Adolescence” focuses on schizophrenia in adolescence. It is particularly effective for students. The second part of this segment covers addiction and adolescence. The Impact of Psychological Disorders Who suffers from psychological disorders? Frequency of Psychological Disorders World Health Organization estimates that 400 million people worldwide suffer from psychological disorders US government survey suggests that 15% of population is in need of psychological therapy 2 million people per year are admitted to mental hospitals and psychiatric units 2.4 million American seek out-patient care In any given year, 5 million adults and 3 million children will suffer an acute episode of a serious disorder. Stigma of Mental Illness Misconceptions about people with mental illness leads to misunderstandings and discrimination. Misconception People with mental illness will never recover. Misconception All people with mental illness are dangerous to society. Misconception Individuals treated for psychological disorders will make poor employees. Efforts to combat stigma of mental illness Some organizations that make efforts to combat misconceptions and stigma attached to mental illness APA NMHA NAMI Goals of these organizations Educate the public Confront discrimination Challenge negative stereotypes Emphasize that treatment works Ultimately achieve understanding that serious mental illnesses are no-fault, biologically based diseases that should receive the same attention, concern, research and care dollars that other diseases garner. The Big Picture: Perspectives in Studying Personality, Abnormal Behaviors and Treatment Draw a graphic of your choosing (flower, fish, balloons, whatever) Somewhere on your graphic, identify, define and list names associated with the 6 current perspectives in psychology (listed below) behavioral, biological, cognitive, evolutionary, humanistic, psychodynamic/psychoanalytic Predict how each perspective would explain development of personality. Analyze (Predict) how each perspective would explain the development of a disordered behavior. Evaluate a list of major treatment orientations for each perspective used in therapy. Note To Teacher: This may be a preview or review of content. Suggested Activities Student Project: Encounters with the Mentally Ill Multimedia Project for the Introduction of Psychological Disorders Foldable of Psychodiagnosis Movies and Mental Illness Your Suggestions? From the Office of Teaching Resources in Psychology (OTRP) APA Div. 2 Society for the Teaching of Psychology Films Illustrating Psychopathology OTRP Danny Wedding Using Film to Teach Psychology Elizabeth M. Nelson ON To Treatment! Back to Big Picture for Treatment