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Abnormal Psychology Chapter Fifteen I. Basics of Abnormal Psychology A. Definitions of Abnormality 1. Abnormal behavior refers to patterns of behavior, thought & emotion that are abnormal – Also known as psychopathology 2. Reasons for Abnormality: – The behavior occurs rarely/infrequently in the general population • Exceptions– extremely high intelligence & exceptional athletic ability – The behavior causes personal distress • • People will deny the problem in some disorders The problem causes little or no emotional discomfort to the individual A. Definitions of Abnormality – The behavior results in a loss of normal functioning or impairs normal functioning • People unable to get along with others, to hold a job, to eat properly or to function on a daily basis – The behavior is unconventional (if a behavior violates the norms or standards of society) – The behavior causes discomfort to others – The behavior is irrational • It impairs one’s ability to think clearly & to make rational decisions – The behavior is unpredictable (fluctuates from one extreme to another for no apparent reason) B. Views of Psychopathology 1. Believed to be caused by evil spirits & witchcraft (1600s) – Displayed odd/abnormal behavior were believed to be witches or to be possessed by demons 2. Mental illness was viewed as a disease of the mind (18th century) 3. Abnormal behavior is result of multiple factors (including biological, cognitive, social & psychological factors) C. Theories of Psychopathology 1. Psychoanalytic– abnormal behavior is the result of childhood conflicts that were not adequately resolved – Over- and under-indulgence of desires across childhood; conflicts with parents early in life 2. Humanistic– one’s self concept & one’s relationship with society as important influences on behavior – Can result from denial, distortion or questioning of one’s true self; lack of C. Theories of Psychopathology 3. Cognitive– faulty thoughts & beliefs are central to abnormal behavior – Results from inappropriate thoughts, distorted perceptions, & irrational beliefs 4. Biological– biological and/or genetic influences on behavior – Results from structural/anatomical, chemical and/or functional abnormalities in the brain 5. Behavioral– product of family learning through conditioning and/or modeling – Learned through past experience and present environmental conditions C. Theories of Psychopathology 6. Sociocultural– emphasizes social & cultural factors as important contributors to abnormal behavior – Behavior is defined by culture & influenced by socialization & cultural values – Can be shaped by family and society 7. Diathesis-stress model– incorporates elements from other perspectives – Inherited characteristics combine to create varying degrees of predisposition for a psychological disorder – Developing a disorder depends on degree of stress/negative experiences one has D. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) 1. Manual used by professionals to aid in the diagnostic process 2. Published by the American Psychological Association 3. Provides a classification system for mental disorders & describes in detail the criteria & symptoms that must be present for a particular diagnosis to be made E. Axes of the DSM-IV TR 1. Classifies behavior across 5 dimensions or axes 2. First 3 axes assess an individual’s clinical condition 3. Axes: – Axis I: presence of clinical conditions (mood disorders, anxiety disorders, schizophrenic disorders, & addictive behaviors) – Axis II: presence of personality disorders & mental retardation – Axis III: general medication conditions that might/might not be involved in conditions assessed in Axes I and II – Axis IV: presence of psychosocial & environmental stressors that the individual might currently be facing II. Mood Disorders Chapter Fifteen A. Basics 1. Characterized by disturbances or extreme fluctuations in emotion or mood 2. Previously known as an affective disorder 3. Mood disorders are among the most common mental health problems experienced by children and adolescents B. Unipolar Disorder 1. Also known as major depressive disorder 2. Characterized by persistent & intense sadness, despair, feelings of worthlessness, helplessness, low selfesteem, & high guilt & shame 3. Sadness they feel will interfere with their ability to function, to feel pleasure, & to maintain interest in life 4. Also experience physical changes, including sleep & eating disturbances & reports of physical illness & pain C. Bipolar Disorder 1. Also known as manic depression 2. Characterized by alternating periods of depression & mania – Depression similar to that of unipolar depression – During a manic episode, an individual might be overly excited & extremely active – They might show unrealistically high selfesteem & an inflated sense of importance – Might make elaborate plans, be impulsive, hyperactive & sleepless for days at a time – Flight of ideas & speech often becomes rapid D. Seasonal Affective Disorder (SAD) 1. Developing a deep depression typically during winter, but can also happen in spring 2. They tend to sleep and eat excessively 3. The hormone melatonin (higher levels) may play a role E. Factors that Contribute to Mood Disorders 1. Depressive disorders might be partially inherited (increased risk of developing depression if family member suffers from it) – Stronger genetic link for bipolar disorder 2. Biological factors are also associated with depressive disorders – Significant differences in brain activity during depressive & manic episodes – Depression is linked to chemical imbalances Depressed state Manic state Depressed state III. Anxiety Disorders Chapter Fifteen Normal Anxiety or Not? • If you are walking down the street and a large dog runs at you barking, it’s perfectly normal to be afraid. However, if you get anxious if a dog appears on the TV you’re watching, that’s a disorder. If a student gets up to give a speech in class and finds that his hands are trembling and his throat is dry, that’s normal anxiety. If a student runs out of the room crying when called on to speak or faints while giving a speech, that isn’t normal. -from the files of Judith R. Levine, SUNY Farmingdale A. Basics 1. Characterized by tension, worry, nervousness, panic or fear that is debilitating, distressing, & interferes with an individual’s ability to function on a daily basis 2. Many disorders will fall under this category B. Generalized Anxiety Disorder 1. Involves a chronic state of high anxiety, tension & worry in which individual cannot pinpoint any particular cause of the stress 2. Report sense of impending doom & a feeling that something dreadful is about to happen – Cannot identify any reason for anxiety/worry C. Panic Disorders 1. Involves anxiety attacks that produce a sudden & intense rush of anxiety, fear or impending doom that arises abruptly & for no reason 2. Attacks are usually brief (10-15 minutes) but leave people worrying excessively about future attacks & avoiding activities for fear of having an attack D. Phobic Disorders 1. Involves intense, irrational fear & avoidance of specific object or situation that poses little or no objective danger 2. People will recognize the irrationality, but still experiences anxiety & goes to extremes to avoid or escape presence of feared object 3. Common examples: – Arachnophobia: fear of spiders – Acrophobia: fear of heights – Claustrophobia: fear of close spaces E. Obsessive-Compulsive Disorder (OCD) 1. Involves persistent, unwanted thoughts (obsessions) that cause anxiety & lead individual to engage in repetitive acts/rituals (compulsions) in an attempt to reduce anxiety 2. Thoughts & acts become uncontrollable & interfere with individual’s ability to function 3. Examples: – Endless counting; checking locks & repeatedly washing their hands IV. Schizophrenia A. Symptoms of Schizophrenia 1. Major feature of all schizophrenic disorders– a break from reality (or a psychotic episode) 2. Might experience hallucinations (perceive things without external stimulation) – Voices & sounds are most common forms 3. Exhibit disorganized & incoherent speech (words become scrambled; create artificial words) 4. Logic is impaired & thoughts are disorganized & bizarre – Experience delusions (distorted beliefs)– being watched; someone important; giving/sending them A. Symptoms of Schizophrenia 5. Involves a variety of emotional disturbances including inappropriate affect, exaggerated affect, blunted or flat affect, & rapid fluctuations in affect 6. Certain types of schizophrenia involve unusual mannerisms & movements in which the individual might show excessive, uncontrollable motor activity or tics – May even display catatonic behavior (immobile stance) B. Types of Schizophrenia 1. Paranoid: hallucinations, delusions, & unpredictable behavior 2. Catatonic: motor disturbances 3. Disorganized: incoherent speech, emotional disturbances, social withdrawal & bizarre behavior 4. Undifferentiated: Meets criteria for a diagnosis of schizophrenia but no defining symptom exists 5. Residual: Major psychotic episode/symptoms are not present, but C. Factors Contribute to Schizophrenia 1. Schizophrenia results from a complex interaction of genetic, biological, & environmental factors – One’s risk of developing schizophrenia increases as genetic relatedness to an individual with schizophrenia increases – Excess levels of certain neurotransmitters in the brain are associated with schizophrenia – There are even structural differences in the brains of individuals with schizophrenia & those without V. Somatoform Disorders Chapter Fifteen A. Basics 1. Involve problems in which one experiences physical symptoms that have no physiological or biological basis 2. Two types: – Hypochondriasis: an individual has physical complaints for which medical doctors are unable to locate the cause • Believe that minor problems such as headaches are signs of a severe physical illness even after he/she is assured by doctors that no evidence exists – Conversion disorder: an individual will report the existence of a severe physical problem such as paralysis/blindness without any physiological B. Causes 1. Psychoanalytic theorists feel that these disorders are merely outward manifestations of unresolved unconscious conflicts 2. Behaviorists would say that people with this type of disorder are being reinforced for their behavior – Examples: • • Someone experiencing blindness due to conversion disorder may avoid unpleasant tasks like working Someone with hypochondriasis may receive a VI. Dissociative Disorders Chapter Fifteen A. Basics 1. Characterized by the fragmentation of experience, memory, or consciousness 2. Involves a number of related disorders B. Types of Dissociative Disorders 1. Dissociative Amnesia: involves memory loss that is typically selective – Examples: Not being able to recall one’s own name, not recognizing loved ones, not remembering one’s address – People will generally appear normal, maintaining memories for previously learned skills & abilities 2. Dissociative Fugue: form of amnesia in which one forgets who they are, wanders from home & starts a completely new life – Flee from their usual environment & assume a B. Types of Dissociative Disorders 3. Depersonalization Disorder: involves a separation of mind & body in which individuals experience episodes of feelings detached from their body 4. Dissociative Identity Disorder: occurs when two or more distinct personalities develop in one individual – Each personality has unique memories, behaviors & social relationships – Personalities might even be a different sex, race, or age than the original personality – Formerly known as multiple personality disorder C. Causes 1. Psychoanalytic theorists believe that this disorder results when an extremely traumatic event has been repressed that a split in consciousness occurs 2. Behaviorists state that people who have experienced trauma simply find not thinking about it to be rewarding, thus producing amnesia or DID D. Criticisms of DID 1. Cases of DID are rare outside of the U.S. 2. Numbers increased dramatically as cases became more publicized 3. Percentage of population question whether DID is a legitimate psychological disorder – Some diagnosed with DID may have been led to role-play the disorder inadvertently as a result of VII. Personality Disorders Chapter Fifteen A. Basics 1. Personality disorders are characterized by long-standing, inflexible, & maladaptive behavior patterns that cause an individual or society impairment or distress – All begin by early adulthood and are present in a variety of contexts – All cannot be explained by any other disorder (i.e., schizophrenia, major depressive disorder, etc.) B. Categories of Personality Disorders 1. Cluster A – Disorders that resemble schizophrenic-like behaviors, but not as severe – Paranoid - distrust others and are suspicious of their motives (secretive/jealous behavior) – Schizoid - express only a limited range of emotion in social interactions and form few if any close relationships with others – Schizotypal - have little capacity for close B. Categories of Personality Disorders 2. Cluster B – Disorders that affect emotional & behavioral norms. – Antisocial - regularly disregard and violate the rights of others. These behaviors may be aggressive or destructive. They may be selfcentered & lack a sense of responsibility & feel little personal distress – Borderline - behave impulsively and their relationships, self-image, and emotions are unstable (feelings of depression, emptiness– high suicide risk) – Histrionic - exaggerate their emotions and go to excessive lengths to seek attention. – Narcissistic - an excessive sense of how B. Categories of Personality Disorders 3. Cluster C – Disorders that reflect anxiety & are not severe enough for diagnosis as an anxiety disorder. – Avoidant - socially inhibited, usually feel inadequate & are overly sensitive to criticism. – Dependent –characterized by extreme dependence on others, submissive & clingy behavior, difficulty making decisions, & helplessness – Obsessive-Compulsive - sacrifice openness, spontaneity, & flexibility to pursue orderliness, control, and perfectionism.