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Abnormal Psychology
A.K.A. Psychological Disorders
Deviant, distressful, dysfunctional patterns
of thoughts, feelings or behaviors
Early Theories
• Abnormal behavior was caused by
demon possession
• Led to harsh, ineffective remedial
treatments
– Trephining, beatings, burnings, etc.
History of Mental Disorders
• Medical Model (Pinel)–
psychological disorders are
a biologically based…a
“sickness”/disease that
needs to be diagnosed and
cured
– Neglects the importance of social
circumstances and psychological
factors.
History of Mental Disorders
• Biopsychosocial Model– current
approach
– Interaction of nature and nurture
– Adds influence of culture and psych to
Medical model
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
Learning : classical or operant
(rewards and punishments)
conditioning, modeling
Cognitive
Irrational, dysfunctional thoughts or
ways of thinking.
Sociocultural
Biomedical/Neuroscience
Dysfunctional Society, family
Organic problems, biochemical
imbalances, genetic predispositions.
DSM IV
• Diagnostic Statistical
Manual of Mental Disorders:
– used to identify and diagnose
disorders
– Diagnoses only observable
patterns of behavior
• Facilitates reliability
– Answer questions from 5 levels
• DSM will NOT explain the
causes or possible cures.
• Criticism: classifies an
excessively broad range of
human behaviors as
psychologically disordered.
Classifying Psychological
Disorders
Two Major Classifications in the
DSM
Neurotic Disorders
• Distressing but one can
still function in society
and act rationally.
Psychotic Disorders
• A mental state that
impairs thought,
perception and
judgment
John Wayne Gacy
The Rosenhan Study
• Rosenhan’s associates were feigning symptoms of
hearing voices.
• ALL 8 normal people were misdiagnosed with
schizophrenia.
• What are some of the questions raised by this
study?
• Labeling
• Advantage - allows mental health professionals
to quickly communicate complex symptoms
• Disadvantages
• biasing power - make false assumptions
about the person
• self fulfilling prophecy- process by which
one’s expectations about another person
eventually lead the other person to behave
in ways that confirm these expectations
ADHD
• Symptoms:
– Inattention/distraction
– Hyperactivity
– Impulsivity
• Causes:
– Biological
• Normal but delayed thinning of frontal cerebral
cortex
• Genetic
– Social
• Watching lots of TV as a toddler (correlational)
ADHD
• Assessing:
– Eye Tracking device
• Gender:
– 2-3X more in Boys
• Prevalence:
– 4% of all children (10% US)
ADHD Treatment
• Treatment
– Biological – assume problem is organic
requires drug treatment therapy
• Stimulant drugs – help calm hyperactivity and
increase focus
– Aderall
– Ritalin
– Behavioral – assume problem behaviors are
the problem and apply operant and
classical conditioning principles
• Token economy –earn token for exhibiting
desired behavior, that can later be exchanged
for privileges or treats
Anxiety Disorders
• Anxiety Disorders - a group of
conditions where the primary
symptoms are persistent or
distressing anxiety or maladaptive
defenses against anxiety.
• Examples:
– Generalized anxiety disorder
– Panic disorder
– Phobias
– Obsessive compulsive disorder
– Post-traumatic stress disorder
Generalized Anxiety Disorder
• GAD - An anxiety disorder
in which a person is
continuously tense,
apprehensive and in a state
of autonomic nervous
system arousal.
– Fearful most of the time
accompanied by heart
palpitations, fatigue, dread,
difficulty concentrating,
sweating, or icy cold hands
– Often accompanied by
depression
– Free Floating – person can’t
identify, deal with or avoid
cause
Panic Disorder
• Panic Disorder - An anxiety
disorder marked by a
minutes-long episode of
intense dread that
something terrible will
happen
– Panic attack - chest pain,
choking, heart palpitations,
trembling, or dizziness
Phobias
• Phobia - irrational fear
causes person to avoid an
activity or situation
– Animals, insects, heights,
blood, closed spaces
– Social Phobia – fear of being
scrutinized by others…avoid
embarrassing social situations
– Agoraphobia – fear of open
spaces…having a panic attack
with no way to escape…may
accompany panic disorder
– Phobia List
Obsessive-compulsive disorder
• OCD - Persistent
• Obsessions – repetitive
thoughts
• Compulsions – repetitive
actions
• Examples – hoarders,
checkers, counters,
cleaners
• Causes
• Evolutionary Exaggerated behaviors of
ancestors – checking
territorial boundaries
• Biological
• insufficient serotonin
• Anterior cingulated cortex
• Learned – anxiety
reduction reinforces
behavior
Post-traumatic Stress Disorder
• PTSD – Flashbacks,
nightmares, withdrawal,
anxiety, insomnia for more than
4 weeks following extremely
stressful event.
– Greater emotional distress the
higher the risk for PTSD
– Cause:
• Sensitive limbic system increases
vulnerability by flooding body with
stress hormones
• Genes
• Survival resiliency - ability to survive
dozens of episodes of trauma
• Post-traumatic growth – increased
personal growth due to trauma
Causes of Anxiety Disorders
• Learned Perspective
– Conditioned
• Classically conditioned by associating stimuli (i.e. a traumatic
event) with anxiety
– Example: Rats who received unpredictable shocks in a lab become
fearful when they return to the lab
• Stimulus generalization – fear stimuli that are associated with
the original CS
– Example: Fear all dogs after bitten by Maui
• Reinforcement (operant) – helps maintain phobias and
compulsions after they arise
– Avoiding or escaping the feared situation reinforces the behavior
– Example: After feeling anxious you go inside your house which
calms you down
– Observational Learning
• Observing others’ fears
– Example: Monkeys transmit fear of snakes to offspring
Causes of Anxiety Disorders
• Biological Perspective
– Natural Selection/evolutionary perspective
• Biological predisposition to fear: spiders, snakes, close spaces, heights, storms
and darkness
• Compulsive acts exaggerate fears that contribute to survival:
– Examples:
» Washing up = ritual hand washing
» Checking boundaries = checking and rechecking locks
– Genes
• High strung temperament
– Anxiety disorders: high correlation in identical twins
– 17 genes expressed with Anxiety
• Neurotransmitters
– Anxiety gene affects brain levels of serotonin
– Too much glutamate : brain’s alarm centers overactive
– Brain
• Anterior Cingulate Cortex monitors actions and checks for errors – elevated
activity in OCD
• Amygdala – fear circuits created in traumatic experiences
– Neurotransmitters
• Serotonin low
• Glutamate High
Causes of Anxiety Disorders
• Psychoanalytic
Perspective
– Produced by repressed
memories, hidden wishes,
unconscious conflicts
• Example: Afraid to go out
on dates because sexually
abused by father
Think Pair Share
• A variety of specific psychological disorders are
categorized as anxiety disorders in the DSM-IV-TR.
List at least three specific anxiety disorders, and
identify elements they have in common and those
that are unique to each disorder.
Somatoform Disorders
• Somatoform Disorders psychological problem that
presents itself through
physical symptoms
– Examples
• Conversion Disorder
• Hypochondrias
– Cause: socio-cultural
• Cultural expectations about what
symptoms/diseases are socially
acceptable
• More common in Freud’s day
• China – depression not acceptable =
more somatoform disorders
Conversion Disorder
• Conversion Disorder –
anxiety is converted to
a physical symptom
with no physiological
basis.
– Examples: blindness or
paralysis.
– 12 teenage girls in
LeRoy, NY report
uncontrollable body
movements, tics and
verbal outbursts
Hypochondriasis
• Hypochondriasis –
normal sensations
are interpreted as a
symptoms of a
dreaded disease
• Patients go from
physician to physician
seeking medical
attention, but fail to
find a biological root.
• Example: Headache=
brain tumor
Dissociative Disorders
• Dissociative Disorders – involve
– disruption to conscious awareness
– sudden loss of memory
– change in identity,
• Two types
– Dissociative Fugue, Dissociative Identity
Disorder
• Symptoms in common
– Memory loss of time periods, events, people
– Distorted perception of people and things
• watch self with sense of attachment
– Blurred sense of identity
Dissociative Fugue
• Conscious awareness is
separated from painful
memories or feelings
• Patients find
themselves in an
unfamiliar environment
with no knowledge of
past life - create
physical distance from
real identity
• Triggered by stress
Dissociative Identity Disorder
• Dissociative Identity
Disorder (DID) - 2
or more distinct
personalities control
a person’s behavior
– Used to be known as
Multiple Personality
Disorder.
– Patients commonly
have a history of
childhood abuse or
trauma.
DID Controversy
AGAINST
1.
2.
3.
4.
Could be extreme version of
our capacity to vary the
“selves” we present in
different situation
Constructive memory –
leading questions may lead
to constructing false
memories of childhood
trauma
Role-playing (Spanos) of
fantasy-prone patients in
response to leading
questions
Increase in DID in last 20
years (Outside US disorder
is much less prevalent)
FOR
1.
2.
Distinct brain and body
states associated with
differing personalities
Heightened brain activity in
areas associated with
control and inhibition of
traumatic memories
DID Causes
• Psychoanalytic – defense against anxiety
caused by unacceptable impulses
• Learning – behaviors reinforced by anxiety
reduction
Mood Disorders
• Characterized by emotional extremes
– 2 typical forms
• Major Depressive Disorder
• Bi-polar
• The Common Cold of Psych Disorders
• Inhibits aggression and risk taking, slows us
down
• More prevalent in women
Causes of Mood Disorders
• Biological
– Genes
• Increased risk if have parent or sibling with disorder
• Identical twins
– Major Depression = 1 in 2 chance
– Bipolar = 7 in 10 chance (2 in 10 for Fraternal)
• Linkage analysis – isolating genes across generations
– Not one single gene found
• Heritablity – 35 to 40% in major depression
– Brain
• Less activity in brain during depressed states, more activity during mania
• Left frontal lobe (positive emotions ) is inactive during depression
• Hippocampus – vulnerable to stress related damage
– Biochemical
• Norepinephrine – scarce: depression; abundant: mania
• Serotonin – scarce; abundant: mania
• Drugs used to block reuptake of norepinephrine and serotonin relieve
symptoms
– SSRI – Selective Serotonin Reuptake Inhibiter (Zoloft/Prozac)
Causes of Mood Disorders
• Social Cognitive
– Cognition
increased expectations of negative outcomes
Self defeating beliefs
Learned helplessness
Negative explanatory style - tend to explain events in
stable (forever), global (affects everything) and internal
(my fault) terms
• Women : greater emotional memory to recall negative
events, more likely to sense a lack of personal control, and
over think in response to stressful situations
•
•
•
•
– Social
• Stressful life experiences
• Individualistic countries
• Psychoanalytical
– Internalization of anger
Suicide
• Risk highest when
rebounding from
depression
• Higher risk if abuse
alcohol
• Social suggestion
may trigger suicide
• Talk about suicide –
attempt suicide –
few succeed
Major Depression
• Major Depressive Disorder – at
least 5 signs of depression and
lasts 2 or more weeks
• Signs of depression:
–
–
–
–
–
–
lethargy
feelings of worthlessness
loss of interest in family/friends
Loss of interest in activities
Withdrawn
Self-defeating beliefs
• With or without therapy, episodes
usually end
Bipolar Disorder
• Bipolar Disorder – alternating between depression
and mania.
• Mania – euphoric, hyperactive/high energy, overtalkative, overactive, require less sleep, take more
risks, and are wildly optimistic state
• Formally manic depression.
Seasonal Affective Disorder
• Seasonal Affective
Disorder Experience
depression during
the winter months.
• Based not on
temperature, but on
amount of sunlight.
• Treated with light
therapy.
Personality Disorders
• Personality Disorders - Wellestablished, maladaptive ways of
behaving that negatively affect
people’s ability to function.
• 3 clusters
– Anxious/fearful
• Avoidant personality disorder
– Eccentric/Odd
• Schizoid personality disorder
– Impulsive/erratic/Emotional
• Histrionic personality disorder
• Narcissistic personality disorder
• Antisocial personality disorder
Antisocial Personality Disorder
• Antisocial Personality
Disorder – Lack of
conscience = antisocial
behavior (lying, cheating,
stealing, sexual
promiscuity
• Feel and fear little
• May be aggressive and
ruthless or a clever con
artist
• Usually Male
• Called Conduct disorder in
children
Causes of Antisocial Personality Disorder
• Biological
– Little or no physical reaction
• No autonomic nervous system
arousal (low levels of adrenaline)to
adverse events
• May lead to fearless behaviors
– Low levels of stress hormones
– Reduced frontal lobe activity
and tissue
– Genes
– Prone to alcohol and drug
addiction
• Social – poverty and family
instability, child abuse
Histrionic Personality Disorder
• Histrionic
Personality Disorder
– attention seeking
behaviors
Narcissistic Personality Disorder
• Narcissistic Personality
Disorder – self
involvement/obsession
with self
• Thinking that you are
the center of the
universe.
Schizoid Personality Disorder
• Schizoid Personality
Disorder – lack of
interest in social
events and
relationships
Avoidant Personality Disorder
• Anxiety personality
disorder
• Lifelong pattern of
feeling very shy,
inadequate, and fear
social rejection.
Schizophrenic Disorders
• Schizophrenia – meaning split mind and
characterized by
1. Disorganized thinking.
2. Disturbed Perceptions
3. Inappropriate Emotions and Actions
• 2 General Types
– Reactive (acute) schizophrenia – develops rapidly,
but more likely recovery
– Chronic (process) schizophrenia– slow to develop
and less likely to recover
• Prevalence 1/100
• Gender – Men slightly more than women
Disorganized Thinking
• Thinking that is
fragmented, bizarre and
distorted with false
beliefs (delusions).
• Speech is fragmented
and full of unrelated
words = word salad
• May be caused by
breakdown in selective
attention –inability to
filter out information.
Delusions (false beliefs)
• Delusions of
Persecution
• Example: “The
police are trying to
get me and take me
to prison”
• Delusions of
Grandeur
• Example: “I am
Jesus and can walk
on water”
Disturbed Perceptions
• hallucinationssensory experiences
without sensory
stimulation.
• Example:
– Hear voices saying
“You are bad and
should burn yourself
with a cigarette”
Inappropriate Emotions and
Actions
• Laugh at
inappropriate times.
• Flat Effect – no
emotion
• Senseless,
compulsive acts.
• Catatonia- remain
motionless for hours
Positive v. Negative Symptoms
Positive Symptoms
•Presence of
inappropriate symptoms
•Hallucinations,
disorganized thoughts,
delusion, inappropriate
emotions
Negative Symptoms
•Absence of
appropriate ones.
•Toneless voices,
expressionless faces,
mute, rigid bodies
Subtypes of Schizophrenia
• Disorganized - disorganized
speech or behavior, or flat or
inappropriate emotion.
• Paranoid – preoccupation with
delusions or hallucinations,
often with themes of
persecution or grandiosity
• Catatonic – immobility, extreme
negativism, parrot-like
repeating of speech and
movement
• Undifferentiated – many and
varied symptoms
• Residual – Withdrawal after
hallucinations and delusions
have disappeared.
Causes of Schizophrenia
• Brain Abnormalities
– Dopamine Hypothesis – excess dopamine receptors
• May intensify brain signals creating positive symptoms
– Abnormal Brain Activity and Anatomy
• Low brain activity in frontal lobes critical for planning and
reasoning
• Out of synch neurons
• Smaller thalamus (difficulty filtering info) and increased
activity (hallucinations)
• Increased activity in amygdala (paranoia)
• Enlarged fluid filled areas and shrinkage of cerebral
tissue
Causes of Schizophrenia
– Maternal Virus during Pregnancy
• Affects fetal brain development
– Flu epidemics increase risk
– Born during winter and spring months after
fall/winter flu season have greater risk
– Abnormal levels of anti-bodies
• Genetic Factors
– 1 in 10 chance if sibling or parent has
– 6 in 10 in identical twins
• Some genes influence the effects of dopamine
• Some genes affect the production of myelin