Abnormal Psychology and Therapy

Abnormal Psychology and Therapy By: Jonathan, Kevin, Alex, Evan

Abnormal Behavior • Defined as Behavior that is deviant, maladaptive, or personally distressful over a relatively long period of time. • Behavior that is deviant might not necessarily be harmful to the person just different from the culture they are in. • Maladaptive behavior interferes with a persons ability to function in the world • Personal distressful behavior may not even be seen by others but is very harmful to the person doing it to the self.

Biological Approach • Attributes disorders to organic or internal causes • Focuses mainly on the Brain, genetic factors, and neurotransmitters. • Used in the Medical Model which is when psychological diseases are thought of as medical diseases with a biological origin

Sociocultural Approach • Emphasizes social context of how a person lives taking into account gender, ethnicity, socioeconomic status, family relationships, and culture • Stresses that cultural influence the understanding and treatment of psychological disorders as well as the frequency and intensity

Biopsychosocial Approach • This approach states that it can be any of the three (Biological Psychological or Psychosocial) that influences mental illnesses • It states that to understand the development of psychological illnesses you have to take into consideration many different factors in the persons life • This would mean that two people with the same illnesses could have a number of factors interacting in a different way but yielding the same results

Classifying Abnormal Behavior • The main tool used to classify abnormal behavior is the DSM • It is important to be able to have a consensus between all psychologists so if one person is diagnosed with one illness the other will understand the correct treatment and symptoms they will exhibit.

DSM-IV • Stands for Diagnostic and Statistical Manual of Mental Disorders • Classifies people in five different axes based on the individual’s history and highest level of functioning in the last year • Created so individuals are not only assigned to a psychological disorder but instead characterized by a number of factors

DSM-IV Axes 1 and 2 Axis 1- All diagnostic categories except personality disorders and mental retardation Axis 2- Personality disorders and mental retardation Axis 1 • Substance-Related Disorders • Sexual/Gender disorders • Eating disorders • Sleep disorders • Impulse disorders or ones not classified anywhere else Axis 1 • Childhood disorders • Anxiety disorders • Somatoform disorders • Factitious disorders • Dissociative disorders • Cognitive disorders • Mood disorders • Psychotic disorders • Adjustment disorders Axis 2 • Intellectual disability • Personality disorders • Other conditions that are focused on clinical attention

DSM-IV Axes 3,4, and 5 • Axis 3 General medical condition. Considers overall life situation to see if the disorder stems from a physical illness • Axis 4 Psychosocial and environmental problems. Focuses on whether the person is experiencing disruptions in various life conditions • Axis 5 Current level of functioning. The clinician evaluates the highest level of adaptive functioning the person has attained in the preceding year

Critiques of the DSM • Classifies based on symptoms thinking of the disorders as a disease which means that they have a purely internal cause with no environmental factors • It focuses strictly on pathology and problems should emphasize strengths and weaknesses

Psychological Disorder & Health & Wellness • Over 26% of Americans who are over the age of 18 suffer from some kind of psychological disorder. • Disorders can give healthy people a lot of problems when trying to live a normal life. • Once diagnosed, humans have a very hard time living normal lives because people are biased towards them due to what they are diagnosed with. • Stigma- A mark of disgrace associated with a particular circumstance. • Stigma’s are usually very bad because they can affect the person negatively while they are trying to recover from a disorder.

Consequences of Stigma Prejudice and Discrimination • Labels can be damaging because they lead to negative stereotypes. • Cho Seung-Hui, Virginia Tech shooter who was labeled with psychological disorders and reinforced stereotypes. • Illegal to discriminate against a person with a disorder in the work place. http://www.youtube.com/watch?v=KElyLrrTLB0

Examples of Stigmas Schizophrenic- often associated with things such as “frightening” or “dangerous”. Race- Stereotypes used with different races such as Whites, Blacks, and Hispanics. Bipolar- Often thought of as scary or mean. Multiple personalities- People perceive them as people who can’t act the same and are always changing.

Overcoming Stigma • Stop thinking of people with disorders as limited. • Focus on their strengths. • Create a positive environment for the person. • become positive role models for people with disorders. • Try to empower the people who have disorders to be more positive.

Psychotherapy • Defined as a nonmedical process that helps individuals with psychological disorders recognize and overcome their problems.

Psychodynamic Therapies PSYCHOANALYSIS: Freud’s therapeutic technique for analyzing an individual’s unconscious thoughts. • The psychoanalyst’s goal is to bring unconscious conflicts into conflicts awareness, thus giving the client insight into his or her core problems and freeing the individual from unconscious influences. • Free Association: Technique that involves to say whatever is on your mind aloud. • Interpretation: A psychoanalyst’s search for hidden meanings in what their client says during therapy. http://www.youtube.com/watch?v=xuMPKu1Svbs

Psychodynamic Therapies(Cont.) • Dream analysis: Technique for interpreting a person’s dream. Used because it’s believed dreams contain info about thoughts, wishes, and conflicts. • Transference: A clients relating to the psychoanalyst in ways that reproduce or relive important relationships in the individuals life. Freud thought this was essential in the client analyst relationship. • Resistance: A client’s unconscious defense strategies that interfere with the individual's problems.

Contemporary Therapies • Psychoanalysts accord more power to the conscious mind and to a person’s current relationship. • Generally place less emphasis on sex. • Some focus on the self in social contexts.

Humanistic Therapies • Encourage clients to understand themselves and grow personally. • Emphasis conscious rather than unconscious thoughts.

Classical Conditioning Techniques • Used for treating phobias. • Systematic Desensitization: Method that treats anxiety by teaching the client to associate deep relaxation with increasingly intense anxiety-producing situations. • More intense form is flooding--- exposing an individual to feared stimuli without avoiding it.

Operant Conditioning Techniques • Involves conducting a careful analysis of the person’s environment to determine which factors need modifications. • Especially important is changing the consequences of the person’s behavior are followed by positive reinforcement.

Cognitive Therapy • Treatments that point to thoughts as the main source of psychological problems and that attempt to change the individual’s feelings and behaviors by changing cognitions. • Focus on overt symptoms.

Ellis’s Rational-Emotive Behavior Therapy • A therapy based on Ellis’s assertion that individuals develop a psychological disorder because of irrational and self-defeating beliefs. • Goal is to get clients to eliminate these beliefs.

Therapy Integrations • A combinations of techniques from different therapies based on the therapists judgement of which particular methods will provide the greatest benefit for the client.

How Therapy Changes the Brain • Increased activation • No longer different than “healthy” brains • Normalizes brain function

Antianxiety Drugs • These drugs reduce anxiety making people calmer and less excitable • Benzodiazepines are the ones that cause the greatest amount of relief and are very fast acting examples of these include Xanax, Valium, and Librium. • Nonbenzodiazepine is used to treat general anxiety disorder and can take weeks of constant use to feel any effect. The only example of this was Buspar which was discontinued in the US • These drugs work by constricting the neurotransmitters that become overactive during anxiety.

Antidepressant Drugs • Antidepressant drugs regulate mood and are separated into four main categories tricyclics (Elavil), tetracyclics (Avanza) , monoamine oxidase inhibitors or MAO inhibitors (Nardil) , and selective serotonin reuptake inhibitors also known as SSRIs (Prozac). • All of these elevate people’s mood with different effects on the brain primarily the increase in neurotransmitters mainly serotonin and norepinephrine • http://www.youtube.com/watch?v=ocSptPUBbuo

Tricyclics and tetracyclics Tricyclics • Tricyclics are named that because of a three ringed molecular structure • They work by increasing levels of serotonin and norepinephrine in the brain • They take a month to change someone's mood Tetracyclics • Related to tricyclics are named so because of a four ringed molecular structure • Also known as Noradrenergic and specific serotonergic antidepressants or NaSSAs • Also Increases levels of serotonin and norepinephrine in the brain

MAO inhibitors and SSRIs MAO inhibitors • Block the enzyme Monoamine oxidase • More potentially harmful to the body than any other antidepressant • Some people are immune to MAO inhibitors SSRIs • Work by interfering with the reabsorption of serotonin • Fewer side effects than other antidepressants and work the best • Can lead to severe withdrawal symptoms

Antipsychotic Drugs • Defined as powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals with a severe psychological disorder, especially schizophrenia • Neuroleptics are the most widely used antipsychotic drug • Block many schizophrenic symptoms by blocking dopamine actions in the brain • Can have severe side effects like reduced lack of pleasure and tardive dyskinesia which is involuntary movement of facial muscles, tongue, and mouth and twitching of neck, arms, and legs. • New drugs called atypical antipsychotic medication are starting to become more common and do not have the side effects neuroleptics do.

Electroconvulsive Therapy • Commonly called shock therapy or ECT • A seizure is set off in the brain which has been seen to cure some mental illnesses • In the 20th century they started inducing these seizures with insulin overdoses. Then in 1937 Ugo Cerletti found a way to induce seizures with an electric shock. Now rather than using electricity they apply electrical stimulus to specific parts of the brain in what is called deep brain stimulation. • Mostly used to treat Major depressive disorder and Chronic post traumatic stress disorder

How effective is ECT? • Today it is only given to individuals who do not respond to drug treatments or psychotherapy • Its effectiveness has been compared to that of cognitive and drug therapy with 4 out of 5 people showing improvements. However the relapse rate is high • ECT more than any treatment or drugs provides rapid relief to a persons mood making it very useful for acute depression and individuals at risk for suicide.

Psychosurgery • Defined as A biological therapy with irreversibly effects, that involves removal or destruction of brain tissue to improve the individual's adjustment. • In the 1930’s Portuguese physician Antonio Moniz discovered that if you severed the fibers that connect the frontal lobe you could alleviate some symptoms of psychological disorders • Some patients though were left in vegetative states and Antonio Moniz himself said it should only be used as a last resort • Today very few people undergo Psychosurgery it is used for people with OCD, Major depression, and bipolar disorders and only used as a last resort.

Do antidepressants increase suicide risk in children? • In 2004 the FDA reviewed 23 clinical trials involving 4,300 children who were randomly assigned either an antidepressant or a placebo. • None of the children attempted or committed suicide and the self-report ratings of their suicidal thoughts and behaviors found no differences but did find an increase in adverse event reports or spontaneous thoughts or comments about suicide. • In October 2005 the FDA required all antidepressants to have a warning that they may cause suicidal thoughts. • Since then many studies have found that antidepressants cause no increase in suicidal thoughts in either adults or children and it is a controversial issue still.

Treatments for Different Psychological illnesses Everyday Anxiety - Anti Anxiety/Anti Depressants - Good improvement - Less effective over time and addictive General Anxiety - Anti Anxiety drugs - Not effective - Less effective over time, Addictive Panic Disorder - Anti Anxiety drugs - Half show improvement - Less effective over time, Addictive Specific phobias - Antianxiety drugs - Not effective - Less powerful over time, Addictive Agoraphobia - Tricyclic drugs - Very effective - Restlessness, Fainting, and Trembling Depressive Disorders - Antidepressants- Very Effective - Varies depending on drug Bipolar Disorder - Lithium - Very effective - Toxicity Schizophrenia - Neuroleptics - very effective - irregular heartbeat, low blood pressure, uncontrolled fidgeting, tardive dyskinesia, and immobility of face

Sociocultural Approach Definition- Views individuals as a part of a system of relationships that are influenced by social and cultural factors. Group Therapy- People who share disorders gather with a mental health professor and have a therapy session together. Family/Couples Therapy- Group therapy with only families or couples Self Support- People choose to meet and discuss common interest. Community Mental Health- Community members are trained to offer consoling and workshops

Sociocultural Approach Cultural Perspective- Focuses on the needs of individuals who live in cultures that place importance on groups. Ethnicity and Gender- These are important when trying to insure the patients comfort in therapy.

Effectiveness of Psychotherapy Two underlying factors are… Therapeutic Alliance- Relationship between therapist and client Client Factor- Clients motivation accounts for therapeutic success

Health and Wellness Well-being Therapy- Encourages client to see the positive sides of things

Bibliography http://sites.lafayette.edu/neur401-sp10/applications-in-health-and-medicine/depression/,

Duties Jonathan- Topic #7,9 and guided notes Kevin- Topic #9 Alex- Topic #1,8 Primm-Topic #10

Abnormal Psychology and Therapy