Abnormal Psychology and Therapy

Abnormal Psychology and Therapy By: Sonya Zaguzina, Bailee Cline,Jacob Hall, William Bowen

Personality Disorder Personality disorder: is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a sydney personality disorder has trouble perceiving and relating to situations and to people. This causes significant problems and limitations in relationships, social encounters, work and school. • In some cases the person who has the disorder does not notice what they're doing because their behavior seems normal to them. • Personality disorders generally begin in the teenage years or early adulthood. There are many types of personality disorders. • Cluster A (Odd, bizarre, eccentric) Paranoid PD, Schizoid PD, Schizotypal PD • Cluster B (Dramatic, erratic) Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD • Cluster C (Anxious, fearful) Avoidant PD, Dependent PD, Obsessive-compulsive PD • Paranoid personality disorder • Schizoid personality disorder • Avoidant personality disorder • Dependent personality disorder

Antisocial Personality Disorder • A type of chronic mental condition in which a persons way of thinking, perceiving situations and relating to others are dysfunctional. • Antagonist • Very manipulative and treat others harshly • May do something wrong and feel no guilt or remorse. • Can be violent and use drugs and alcohol Causes • Genetics. Inherited tendencies are aspects of a person's personality passed on by parents, such as shyness or having a positive outlook. (temperament) • Environment. The surroundings a person grows up in, events that occurred, and relationships with family members and others.

Antisocial Personality Disorder Symptoms Antisocial personality disorder signs and symptoms may include: • Disregard for right and wrong • Persistent lying or deceit to exploit others • Using charm or wit to manipulate others for personal gain or for sheer personal pleasure • Intense egocentrism • Recurring difficulties with the law • Repeatedly violating the rights of others by the use of intimidation, dishonesty and misrepresentation • Hostility, significant irritability, agitation, impulsiveness, aggression or violence • Lack of empathy for others and lack of remorse about harming others • Irresponsible work behavior • Failure to learn from the negative consequences of behavior

Antisocial Personality Disorder CASE STUDY http://samvak.tripod.com/personalitydisorders66.html • He is serving time in prison, having been convicted of grand fraud. The involved hundreds of retired men and women in a dozen states over a period of three years. All his victims lost their life savings and suffered grievous and life-threatening stress symptoms • Laughed out loud when asked how he felt about killing three people • Denied any responsibility “They knew that they were dealing with”

Treatment • Psychotherapy- Talk Therapy • Medications- No specific Pill • Skills for family members- Help your family member out by learning how to set boundaries.

Borderline Personality Disorder • Seems to run in families • Often people who get it faced some kind of childhood trauma such as abuse, neglect, or the death of a parent. • ^ Greater chance of having disorder if you have trouble dealing with stress or anxiety^ • Feel Empty • Problems with anger Causes No exact cause but a theory is that there is a chemical deformity in the brain that deal with mood changes

Borderline Personality Disorder Symptoms An individual diagnosed with borderline personality disorder needs to show at least 5 of the following criteria: • Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior here.) • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. • Identity disturbance: markedly and persistently unstable self-image or sense of self. • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior here.) • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. • Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). • Chronic feelings of emptiness. • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). • transient, stress-related paranoid ideation or severe dissociative symptoms.

Video http://bpdvideo.com/

Treatment • Counseling and therapy. It's important to find a counselor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counselor as caring one minute and cruel the next, especially when he or she asks you to try to change a behavior. Try to find a counselor who has special training in treating this disorder. • Medicines, such as antidepressants, mood stabilizers, and antipsychotics. • Healthy habits, such as getting enough sleep, eating healthy foods, getting regular exercise, and avoiding alcohol and drugs. These habits can help reduce stress and anxiety.

Schizophrenia • Severe psychological disorder that is characterized by highly disordered thought process • About ½ of patients in psychiatric hospitals have schizophrenia and suicide risk is 8x higher than that of the general population http://www.youtube.com/watch?v=ynin-1yAERY

Positive Symptoms • Hallucinations: sensory experiences with absence of real stimuli • Delusions: false, unusual, and sometimes magical beliefs that are not part of an individual's culture • Thought Disorder: unusual, sometimes bizarre thought process, do not make sense when they speak or write • Referential Thinking: ascribing personal meaning to completely random experiences • Catatonia: state of immobility and unresponsiveness that lasts for long periods of time

Negative and Cognitive Symptoms Negative: (social withdrawal) • Flat Affect: the display of little or no emotion Cognitive: • difficulty sustaining attention • problems holding information in memory • inability to interpret information and make decisions

Causes Biological Factors: • Heredity: partially caused by genetic factors • Structural Brain Abnormalities: MRI scans clearly show enlarged ventricles in the brain which means deterioration in other brain tissue; also small frontal cortex and low activity in this area • Problems in neurotransmitter regulation Psychological Factors: • Stress may contribute to this disorder • Diathesis Stress Model: argues that combination of biogenetic disposition and stress causes schizophrenia (extreme stress)

Causes (cont.) Sociocultural Factors: • not considered cause but appear to affect course of disorder • influences how schizophrenia progresses • individuals in developing, non industrialized nations have better outcome than those in developed and industrialized • developing nations are more accepting and supportive • marriage, warm supporting friends, and employment are related to better outcomes and research suggests individuals with schizophrenia enjoy marriage, productive work, and friendships

Case Study Jani Schofield: • diagnosed with onset schizophrenia at age 6 • tested with genius IQ • spends almost 95% of time in imaginary world • imaginary friends cause comfort and violence http://www.youtube.com/watch?v=2-LWQDCefPw

Treatment • Atypical Antipsychotics: helps hallucinations, delusions, and blunted emotional expression • family educational interventions • early/sustained treatment involving antipsychotics improves long term course • some may refuse treatment or stop

Anxiety Disorders • They are psychological disorders involving fears that are uncontrollable, disproportionate to actual danger a person might be in and disruptive to ordinary life Symptoms: they can often differ from person to person but they share a persistent or severe fear or worrying in situations where others wouldn't feel threatened • Other symptoms include, trouble concentrating, tense or jump, irritability etc. Treatment: medical check up, therapist, or medication

GAD (Generalized Anxiety Disorder) Psychological disorder marked by persistent anxiety for at least 6 months and in which the individual is unable to specify the reason for their anxiety http://www.youtube.com/watch?v=3WJYmgXcoEI

GAD Signs and Symptoms: • Nervousness • Physical symptoms include, fatigue, muscle tension and stomach problems Causes: genetic predisposition, deficiency in neurotransmitters GABA, sympathetic nervous system activity and respiratory system abnormalities

GAD Psychological and Sociocultural Factors: • having harsh self- standards • overly strict parents • negative thoughts when feeling stressed • a history of uncontrollable traumas or stressors Case Study • 47 years old • worried a lot as a child • joined the army • after he left he began to worry more http://at-ease.dva.gov.au/veterans/resources/case-studies/case-study-gad/

Panic Disorder Anxiety disorder in which the individual experiences recurrent, sudden onsets or intense apprehension or terror often without warning and with no specific cause http://www.youtube.com/watch?v=wdxAHqXeIkQ

Panic Disorder Signs and Symptoms • produces severe palpitations • extreme shortness of breath • chest pains • trembling, sweating and feelings of helplessness Case Study • 30 years old • has always been anxious and still have very good memory of her first panic attack • has had to change her way of living to cope with her panic attacks

Panic Disorder • It might feel like you are having a heart attack Biological Factors include • genetic predisposition • autonomic nervous system is overly active • problems involving either or both norepinephrine and GABA

Phobic Disorder Anxiety disorder characterized by an irrational, overwhelming, persistent fear of a particular object or situation • you can pinpoint the cause of nervous feeling unlike other disorders http://www.youtube.com/watch?v=iafjTpRPcac

Phobic Disorder • A fear becomes a phobia when a situation is so dreaded that the person goes to the extreme to avoid it • Phobias are fears that are uncontrollable, disproportionate and disruptive • Some think phobias are learned fears

Phobic Disorder Signs and Symptoms: • difficulty breathing • racing heart • chest pain • trembling or shaking Treatment: • therapy • exposure • relaxation etc.

OCD (Obsessive- Compulsive Disorder Anxiety disorder in which the individual has anxiety provoking thoughts that will not go away and/or urges to perform repetitive,ritualistic behaviors to prevent or produce some future sensation http://www.youtube.com/watch?v=vnKZ4pdSU-s

OCD • people with OCD often dwell on normal thoughts and repeat their routines multiple times • most common compulsions are; excessive checking, cleaning and counting • people with OCD often feel very anxious when they do not carry out a certain behavior

OCD Signs and Symptoms • obsessive thoughts • compulsive behaviors Treatment • cognitive- behavioral therapy • group therapy • self help steps

PTSD Post Traumatic Stress Disorder Anxiety disorder that develops through exposure to a traumatic event that has overwhelmed the persons abilities to cope • very common in veterans and car accident victims http://www.youtube.com/watch?v=azWNpCap_Ww

PTSD Signs and Symptoms • flashbacks • avoidance of emotional experiences • reduced ability to feel emotions • excessive arousal etc. Treatment • trauma focused cognitive behavior therapy • family therapy • medication etc.

PTSD Case Study • 90 year old woman • Husband died in 2000 then her house was broken into and she was raped and robbed • sent to live in a nursing home and showed she was getting better then was released • two months later showed signs of being distraught, stressed and confused http://www.hopkinsmedicine.org/gec/studies/ptsd.html

Abnormal Behavior Defined as behavior that is disturbing (socially unacceptable), distressing, maladaptive (or self‐defeating), and often the result of distorted thoughts.

Biological Approach • Abnormal behaviours are ‘illnesses’ caused by the possible combination of genetic, biochemical, hormonal and/or neurological factors. • It has been observed that first-degree relative of a person suffering schizophrenia have a 10% chance of developing the disorder. • This is much greater than the 1% in the normal population. • Neurotransmitters are thought to be imbalanced in the nervous system of people suffering from psychological disorders. • Excessive amounts of dopamine have been associated with schizophrenia and other illnesses.

Sociocultural Approach • Psychologists believe that abnormal behavior is rooted from social ills, such as poverty, discrimination, and social stressors.

Bio Psychosocial Approach • This approach is a combination of biological and sociocultural approach. • Many of these illnesses will drastically distort or intensify common emotions.

DSM-IV (V) • The standard abnormal psychology and psychiatry reference book in North America is the Diagnostic and Statistical Manual of the American Psychiatric Association. • Includes symptoms to make an accurate diagnosis.

Classifying Abnormal Behavior • The diagnostic process uses five dimensions called "axes" to ascertain symptoms. • Axis I - Clinical disorders, which would include major mental and learning disorders • Axis II - Personality Disorders and a decrease of the use of intellect disorder. • Axis III - General medical conditions and "Physical disorders". • Axis IV - Psychosocial/environmental problems. • Axis V - Global assessment of functioning. An assessment of how a patient is doing presently.

Critiques of DSM • Main criticisms based on agreeability of symptoms. • Some disorders are omitted from year to year but still exist in society. • Only includes weaknesses and not strengths.

List of Disorders Mood disorders Dissociative disorders Dissociative amnesia Dissociative fugue Depersonalization disorder Dissociative identity disorder Schizophrenia Major types of schizophrenia Personality disorders Narcissistic Antisocial Borderline Developmental disorders Major developmental disorders Hallucinations Delusions

Treatments • Patients usually referred to counseling psychologist, and then possibly a psychiatrist. • Dream analysis - An expert analyzes the patient’s dream symbolically. • Use of psychotropic drugs is common.

Reference Slide http://allpsych.com/disorders/dsm.html http://dsm.psychiatryonline.org/book.aspx?bookid=556 http://www.apa.org/pubs/journals/abn/index.aspx

Psychosurgery Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder Portuguese neurologist Egas Monizis usually credited with being the originator of psychosurgery • Psychosurgery has greatly evolved. • Surgeons no longer destroy large amounts of brain tissue in futile efforts to "cure" schizophrenia and neurosis. • Now they take pinpoint aim at millimeter-long clusters of cells to stop suicidaldepression, disable obsessive-compulsive disorders, cripple anxiety, and smother the uncontrollable rage and aggression that keep sick people in locked wards. • Many people get this surgery because it is their only way out of this disease • Nothing else has worked

Therapy Anxiety Drugs: Commonly known as tranquilizers, drugs that reduce anxiety by making the individual calmer and less excitable. • Benzodiazepines are anxiety drugs generally offered • Xanax, Valium, and Librium • Side effects of Benzodiazepines include fatigue, loss of coordination, mental slowing and some abnormalities in babies whose mothers took them while pregnant

Therapy Antidepressant Drugs: regulate mood • Four main classes include • Tricyclies which increase the level of certain neurotransmitters • Tetracyclics which enhance brain levels of norepinephrine and serotonin • Monoamine Oxidase which block enzyme monoamine oxidase and break down serotonin and norepinephrine • Selective Serotonin Reuptake Inhibitors which target serotonin and interferes with only reabsorption of serotonin in the brain

Therapy Antipsychotic Drugs: powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior and produce better sleep patterns in people with severe psychological disorders • The most used antipsychotic drugs are neuroleptics which reduce a variety of schizophrenic symptoms • Also block dopamine action in the brain

Therapy 2004 FDA held hearing with health professionals and parents about suicide risks in young children from antidepressants • 23 clinical trials and 4300 children given antidepressant or placebo • none committed or attempted suicide • “adverse event reports” show 2% of placebo participants showed spontaneous reports of suicide and so did 4% of antidepressant group October 2004, FDA required “black box” warning on antidepressants • numbers of prescriptions for children declined dramatically • since this, number of studies have shown no link between antidepressants and suicide in either adults or children

Therapy Electroconvulsive Therapy: commonly called shock therapy, set of a seizure in the brain, much like spontaneous epilepsy • In early 20th century, doctors induced seizures by insulin overdose and used this to primarily treat schizophrenia • Ugo Cerletti developed this procedure and ECT was used in earlier years in mental institutions and often to punish patients • Today doctors use ECT to treat depression • 100,000 individuals a year undergo ECT for major depressive disorder and PTSD • Today, treatment involves passing a small electrical current of two electrodes placed on the head • Only applied on the right side of the brain and patient is asleep during the procedure • potential side effects include: memory loss and other cognitive impairments • Deep Brain Stimulation: procedure for treatment-resistant depression that involves the implantation of electrodes in the brain that emit signals to alter brain’s electrical circuitry • effective for severe depression

Content Bailee- Topic #2 Anxiety disorders Sonya- Topic #5 Schizophrenia Jacob- Topic #6 Personality Disorders Will- Topic #1 Abnormal Behavior Everyone worked on Topic #8 Therapy

Abnormal Psychology and Therapy