Abnormal Psychology

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Anxiety Anx·i·e·ty (n.) A state of uneasiness and apprehension A state of intense apprehension, uncertainty, and fear A condition of heightened and often disruptive tension

Anxiety Disorders • Generalized Anxiety Disorder (GAD) • Social Phobia (or Social Anxiety Disorder) • Specific Phobias • Post-Traumatic Stress Disorder • Obsessive-Compulsive Disorder (OCD)

Generalized Anxiety Disorder • Anxiety is an unsettling feeling of worry, being unsure, and fear • When anxiety lasts for long periods of time, it is a disorder • 18% of American adults have anxiety disorders

Symptoms of GAD • Constant worrying about everyday things (lasting for 6 mos.) • Can’t control worries • Know they worry more than they should • Can’t relax • Can’t concentrate • Trouble sleeping or falling asleep • Easily startled

Physiological Symptoms • Fatigue • Muscle aches • Headaches • Trembling • Irritable • Sweating • Difficulty swallowing • Feeling light-headed • Out of breath • Hot flashes

Treatment of Anxiety • Medications • Anti-anxiety medicine • Antidepressants • Beta-blockers • Therapy • Individual • Group

Evolutionary Theory of Anxiety • Anxieties are natural • Help people be aware of potentially harmful situations • Help prepare people for these situations • When anxiety occurs without a stressor, and for long periods of time it harms instead of helps

Phobias Pho·bia (n.) A persistent, irrational, intense fear of a specific object, activity, or situation

Types of Phobias • Social Phobia • Specific Phobia • Agoraphobia

Social Phobia • A strong fear or being judged and embarrassed • Fear gets in the way of everyday life, school, and work • Recognize fear is unreasonable • Can’t control fear

Common Symptoms • Anxious about being with people • Extremely self-conscious • Afraid of being embarrassed • Afraid of being judged • Worry days or weeks before an event • Stay away from social settings • Difficulty making and keeping friends

Physiological Symptoms • Blushing • Heavy sweating • Trembling • Nausea • Difficulty talking

Specific Phobias • 11.5 million adults suffer from phobias • 3 main types • Situational • flying, driving, tunnels, enclosed spaces, elevators • Object • Animal, natural environment, blood-injection-injury • Animal – animals/insects • Natural – storms, water, heights • Blood, injury, and injection • Other • vomiting, choking, clowns, becoming ill, falling down

Common Specific Phobias • Public speaking • Mice • Snakes and other reptiles • Spiders and insects • Heights • Death • Clinically, animal fears are found to be most common

Agoraphobia • Fear of unfamiliar places • Includes wide open spaces, crowds, traveling, and anywhere from which escape may be difficult • Suffer from panic attacks when they feel they aren’t in control • About 3.2 million Americans have agoraphobia

Treatment of Phobias • Medications • Anti-anxiety medicine • Antidepressants • Beta-blockers • Therapy • Individual • Group • Behavior • Virtual

Evolutionary Theory of Phobias • Fear alerts people to danger and prepares their bodies to handle the situation, hopefully keeping them safe • Fear which occurs without a stimulus impedes life without being helpful • Constant fear interrupts people’s normal lives

PTSD • Posttraumatic Stress Disorder is an anxiety disorder that develops after exposure to a terrifying or traumatic event where severe physical harm was inflicted or threatened • Traumatic events include: assault, rape, car accidents, child abuse, kidnapping, bombing, natural disasters, military combat, etc. • One can suffer from PTSD after witnessing, being the victim, or being close to the victim

Symptoms of PTSD • Startle easy • Become emotionally numb, with family and friends • Irritable • Become aggressive or violent • Have trouble being affectionate • Avoid situations that may remind them of the traumatic incident • Reliving the trauma in flashbacks, during the day or in nightmares

PTSD • Onset of symptoms is usually within three months of the trauma, but it can be as late as a year after the trauma • The symptoms must last at least a month to be diagnosed as PTSD • Recovery can happen in six months with proper treatment but can last a lot longer, or even become chronic • 7.7 million Americans suffer from PTSD • PTSD can affect children and adults • PTSD patients may also suffer from depression, substance abuse, or another anxiety disorder

Treatment of PTSD • Medications • Psychotherapy • Exposure therapy – exposed to the trigger and desensitize the patient • Virtual reality treatments – similar to the technology used with phobias

Evolutionary Theory of PTSD • Flight is a common symptom in PTSD • leaving a situation that is thought to be threatening • this is an adaptation– predator avoidance is less dangerous than predator confrontation • Vigilance is one of the symptoms of PTSD • this is just being wary and watchful of different situations and their potential threats • Re-experiencing the memory is going to promote the flight reflex to avoid the previously traumatic experience • Although memories may intensify over time, the phenomenon of re-experiencing events seems to fade once the avoidance/defense behavior is reinforced • PTSD is based on fear, rather than emotion – thus motivates action

How can PTSD be adaptive • A small dose of vigilance, avoidance, flight, etc. is always going to promote survival • there are varying degrees of PTSD • Maladaptations are always adaptations at some point • for example aggression is favorable during wartime but not so much during peacetime • PTSD and being overly cautious is favorable in times of high risk and danger • In war-time or during a natural disaster your kin will be safer by keeping them more protected • using avoidance, flight, etc.

Video Clip of PTSD • Posttraumatic Stress Disorder – Clip 2 - 2:17 minutes • PTSD

Video Clip of OCD • OCD – As OCD As It Gets – 1:06 minutes • OCD

Obsessive-Compulsive Disorder • Obsessive-Compulsive Disorder or OCD is an anxiety disorder characterized by frequent, unwanted thoughts, obsessions, and/or repeating specific behaviors, compulsions • Repeated behaviors can include: hand washing, counting, checking, cleaning, etc. • These behaviors are performed with the hope of relieving or alleviating the obsessive thoughts • Not performing these rituals causes intense anxiety

Obsessive-Compulsive Disorder • It affects approximately 2.2 million American adults • Can and frequently is coupled with another mental disorder • such as an eating disorder, another anxiety disorder, or depression • Onset during adolescence or early adulthood • The disease can come and go over time • It can get better or worsen as a person gets older • Severe OCD can keep people from functioning in their daily lives • Research indicates that OCD runs in families

Symptoms of OCD • Symptoms are • Obsessions – frequent, unwelcome thoughts that will not go away • Obsession: germs or dirt • Obsession: security • Compulsions – repetitive behavior that is thought to relieve the anxiety and/or obsessions • Compulsion: excessive and repetitive hand washing • Compulsion: checking many times to make sure the door is locked

Treatment of OCD • Personal treatments • People with OCD are likely to try to self-medicate with drugs or alcohol • They will try to avoid situations that trigger their obsession or compulsions • Clinical treatments • Medication • Exposure-based psychotherapy – desensitizing them to the anxiety-producing situation • New treatments – deep brain stimulation

Evolutionary Theory of OCD • Most symptoms of OCD revolve around safety, security, and/or preservation of self and/or others • OCD as a symptom of a security motivational system – although security is not officially recognized as one of the five motivations it is an intrinsic need • Security is a “special motivation” – motivation based on a biologically primitive need

Evolutionary Theory of OCD • OCD sufferers are constantly assessing and processing potential danger – with a slight threat the defense system is activated and is slow to deactivate • Favors action – being proactive to avoid the predator – predators rely on the element of surprise – so gathering information and being constantly alert diminishes or eliminates this element • Prevention – being prepared and avoiding the threatening situations • Most of the symptoms of OCD are security behaviors – like cleansing, checking, or hoarding • Cleansing – teratogens, spice hypothesis, germs, etc. • Checking – security, safety of kin • Hoarding – in case of food shortage, famine, or natural disaster

Evolutionary Theory of OCD • Overexposure and Protection • Childhood – two extremes • Highly protected during their childhood, seen the world from a distance, hold onto their parents, fear, a lot of restrictions • Taught to fear the outside world and thus they do not feel like they are in a safe environment, OCD develops • Very permissive experience – parents allowed them to do a lot of things very early in life, over stimulated, were not equipped to handle all their experiences • Lack of a safe and secure environment – thus the obsessive and compulsive behavior creates a sense of security

DISSOCIATIVE DISORDERS

What are Dissociative Disorders? Involuntary escape from reality Ranges from suppressing memories to complete alternate identities 7% of Americans experience a dissociative disorder in their lifetime

Four Types of Disorders • Dissociative Amnesia • Dissociative Identity Disorder (DID) • Dissociative Fugue • Depersonalization Disorder

Signs and Symptoms Memory loss (amnesia) of certain time periods, events and people Mental health problems, including depression and anxiety A sense of being detached from yourself (depersonalization) A perception of the people and things around you as distorted and unreal (derealization) A blurred sense of identity

Dissociative Amnesia Memory loss that's more extensive than normal forgetfulness and can't be explained by a physical or neurological condition. Sudden-onset amnesia following a traumatic event, such as a car accident, happens infrequently. More commonly, conscious recall of traumatic periods, events or people in your life — especially from childhood — is simply absent from your memory.

Dissociative Identity Disorder Formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress. You may feel the presence of one or more other people talking or living inside your head. Each of these identities may have their own name, personal history and characteristics, including marked differences in manner, voice, gender and even such physical qualities as the need for corrective eyewear.

Dissociative Identity Disorder • Considerable variation in each alternate personality's familiarity with the others. • People with DID typically also have dissociative amnesia. • Edward Norton in Primal Fear • Martin meets Roy (DID)

Dissociative Fugue People with this condition dissociate by putting real distance between themselves and their identity. For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location. Typically retain all their faculties and may be very capable of blending in wherever they end up.

Dissociative Fugue A fugue episode may last only a few hours or, rarely, as long as many months. Ends as abruptly as it begins. May feel intensely disoriented, depressed and angry, with no recollection of what happened

Depersonalization Disorder Characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie. Distortion of the size and shape of your body or of other people and objects around you. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may last over many years.

Causes Develop as a mechanism for coping with trauma. Often form in children subjected to chronic physical, sexual or emotional abuse or a home environment that is otherwise frightening or highly unpredictable. A child is more able than is an adult to step outside herself or himself and observe trauma as though it's happening to a different person.

More Causes A child who learns to dissociate in order to endure an extended period of his or her youth may reflexively use this coping mechanism in response to stressful situations throughout life. Adults rarely develop dissociative disorders in response to severe trauma

Risks People who experience chronic physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders. Children and adults who experience other traumatic events, including war, natural disasters, kidnapping, torture and invasive medical procedures also may develop these conditions.

Prevention If stress or other personal issues are affecting the way you treat your child, seek help. Talk to a trusted person such as a friend, your doctor or a leader in your faith community. Ask for help locating resources such as parenting support groups and family therapists. Parenting classes may help you learn a healthier parenting style. If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to mental health professionals who can help your child recover and adopt healthy coping skills.

Diagnosis Doctors diagnose dissociative disorders based on a review of your symptoms and your personal history. Perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality. If your doctor rules out physical causes, he or she will likely refer you to a mental health professional for an in-depth interview. To help diagnose dissociative identity disorder, some doctors use medication or hypnosis. Helps identify alternate personalities or may help you describe repressed memories

Treatment Psychotherapy is the primary treatment for dissociative disorders. Involves talking about your disorder and related issues with a mental health professional. Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances. Psychotherapy often involves techniques, such as hypnosis, that help you remember and work through the trauma The course of your psychotherapy may be long and painful, but this treatment approach often is very effective in treating dissociative disorders.

More Treatment • Creative art therapy. • Uses the creative process to help people who might have difficulty expressing their thoughts and feelings. • Helps you increase self-awareness, cope with symptoms and traumatic experiences, and foster positive changes. • Includes art, dance and movement, drama, music and poetry. • Cognitive therapy. • Helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. • It's based on the idea that your own thoughts — not other people or situations — determine how you behave. • Even if an unwanted situation has not changed, you can change the way you think and behave in a positive way. • Medication. • Your doctor may prescribe antidepressants, anti-anxiety medications or tranquilizers to help control the mental health symptoms

Abnormal Psychology