Abnormal Psychology

1. Abnormal Psychology CS 8: The SW examine how psychological disorders are diagnosed, classified and treated

2. Class Activity • Students will get in groups of four and develop a definition for “psychological disorder” • Be specific, identify criteria for the line between normality and abnormality

3. Who has a mental disorder? • The World Health Organization (WHO, 2008) reports approximately 450 million people suffer from a mental or behavior disorder

4. Perspectives on Psychological Disorders • Psychological Disorder: • Deviant, distressful, and dysfunctional patterns of thoughts, feelings or behaviors

5. MUDA • Four attributes of a psychological disorder • Maladaptive • Unjustifiable • Disturbing • Atypical www.ghaps.org

6. Maladaptive • An exaggeration of normal, acceptable behaviors • Destructive to oneself or others www.ghaps.org

7. Unjustifiable • A behavior which does not have a rational basis www.ghaps.org

8. Disturbing • A behavior which is troublesome to other people www.ghaps.org

9. Atypical • A behavior so different from other people’s behavior that it violates a norm • Norms vary from culture to culture www.ghaps.org

10. Cultural Connections • Hissing is a polite way to show respect for superiors in Japan • Among the Karaki of New Guinea, a man is considered abnormal if he has not engaged in homosexual activity before marriage • Public displays of affection between men and women in Thailand are unacceptable • Men holding hand is considered a sign of friendship • Using straws is considered vulgar

11. Cultural Connection • Statistically speaking, any behavior is atypical if it is NOT exhibited by 68% of the people in a particular group or culture • What behaviors would be considered normal if we followed this definition of abnormality? • Who would suffer discrimination? • Religious practices • Ways of life would be abnormal? Single-parent households? Two-parent households? • What ethnic groups would be considered abnormal? • Styles of dress, music preferences, post-high school choices?

12. ADHD • US: Controversy with ADHD • (ADHD) Attention-deficit hyperactivity disorder: • A psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: Extreme inattention, hyperactivity and impulsivity

13. “The Devil Made Me Do It” • Middle Ages: • Trephination

14. Understanding Psychological Disorder • The Medical Model: • The concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated and in most cases, cured often through treatment

15. The Biopsychosocial Approach Biological Influences: Evolution Individual Genes Brain Structure and Chemistry Psychological Influences: Stress Trauma Learned Helplessness Mood-Related Perceptions and Memories Psychological Disorder Social-Cultural Influences: Roles Expectations Def. of Normality and Disorder

16. Classifying Psychological Disorder • DSM-IV-TR: • The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; a widely used system for classifying psychological disorders (2000)

17. How are psychological disorders diagnosed? • Five “Axis” diagnostic criteria used in DSM • Helps doctors determine not only the type of mental illness a person has, but also some contributing factors that probably need to be dealt with in order to get the primary mental illness symptoms under control

18. “Axis” Five • Axis I: Is a clinical syndrome present? • Axis II: Is a personality disorder or mental retardation present? • Axis III: Is a General Medical Condition, such as diabetes, hypertension, or arthritis, also present? • Axis IV: Are psychosocial or environmental problems, such as school or housing issues, also present? • Axis V: What is the Global Assessment of this person’s functioning? • http://faculty.fortlewis.edu/burke_b/Abnormal/Abnormalmultiaxial.htm

19. Labeling Psychological Disorders Insurance companies and DSM

20. Ask Yourself • How would you draw a line between sending disturbed criminals to prisons or to mental hospitals? Would the person’s history (child abuse) influences your decisions? • What is the biopsychosocial perspective and why is it important in our understanding of psychological disorders?

21. Critical Thinking • Does well being refer to the absence of a disorder? • Are people mentally sound if they do not suffer from anxiety, depression, or other forms of psychological symptomology? • What characteristics mark psychological well-being?

22. Carol D. Ryff • Psychologist who argues we must define mental health in terms of positive

23. Six Core Dimensions of Well-Being • Self-Acceptance: A person not only has a positive attitude toward the self the self but accepts multiple aspects of the self-good and bad, past, present, and future • Positive relations with other people: Healthy people have warm, satisfying, and trusting interpersonal relationships • Autonomy: The person is independent, self-determining, and self-controlled

24. Six Core Dimensions of Well-Being • Environmental Mastery: The healthy are able to choose or create contexts that are supportive of personal needs or values • Purpose in life: The person has both goals and a sense of directedness • Personal growth: Healthy people see themselves as growing and expanding

25. Insanity or Hospital?

26. Anxiety Disorders • At some point we all become anxious; speaking in front of an audience, playing a big game. Usually these feelings go away after event is over • For some, they do not • Anxiety Disorder: • Marked by distressing, persistent anxiety or dysfunctional anxiety reducing behaviors

27. Anxiety Disorder • Generalized Anxiety Disorder: • Person is continually tense, apprehensive and in a state of autonomic nervous system arousal • Jittery, agitated and sleep-derived • Panic Disorder: • Marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking or other frightening sensations • 1 in 75 people • Panic Attack: minute long episode of intense fear that something horrible is about to happen • Smokers Double risk

28. Anxiety Disorder • Phobias: • An anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation • Social phobias: animals, insects, heights, etc (may hide in fear) • Agoraphobia: Fear or avoidance of situations • Obsessive-Compulsive Disorder: • An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

29. Anxiety Disorders • Post-Traumatic Stress Disorder: • Characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience • Post-Traumatic Growth: • Positive psychological changes as a result of struggling with extremely challenging circumstances and life crisis

30. Critical Thinking • Today 24- hour news channels show up-to-date-minute coverage of war and disaster. People can watch violence as it happens. While it represents advance in TV journalism, it exposes everyday people to experiences that could lead to PTSD • http://www.youtube.com/watch?v=-mNFqqB6EPU • http://www.youtube.com/watch?v=umatZvJnvFM • http://www.youtube.com/watch?v=3aEvzuA4f0c

31. Critical Thinking • How does view trauma on TV affect people who haven’t experienced the tragedy or conflict firsthand? • Can people develop PTSD vicariously? How different are experiences with PTSD from those who developed it vicariously compared to those who developed it through firsthand experience with trauma? • How did coverage of the events of September 11, 2001 attacks and Hurricane Katrina affect the viewing public? • Were lessons learned from coverage of the first Gulf War applied to coverage of the Iraq War? Why or Why not?

32. Understanding Anxiety Disorder • The Learning Perspective: • Fear Conditioning • Observational Learning • The Biological Perspective: • Natural Selection • Genes • The Brain: Anterior Cingulate Cortex

33. Critical Thinking • Can you recall a fear you have learned? What role was played by fear conditioning and by observational learning? • How do generalized anxiety disorder, panic disorder, phobias, obsessive-compulsive disorder and post-traumatic stress disorder differ?

34. Somatoform Disorders Often people come to the doctor’s office with “medically unexplained illnesses” • Somatoform Disorder: • Psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause

35. Somatoform Disorders • Conversion Disorder: • A rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found • Hypochondriasis: • A somatoform disorder in which a person interprets normal physical sensations as symptoms of a disease

36. Other Somatoform Disorders • Body Dysmorphic Disorder • Pain Disorder • Somatization Disorder • P/T under 30 will exhibit a variety of unexplained physical symptoms

37. Ask Yourself • Describe a time when you have fretted needlessly over a normal bodily sensation? • In your own words, what does somatoform mean?

38. Dissociative Disorders • Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings • Disorder of the consciousness • A person appears to experience a sudden loss of memory or change in identity in response to an overwhelmingly stressful situation • “I was not myself at the time” • Driving in a car and driving to some unintended location while your mind was preoccupied elsewhere

39. Dissociative Identity Disorder • DID: • A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder

40. Dissociative Disorder • Dissociative Amnesia: • Patients suffer from a complete loss of identify. They forget who they are due to a trauma • Dissociative Fugue: • Patients suffer the identity loss as in dissociative amnesia, but these patients also travel away from home, often showing up as a “John/Jane Doe” in another community far away

41. Understanding Dissociative Identity Disorder • Outside US, DID is rare • Other countries it is viewed as “possessed” • Britain considers it an “American Fad” • India and Japan do not recognize • Included under umbrella of post-traumatic disorders • Symptoms are ways of dealing with anxiety

42. Chris Sizemore • “The Three Faces of Eve” gave early visibility to what is now called DID • http://www.youtube.com/watch?v=SOxxf8zJt9M • 14:10-25:29

43. Ask Yourself • In a normal way, do you ever flip between displays of different aspects of your personality? • The psychoanalytic and learning perspectives argue that dissociative identity disorder symptoms are ways of dealing with anxiety. How do their explanations differ?

44. Mood Disorders Psychological disorders characterized by emotional extremes Two Principle Forms 1) Major depressive disorder: prolonged hopelessness and lethargy 2) Bipolar Disorder: A person alternates between depression and mania, an overexcited, hyperactive state

45. Mood Disorders • Seasonal Affective Disorder • Postpartum Depression

46. Major Depressive Disorder • Major Depressive Disorder: • Mood disorder in which a person experiences in the absence of drugs or a medical conditions, two or more weeks of significantly, depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

47. Bipolar Disorder • Mania: • A mood disorder marked by a hyperactive, wildly optimistic state • Bipolar Disorder: • A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania • Walt Whiman, Virginia Woolf, Samuel Clemens (Mark Twain), and Ernest Hemingway

48. Bipolar Disorder • Bipolar Disorder I: The classic diagnosis of this disorder. Patients experience periods of inflated mood followed by depressive episodes occurring in cycles • Bipolar Disorder II: A milder form; patients experience at least one episode of hypomania and at least one major depressive episode

49. Understanding Mood Disorders Help students see that depression following a traumatic even (death of a loved one, failure, serious physical injury) are considered normal. Depression without a known stressor or causal event may be due to biological or psychological reasons.

50. Understanding Mood Disorders • Many behavior and cognitive changes accompany depression • Depression is widespread • Compared with men, women are nearly twice as vulnerable to major depression • Most major depressive episodes self-terminate • Stressful events related to work, marriage and close relationships often precede depression • With each new generation, depression is striking earlier