Abnormal Psychology

Abnormal Psychology Unit 7

What are we studying? • Abnormal Behavior • Classifying Psychological Disorders • Anxiety and avoidance Disorders • Affective Disorders • Schizophrenia • Dissociative Disorders • Personality Disorders • Treating Psychological Disorders • Cognitive Therapies • Family Systems Theory • General Trends in Psychotherapy • Community and Preventive Approaches

Why study abnormal psychology? • Abnormal behaviour is part of our common experience • Lots of unanswered questions and complexities • Preparation for future careers • www.apa.org/students/

Abnormal Behavior • Behavior that results in: • Stress • Pain • Impairs functioning • An increased risk of death or loss of freedom • Let individuals decide for themselves

Abnormal Behavior • Cultural Influences • Normal or abnormal • Abnormal based on time or place • Particular worldview • Middle Ages: Deviant behavior meant you were possessed by demons,

Abnormal Behavior- Bio Psychosocial Model • Biological: • Genetic Factors • Neurotransmitter deficiency activities • Hormonal abnormalities • Further behavior can be affected by: Brain damage, malnutrition, infectious disease and drug overuse

Abnormal Behavior- Bio Psychosocial Model • Psychological: • People’s reactions to events • Reaction depends on the circumstances of the event as well individuals own vulnerabilities to the event • A important component is: individuals past history, or genetic predisposition relating to a person’s reactions

Abnormal Behavior- Bio Psychosocial Model • Social: • Cultural Perspective • People are influenced both by how others act towards them and by the expectations of others

Classifying Psychological Disorders • Diagnostic Statistics Manual (DSM) - A list of accepted labels for psychological diagnosis • Currently in it’s 4th edition, revised (DSM-IV-Tr) • 5 Separate Axes

Diagnostic Statistics Manual DSM • Current diagnostic system • Axis I: Clinical, mental, and learning disorders • Childhood Disorders (ADD) • Stuttering • Substance abuse, • Eating disorders, • Anxiety and mood disorders • Sleep disorders • Impulse control disorders • Autism • Mental Retardation

Diagnostic Statistics Manual DSM • Current diagnostic system • Axis II: Personality disorders and intellectual disabilities. Classifies those disorders that last a lifetime: • Personality disorders • Impaired effectiveness in getting along with others • Mental Retardation • Narcissism • Axis III: Evaluation of general medical conditions, as these can contribute to overall mental functioning. • Diabetes • Cirrhosis of the liver • Axis IV: Psychosocial and environmental problems, particularly stress.

Diagnostic Statistics Manual DSM • Current diagnostic system • Axis V: Global Assessment of Functioning

Anxiety and Avoidance Disorders • According to DSM-IV Anxiety Disorders: • Are lingering, • Almost constantly present, • Cause thoughts or environmental triggers to induce psychological and physiological symptoms of distress • Those who feel helpless to control major life events are most prone to severe anxiety

Anxiety and Avoidance Disorders • Examples of DSM-IV Anxiety Disorders: • Panic Disorder (PD): 2% of all adults in US with more woman than men. Panic attack causes one to experience sudden expected anxiety at an almost unbearable level. The person sweats, trembles, gasps for air, experience dizziness and accelerating pulse rate. • Perceive the world as unreal to themselves • Sense of personalization • Catastrophic thoughts, they feel out of control, may wind up in the hospital , last several minutes but can consume several hours. • Social Phobia: Fear of anything public and avoidance of people • Agoraphobia: An excessive fear of public areas

General Anxiety Disorders • Generalized Anxiety Disorder (GAD): Excessive and exaggerated anxiety • Areas: Worry; include work, family, money and health • Extreme pervasiveness of the worry is what labels the condition and generalizes anxiety disorder • Cognitive and physiological difficulties • Difficulty with decision making • Difficulty remembering commitments • Individual experiences muscle tension, heightened arousal of the nervous system • Headaches, nervous twitches, indigestion and insomnia • GAD is frequently accompanied by Depression • Antidepressant drugs are an effective treatment providing immediate results • Relaxation training provides more long lasting than drug therapy

Phobias (Phobic Disorder) • Phobia: Characterized by intense fear of specific object or situation that actually poses no threat to the individual. • Interferes with daily living, • Confrontation may lead to sweating, trembling, rapid heart rate and breathing • Difference in phobic reactions are established based on severity • We are born with some fears however most are learned and can be traced to a certain event. • Therapeutic Phobia treatments include: • Flooding: Sudden exposure to the feared object • Systematic Desensitization: Gradual, repeated exposure to the feared object • The most successful

Obsessive-Compulsive Disorder • Obsessive-Compulsive Disorder aka “OCD”: Characterized by repetitive obsessions and/or compulsions. • Obsession: Repetitive thought that exists and continues to invade an individuals conscious mind • Compulsion: Repetitive action that an individual has no conscious desire to repeat (an almost irresistible action) • Obsessions continue even when an individual tries to repress them; obsessions surround themes of violence, sex or contamination • Two Common Compulsions • Checking Rituals: Interruption of their daily activities continually checking to make sure then performed what was required • Cleaning Rituals: Involve an obsession with the idea of contamination, IN the most severe form, obsessive-compulsive disorders can be completely disabling

Obsessive-Compulsive Disorder • Exposure Therapy: Normally perform a ritual however they are prevented form performing it • Drug Therapy: Clomipramine (Anafranil) is helpful for about half of obsessive- compulsive patients

Post-Traumatic Stress Disorder • (PTSD): Acute reactions to significantly traumatic events • Include: War, Assault, Rape, Floods, Earthquakes, accidents and fires. • Numbness to the world • Relive the trauma and experience anxiety • Symptoms appear shortly after the trauma • DSM-IV: acute or chronic? • Fear, helplessness or horror

Affective Disorders • Affective Disorders: Extreme moods and swings • Normal functioning may experience an episode of despair or mania • Major Depressive Disorder: One or more major depressive episodes without a history of manic, hypomanic, or mixed episodes • Depressed individuals often feel helpless and hopeless • Suffer from loss of pleasure or interest in regular activities • Disturbance in eating habits • Sleep disturbance • Loss of energy • Feeling of worthlessness or guilt, difficulties in thinking, concentration, and memory and recurrent thoughts of death and suicide. • DSM-IV- Symptoms must persist most every day for at least two weeks • Distress in social, occupational or areas important to functioning

Affective Disorders • Dysthymia: A “flat affect” and inability to connect. • Introverted • Morose • Over conscientious • Low energy level • Low self-esteem • Suicidal Ideation • Disturbances of Eating, Sleeping and Thinking • Also associated with major depression • Do not experience symptoms chronic enough for a diagnosis of major depression • Heredity and family influences • Adolescent boys and girls suffer from depression equally • After adolescence woman suffer from depression about twice as often as men

Affective Disorders • Depression usually involves an unpleasant event • It occurs most often among people with little or no social support • Seasonal Affective Disorder (SAD) • Depression with seasonal pattern of the year • Sleep and eat excessively during depressed time • Fall asleep late and awaken late • Get sleepy early and wake up early • Depressive mood swing • Elevated mood swing

Bipolar Disorder • Depressive as well as manic episodes • Appear late in adolescence in the form of a manic episode • Variety of patterns • Initial manic episode may be followed by a normal period, then a depressed period • Bipolar disorder is much less common than major depression • Women are twice as likely to be diagnosed with depression • Bipolar disorder occurs in both sexes at the same frequency • Bi-polar disorder is more prevalent among higher socioeconomic groups

Causes of Mood Disorders • Biological disorders • Heredity • Neurobiological Abnormalities • Neurotransmitter • Deregulation • Hormones • Learned Helplessness: A response to prolonged stress over which the individual has no control, where apathy and helplessness may lead to depression and cognitive explanations • Sociocultural factors include interpersonal relationships, socioeconomic and ethnic factors, cultural variations and gender

Treatments • Severe and debilitating • Responds well to both psychotherapy and drug therapy • Common Antidepressant drugs: • Tricyclics: Blocks reabsorption of neurotransmitters dopamine, norepinephrine and serotonin. Side effects: dry mouth, heart irregularities, difficulty urinating and drowsiness • Selective Serotonin Reuptake inhibitors (SSRIs)—block reputake of neurotransmitter Serotonin • Fewer and milder side effects than Tricyclics that include nausea and headaches. Ex: Zoloft, Luvox, and Paxil • Monoamine Oxidase Inhibitors: Block metabolic breakdown of released dopamine, norepinephrine and serotonin

Treatments • Electro conclusive Therapy (ECT): A brief electrical shock administered across the patients head to induce convulsion • ECT became poplar in 1940’s as a treatment for schizophrenia and depression • More antidepressant drugs became more readily available, ECT lost favor • Since 1970’s however ECT is being used for severely depressed patients who fail to respond to drug therapy

Mood Disorders and Suicide • Severely depressed people with bipolar disorder consider suicide and may attempt it • Feelings of guilt or disgrace • Cult leader tells them that death is a route to salvation • Records are not always accurate; people sometimes disguise their suicide to look like accidents • More than 13% of adults had considered suicide and more than 4% had survived a suicide attempt • Differences in suicide rates as function of age, country and gender • Most men use a gun or other violent means • Woman try poison, drugs or other no-violent methods that are fatal • Warning signs are given in advance

Schizophrenia • Positive (Present) Symptoms • Behaviors that are notable due to their presence and include: • Hallucinations, • Delusions • Thought disorders • Negative (Absent) Symptoms: • Notable due to their absence, such as… • Speech deficits, • Lack of emotional expression • Inability to care for one’s self

Schizophrenia • Types of Schizophrenia • Undifferentiated Schizophrenia: Deterioration of daily functioning plus a combination of hallucinations, delusions, inappropriate emotions and thought disorders • Catatonic Schizophrenia: Prominent movement disorder; either rigid inactivity or excessive activity • Disorganized Schizophrenia: Incoherent speech, extreme lack of social relationships, and odd behavior • Paranoid Schizophrenia: Elaborate hallucinations and delusions around feelings of persecution and delusions of grandeur

Causes of Schizophrenia • Due to genetics • Predisposition toward schizophrenia • Neurodevelopment Hypothesis: • Abnormal brain development before or at the time of birth due to difficult pregnancy, mothers poor nourishment, small birth weight or an Rh-negative mother with an RH positive baby • Season of birth effect where people born in the winter moths slightly more likely to develop schizophrenia than people born at other times

Therapies for Schizophrenia • Antipsychotic Drugs • Take effect gradually • Have some unwelcome side affects • Tardive Dyskinesia: Tremors and involuntary movements • Types of Antipsychotic Drugs • Chlorpromazine • Throazine-1st Schizophrenic drug • Haloperidol (Haldol)- helps to control schizophrenia and allow people to leave mental hospitals • Successful drug therapy • Sudden relapses • Family therapy • Reduces hostile comments improves chance of recovery

Dissociative Disorders • Psychogenic Amnesia • Psychogenic Fugue • Dissociative Identity Disorder (DID) • Depersonalization Disorder • Derealization

Dissociative Disorders • In general, the concept of “mental disorder” can be defined as: • A biomedical, culturally independent, value-free concept • Or as a social, culturally relative, value-based concept.

Dissociation • Is a splitting apart of normally integrated components of personality • Screening out of identity and memory • Exists w/o recognized damage to the brain • A way of coping with psychological stress

Amnesia • Forgetting past events and experiences • Confusion and disorientation • May result because of organic brain damage not always • A result of psychological stress • Two Forms: • Retrograde Amnesia • Anterograde Amnesia

Psychogenic Amnesia • Often appears suddenly after psychological stress • May suddenly disappear • Forgotten and screened out consciousness • Hypnosis may help in recovering events that are lost

Psychogenic Fugue • Sudden, unexpected excursion, then the individual forgets their true identity only to assume a new identity • Purposeful in their movements • Occurs suddenly • Individuals wake up experiencing complete amnesia concerning events that occurred

Dissociate Identity Disorder • DID aka Multiple Personality Disorder • Alienation between two distinct personalities • Each personality exists as well-integrated and developed • Each has it’s own tastes, memories, learned behaviors • Many different patterns of personalities • Increase in personalities leads to increase complexity

Depersonalization Disorder • Disruption in personal identity • Disruption exists w/o amnesia • Cut off from selves as if they are viewing themselves from the outside • Strangeness of self leads to strangeness of the world

Depersonalization Disorder • Derealization: Episodes of… • Déjà vu (already seen) • Jamasis vu- (never seen) • Familiar place of never having experienced the location before

Hypochondriasis • Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms

Somatization Disorder • Formerly known as Briquet’s syndrome • Recent and numerous physical complaints • Can persist for several years and cause one to seek medical help; no medical basis for complaints can be found • Symptoms are explained in a vague and exaggerated way • Several medical symptoms for a diagnosis

Conversion Disorder • Actual impairment of motor and sensory function • Conversion Symptoms include: blindness, deafness and paralysis • Sometimes mimic epilepsy or cancer • DSM-IV conversion disorder specifies deficit affect is voluntary motor or sensory function

Paranoid Personality Disorder • Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.

Paranoid Personality Disorder • They search for hidden meanings in everything and read hostile intentions into the actions of others. • They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges.

Schizotypal Personality Disorder • Detachment from social relationships • Odd thinking • Neglect of normal grooming • Restricted range of emotional expression in interpersonal situations • Difficult to get along with - often have problems in close relationships • .

Antisocial Personality Disorder • Antisocial personality disorder is characterized by a lack of conscience • People with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of • They tend to lie and steal • They are careless with money and take action without thinking about consequences • They are often aggressive and are much more concerned with their own needs than the needs of others

Borderline Personality Disorder • Characterized by mood instability and poor self-image • People with this disorder are prone to constant mood swings and bouts of anger. • They will take their anger out on themselves, causing themselves injury • Suicidal threats and actions are not uncommon • They are quick to anger when their expectations are not met.

Abnormal Psychology