Chapter 14 & 15

1. Chapter 14 & 15 Abnormal Psychology & Treatment

2. Abnormal • 4 Components of Abnormality • Unusual – against majority • Maladaptive – interferes with ability to function • Labeled as abnormal by society it occurs in • Perceptual or cognitive dysfunction

3. Theories of Psychopathology • Psychoanalytic • Result: Freud problems between Id, Ego, Super Ego lead to abnormalities • Unconscious drive • Humanistic • Result: Too sensitive to criticisms/judgments of others • Cognitive • Result: Faulty illogical thoughts • Behavioral • Result: All behavior is learned • Biological • Result: Brain function due to structural/chemical abnormalities • Sociocultural • Result: Society/culture decide what is acceptable behavior

4. DSM-IV-TR • Axis I: clinical disorders, including major mental disorders, as well as developmental and learning disorders • Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, phobias, and schizophrenia.

5. DSM-IV-TR • Axis II: underlying pervasive or personality conditions, as well as mental retardation • Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.

6. DSM-IV-TR • Axis III: Acute medical conditions and physical disorders. • Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

7. DSM-IV-TR • Axis IV: psychosocial and environmental factors contributing to the disorder. • Negative life events, an environmental difficulty, family or interpersonal stress.

8. DSM-IV-TR • Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children under the age of 18. (on a scale from 100 to 1) • 100- superior functioning in a wide range of activities. • 50-serious symptoms or difficulty in social, occupational, or school functioning. • 20-some danger of hurting self or others, occasional failure to maintain minimal personal hygiene, or gross impairment in communication.

9. David Rosenhan (1973) • Dangers of labeling – labels behavior as disorders and because labeling is not an exact science it can have adverse effects on how a person is judged. • Rosenhan along with seven others reported hearing voices however responded to question showed no evidence of pathology . . . Still diagnosed mentally ill

10. Anxiety Based Disorders • Anxiety – tension/nervousness/panic attacks overwhelming sense of panic, fear and desire to escape • Panic Disorder • General Anxiety Disorder (GAD) • Obsessive-Compulsive Disorder (OCD) • Post-Traumatic Stress Disorder • Phobias

11. Somatoform Disorders • Somatoform – disorder characterized by physical symptoms without any actual physical cause • Conversion Disorder – Paralysis or blindness (no physical cause) • Freud • Hysteria • Hypochondriasis • Factitious Disorders – person inflects injury to self to produce symptoms

12. Mood Disorders • Mood Disorders – extreme disturbance of emotional balance • Unipolar (major depression) • 2 or more weeks • Bipolar Disorder • Primarily Depressive • Primarily Manic – rear • Normal – Manic – Depressive • Seasonal Affective Disorder • Sunlight not weather!

13. Schizophrenia • Schizophrenia – disordered thoughts/behaviors which include delusions/hallucinations/inappropriate response • Disorganized – incoherent speech, inappropriate emotion • Catatonic – stupor, rigid boy postures fixed position • Paranoid – auditory hallucinations, secret codded messages hidden for them • Undifferentiated – Multiple symptoms not easily categorized • Residual – Some schizoid tendencies/traits but not profoundly schizophrenic • Dopamine hypothesis - excess dopamine receptors in brain

14. Organic Disorders • Organic Disorders – caused by damage to brain tissue • Mostly result of disease or chemicals: Dementia, Alzheimer’s disease, and some drug/alcohol dependence

15. Personality Disorders • Personality Disorders – extreme abnormal personality that conflicts with social functioning • Paranoid – extreme distrust, suspicion of others • Antisocial – disregard for the rights/interests of others • Narcissistic – Self-preoccupation and focus on self • Dependent – need to be cared for • Histrionic – excessive emotional reactions and excitability, need for attention

16. Dissociative Disorders • Dissociative Disorders – dysfunction of memory or altered sense of identity • Amnesia – sudden memory loss caused by trauma • Anterograde amnesia – loss of memories occurring after traumatic event • Retrograde amnesia – loss of memory prior to event • Fugue – sudden complete loss of identity, caused by stress, create new identity • Dissociative Identity Disorder (DID) – Multiple personality disorder

17. Attention Deficit & Disruptive Behavior Disorder • Attention Deficit Hyperactivity Disorder (ADHD) – inattentiveness, difficulty paying attention, organization, forgetfulness, distractible • Need for attention • Conduct disorder • Oppositional Defiance Disorder

18. Chapter 15 Treatment

19. Psychoanalysis • Free association • Patient reports any and all conscious thoughts • Hypnosis – unconsious • Manifest Content – subject of dream • Latent Content – symbols • Transference – patient shifts thoughts/feelings about people/events onto therapist • Countertransference – therapist transfers their feelings onto their patient

20. Humanistic • Client-Centered Therapy • Carl Rogers (invented) • Understand client through their own reality • Nondirectional approach – focus on clients perception and how that effects them • Goal of therapy: self-actualization (full potential) • Genuineness – active listener and relate to client • Unconditional Positive Regard – show complete acceptance of client no matter what • Accurate empathic understanding – therapist ability to view world from clients eyes (empathy)

21. Gestalt Therapy • Fritz Perls • Combines both physical/mental therapies • Client maybe asked to act out conflict in order to make them aware of their interactions between body and mind

22. Behavioral Therapy v. Insight Therapy • Behavioral Therapy – short-term process, no deep underlying cause of problem, abnormal behavior is the problem and symptom • Insight • Insight into the cause is the processes of getting better • Psychoanalysis

23. Behavioral TherapyCounterconditioning • Conterconditioning – response to a given stimulus is replaced by a different response • Alcoholic – replace good feelings while drinking, with feelings concerning alcohol • Aversion Therapy – Administer punishment while stimulus • Drink alcohol get slapped! • Systematic Desensitization – replace anxiety with relaxation

24. Behavioral Psychology • Extinction Procedures – weaken maladaptive responses • Flooding – expose client to stimulus that causes undesirable response • Fear spiders, here’s a Camel spider have fun! • Implosion – client imagines stimulus rather than confront it

25. Behavioral Psychology • Operant Conditioning • Behavior-control technique • Behavioral contracting • Patient and client draw up a contract both agree to follow. Follow behavior, rewarded if do the right thing • Modeling • Bandura’s social learning theory • Vicarious learning – watch and learn

26. Cognitive Therapy • Rational-emotive behavior therapy (REBT) also called Rational-emotive therapy (RET) • Albert Ellis – when confronted with situations, people recite statements to themselves that express maladaptive thoughts • Change thoughts by facing it • Aaron Beck – focus on maladaptive schemas • Negative triad – negative view of self, world, future • Maladaptive inference – person draws conclusions without evidence • Dichotomous thinking – all-or-none conceptions of situations • “If I don’t get this job, I’ll be a complete failure.”

27. Biological Therapies • Electroconvulsive Therapy (ECT) • High voltage electricity pass through head • Causes temp amnesia, possible seizures • Success with depression (last option) • Possible memory loss • Psychosurgery • Prefrontal lobotomy – patient left catatonic state

28. Biological Therapies • Psychopharmacology - treatment of psychological and behavioral maladaptations with drugs • Psychotropic (psychologically active drugs) • 4 classes of psychotropic/psychologically active drugs: • Antipsychotics • Antidepressants • Anxiolytics • Lithium salts • Antipsychotics – Clozapine, Thorazine, Haldol • Reduce schizophrenia symptoms blocking neural receptors for dopamine • Tardive dyskinesia – shaking (side effect)

29. Biological Therapies • Antidepressants – Monoamine oxidase (MAO) inhibitors, tricyclics, selective reuptake inhibitors • MAO – like Eutron increase amount of serotonin, norepinephrine in synaptic cleft • Tricyclics – like Norpramin, amitriptyline, impiramine • Increase amount of serotonin/norepinephrine • Selective reuptake inhibitors (selective serotonin reuptake inhibitors or SSRIs) – block reuptake mechanism of cell that released the neurotranmitters. • Prozac (fluoxetine) • Fewer side effects

30. Biological Therapies • Anxiolytics – depress CNS and reduce anxiety, increase feelings of well-being, and reduce insomnia • Common anti-anxiety is Xanax, also include barbiturates (rarely used) • Benzodiazepines – Valium (diazepam) and Librium (chlordiazepoxide) cause muscle relaxation • Lithium Carbonate • A salt effective in treatment of bipolar disorder

31. Modes of Therapy • Group therapy • 12 Step programs • Couples therapy • Family therapy