Chapter 14: Psychological Disorders (Abnormal Psychology)

1. Chapter 14: Psychological Disorders (Abnormal Psychology)

2. Defining Abnormality • Defining abnormality is not simple, it appears to be more a matter of degree of behavioral change & distress rather than the presence or absence of a behavioral change or distress • Some criterion seem helpful in defining abnormality: • Behavior is outside of social norms (shouting at strangers…*shows what is “normal” is culturally dependent) • Inability to function (being unable to go to work due to alcohol abuse) • Personal Distress (trouble sleeping, worry all the time, thoughts of suicide) • Prolonged Suffering (depression that lasts months rather than days)

3. Normality-Abnormality Continuum

4. DSM IV Diagnostic and Statistical Manual (DSM IV) 1952- First edition 1994- 4th edition 2000- 4th revised 2013- 5th edition

5. Personality Disorders- a few examples • Antisocial Personality Disorder (sociopath): marked by impulsive, callous, manipulative, aggressive, lacks conscience (often charming) • Narcissistic: exaggerated feelings of self-worth and constant need for affirmation • Histrionic: OVERLY emotional/seductive • Borderline: irrational fear of abandonment, self injury • Schizotypical and schizoaffective

6. Dissociative Disorders • Dissociative Amnesia: sudden loss of memory for personal information that is not due to normal forgetfulness • Fugue: forming a new identity • Dissociative Identity Disorder (DID): the coexistence of more than one personality in an individual • Depersonalization/Derealization: Feelings of unreality concerning the self and environment. Anxiety producing. Many young adults have felt this.

7. Schizophrenia Spectrum and Other Psychotic Disorders • Group of disorders marked by disturbances in thought patterns (distortions in perception and abnormal emotional responses). • Catatonia: marked by motor disturbances ranging from immobility to excessive, purposeless activity • Schizophrenia: must have at least one of these three “positive symptoms” (delusions, hallucinations, or disorganized speech) • 1% of population in every culture • 30% resistant to drugs • Gradual vs. Sudden onset

8. Potential Causes of Schizophrenia • Physiological Explanations • Neurochemicals- excess dopamine • Enlargement of the ventricles of the brain(genetics- there is a 46% concordance rate for identical twins with one twin suffering schizophrenia • Environmental Explanations • Stress- can precede the onset of schizophrenia and precede subsequent relapses • Unhealthy Family Dynamics- high expression of emotion and communication difficulties in a family • Date of birth- maybe flu season during time in womb? (see next slide)

9. Risk Month Born

10. Relatives of ppl with schizophrenia

11. Anxiety Disorders • Panic Attacks: recurrent attacks of anxiety not due to a specific event • Phobias: chronic, irrational fear of a specific object or situation agoraphobia (open spaces), social phobia • Generalized Anxiety Disorder: chronic anxiety that is not caused by a specific stimulus • Selective Mutism: child can’t speak and communicate effectively in select social settings

12. Common Phobias Less Common (but entertaining)…phobias list

13. Some Potential Causes of Anxiety Disorders • Behavioral explanations: Classically conditioned phobic responses • Neuro-chemical: decreases in GABA activity and serotonin activity are associated with anxiety disorders • Cognitive: people who suffer from anxiety disorders may chronically overestimate the severity of a perceived threat

14. Somatoform Disorders • significant loss of function in one single organ system without a physiological cause • Conversion Disorder (Functional Neurological Symptom Disorder)

15. Some Potential Causes of Somatoform Disorders • Personality Factors: people with histrionic and neurotic personality traits seem to be more susceptible to the somatoform disorders • Behavioral Factors: people who have previously received a lot of attention because of illness may begin to find reward in the somatoform disorders

16. Obsessive-Compulsive Disorder • Obsessions: persistent obtrusive thoughts • Compulsions: need to engage in unnecessary rituals • Body Dysmorphic Disorder • Hoarding Disorder • Trichotillomania (Hair-Pulling Disorder) • Excoriation (Skin-Picking) Disorder

17. Trauma- and Stressor-Related Disorders • Acute Stress Disorder: immediate reaction to trauma • Adjustment Disorders: adjusting after trauma • Posttraumatic Stress Disorder (PTSD): after traumatic life event person has severe anxiety, helplessness, fear, flashbacks • Reactive Attachment Disorder: result of social neglect or other situations that limit a child’s opportunity to form attachments

18. Depressive Disorders • Major Depressive Disorder: persistent feelings of sadness and a loss of interest in finding pleasure (more than 2 weeks) • Persistent Depressive Disorder (more than two years) • Post-partum Depression • Premenstrual Dysphoric Disorder • Seasonal Affective Disorder (cloudy weather) • Disruptive Mood Dysregulation Disorder: kids who exhibit persistent irritability and frequent episodes of extreme behavioral dyscontrol

19. Bipolar Disorder • Bipolar Disorder: marked by chronic experience of manic and depressive episodes • Mania = increased activity • Depression = decreased activity

20. Episodic Patterns in Mood Disorders

21. Some Potential Causes of Depression • Cognitive and Behavioral Mechanisms • Behavioral: ”learned helplessness” believe outcomes in their life are out of their control (external locus of control) • Cognitive: negative self-talk is associated with depressive episodes • Physiological Mechanisms • Neurotransmitters: decreased norepinephrine and serotonin is associated with depression • Genetics: there is a 65% concordance rate between identical twins

22. Mood Disorders chart

23. Suicide • White > Black, Men > Women (China), Woman attempts > Men attempts • Spike for men after 65 • Alcoholics and depression very high rate • Few who talk about it do it, but most who do it give clues ahead of time • Arizona over 1000 suicides last year- Mesa 60, Chandler 30

24. Suicide facts • Take all threats seriously • Most suicidal people are ambivalent and want help • Asking a person can minimize anxiety and act as a deterrent • An attempter is often upset or depressed

25. Clues and Warning Signs • Change in interest or mood (including extremely happy or peaceful. • Change in lifestyle, eating, sleeping • Change in perception of the world • Change in attitude about personal property- giving away prized possessions

26. Insanity Pleas • Does not know right from wrong • Standard = Would the person have committed the crime if a cop was in the room? • A disorder alone does not absolve responsibility • John Hinkley - President Reagan • Ted Kaczynski, Jeffrey Dahmer, Andrea Yates, Kip Kinkel- all found guilty by juries

27. Problems with DSM/disease model • Thomas Szasz- no such thing as mental ill • Rosenhan- empty, hollow, thud- 19 days • Labeling theory • Not easy to classify- crossover • Infers more understanding than actual • Everyday problems • Insurance