Abnormal Behavior *

1. Abnormal Behavior * A psychological disorder, causing distress, disability, or dysfunction. Defined symptomatically by the DSM.

2. Statistics on Disorders • 1 in 4 affected each year • Each year prevalence: 18.1% anxiety disorders; • 1% schizophrenia; 4.4% alcohol use disorder • More lower SES • Mentally ill stigmatized • Many disorders comorbid. • Comorbid = more than one disorder at a time • Most severe disorders in a small group of people • 6% of population have 3 or more disorders

3. DSM * • Diagnostic and Statistical Manual • American Psychiatric Association • Currently DSM IV-TR • Common language and standard criteria for classifying mental disorders • Controversies include: • Cultural bias (e.g. sexual disorders) • Medical rather than behavioral model • Diagnosing, e.g. ADHD, autism, asperger’s.

4. Diagnosing Disorder: The DSM • Source: Adapted from American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. • The DSM organizes the diagnosis of disorder according to five dimensions (or axes) relating to different aspects of disorder or disability. * • *The axis system is no longer being used as of 5/22/13

5. Categories of Disorders include: • Disorders Diagnosed in Infancy/Early Childhood * • Delirium, dementia, & amnesia * • Dissociative disorders * • Substance Abuse Disorders * • Schizophrenia & other Psychotic Disorders • Mood Disorders * • Anxiety Disorders * • Somatoform Disorders * • Eating Disorders * • Sexual Disorders * • Personality Disorders • Impulse Control Disorders/ * • * Major Changes in DSM V pub. date May 2013

6. Biopsychosocial Model * Key concept is Interaction.

7. Anxiety Disorders • Anxiety – irrational fear, dread, or agitation; physiological arousal • 1. Phobias: unreasonable fear; avoidance • a. Specific phobia – clearly defined object or situation, e.g. dogs Video‬‏ • b. Social phobia – extreme shyness or discomfort in social situations • 2. Panic Disorder * • Sudden attacks of terror leading to behavioral changes & physical symptoms

8. Anxiety Disorders, cont. • Post Traumatic Stress Disorder • Obsessive Compulsive Disorder * • a. Obsessions * • Repetitive, distressing or frightening thoughts • b. Compulsions * • Repetitive behaviors (an attempt to calm the thoughts)

9. Dissociative Identity Disorder * • 2 or more distinct personalities in the same person • Memory disruption regarding the “alter” • Rare • Some psychologists don’t believe the disorder really exists • NOT the same as Schizophrenia • DID Video‬‏

10. Mood Disorders * • Major depressive disorder * • Low mood (despair) - withdrawal, loss of interest & pleasure; eating & sleeping disturbance Video‬‏ • More than 2 weeks • Impaired functioning • Twice as many women • May have psychotic features • Suicidal thoughts or attempts

11. Mood Disorders, cont. • Dysthymia * • Mild, chronic depression, more than 2 yrs. • Bipolar disorder * Video‬‏ • Swings from low (depression) to high (mania); near normal in between • Mania * • Exceptional energy, enthusiasm, agitation, irritable

12. Risk Factors for Suicide * • Diagnosable psychiatric disorder • Male, esp. older and physically ill • Method (guns succeed more than pills) • Prior attempts, family history, exposure • History of being abused • Incarceration • High risk behavior • Adolescence 2% attempt

13. Schizophrenia * Video – Gerald • Psychosis: loss of contact with reality • Positive symptoms – hallucinations, delusions, inappropriate affect, disorganized speech and behavior • Negative symptoms – social withdrawal, deterioration of adaptive behavior, flat affect, poor problem solving abilities

14. Types of Schizophrenia * • Disorganized * • Language and/or behavior chaotic, illogical • Catatonic * • Extreme disorder of movement or no movement • Paranoid * • Hallucinations or delusions most prominent symptom • Undifferentiated * • Mixed; symptoms from 2-3 other types

15. Possible Causes of Schizophrenia * • Genes – runs in families • Brain– loss of neurons; enlarged ventricles • Neurotransmitters – e.g. excess dopamine • Poverty, malnutrition, disease • Prenatal damage – e.g. viruses • Stress • Substance Abuse may trigger • Interactions between items above

16. Personality Disorders * • Inflexible patterns of thinking, feeling or relating to others • These patterns cause problems in personal, social & work situations. • Inability to understand needs of others • Three “clusters” • A) Odd, eccentric • B) Dramatic/erratic, BPD Video • C) Anxious/inhibited

17. Antisocial Personality Disorder * • Pervasive pattern of violating the rights of others • Begins in childhood or early adolescence • Continues through adulthood • 3x more males • Alcohol, drug abuse • Egocentric, impulsive • Lie, cheat, steal, criminal behavior • Biological and environmental factors

18. Somatoform Disorders * • Real physical symptoms • Not explained by medical condition. • Stress-related • More females • Ex: conversion disorder, hypochondriasis * • Hypochondriasis = excessive worry about having a physical illness • Contrast with factitious disorder – no real physical illness, just imagined or faked

19. Discussion Questions • Why is lower SES associated with mental illness? • Should treatment for mental illness be required? • Should the homeless, alcoholic mentally ill be institutionalized? • Should mental health “check-ups” be part of yearly physicals for children? Adults?