1. Some behavior people

see as normal while others

see the same behavior as

abnormal

a. “Insanity:” doing the

same thing over and over,

expecting a different result

b. “Insane” is not often

used anymore in medicine;

replaced with

psychopathology

2. Deviation from Normality

a. Any deviation from the average or majority

b. Different cultural norms must be taken into consideration

i. Because the majority isn’t always “right” or “best,” the

deviance approach is not a great/useful standard

3. Adjustment

a. “Normal” people can get along socially, physically

and emotionally in the world

b. Feed, clothe themselves

c. “Abnormal” people fail to adjust in these ways

d. Remember– behavior in one society may not be

acceptable in others

4. Psychological Health

a. Self-Actualization– Humanistic

view that to be normal or healthy

involves full acceptance and

expression of one’s own individuality

and humanness

i. Problem: hard to determine if a

person is actualizing themselves

b. Labeling a person “mentally ill”

because of odd behavior is a mistake,

cruel, and irresponsible

c. Many of these people just have

problems in living that causes conflicts

d. Only when a psychological problem

is severe enough to disrupt everyday

life should it be seen as an

abnormality or illness

5. The Problem of Classification

a. DSM– The Diagnostic and

Statistical Manual of Mental

Disorders

i. Currently in its 5th revision

(2013)

ii. A classification manual that

shows such things as

1. Features

2. Diagnosis

3. 5 Axes in DSM-IV; Axes

1-3 have been essentially

folded together in DSM-5

1. Anxiety– general state of dread or

uneasiness a person feels in response

to a real or imagined danger

a. Feeling anxiety out of proportion to

the situation provoking it

b. Affects 20-40 million Americans

c. Characteristics:

i. Feelings of anxiety

ii. Personal inadequacy

iii. Avoidance of dealing with

problems

iv. Unrealistic images of themselves

v. Unable to free themselves of

recurring fears and worries

1. Anxiety (cont.)

d. Expressed through:

i. Constant worrying

ii. Sudden mood swings

iii. Physical symptoms

a. headaches

b. sweating

c. muscle tightness

d. weakness

e. fatigue

e. Anxious people often have difficulty forming stable,

satisfying relationships

2. General Anxiety Disorder

a. Feeling nervous for reasons they can’t explain

b. Can become full blown panic attacks

i. Choking sensation

ii. Chest pain

iii. Dizziness

iv. Trembling

v. Hot flashes

c. Neglect social relationships

d. Trouble dealing with friends, family, or responsibilities

e. The more worry, more difficulty they have... the more difficulty, the more

they worry (a vicious cycle)

f. Physical symptoms: poor appetite, frequent urination, indigestion,

diarrhea

g. Causes:

i. Learned anxiety

ii. Inherited

iii. Environmental factors

iv. Uncertainties of modern life

3. Phobic Disorder (phobia)

a. Phobia/Phobic Disorder–

when severe anxiety is

focused on a particular

object, animal, activity or

situation that seems out of

proportion to the real danger

involved

b. Elaborate plans to avoid

those situations

c. Ranges from mild to severe

d. Treatment

i. Providing the person a experience their phobia under

conditions where they feel safe

4. Panic Disorder

a. Panic– a feeling of sudden, helpless terror

b. Panic attack: the person experiences sudden, unexplainable,

attacks of intense anxiety, leaving them fearing death and doom

c. Physical Symptoms:

i. Sense of smothering

ii. Choking

iii. Difficulty breathing

iv. Faintness or dizziness

v. Nausea

vi. Chest pains

d. Can last minutes or hours and occur without warning

e. Causes:

i. Inherited

ii. Environment

a. interpreting a physiological arousal (higher heart rate) as

disastrous

5. Obsessive-Compulsive Disorder

a. Obsession– an uncontrollable pattern

of thoughts

b. Compulsion– repeatedly performing

coping behaviors

c. Obsessive-Compulsive Disorder–

experiencing both together

i. Everyone has obsessions and

compulsions, but it’s a problem when it interferes with what a

person wants and needs to do

ii. Causes:

a. Serve as diversions from a person’s real fears/origins;

may reduce anxiety

b. May run in families, genetic

c. Most sufferers know that their thoughts and

actions are irrational, but feel unable to stop

them

6. Post-Traumatic Stress Disorder

a. PTSD– a person who has experienced a traumatic event feels severe and

long lasting aftereffects

b. Those who suffer include:

i. Veterans of wars

ii. Survivors of terrorist attacks

iii. Natural disaster victims: hurricanes, tornadoes

iv. Plane crashes

v. Assault and rape victims

c. The event that triggers the disorder overwhelms a person’s sense of

reality and ability to cope

d. Can begin immediately after the event or later in life

e. Symptoms

i. Flashbacks

ii. Nightmares

f. Can be long lasting

g. People exposed to events repeatedly or over a long period of time are

more likely to develop the condition

1. Somatoform Disorders– when anxiety creates a variety of

physical symptoms for which no physical cause is apparent

a. Also known as hysteria– unexplainable fainting, paralysis or

deafness, used in Freud’s time

b. Conversion Disorders

i. Conversion Disorder– the conversion of emotional

difficulties into the loss of a specific physiological function

a. No actual physical damage is present

ii. When someone is frightened and they can’t move

(common), uncommon for it to persist

iii. Results in a real and prolonged handicap

iv. If a person wakes up paralyzed from the waist down and

accepts it with calmness (la belle indifference), it’s known to

be a psychological problem

v. Psychologists believe sufferers gain “freedom” from

unbearable conflict

vi. Very Rare!

c. Hypochondriasis

i. A healthy person who becomes

preoccupied with imaginary ailments

ii. Hypochondriacs spend time looking

for signs of serious illness; misinterpret

minor aches, pains, and bruises as

early signs of fatal illness

a. Beliefs persist regardless of medical

tests and diagnosis

b. Typically occurs in young adulthood

c. Occurs when an individual represses

emotions, then expresses them

symbolically in physical symptoms

2. Dissociative Disorders– when a person experiences

alterations in memory, identity, or consciousness

a. Can be normal (e.g., daydreaming/not hearing your name

being called)

b. Amnesia and multiple personality are very, very rare

c. Dissociative Amnesia

i. Memory loss that has no

biological explanation

ii. May be an attempt to escape

from problems by blotting them

out entirely

iii. Remember how to speak and

retain general knowledge, but

don’t know who they are, where

they are from, how they got

where they are

iv. Most often results from a

traumatic event/terrible accident

d. Dissociative Fugue

i. Amnesia coupled with an active

flight to a different environment

ii. Person disappears, then wakes

up the next day long ways from

home

iii. If not treated, they establish a

new identity in the new place

iv. Represses all knowledge of a

previous life

v. Can last for days, even years

vi. Upon re-emerging, they have

no memory of what had happened

vii. Escape from unbearable conflict or anxiety

e. Dissociative Identity Disorder (Multiple Personality Disorder)

i. A person exhibits two or more personality states, each with its own behavior/

thinking patterns

ii. Different states may take controls at different times

iii. Famous Case– Eve White

a. Treatment for severe headaches and blackouts, conscientious, self-

controlled, and shy

b. During one treatment, her expression and personality suddenly

changed, became “Eve Black” (child-like, fun-loving, irresponsible;

opposite of Eve White); Film– The 3 Faces of Eve

c. Eve Black was conscious of Eve White, but considered her a separate

person; White didn’t know about Black, nor of Jane (a 3rd personality)

d. Went on to write a book detailing 22 identities

iv. Psychologists believe dividing up the personality is done in the effort to

escape from a part of the self that they fear

v. The secret self then emerges as a separate identity

vi. EXTREMELY RARE, controversial

vii. People diagnosed usually suffered from severe physical, psychological, or

sexual abuse during childhood

1. People with schizophrenia often

have difficulty using language to

communicate

a. Go from one phrase to another

by random association

b. Schizophrenia affects the area

of the working memory used to

make sentences

c. Don’t remember the beginning of

the sentence so they finish it with

an unrelated thought

2. People with schizophrenia withdraw

from normal life, have distorted

perceptions; behavior can reach

irrational, fantastic, fear-laden levels

3. Examples:

a. Marshall Applewhite and 38 members of Heaven’s Gate

b. Charles Manson (disputed)

c. Joan of Arc

d. Adolf Hitler

e. Jim Jones

f. “Son of Sam” David Berkowitz (disputed)

g. “Unabomber” Ted Kaczynski (disputed)

h. Syd Barrett

i. Mary Todd Lincoln

4. What is Schizophrenia

a. Schizophrenia– involves confused, disordered thoughts

and perceptions

i. Affects about 1 in 100 worldwide

ii. Thoughts are disturbed and contact is lost with reality to

a considerable extent

iii. Can live life as an unreal dream

iv. Not a single problem, so no single cause or single cure

v. Symptoms

a. Delusions– false beliefs maintained in the face of

contrary evidence

b. Hallucinations– perceptions in the absence of

corresponding sensation

c. Incoherence– marked decline in thought process

d. Word Salad– lots of words thrown together

e. Disturbances of affect– emotions that are

inappropriate for the circumstances

f. Deterioration in normal movement– slowed movement,

Non-movement, or highly agitated behavior

g. Decline in previous level of functioning– sharp drop off

in productivity of work

h. Diverted attention– as if the person is unable to

focus their attention

b. Types of Schizophrenia

i. Paranoid Type

a. Involves hallucinations and delusions

aa. Grandeur– “I am the savior of my people”

bb. Persecution– “Someone is always watching me”

ii. Catatonic Type

a. Remain motionless for long periods

b. Exhibiting waxy, flexibility in which limbs in unusual positions may

take a long time to return to a resting, relaxed position

iii. Disorganized Type

a. Incoherent language, inappropriate emotions, giggling for no

apparent reason, generally disorganized motor behavior and

hallucinations/delusions

iv. Remission Type

a. Anyone whose symptoms are gone or still exist, but aren’t severe

enough to have received a diagnosis of schizophrenia

b. Belief is that the symptoms will return

v. Undifferentiated Type

a. Encompasses a large amount of the symptoms all in one person

c. Treatment

i. Very complex condition

ii. Treatment is long term, usually requires

hospitalization

a. Sometimes leads to burn-out– one who is not

likely to function normally in society

iii. May go into remission, but adjustment tends to

deteriorate between successive episodes of the

reappearance of symptoms

iv. No real cure for schizophrenia exists

d. Cause of Schizophrenia

i. Biological Influences/Genetics

a. Almost certainly involved

b. 1% chance of having schizophrenia, 10% if a family member has

it, 48% chance if one identical has it, the other will

c. Can’t specify the exact contribution hereditary factors have

ii. Biochemistry and Physiology

a. Chemical imbalances in the brain

b. Too much or too little of a specific chemical in the brain has upset

The processing of information, interferes with normal synaptic

transmission

c. Dopamine Hypothesis– too much dopamine at the selected

synapses

d. CAT and MRI scans can show signs of deteriorated brain tissue

e. Exact role of the environment is fostering schizophrenia is

unclear, but it is involved

iii. Family and Interactions

a. Pathogenic, unhealthful, families may contribute to problems in

adult years, but don’t in and of themselves lead to schizophrenia

5. Mood Disorders

a. Emotions that hamper the ability to function effectively

i. In extreme cases, a mood may cause them to lose touch with

reality or threaten their health or lives

b. Major Depressive Disorder

i. Spend at least 2 weeks feeling depressed, sad, anxious, fatigued

and agitated

a. Causes a reduced ability to function and interact with others

b. Mild (uneasiness, sadness, apathy) to intense (suicidal

despair)

c. CANNOT be associated with bereavement– loss of a loved

one

d. Marked by 4 symptoms

aa. Problems with eating, sleeping, thinking, concentrating,

decision making

bb. Lacking energy

cc. Thinking about suicide

dd. Feeling worthless or guilty

c. Bipolar Disorder– individuals are excessively and

inappropriately happy or unhappy

i. High elation, hopeless depression, or an alternation

between both

ii. Manic Phase

a. Elation, extreme confusion, distractibility, racing

thoughts

b. Exaggerated sense of self-esteem; engages in

irresponsible behaviors

aa. e.g., shopping sprees or insulting remarks

c. Act as though they need less sleep, activity level

increases, as does volume and frequency of speech

c. Bipolar Disorder (cont.)

iii. Depressive Phase

a. Failure, sinfulness, worthlessness, despair, lethargy,

unresponsiveness

c. Essentially the same as major depressive disorder

d. May alternate between frantic action/motionless despair

iv. Some have episodes separated by long intervals of normal

behavior, others just alternate between mania and depression

d. Seasonal Affective Disorder

i. In winter, sufferers develop

a deep depression

ii. Spirits only lift with the

coming of spring

iii. Tend to sleep, eat

excessively during their

depressed period

iv. Cause

a. Melatonin may play a role

aa. Less light (winter) more melatonin is secreted by

the pineal gland

bb. High levels can cause Seasonal Affective

Disorder

b. Can be treated by sitting under bright fluorescent

lights during the evening or early morning hours

e. Explaining Mood Disorders

i. Psychological Factors

a. Personality traits (self esteem)

b. Amount of social support

c. Ability to deal with stressful situations

ii. Beck Theory

a. Sufferers draw illogical conclusions about

themselves, blame themselves for normal problems,

consider minor failures as catastrophic

iii. Seligman Theory

a. Caused by feeling of learned helplessness

b. Learns to believe that they have no control over

events in their lives and that it’s useless to try

f. Suicide and Depression

i. Not all people who commit suicide are depressed; not all

depressed people attempt suicide

ii. Many depressives do think about suicide; though; some

translate thought into action

iii. People commit suicide for many reasons

a. Escape from physical pain or terminal illness

b. Escape from emotional pain, e.g., loneliness of old

age

c. Escape from the torment of unacceptable feelings

d. To punish themselves for wrongs they committed

e. To punish others

f. Often, no seeming explanation

f. Suicide and Depression (cont.)

iv. More than 30,000 Americans

end their lives by suicide

a. 1 every 20 minutes

v. More women attempt

suicide; more men succeed

vii. Most common among the elderly

viii. 2nd most cause of death for college students

ix. People who threaten or make an

unsuccessful attempt are very serious

x. 70% of those who commit suicide threatened

to do so within 3 months preceding

a. Unsuccessful attempts are often a trial run

1. Personality Disorder

a. Generally don’t suffer from acute anxiety,

nor behave in bizarre, incomprehensible

ways

b. Unable to establish meaningful/long-term

relationships with others, assume social

responsibilities, or adapt to their social

environment

1. Personality Disorder (cont.)

c. Antisocial Personality (Sociopaths

and Psychopaths)

i. Exhibit persistent disregard for

and violate of others’ rights

ii. Treat people as objects

iii. Live for the moment

iv. Seeking thrills is a major

preoccupation

v. If they injure or hurt people along the way, they feel no

shame or guilt

vi. No matter how often they get into trouble, punished, or

jailed, they never “learn” to stay out of trouble

vii. Often intelligent, entertaining, and good at faking emotions;

win the confidence, affection of others

2. Drug Addiction

a. Become a major psychological problem

b. Millions depend so heavily on drugs that they hurt

themselves physically, socially and psychologically

c. Psychological Dependence– depend so much on a drug

that without it they feel nervous and anxious, that feeling of

well-being

i. Alcohol

ii. Caffeine

iii. Nicotine

iv. Cocaine

v. Marijuana

vi. Amphetamines

2. Drug Addiction (cont.)

d. Physical Addiction– when the drug state becomes the

normal body state, there is extreme physical discomfort without

the drug

i. Tolerance– developed when a person becomes so

addicted to a drug that they have to continually increase the

dosage to obtain the high once achieved with lower doses

ii. Withdrawal– state of physical and psychological upset,

during which the body and mind revolt against/finally gets

used to the absence of the drug

aa. mild nausea, shakes, hallucinations, convulsions,

coma and death

2. Drug Addiction (cont.)

e. Alcoholism

i. Most serious drug addiction

ii. 10 to 12 million Americans abuse alcohol

iii. Alcohol involved in 40% of all auto deaths, 40% of all

murders

iv. Social drug, causes one to lose some inhibition

v. Is actually a depressive

vi. Perceptions, sensations become distorted, behavior may

become obnoxious

vii. People stumble, weave, slurred speech, slow reaction

times

2. Drug Addiction (cont.)

e. Alcoholism (cont.)

viii. Unconsciousness, coma, death

ix. Can produce psychological dependence, tolerance,

addiction

x. Can develop from both environmental and genetic factors

aa. 3 to 4 times higher if a family member is an alcoholic

bb. Poor home life

xi. Treatment

aa. Get through delirium tremens, violent withdraw

bb. Drugs and/or psychotherapy

cc. Group Therapy– AA

dd. Medication– Antabuse, causes a person to become

violently sick if they drink alcohol

ee. No cure