Abnormal PsychologyA.K.A. Psychological Disorders

Psychological Disorder1.unusual (deviant from typical behavior in that culture)2.causes distress in the person experiencing the symptoms3.harmful dysfunction : interferes with life

Early Theories• Abnormal behavior was evil

spirits trying to get out• Beatings, burnings,

castration, pulling teeth, removing parts of intestines, caged like animals, animal blood transfusions, & trephining were often used

Medical Model• 1800s medical model emerges, replaces

“evil” cause of mental illness• Medical Model: A mental illness needs

to be diagnosed on the basis of its symptoms and can be treated

• Biopsychosocial approach: today’s psychologists say that all behavior (normal or disordered) arises from interaction of nature & nurture– Nature: depression & schizophrenia…– Nurture: eating disorders, phobias…

Perspectives and DisordersPsychological

School/PerspectiveCause of the Disorder

Psychoanalytic/Psychodynamic Internal, unconscious drives, root in childhood

Humanistic Failure to strive to one’s potential or being out of touch with one’s feelings, being too sensitive to others’ criticisms/judgments, lack of positive regard as a child

Behavioral Reinforcement history, the environment. At some point the abnormal behavior has been rewarded or reinforced & is now an established pattern of behavior

Cognitive Irrational, illogical, dysfunctional thoughts or ways of thinking lead us to misperceive the world (leading to abnormal behavior)

Sociocultural Society & culture help define what is acceptable behavior

Biological/Neuroscience Organic problems, biochemical imbalances, genetic predispositions (very popular in US right now)

DSM IV• Diagnostic and

Statistical Manual of Mental Disorders: the big book of disorders

• DSM will classify disorders and describe the symptoms

• DSM will NOT explain the causes or possible cures

DSM IV• Axis I

– major disorders (schizophrenia, depression, dementia, mood, eating, sleep…)

• Axis II– Developmental & Personality disorders

(antisocial, narcissism, autism, mental retardation…)

• Axis III– Physical disorders (brain injury, HIV/AIDS…)

• Axis IV– Assesses the level of psychosocial &

environmental stress the person is experiencing • Axis V

– Overall assessment of the person’s level of functioning

Two Major Classifications in the DSM

Neurotic Disorders• Distressing but one

can still function in society and act rationally.

Psychotic Disorders• Person loses contact

with reality, experiences distorted perceptions.

John Wayne Gacy

Anxiety Disorders• Psychological disorders

characterized by distressing, persistent anxiety or dysfunctional behaviors to reduce anxiety

• the patient fears something awful will happen to them

• They are in a state of intense apprehension, uneasiness, uncertainty, or fear

Generalized Anxiety DisorderGAD• An anxiety disorder in

which a person is continuously tense, apprehensive, & in a state of autonomic nervous system arousal

• The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia

• 2/3 are women

Phobias• An anxiety disorder marked by

a persistent, irrational fear and avoidance of a specific object, activity, or situation

• Social phobia: intense fear of being scrutinized by others, avoid potentially embarrassing situations (speaking up, going to parties…)

• Phobia List

PhobiasTop 10 phobias

•Fear of snakes•Fear of being buried alive•Fear of heights•Fear of being bound/tied up•Fear of drowning•Fear of public speaking•Fear of hell•Fear of cancer•Fear of tornadoes/hurricanes•Fear of fire

What are the following phobias?

•Uxoriphobia•Mikrophobia•Xenophobia•Trichophobia•Nyctophobia•Triskadekaphobia

Panic Disorder• An anxiety disorder marked

by a minutes-long episode of intense dread in which a person experiences terror

• Will have chest pain, heart palpitations, dizziness, choking and other frightening sensations

• Those who smoke have double risk of panic disorder

Obsessive-Compulsive Disorder

• Persistent unwanted thoughts (obsessions, ex: germs, death…) cause someone to feel the need (compulsion, ex: checking locks, in/out of a door…) to engage in a particular action

• Ex: Obsession about dirt and germs may lead to compulsive hand washing

• 2-3%, often in late teens/early twenties

Post-Traumatic Stress Disorder (PTSD)• Flashbacks/nightmares following a

person’s involvement in or observation of an extremely stressful event (accident, disaster, sexual assault, violence…)

• Memories of the event cause anxiety– Half of adults will experience at least 1

traumatic event, only 1 in 10 women ptsd, 1 in 20 men

• After 9/11, 8% ptsd, 19% of Vietnam vets• 1 in 6 Iraq vets have symptoms (1 in 4

some psych disorder)• Post-traumatic growth: positive

psychological changes that come from challenging circumstances– Greater appreciation for life,

priorities…– Good can come from our worst

experiences

Somatoform Disorders

• Occur when a person manifests a psychological problem through a physiological symptoms

• Two types……

Conversion Disorder

• A health problem that starts as a mental/emotional crisis and converts into a physical problem

• Often related to the stress they are under-Ex: blindness, loss of sensation...-Ex: you fall off a horse & you become paralyzed even though you are not physically injured

Hypochondriasis

• A person interprets normal physical sensations as symptoms of a disease

• They usually believe that the minor issues (headache, upset stomach) are indicative are more severe illnesses

Mood Disorders• Mood Disorders: Characterized by

emotional extremes

Major Depressive Disorder• 2 weeks or more of very depressed moods

– Lethargic/fatigue/lack of energy– feelings of worthlessness– loss of pleasure/interest in activities– Loss of appetite/overeat– Lack of sleep/too much sleep

• Not caused by drugs or a medical condition• Survey: 29% hs students, 44% college

students• 13% of adults• World Health Org- affects 5.8% of men &

9.5% women in any yr• 1 in 4 w/ depression is struggling w/ a

significant loss (death, job, relationship)

Seasonal Affective Disorder

• Experience depression during the winter months

• Based not on temperature, but on amount of sunlight

• Treated with light therapy

Bipolar Disorder• Person alternates b/w

hopelessness of depression & overexcited states of mania (formally manic depression)

• Mania: hyperactive, wildly optimistic state– Overactive, overtalkative, little

sleep, find advice irritating, exhibit poor judgment (unsafe sex, reckless spending…)

• Many Creatives: Walt Whitman, Virginia Woolf, Ernest Hemingway, Mark Twain

• What goes up must come down

Neurotransmitters• Norepinephrine (increases arousal &

boosts mood)– Scarce during depression– Overabundant during mania

• Serotonin – Scarce during depression

• Explanatory Style– Our way of thinking- who or what we

blame for our successes & failures– Depressed people tend to blame

themselves, feeding the negative feelings

– Remember: if you feel down, you think negatively & remember bad experiences

Dissociative Disorders

• These disorders involve someone experiencing a sudden loss of memory or change in identity

• Often in response to overwhelming stressful event

• Three types….

Psychogenic (Dissociative) Amnesia

• A person cannot remember things with no physiological basis for the disruption in memory

• Lose memories of distant & recent past

• Lose personal identity• Usually occurs after a

traumatic or stressful event

• Usually temporary

Dissociative Fugue

• Dissociative Amnesia & creating a physical distance from your real life

• Last usually only a few hours or days, rarely months Click above to

watch a real life example

Dissociative Identity Disorder

• Used to be known as Multiple Personality Disorder

• A rare disorder in which a person has 2 or more distinct, alternating personalities

• People with DID commonly have a history of childhood abuse or trauma

• Very controversialClick above to see an explanation of DID

Personality Disorders

• Inflexible & continuous behavior patterns that negatively affect people’s ability to function

• Dominates their personality

Antisocial Personality Disorder

• Lack of conscience & empathy

• Little regard for other’s feelings

• View the world as hostile and look out only for themselves

• Formerly called sociopath

• 3% males, 1% females

Avoidant Personality Disorder

• Feelings of inadequacy, hypersensitive to what others think about them & rejection

• Avoids socializing/interacting with others

• 0.5%-1% of population

Borderline Personality Disorder

• Tries to avoid abandonment (real or imagined)• Pattern of unstable & intense relationships• Unstable self-image, feelings of empitness• Impulsive• Recurrent suicidal behavior• Emotional instability• Intense anger & trouble controlling it• Paranoid thoughts• 75% are female, 2% of population

Dependent Personality Disorder• Fear of being separated

from important people in their lives, become “clingy”

• Difficulty making everyday decisions

• Feels helpless when alone• Excessive lengths to get

support from others• Difficulty disagreeing with

others• Need others to take charge

in most areas of life

Histrionic Personality Disorder

• Needs to be the center of attention & feels uncomfortable when not

• Inappropriate sexual or provocative behavior

• Uses physical appearance to draw attention

• Thinks relationships are closer than they actually are

• Dramatic, theatrical, exaggerated emotions

• 2-3% of population

Narcissistic Personality Disorder

• Having an exaggerated sense of self-importance

• Overwhelming need for admiration

• Patronizing, snobby• Preoccupied w/ fantasies of

unlimited, success, power, beauty…

• Lacks empathy• Arrogant behaviors & attitudes• Exploits others• 1% population (more male)

Paranoid Personality Disorder• Distrustful & suspicious of others• Thinks others’ motives are always bad• Affects every relationship they have• Preoccupied w/ doubts about loyalty of

friends• Reluctant to confide in others bc think it will

be used against• Holds grudges• 0.5%-2.5% of population

Schizoid Personality Disorder• Detached from social relationships• Doesn’t enjoy close relationships (even family)• Difficulty expressing emotions• Uninterested in sex, activities, relationships• Seems emotionally cold & detached• More common in males

Schizotypal Personality Disorder

• Odd beliefs that differ from cultural norms– Telepathy, bizarre fantasies

• Unusual perceptual experiences• Suspicious or paranoid• Odd, eccentric, strange behavior/appearance• Lack of close friends• Social anxiety (often associated w/ paranoia)• Less that 3%

Obsessive –Compulsive Personality Disorder

• Overly concerned with certain thoughts and performing certain behaviors.

• Not as extreme as OCD anxiety.

Schizophrenic Disorders

• About 1 in every 100 people are diagnosed with schizophrenia

Symptoms of Schizophrenia

1.Disorganized thinking2.Disturbed Perceptions3.Inappropriate

Emotions and Actions

Disorganized Thinking

• The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs

• Disorganized thinking comes from a breakdown in selective attention- they cannot filter out information

Delusions (false beliefs)

• Delusions of Persecution

• Delusions of Grandeur

Disturbed Perceptions

• hallucinations- sensory experiences without sensory stimulation

• They see, hear, smell, feel things that aren’t there

• Most often auditory hallucinations

• Seem real!

Inappropriate Emotions and Actions

• Laugh at inappropriate times, angry for no apparent reason

• Flat Effect (emotionless state)

• Senseless, compulsive acts.

• Catatonia- motionless for hours then agitated

Types of Schizophrenia

Disorganized Schizophrenia

• disorganized speech or behavior, or flat or inappropriate emotion

Paranoid Schizophrenia

• preoccupation with delusions or hallucinations

• Somebody is out to get me!!!!

Catatonic Schizophrenia

• Flat effect• Waxy Flexibility• parrot like

repeating of another’s speech and movements

Undifferentiated Schizophrenia

• Many and varied Symptoms.

Other Disorders

• Paraphilias (pedophilia, zoophilia, hybristophilia)

• Fetishism • sadist, masochist• Eating Disorders• Substance use

disorders• ADHD

The Rosenhan Study• Rosenhan’s associates

were Malingering symptoms of hearing voices.

• They were ALL admitted for schizophrenia.

• None were exposed as imposters.

• They all left diagnosed with schizophrenia in remission.

• What are some of the questions raised by this study?

Treatment of Psychological Disorders

• History of treating mental illness was barbaric• Crusaders like Dorothea Dix changed treatment

(mental hospitals)• 2 main categories of mental health therapies:

1. Psychotherapy (overcome difficulties & achieve personal growth)

2. Biomedical therapy (medication or medical procedure)

• Many psychotherapists say they take an eclectic approach-blend different types of therapy

Therapy

• It used to be that if someone exhibited abnormal behavior, they were institutionalized.

• Because of new drugs and better therapy, the U.S. went to a policy of deinstitutionalization.

Psychoanalytic Therapy• Psychoanalysis (manifest and

latent content through…. Hypnosis, free association, dream interpretation)

• Resistance: blocking memories, experiences that cause anxiety

• The analyst will interpret behaviors, dreams, events…in order to promote insight

• Transference: patient transfers emotions linked with other relationships on the analyst (+ or -)

Evaluating Psychotherapy

• Clients and therapists say yes! but that in itself cannot prove its effectiveness

• Meta-analysis: procedure for statistically combining results of different studies

• The verdict: those not undergoing therapy often improve, but those undergoing therapy are more likely to improve

Humanistic Therapy• Psychoanalytic & humanistic therapies are seen

as insight therapies (providing new insights to help boost self-fulfillment & self-acceptance)

• Client-Centered Therapy (Carl Rogers)– Focuses on the person’s conscious self-

perceptions– These are non-directive therapies and use

active listening • Paraphrase (summarize in your own words

to check understanding)• Invites clarification (“What might be an

example of that?”)• Reflect feelings (acknowledge their feelings

& mirror what you are sensing)– Self-actualization, free-will and unconditional

positive regard• Gestalt Therapy by Fritz Perls encourage clients

to get in touch with whole self.

Behavioral Therapies• Behavior therapy: applies

learning principles to eliminate unwanted behaviors

• Believe can replace learned behaviors w/ constructive behaviors

• Counterconditioning: uses classical conditioning to generate new responses to stimuli1. Exposure Therapy2. Aversive Conditioning

1.Systematic desensitization2.FloodingOperant Conditioning• Token Economy

Cognitive Therapy

• Change the way we view the world (change our schemas)

• Aaron Beck• Albert Ellis and

Rational Emotive Therapy

Somatic Therapies

Psychopharmacology• Antipsychotics

(thorazine, haldol)• Anti-anxiety (valium,

barbiturates, Xanax)• Mood Disorders

(serotonin reuptake inhibitors)

• Bipolar (lithium)

Group Therapy