Abnormal PsychologyPsychological Disorders

Before we begin…• Be careful about joking about

psychological disorders… You are not OCD just because

you like your hands clean.

• People-centered language Please be compassionate!

• Sophomore syndrome (or WebMD syndrome) You are not a psychologist—you

can’t diagnose yourself or others!

What if we treated other medical disorders like we treat mental illness?

More Helpful Advice

What makes a behavior a disorder?• Psychological disorder: persistently harmful thoughts,

feelings, and actions

• 3 D’s: deviant, distressful, dysfunctional

• Deviant: must depart from “normal” behavior

• Distressful: must be a problem for the victim/subject and/or those around him or her

• Dysfunctional: must interfere with normal life function

Agoraphobia OCD Schizophrenia

Understanding psychological disorders• Medical model

What role does biology play? Brain formation, parts of the brain, neurotransmitters Mental health: a mental illness needs to be diagnosed on the basis

of its symptoms and cured through therapy, which may include treatment in a psychiatric hospital

• Biopsychosocial approach Today’s psychologists: all behavior, normal or disordered, arises from

the interaction of nature and nurture Takes into account more than brain biology Ex: anorexia nervosa and bulimia, susto, Taijin-kyofusho (same

underlying cause, different manifestations)

Classifying psychological disorders

• Diagnostic and Statistical Manual of Mental Disorders, currently in its 5th printing

• Axis 1: Clinical Syndrome?

• Axis 2: Personality Disorder or Mental Retardation?

• Axis 3: General Medical Condition?

• Axis 4: Psychosocial or Environmental Problems?

• Axis 5: Global Assessment

Labeling psychological disorders• Caution is needed; we see what

we want to see!

• Dangers of “labeling”

• Bias can change our perceptions and our treatment

Anxiety Disorders• Generalized Anxiety Disorder

• Panic Disorder

• Phobias

• Obsessive-Compulsive Disorder

• Post-Traumatic Stress Disorder

Generalized Anxiety Disorder• Pervasive, dysfunctional, near-constant worry which is most

often more intense than the situation warrants

• Sufferers can’t relax, startle easily, and have trouble concentrating

• Accompanied by fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes

• Affects 3.1% of the population; average onset at 31 years old; affects twice as many women as men; genetic component (runs in families)

Panic Disorder• Characterized by sudden, frequent panic attacks with no

definable cause

• Panic attack: difficulty breathing, pounding heart or chest pain, intense feeling of dread, sensation of choking or smothering, dizziness or feeling faint, trembling or shaking, sweating, nausea or stomachache, tingling or numbness in the fingers and toes, chills or hot flashes, a fear that you are losing control

• Can be caused by family history, abnormalities in the brain, substance abuse or major life stress

Obsessive-Compulsive Disorder• A disorder characterized by obsessions (thoughts that can’t be

controlled) and compulsions (behaviors that can’t be controlled). Both must be present in order for it to be obsessive-compulsive disorder.

• Caused by both biology and environment

• Family history and stressful life events are both risk factors

Post-Traumatic Stress Disorder• A mental health condition

triggered by a terrifying event, whether experiencing it or witnessing it

• Many people who go through trauma have difficulty adjusting and coping for a while, but eventually get better. If symptoms get worse or last for months or years, you may have PTSD.

• Symptoms: Intrusive memories, avoidance, negative changes in thinking, changes in emotional reactions

• Coping techniques: Differential focus on the good Survival for some purpose Psychological distancing Mastery Will to live Hope Social support

Phobias• Top 10 Fears:

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

• Over 700 specific fears listed; likely thousands more

Mood Disorders• Major Depressive Disorder (lethargy, feelings of worthlessness,

loss of interest in family, friends, or activities for more than two weeks) Dysthymic disorder (a down-in-the-dumps mood that fills most of the

day, nearly every day, for two years or more)

• Bipolar Disorder (alternation between mania and depression)

Facts about depression• Widespread--Called “the common cold” of abnormal

psychology, but that doesn’t mean it’s not devastating.

• Behavioral and cognitive changes accompany depression, including self-sabotage, sensitivity, lack of motivation, anxiety, substance abuse.

• Women are twice as likely to suffer (or are they…?).

• Most major depressive episodes self-terminate.

• Stressful events often precede an episode.

• With each generation, the rate of depression is increasing, and the disorder is striking earlier.

Depression: Cognitive Errors• Sadder-but-wiser effect

Also known as “depressive realism” Study by Alloy and Abrahamson Being realistic isn’t the same as

being adaptive

• Cognitive Errors Cognitive triad: interpreting facts in

a negative way, focus on the negative aspects of any situation, and has pessimistic expectations of the future

• College student effect College students are at a much

higher risk for depression due to drastic life changes; those who go in with both realistic expectations and optimism succeed most

Why? Biological perspective

Depressed brain Lack of norepinephrine and

serotonin Less good Omega-3 fatty acids

in diet Left frontal lobe (positive

emotions) inactive Hippocampus vulnerable to

stress-related damage Genetic influences

Twin studies Gene studies now under way

• Social-Cognitive Perspective Negative thoughts and negative

moods interact Learned helplessness

Vicious Cycle

Statistics about Suicide• Suicide takes the lives of nearly 40,000 Americans every year.

Many who attempt suicide never seek professional care.

There are twice as many deaths due to suicide than HIV/AIDS.

Between 1952 and 1995, suicide in young adults nearly tripled.

Over half of all suicides occur in adult men, ages 25-65.

In the month prior to their suicide, 75% of elderly persons had visited a physician.

Suicide rates in the United States are highest in the spring.

Over half of all suicides are completed with a firearm.

For young people 15-24 years old, suicide is the second leading cause of death.

Suicide rates among the elderly are highest for those who are divorced or widowed.

80% of people that seek treatment for depression are treated successfully.

15% of those who are clinically depressed die by suicide.

There are an estimated 8 to 25 attempted suicides to 1 completion.

Statistics about Suicide•

The highest suicide rate is among men over 85 years old: 65 per 100,000 persons.

1 in 65,000 children ages 10 to 14 die by suicide each year.

Substance abuse is a risk factor for suicide.

The strongest risk factor for suicide is depression.

In 2011, 39,518 people died by suicide. (CDC)

Suicide is the 10th leading cause of death in the U.S. (homicide is 16th). (CDC)

It is estimated that there are at least 4.5 million survivors in this country. (AAS)

An average of one person dies by suicide every 13.3 minutes. (CDC, AAS)

There are four male suicides for every female suicide. (CDC, AAS)

Research has shown medications and therapy to be effective suicide prevention.

Suicide can be prevented through education and public awareness.

Bipolar Disorder• Symptoms: regular cycling

episodes of depression and mania

• Mania: Mood is euphoric, expansive, and elevated, often accompanied by irritability and frustration; Grandiose cognition; Motivational symptoms, including tendency towards gambling, reckless driving, or poor investments; Physical symptoms like lessened need for sleep

• “When I start going into a high, I no longer feel like an ordinary housewife. Instead, I feel organized and accomplished, and I begin to feel my most creative self. I can write poetry easily. I can compose melodies without effort. I can paint…I feel pleasure, a sense of euphoria or elation. I want it to last forever. I don’t seem to need much sleep. I’ve lost weight and I feel healthy, and I like myself. I’ve just bought six new dresses, in fact, and they look quite good on me. I feel sexy and men stare at me. Maybe I’ll have an affair or perhaps several.”

Somatoform Disorders• Somatization Disorder or Conversion Disorder (long history of

medical problems, usually unexplained, that start before age 30; can include pain, neurologic problems, gastrointestinal complaints, sexual symptoms)

• Hypochondriasis (preoccupied with concern that they have a serious disease)

• Body dysmorphic disorder (obsessed with and exaggerate a physical flaw, or a preoccupation with changing the body through weight loss or gain, tattoos, piercings, or surgery)

• Factitious Disorder (Munchausen syndrome)

Dissociative Disorders• Schizophrenia (means “split mind”)

• Dissociative Identity Disorder (multiple personality)

Schizophrenia• Positive symptoms: means that symptoms are ADDED to

person’s “normal” behavior—hallucinations (auditory, visual), disturbed perceptions, motor behaviors, etc.

• Negative symptoms: means that normal behaviors may be ABSENT or REMOVED—lack of emotion (flat affect), inappropriate emotions, catatonia, social isolation, etc.

5 Truths About Schizophrenia• It’s NOT Multiple Personality Disorder

• Voices don’t make you do terrible things

• You can’t necessarily tell who has it

• The medication is an illness of its own (nervous tics, manic energy, sensitivity to the sun, agonizing muscle cramps…)

• Symptoms vary widely, and what people believe about schizophrenia impacts you more than the disorder

Types of Schizophrenia • Paranoid (preoccupation with

delusions or hallucinations, often with themes of persecution or grandiosity)

• Disorganized (disorganized speech or behavior, or flat or inappropriate emotion)

• Catatonic (immobility or excessive, purposeless movement)

• Undifferentiated (many, varied symptoms)

• Residual (withdrawal after hallucinations and delusions have disappeared)

• “This morning, when I was at Hillside Hospital, I was making a movie. I was surrounded by movie stars…I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”

Why?

Biological

• Brain abnormalities Low brain activity in frontal lobes Fluid-filled areas, shrinkage of

cerebral tissue

• Dopamine overactivity

• Maternal virus during midpregnancy

• Genetic factors (1-in-100 odds become 1-in-10 if parent or sibling has schizophrenia)

Psychological

• Risk factors: A mother whose schizophrenia is

severe and long-lasting Birth complications, often involving

oxygen deprivation and low birth weight

Separation from parents Short attention span and poor muscle

coordination Disruptive or withdrawn behavior Emotional unpredictability Poor peer relations and social play

Dissociative Identity Disorder• The presence of two or more distinct or split identities that

continually have power over person’s behavior

• Thought to stem from trauma

• Some debate among mental health professionals that it even exists

Symptoms• Depression

• Mood swings

• Suicidal tendencies

• Sleep disorders

• Anxiety, panic attacks, phobias

• Alcohol and drug use

• Compulsions and rituals

• Psychotic-like symptoms (hallucinations

• Eating disorders

Personality Disorders• Antisocial Personality Disorder (also called sociopathy;

complete lack of regard for others’ feelings or for social rules)

• Narcissistic Personality Disorder (obsessed with self and others’ impressions; desperate insecurity)

• Borderline Personality Disorder (“I hate you, don’t leave me.”; unstable sense of self, unstable relationships, inappropriate anger and emotions)

• Histrionic Personality Disorder (attention-seeking behaviors and extreme emotionality)

Therapy

PsychotherapyTreatment used by therapists to help troubled

people overcome their problems Verbal interaction between therapist and client Development of a supportive and trusting relationship Analysis by the therapist of the client’s problems

Help people understand and take ownership in solving problems

Can take on many forms

Therapy

Group Therapy

Patients work together with the aid of a leader

Helps patients see how other people are struggling with similar problems

One therapist can help a large number at a reduced cost

Cognitive-Behavioral Therapy

Substituting healthy thoughts for negative ones

Changing disruptive behaviors for healthy ones