Abnormal Psychology Intro
Pg 531-537
Abnormal Psych Psych Disorders (D/O) manifest in people’s
thoughts and behaviors. It’s difficult to determine what constitutes “abnormal.” What’s the difference between odd, little quirks we all have and a legitimate mental illness? M – Maladaptive – makes it difficult to function – in
work, school or relationships A – Atypical – most people don’t do it; unusual I – Irrational – there is no logical explanation for the
behavior D – Disturbing – it is disturbing to self or others
DSM - V How do we know when someone has a D/O? Diagnostic Statistical Manual of Mental Disorders
Has hundreds of disorders Doesn’t discuss cause or treatment Only discusses symptoms for diagnosis/labeling Highly reliable (80%...what does this mean?)
David RosenhanBeing Sane in Insane Places:
https://www.youtube.com/watch?v=D8OxdGV_7lo
https://www.youtube.com/watch?v=j6bmZ8cVB4o
What do YOU think of Rosenhan’s study?
Pros and Cons of Labeling
Pros Get help – you know what
you have and can deal with it - meds, counseling, treatment
Insurance – once officially diagnosed, insurance will help cover costs
Reliability/consistency among professionals
Legal competence – “insanity” is a legal, not medical term
Cons Self-fulfilling prophecy
Stigma – mistreated by society (?)
David Rosenhan Study
Always have label
Perspectives – Approach treatment differently
Psychoanalytic – childhood, fixation, unconscious
Humanistic – low self esteem, failure to reach potential, needs not being met
Behavioral – environment, conditioning, modeling
Cognitive – dysfunctional thoughts
Socio-cultural – dysfunctional culture, society
Biomedical/Physiological – chemical imbalance, gene, inherited
ANXIETY D/O
All Anxiety D/O share the common symptom of anxiety. Abnormalities may be….
1.) Level of Anxiety – excessive
2.) Irrational trigger for anxiety
3.) Prolonged timing for anxiety
PANIC ATTACKS Acute episodes of intense anxiety without any
apparent provocation (you feel like you are in a life or death emergency situation – but you are not)
Sympathetic NS kicks in Choking sensation Trembling Hyperventilating Distress Sweating or peaked
PHOBIAS Intense unwarranted fear of a situation or object. Fear is way
out of proportion to real danger. Some stimuli are easier to avoid and therefore less debilitating)
Claustrophobia – fear of small places, confinement
Arachnophobia – fear of spiders
Agoraphobia – fear of public places – may refuse to leave home and world becomes smaller and smaller
Social Phobia – fear of embarrassing oneself in public
Many phobias are created from a panic attack and classical conditioning (remember the story of my nephew and the elevator)
GENERALIZED ANXIETY D/0 6 months or more of unwarranted, excessive, constant,
unrealistic worry Person always feels jittery, nervous, worried Unusual not in the level of anxiety but in the duration – i.e.
symptoms are commonplace, persistence isn’t 2/3 sufferers are women Often associated with perfectionist personality
Insomnia Ulcers Irritable bowel Muscle aches Head aches
GAD Prevalence
Obsessive Compulsive D/O (OCD) Obsessions: persistent, recurring, disturbing,
unwanted thoughts – cause extreme anx Compulsions: ritual or routine that relieves the anx
temporarily (compulsions are negative reinforcement – removes/reduces anx temporarily)
Most with OCD realize their obsessions are irrational and their compulsions are unnecessary, but cannot stop
Prevalence @ 3% of population Usually appears in late teens, early adulthood Men and women =
OCD – Common compulsions Cleaning Checking Repeating Hoarding
Compulsions can become extremely maladaptive and interfere with normal functioning (school, work, relationships)
Post Traumatic Stress D/O
PTSD Flashbacks/nightmares
after a person’s involvement in a troubling or disturbing event
Relive the trauma
Experience extreme anx
Common for soldiers coming back from war
Theories of Cause - ANX Psychoanalysis – unresolved uncon conflict,
overactive superego Behaviorist – classical conditioning (phobias),
modeling (anx – likely had overly anxious, worrisome parents/environment)
Cognitive – dysfunctional thoughts, unrealistic expectations, fears
Biology/physiology – genetic predisposition Meds – anti-anxiety (depressants) Xanax, Valium
MOOD D/O(Affect D/O)
Experience extreme or inappropriate emotions
Major Depression “common cold” of psychology (highest
prevalence of any mental illness) 2 weeks of symptoms with no clear reason Disrupts normal functioning Symptoms – loss of appetite, fatigue, change in
sleep patterns, lack of interest in previously enjoyable activities, feelings of worthlessness, hopelessness, tired/lethargic, suicidal thoughts
Women 2X as likely as men Rate of depression increased with each
generation and diagnosed at earlier age
Suicide 3-1 suicide – homicide Women more likely to attempt, but men twice as likely
to succeed….why? Suicide rates higher among white, rich, nonreligious,
single, widowed, divorced….why? People seldom commit suicide while in depths of
depression (lack energy and initiative). Suicide attempt actually more likely when person experience slight upswing from depths of depression
TED talk Kevin Briggs – Bridge Between Suicide and Life:
https://www.ted.com/talks/kevin_briggs_the_bridge_between_suicide_and_life
Manic Depression (Bipolar) 1% of population Men and women = Extreme mood swings Depression – looks like
major depression Mania – high energy,
racing thoughts, grandiose ideas, soaring confidence, sense of invincibility, risky behaviors
Link between MD and creativity/genius?
Manic Depression
Manic Depression Treatment – lithium
Left untreated – symptoms get worse and mood swings get more dramatic
Fires of Mind – Manic Depression
https://www.youtube.com/watch?v=Ki6QOfZfCSk
Seasonal Affect D/O (SAD) Depression during winter
months – cold, dark Normal depression
symptoms that follow seasonal patterns
Almost non-existent in ward, sunny climates
Treated with special light bulbs
SAD
Causes of Mood D/O Psychoanalytic – uncon conflict, over powerful
superego Behaviorist – social modeling;
reinforcement/attention Biology – lower levels of serotonin cause
depression anti-depressants – increase
serotonin levels by blocking
reuptake
Ex: Zoloft or Prozac
Causes of Mood D/O - Cognitive Aaron Beck – depression results from
unreasonable thoughts about your cognitive triad – yourself, your world, and your future
Causes of Mood D/O – Cognitive – Attribution Style
Failures
Internal – I suck
Global – I suck at everything
Stable – I’ll always suck
Successes
External – I got lucky
Specific – on just this one test
Unstable – it won’t last
Causes of Mood D/OCognitive Learned Helplessness
Prior experiences cause person to believe they are unable to control aspects of their future that are indeed controllable
When undesirable things occur person feels unable to improve situation
Leads to passivity and depression
Martin Seligman
Learned Helplessness
Schizophrenia
One of more severe and debilitating mental D/O
Anderson Cooper CNN – Schizophrenia simulation
https://www.youtube.com/watch?v=yL9UJVtgPZY
Schizophrenia Schism – literally means a split mind or break
from reality (NOT multiple personality) Surfaces in young adulthood Exists in 1% of population – strong genetic
component Nature/Nurture
at work
Schizophrenia - Symptoms Delusions – beliefs with absolutely no basis in
reality. Cannot be corrected with logic
Delusions of Grandeur –
possess great power or
influence
Delusions of Persecution – people out to get you – makes schizophrenia very difficult to treat – don’t trust anyone, don’t take meds
Schizophrenia - Symptoms Hallucinations – False sensory perceptions
(you see or hear things that are not really there) Auditory Hallucinations most common – hear voices
Inappropriate Language• Word Salad• Neologisms• Clang Associations
Schizophrenia - Symptoms Catatonia – catatonic state
Inappropriate Emotion – laugh at something sad, cry at something funny Flat Affect – no emotion
Schizophrenia - SymptomsPositive – addition of atypical behaviors
Delusions
Hallucinations
Negative – subtraction of normal behaviors
Flat Affect
Inappropriate Emotion
Inappropriate Language
Causes – Biological/Nature Dopamine hypothesis –
higher levels of Dop
Anti-psychotic drugs act as antagonists for dopamine – they block receptor sites to lower dopamine levels
Haldol/Thorazine Help control + symptoms of
hallucinations and delusions Side effects – muscle
stiffness/tremors, weight gain, slow cognitive functioning
Causes – Biological/Nature Brain abnormalities –
schizophrenics have large ventricles and more brain asymmetry
Family prevalence 1% general prevalence 10% if parent is schizo 45% if both parents Almost 50% identical twin
How do you know it’s not ALL nature???
Schizophrenia – Nature/Nurture 1st Hit = genetics
2nd Hit – Nurture/Environment Viruses Drugs Brain trauma Stress Etc…….
Personality D/O
Well established, maladaptive ways of behaving that negatively affect people’s ability to function.
Personality D/O are less maladaptive than other mental
illnesses– may function in school or work but typically strain close,
long-term relationships.
Narcissism Extreme selfishness – cannot see others’
perspective Difficulty with empathy Entitlement
Need for adoration – power Fantasy of beauty or ideal love Exaggerates talents/accomplishments to
appear superior Manipulation/exploitation of others
Anti-Social Personality D/O Disregard for safety of self or others Lack of remorse/guilt – lack moral conscience Deception – lie easily Risky impulsive behavior No empathy – little regard for others’ feelings Disregard societal rules/authority Aggressive or violent behavior Unable to maintain close relationships
Anti-Social Personality D/O
More prevalent among males
High incidence in criminal/incarcerated population
Must be 18 to get diagnosis
Teen boy exhibiting same symptoms =
Conduct Disorder
Not all ASPD become serial killers but all serial killers are ASPD
Dependent Personality D/O See self as helpless/incompetent; lack
confidence Look to others to take the lead, make decisions,
or provide support Inability to make decisions – even common,
every day ones Overly sensitive to criticism Fear being alone – stay in bad/abusive
relationships, go from one relationship to another
Avoid disagreeing with others – fear conflict
Histrionic Personality D/O Overly dramatic – as if performing for others
Display of excessive emotions and yet seems shallow/fake
Need for attention
Dresses provocatively, excessive flirt
Overly concerned with physical appearance
Needs constant approval/reassurance
Easily swayed of influenced by others
Personality D/O – Causes/Treatment
Often caused by family dynamics, parenting styles Deeply ingrained, chronic habits Stronger basis in Nurture/Environment Difficult to treat
Often no magic medicine Person themselves rarely sees that they have a problem Often able to function at work or school Greatest fall-out is in close, long-term relationships – family,
marriage
Somatoform D/O
Patient manifests with a physical problem but
there is no physiological cause – underlying
cause is psychological
Hypochondriasis Physical complaints with
no physiological cause
Chronic
Often feel poorly, sick
Absent from work/school
Always convinced have illness
Conversion D/OAcute
Wake up blind or partially paralyzed
Test after test reveals no physiological cause
Cause = psychological
Dissociative D/O
Involve dysfunction of memory or altered sense
of identity
Psychogenic Amnesia - no biological cause Cannot remember things Periods of time blacked out Unfamiliar with environment May be brought on by traumatic event
Psychogenic Fugue – sudden and complete loss of identity
Caused by severe stress
Assume new identity – leave home, find new identity elsewhere
Dissociative Identity D/O (DID) Multiple Personality
Appearance of 2 + distinct identities in one person Identities may or may not be aware of each other Identities may vary in age, gender, handedness Much more common in women Often from severely traumatic, abusive or neglectful
environment Difficult to treat – extensive, long term therapy Some Psychologists question if it is a real D/O Often confused with schizophrenia – NOT same
thing – Oprah Clip – DID patient https://www.youtube.com/watch?v=n2atzoaA2NI
DID
Remember other D/O Sexual D/O
Fetishes, pedophilia, zoophilia Voyeurs Sadists/Masochists
Eating D/O Anorexia Bulimia
Substance Abuse – Alcohol, Drugs Developmental D/O
Autism, ADD/ADHD (both higher in boys)
Commonalities of all D/O?? MAID Stress - makes D/O surface or makes it worse Most a combo of nature/nurture Many surface in young adulthood (late teens,
early 20s) Strain on families Difficulty finding right medicine, right dosage,
and almost always unwanted side effects
D/O and Gender Skews
Males Alcohol/drug abuse
ADD/ADHD
Anti-social or conduct D/O
Autism
ADD/ADHD
Females Depression
Generalized Anxiety
DID
Anorexia or Bulimia