Abnormal Psychology

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Abnormal Psychology
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Psychological DisordersHow common are they?

• 1994 Michigan Institute for Social Research
• Nearly ½ of people age 15-54 have experienced at
  least one bout with psych disorder
• Psych disorders peak between ages 25 and 34
• Only 1 out of 4 ever receive help
• Many are mild, thus recover without help
• Most common disorders
• Major depressive episode, alcohol dependence,
  social phobia, simple phobia

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Psych Disorders in the U.S. .

• Psych disorders are often culturally based
• Examples p. 8
• Michigan study
• ¼ of Americans met criteria for mental illness
  within prior year
• ¼ of those had serious disorder
• U.S. posed to rank 1 in mental illness
• So what is a mental illness and what criteria
  qualify somehow as mentally ill?

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What is Abnormal Psych??

• Abnormal Psychology
• Study of people who suffer from psychological
  disorders
• Behavior and or thoughts
• From depression, substance abuse, learning
  difficulties to schizophrenia and bipolar disorder

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What constitutes Abnormal?

• 4 Criteria to characterize as abnormal
• Unjustifiable (irrational) cant justify /
  doesnt make sense
• Maladaptive Harmful / disturbing to the
  individual
• Atypical (unusual) not shared by members of
  population
• Disturbing (irrational) Disturbing to others
• All or most not required to be diagnosed
• OR..
• Deviant, Distressful, Dysfunctional

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DSM-IV

• Diagnostic and Statistical Manual of Mental
  Disorders
• Resource to diagnose patients (only)
• Symptoms of everything considered to be
  psychological disorder
• 16 clinical syndromes
• Weakness assumption / labeling of mental
  illness based on symptoms

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Rosenhan Study

• Dangers of labeling patients with disorders
• 8 participants who faked symptoms
• All acted completely normal except for testifying
  to hearing voices (3 words)
• All diagnosed with Schizophrenia and discharged
  as Schizophrenia in remission
• Average stay in institutions- 18 days

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Perspectives on Causes

• Psychoanalytic theorists
• Unconscious conflicts (traumatic events during
  psychosexual stages)
• Behaviorists
• History of reinforcement
• Cognitive theorists
• Maladaptive ways of thinking
• Humanistic theorists
• A persons feelings, self-esteem, self-concept
• Biomedical theorists
• Hormonal / neurotransmitter imbalances, brain
  structure, genetic abnormalities

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An Eclectic Approach

• Specific fields are not exclusive to their
  theories
• Consider any/ all theories as potential
  influence to a specific illness

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6 Major Types of Disorders

• Anxiety Disorders
• Somatoform disorders (psych issue causes
  physiological problem)
• Dissociative disorders (disruption in conscious
  processes)
• Mood / affective disorders (extreme /
  inappropriate emotions)
• Schizophrenic disorders (Disordered, distorted
  thinking)
• Personality Disorders (Maladaptive behavior that
  affects functioning)

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Dont Get Paranoid

• Interns Syndrome
• Tendency to see in oneself the characteristics of
  a disorder one is studying.

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Anxiety Disorders

• When do we classify it as a disorder?
• Distressing, persistent anxiety or maladaptive
  behaviors to reduce anxiety
• Think of one of one of the most stressful moments
  or events in your lifetime. Choose three
  adjectives to describe how you felt and three
  physical characteristics that you experienced.
• Heart palpitations, sweaty palms, dizziness,
  ringing in ears, muscular tension,
  sleeplessness....

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Types of Anxiety Disorders

• Generalized Anxiety Disorder (GAD)
• Constant low-level anxiety (nervousness)
• 2/3 are women
• Patient cant identify its cause and thus cant
  deal with or avoid it.
• Often accompanied by depression
• Tense, jittery, muscular tension, agitation,
  sleeplessness, difficulty concentrating
  (fidgeting, twitching, trembling)

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Panic Disorders

• Acute episodes of intense anxiety without
  provocation (panic attack)
• Tend to increase in frequency (minutes long)
• 1 in 75 (smokers 2-4 x more likely)
• Heart palpitations, shortness of breath, choking
  sensations, trembling, dizziness
• feels like a heart attack
• Charles Darwin (age 28)

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Phobias

• Focuses anxiety on a specific object, activity or
  situation.
• Irrational fear that disrupts behavior
• Identify these phobias
• Agoraphobia
• Social phobia
• Androphobia
• Coulrophobia
• Cynophobia
• Didaskaleinophobia

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Obsessive-Compulsive Disorder

• OCD
• Persistent obsessive (uncontrollable) thoughts
  lead to compulsive (uncontrollable) actions
• Obsession creates anxiety / reduced by compulsive
  behavior
• Cleanliness, security, symmetry, organization
• Often late teens, early twenties (2-3)
• Howard Hughes

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Post-Traumatic Stress Disorder

• PTSD
• Cause experiencing / witnessing a traumatic
  event (fear, helplessness, horror)
• Nightmares, flashbacks, social withdrawal,
  insomnia
• Combat veterans, disaster or accident survivors,
  sexual assault victims, 2/3 of prostitutes
• Basic trust erodes, sense of hopelessness
• 15 of Vietnam vets (45 for heavy combat)
• 1 in 6 Iraqi combat infantry veterans

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Theories Explaining Anxiety Disorders

• Brainstorm with a partner.
• How would the Psychoanalytic theorist explain the
  cause of anxiety disorders?
• Create an example.
• Unconscious conflict
• Conflict of id, ego, superego
• Anxiety disorder is the outward manifestation of
  an internal, unconscious conflict

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Theories Explaining Anxiety Disorders

• How would the behavioral theorist explain the
  cause of anxiety disorders?
• Learned response Classical, or Operant learning
• Provide an example for each. (Pick a specific
  anxiety disorder for the example.)
• Chronically anxious, ulcer-prone rats by
  unpredictable electric shock

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Theories Explaining Anxiety Disorders

• How would the cognitive theorist explain the
  cause of anxiety disorders?
• Dysfunctional , maladaptive ways of thinking
• Example
• GAD the result of unreasonably high standards set
  for oneself thus constant anxiety from
  impossibility of meeting goals

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Theories Explaining Anxiety Disorders

• Biological Perspective
• Natural Selection
• Fear of spiders, snakes, storms, heights etc.
  increase survival (genetic)
• Genes
• Twin studies (together and apart)
• The Brain
• OCD Anterior cingulate cortex monitors actions,
  checks for errors (hyperactive region- like a
  hiccup)

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Theories Explaining Anxiety Disorders

• Two biggest perspectives today
• Behavioral (learning) and biological

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Mood Disorders

• Experiencing extreme or inappropriate emotions.
• Two major forms
• Major depression (unipolar depression)
• Bipolar Disorder (manic depression)

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Major Depressive Disorder

• common cold of psychological disorders
• Biggest cause of therapy (mental health services)
• 2 weeks or more (with absence of clear reason)
• Fatigue, loss of appetite, feelings of
  worthlessness, hopelessness, disinterestedness,
  changed sleeping patterns
• SAD Seasonal-Affective Disorder

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Facts about Major Depressive Disorder

• Women are nearly 2 x more likely to have it
• Leading cause of disability worldwide (5.8 of
  men, 10.5 of women)
• Most major depressive episodes self-terminate
• Stressful events often precede depression
• Rate is increasing with each new generation

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Bipolar Disorder

• Depressed and manic episodes (alternate)
• Depression- typical characteristics
• (1 of pop. , equal between genders, yrs. 20-30)
• Manic- high energy (and often highly illogical)
• Overly active, elated, outspoken, less sexual
  inhibition
• Often reckless, poor judgment
• Mild cases can produce creative genius

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Famous Folks with Disorders

• Depression
• Abraham Lincoln
• Winston Churchill
• Meriwether Lewis
• Emily Dickenson
• Isaac Newton
• Mozart
• Woody Allen
• Buzz Aldrin
• Drew Carey
• Harrison Ford
• Beyonce Knowles

• Bipolar
• Walt Whitman
• Ernest Hemingway
• Virginia Wolf
• Mark Twain
• Edgar Allen Poe
• Kurt Cobain
• Mel Gibson
• Ozzy Osbourne
• Robert Downey Jr.

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Explaining Mood Disorders

• Biological Perspective
• Whole-body disorder
• Genetic predispositions (runs in families),
  biochemical imbalances
• Neurotransmission
• Norepinephrine (increases arousal, mood)
• Too little depression
• Too much mania
• Serotonin
• Too little depression (Prozac, Zoloft, Paxil) /
  Exercise!

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Explaining Mood Disorders

• Social-Cognitive Perspective (Cognitive-Behavioral
  )
• Aaron Beck Cognitive Triad
• Depression stems from unreasonably negative ideas
  about oneself, ones setting and ones future
• (Thus depression is mostly cognition based, not
  mood based)
• Martin Seligman
• Learned Helplessness (prior events convince a
  person of the inability to control future)
  passivity and depression
• More prevalent in Western societies
• Epidemic hopelessness due to individualism and
  decline of commitment to family and religion

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Explanatory Styles and Depression
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The Social-Cognitive Dilemma

• Chicken and Egg Argument
• Does learned hopelessness, self-defeating beliefs
  and negative explanatory styles cause depression,
  or does depression cause them???

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Multiple Factors
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Depressions Vicious Cycle

• Characteristics, factors of depression tend to
  promote each other in a wicked cycle
• helplessness, lethargy, sorrow, isolation,
  dismissal, failure

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Somatoform Disorders

• soma body
• Psychological problem manifested in a
  physiological symptom (IOW physical problem
  without a physical cause)
• Common among those claiming disability
• Two major disorders
• hypochondriasis imagined or exaggerated
  illnesses (no medical cause)
• Conversion disorder involves motor or sensory
  problems with no biological explanation / cause
• Conversion blindness, conversion paralysis

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Explaining Somatoform

• Psychoanalytic
• Outward manifestations of unconscious conflict
• Behaviorists
• Reinforcement for behavior (cant work or
  sympathy / attention)

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Clinical Distinction

• Somatoform patient unconscious of psychological
  causes (does not seek to maintain role of
  patient)
• factitious patient Consciously creating the
  symptoms, prolonging role of patient
• Malingering patient consciously creating
  symptoms,end goal (often financial)

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Dissociative Disorders

• Disruption in conscious processes (lose identity)
• Usually from traumatic event
• Famous films Sybil, Three Faces of Eve, Dr.
  Jekyll and Mr. Hyde

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Types of Dissociative Disorders

• Psychogenic Amnesia Amnesia with no
  physiological basis
• biologically induced amnesia organic amnesia)
• Fugue Psychogenic Amnesia unfamiliar
  environment (fugue flight / loss of identity
  and flee)

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Types of Dissociative Disorders

• Dissociative Identity Disorder (DID)
• AKA Multiple Personality Disorder
• Usually from traumatic event / overwhelming
  stress (high report child abuse)
• often at young age (3-5 years)
• Self-protection / coping mechanism
• Distinctive identities for different events
  (toddler to adult)
• Norm- 3-6 identities (2 to qualify)
• Almost entirely confined to N. America
• Very controversial as medical diagnosis

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Explaining Dissociative Disorders

• Psychoanalytic theorist
• Extremely traumatic event so repressed that
  causes split in consciousness
• Behaviorist
• putting event out of mind is reinforcing (to
  feel better)

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Schizophrenia
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Schizophrenia

• Disordered / distorted thinking
• Breakdown in selective attention (Cant filter
  out information)
• Disturbed perceptions
• Delusions beliefs that have no basis in reality
• Delusions of persecution paranoia
• Delusions of grandeur greatness
• Hallucinations Perceptions in the absence of
  sensory stimulation
• Inappropriate actions / emotions

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Things to consider

• Most severe of psych disorders
• Usually starts in late teens / early twenties
• 1 out of every 100 people have Schizophrenia

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Types of Schizophrenia

• Disorganized Schizophrenia
• Paranoid Schizophrenia
• Catatonic Schizophrenia
• Undifferentiated Schizophrenia
• Acute vs. Chronic Schizophrenia
• Whats the difference?
• Acute Abrupt display of symptoms- can be short
  duration and never return or become longterm
  issue
• Chronic Long-term struggle with Schizophrenia

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Disorganized Schizophrenia

• Odd use of language (Word Salad fragmented
  speech
• Neologisms made up words
• Clang associations string together nonsense
  words that rhyme
• Inappropriate effect
• Laugh in sorrowful setting
• Flat effect no emotional response at all

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Paranoid Schizophrenia

• Delusions of persecution
• out to get me

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Catatonic Schizophrenia

• Engage in odd movements
• Remain motionless for hours (odd positions /
  poses / Waxy flexibility
• parrot-like repeating of speech, movement

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Undifferentiated Schizophrenia

• Disordered thinking, but no symptoms of other
  types of Schizophrenia

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Schizophrenic Symptoms 2 Types

• Positive Symptoms
• Excesses in behavior, thought, mood

• Negative Symptoms
• Deficits, such as flat effect, or catatonia.
  (Absence of normal behavior)

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Explaining Schizophrenia

• Biological
• Dopamine hypothesis
• Excessive levels Schizophrenia (average 6x
  normal levels)
• Enlarged brain ventricles
• Genetic predispositions
• Abnormality of 5th chromosome
• Social-Cognitive
• Double binds contradictory messages distorted
  ways of thinking

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Personality Disorders(Notes Dark Green)

• Enduring, maladaptive behavior that negatively
  affects ones ability to function.
• Usually less serious than other disorders.
• Nurture based

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Personality Disorder

• Antisocial disorder (most serious)
• No regard for others feelings / world as hostile
  / look out for oneself / absence of conscience
• No fear, no shame
• serial criminals, serial killers (worst case)
• Electric shock no increased anxiety in
  anticipation
• Causes Both Biological and Psychological
• Nurture influential hero or villain

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More Personality Disorders

• Borderline Personality
• Disorder of emotions (intense instability)
  self-mutilation
• Severe anxiety, depression
• Dependant personality disorder
• Overly dependant on attention, help from others
• Paranoid Personality Disorder
• Feel persecuted, very distrustful
• Narcissistic Disorder
• Self-love, grandiose self-importance,
  entitlement, failed relationships, narcissistic
  paradox
• Histrionic Disorder (center of attention)
• Overly dramatic behavior
• Obsessive-Compulsive Disorder
• Overly concerned with thoughts and behaviors

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Other Personality Disorders

• Paraphilia sexual attraction to things not
  normally seen as sexual (object, person,
  activity) Examples below
• Pedophilia / children
• Zoophilia / animals
• Fetish (objects, shoes, feet etc.)
• Voyeur watching others sexual activity
• Masochist / having pain inflicted on oneself
• Sadist inflicting pain on others
• More common in men (exception is masochism)

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Other Personality Disorders

• Eating Personality Disorders
• Anorexia Nervosa, Bulimia
• Substance Abuse Disorder (Addictions)
• Drugs, alcohol
• Developmental Disorders
• Autism, Attention deficit / hyperactivity
  disorder (ADHD)

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Remember

• Personality disorders are more minor than other
  disorders ( in thought and behavior)
• Example
• Paranoid personality disorder
• Suspicion of persecution, but not the delusions,
  hallucinations of the Paranoid Schizophrenic

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Mental Disorders by Nation