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Psychology AP Exam Abnormal Psychology

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Title: Psychology AP Exam Abnormal Psychology


1
PsychologyAP ExamAbnormal Psychology
  • Instructor Roberta M. Diddel, Ph.D.
  • diddel_at_psychologyworks.com

2
Content Covered
  • Defining abnormality
  • Assessment Diagnosis
  • Causal factors
  • Approaches to treatment
  • Information on depression, ADD, schizophrenia
    panic disorder woven into the topics above

3
What determines whether a behavior or experience
is abnormal?
4
Are these people abnormal?
5
Or these?
6
Or this person?
7
What are the criteria for being a subject of
study in Abnormal Psychology?
8
The 4 Ds of Abnormal Psychology
  • Deviance
  • Distress
  • Dysfunction
  • Dangerousness

9
Deviance Psychopathology
  • Unusualness of behavior
  • How do we know if somethings uncommon?
  • Is uncommonness enough?

If over half of American women have poor body
image, does that put it beyond the scope of our
subject of study?
10
Deviance Cultural Relativism
  • No universal standards or rules for labeling a
    behavior as abnormal.
  • Behaviors can only be abnormal relative to
    cultural norms.

Example Should a baby sleep in its own bed?
11
Distress
  • What if the person experiences no distress but
    causes problems for others?
  • Is subjective distress an adequate criterion for
    abnormality?

12
Should these causes of distress have a diagnosis?
  • Bereavement
  • Disability
  • Cross dressing
  • Marital discord / Divorce

13
Dysfunction
  • Psychological /Emotional
  • Vocational (work, school)
  • Cognitive
  • Social

14
Dangerousness
  • To oneself
  • Suicide
  • Euthanasia?
  • Drug abuse?
  • To others
  • Homocide
  • Abuse / neglect?
  • Euthanasia?

15
Assessment
16
Types of Assessment
  • IQ
  • Aptitude
  • Personality
  • Projective
  • Objective
  • Psychological state
  • Clinical interview
  • Neuropsychological
  • Medical testing

17
Intelligence TestingExample Wechsler (WAIS)
These pictures tell a story but they are in the
wrong order. Put them in the right order so they
tell a story.
PICTURE ARRANGMENT
18
WAIS performance task
BLOCK DESIGN
Put the block together To make this picture.
19
What do you see?
Personality Testing
Projective Tests e.g., Rorschach
20
Personality TestingObjective Tests, e.g., MMPI
  • Items similar to those on the MMPI
  • Hypochondriasis
  • My stomach frequently bothers me. At times, my
    body seems to ache all over.
  • Depression
  • Nothing seems to interest me any more. My sleep
    is often disturbed by worrisome thoughts.
  • Schizophrenia
  • Things seem unreal to me at times. I sometimes
    hear things that other people cant hear.

21
Sample MMPI Profile
22
Neuropsychological Assessment
Bender Gestalt
23
Medical Assessmentof Neurological Functioning
  • Computerized Tomography (CT) scan
  • Magnetic Resonance Imaging (MRI)
  • Positron Emission Tomography (PET and SPECT) scans

24
SPECT scan (type of PET scan)
25
ADD before after treatment
26
Assessment can indicate levels of progress for
both therapist patient
27
The Diagnostic and Statistical Manual of Mental
Disorders IV (DSM-IV-TR)
Clinical disorders
Axis I
Personality disorders Mental retardation
Axis II
General medical conditions
Axis III
Psychosocial and environmental problems
Axis IV
Global assessment of functioning
Axis V
28
Define a box.
29
Presenting Symptoms
30
Causal Factors in Psychopathology
Biological Factors e.g., genetics,
temperament neurochemistry
Psychological Factors e.g., early childhood
experience, trauma and self-esteem
Feedback Loops
Social Factors Interpersonal stress, family, work
social environment
Feedback Loops
Feedback Loops
31
Current Models of Causation
  • Biopsychosocial Model (Engels)
  • Diathesis-Stress Model

32
Biological Factors in Abnormality
  • Biochemical factors
  • Neurotransmitters / receptors
  • Endocrine / hormonal factors / HPA Axis
  • Structural factors
  • Brain injury or congenital malformations
  • Brain pathways implicated in specific disorders
  • Genetic factors
  • Chromosomes, temperament, susceptibility

33
How we discovered that the brain affects behavior
  • Phineas Gage
  • 1848

From Damasio, 1997
34
The Triune Brain
Cortex Higher level thinking (reasoning,
language, self-control)
Hind Brain Basic survival (arousal, heart rate,
breathing, movement)
Limbic System Emotion, memory (conditioned
learning)
35
Neurotransmitters
The Brains Chemical Messengers
They carry signals from one nerve cell to the
next.
36
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37
Synaptic Cleft
38
What Different Neurotransmitters Do
  • Serotonin
  • Mood, hunger, sleep, arousal
  • Facilitates or dampens responses
  • Norepinephrine alertness arousal
  • Dopamine
  • Movement, learning, attention, emotion
  • Facilitates or dampens responses

39
Sample of how different neurotransmitters affect
different parts of the brain
40
Abnormalities in Depression
  • Anterior cingulate
  • Stress response, emotional
  • expression, social behavior
  • Less activity
  • Prefrontal cortex
  • Approach-related goals
  • Less metabolic activity
  • Less gray matter
  • Hippocampus (Memory fear-related learning)
  • Less volume and lower metabolic rate
  • Associated w/ rumination?
  • Amygdala chronic hyperactivity high cortisone
    levels

41
Hypothalamus-Pituitary-Adrenal(HPA) Axis
Physiology of Stress
42
Neuroendocrine Dysregulation
  • Chronic high levels of cortisol may be the result
    of the failure of the HPA feedback loop to shut
    off stimulation
  • Oversensitivity to stress
  • Exhaustion / Depression

HPA Axis
43
Heredity as a Risk Factor for Depression
Risk of MDD
44
Is mental illness really an illness?
(like diabetes, heart disease or cancer)
45
Positive Symptoms Type I
  • Delusions
  • Persecutory
  • Delusions of reference
  • Grandiose delusions
  • Delusions of thought insertion
  • Hallucinations
  • Disorganized Thought and Speech
  • Disorganized or Catatonic Behavior

Painting by schizophrenic patient
46
Negative Symptoms Type II
  • Flattened/Blunted affect
  • Severe reduction or absence of affect
  • Alogia
  • Severe reduction or absence of speech
  • Avolition
  • Inability to persist at common, goal-oriented
    tasks

47
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48
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49
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50
Role of Dopamine in Schizophrenia
  • Excess number of dopamine receptors
  • related to positive symptoms
  • Less dopamine activity in prefrontal cortex
  • associated with negative symptoms
  • Receptors in mesolimbic pathway
  • Atypical antipsychotics (e.g. clozapine) block
    action of dopamine in this system

51
Poorer connections between
  • Prefrontal cortex
  • Language, emotional expression, planning
    producing new ideas, social interactions
  • Limbic system
  • Emotion, cognition (working memory)
  • Basal ganglia
  • Motor control, movement

52
Glutamate Theory in Schizophrenia
  • PCP patients often experience psychosis
  • blocks glutamate receptors
  • Suggests that schizophrenia results from
    under-activity of glutamate
  • Better explains negative symptoms cognitive
    deficits
  • LY2140023 may help by increasing action at
    NMDA/glutamate receptor sites

53
Treatment - Medications
  • Neuroleptics
  • Most function as dopamine blockers
  • Work best for Type I symptoms
  • Serious side effects
  • sedation, akinesia, akathesis, tardive dyskinesia
  • Atypical anti-psychotics
  • Type II symptoms (as well as Type I)
  • Dopamine receptors as well as serotonin
  • Avoids side effects of neuroleptics
  • Better at preventing relapse

54
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55
Psychological, Social Cultural Factors
56
Psychoanalysis Psychodynamic Theory Therapies
57
Psychodynamic Therapies
Therapeutic Alliance
Free Association
Concepts
Working Through
Resistance the defenses
Transference
Counter-Transference
58
Personality DisordersDramatic Erratic Cluster
  • Histrionic
  • Narcissistic Attachment difficulties?
  • Borderline
  • Longstanding pattern of behaviors developed as a
    defense against fear of attachment.

59
Classical Conditioning Pairing an event or
object with a naturally occurring response leads
to a persistent connection between the two
US
CS
UR
CR
60
Panic Disorder with Agoraphobia
61
Biological Theories of Panic Disorder
  • Biological
  • Genetic
  • Norepinephrin, serotonin, GABA, CCK
  • Locus ceruleus
  • Suffocation false alarm
  • Hypersensitivity to CO2
  • Kindling

62
Producing Change Based onOperant Conditioning
Increase Behavior
Decrease Behavior
Add
Remove
63
The naughty stool(aka time out from
reinforcement)
64
Controversial Issue
  • Should kids with behavioral disorders like ADHD
    be medicated? (And, if so, when?)
  • Should parents teachers be required to learn
    behavioral techniques before using medication?

65
Medication ADHD
  • Improvement in 3 out of 4 children in
  • Reduced impulsivity anti-social behavior
  • Improved attention
  • No significant improvement in school performance,
    unless paired with a behavioral program
  • Improvements generally lost once the drug is
    discontinued

66
Cognitive Theories
What are the unspoken rules in your family of
origin?
  • Core beliefs
  • Schema
  • Rule of Laws
  • Cognitive distortions
  • Internal dialogue (self-talk)

67
Spiral of Self-Esteem(from M. Basch,
Understanding Psychotherapy)
68
Drugs Combined with Therapy Work Best
69
Socio-cultural Factors
  • Culture - Norms, gender roles, marginalization
  • Socioeconomic factors
  • Political environment
  • Social systems

70
Erik Erikson
We are shaped by our social interactions.
71
Family Systems
  • Social group as an eco-system
  • Operational rules patterns of interaction
  • Alliances, coalitions, triangulation,
    scapegoating
  • Homeostasis - tendency of system is to remain
    stable (even if unhappy dysfunctional)
  • Roots of disorder are within the family, not the
    individual.

72
The Hunter Family
Janie 39
Ed 38

Erin 16
Jimmy 13
Sammy 9
School phobic
73
Dad 75
Mom 72
Chronic pain/ obese
46
48
38
36

Ed 38
Janie 39
Chronic pain / Obese
Erin 16
Jimmy 13
Sammy 9
Obese / Somatizing
74
Individual Choice Self-Determination
How much does our personal history determine who
we are?
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