Title: Psychology AP Exam Abnormal Psychology
1PsychologyAP ExamAbnormal Psychology
- Instructor Roberta M. Diddel, Ph.D.
- diddel_at_psychologyworks.com
2Content Covered
- Defining abnormality
- Assessment Diagnosis
- Causal factors
- Approaches to treatment
- Information on depression, ADD, schizophrenia
panic disorder woven into the topics above
3What determines whether a behavior or experience
is abnormal?
4Are these people abnormal?
5Or these?
6Or this person?
7What are the criteria for being a subject of
study in Abnormal Psychology?
8The 4 Ds of Abnormal Psychology
- Deviance
- Distress
- Dysfunction
- Dangerousness
9Deviance 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?
10Deviance 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?
11Distress
- What if the person experiences no distress but
causes problems for others? - Is subjective distress an adequate criterion for
abnormality?
12Should these causes of distress have a diagnosis?
- Bereavement
- Disability
- Cross dressing
- Marital discord / Divorce
13Dysfunction
- Psychological /Emotional
- Vocational (work, school)
- Cognitive
- Social
14Dangerousness
- To oneself
- Suicide
- Euthanasia?
- Drug abuse?
- To others
- Homocide
- Abuse / neglect?
- Euthanasia?
15Assessment
16Types of Assessment
- IQ
- Aptitude
- Personality
- Projective
- Objective
- Psychological state
- Clinical interview
- Neuropsychological
- Medical testing
17Intelligence 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
18WAIS performance task
BLOCK DESIGN
Put the block together To make this picture.
19What do you see?
Personality Testing
Projective Tests e.g., Rorschach
20Personality 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.
21Sample MMPI Profile
22Neuropsychological Assessment
Bender Gestalt
23Medical Assessmentof Neurological Functioning
- Computerized Tomography (CT) scan
- Magnetic Resonance Imaging (MRI)
- Positron Emission Tomography (PET and SPECT) scans
24SPECT scan (type of PET scan)
25ADD before after treatment
26Assessment can indicate levels of progress for
both therapist patient
27The 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
28Define a box.
29Presenting Symptoms
30Causal 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
31Current Models of Causation
- Biopsychosocial Model (Engels)
- Diathesis-Stress Model
32Biological 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
33How we discovered that the brain affects behavior
From Damasio, 1997
34The 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)
35Neurotransmitters
The Brains Chemical Messengers
They carry signals from one nerve cell to the
next.
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37Synaptic Cleft
38What Different Neurotransmitters Do
- Serotonin
- Mood, hunger, sleep, arousal
- Facilitates or dampens responses
- Norepinephrine alertness arousal
- Dopamine
- Movement, learning, attention, emotion
- Facilitates or dampens responses
39Sample of how different neurotransmitters affect
different parts of the brain
40Abnormalities 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
41Hypothalamus-Pituitary-Adrenal(HPA) Axis
Physiology of Stress
42Neuroendocrine 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
43Heredity as a Risk Factor for Depression
Risk of MDD
44Is mental illness really an illness?
(like diabetes, heart disease or cancer)
45Positive 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
46Negative 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
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50Role 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
51Poorer connections between
- Prefrontal cortex
- Language, emotional expression, planning
producing new ideas, social interactions - Limbic system
- Emotion, cognition (working memory)
- Basal ganglia
- Motor control, movement
52Glutamate 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
53Treatment - 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
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55Psychological, Social Cultural Factors
56Psychoanalysis Psychodynamic Theory Therapies
57Psychodynamic Therapies
Therapeutic Alliance
Free Association
Concepts
Working Through
Resistance the defenses
Transference
Counter-Transference
58Personality DisordersDramatic Erratic Cluster
- Histrionic
- Narcissistic Attachment difficulties?
- Borderline
- Longstanding pattern of behaviors developed as a
defense against fear of attachment.
59Classical Conditioning Pairing an event or
object with a naturally occurring response leads
to a persistent connection between the two
US
CS
UR
CR
60Panic Disorder with Agoraphobia
61Biological Theories of Panic Disorder
- Biological
- Genetic
- Norepinephrin, serotonin, GABA, CCK
- Locus ceruleus
- Suffocation false alarm
- Hypersensitivity to CO2
- Kindling
62Producing Change Based onOperant Conditioning
Increase Behavior
Decrease Behavior
Add
Remove
63The naughty stool(aka time out from
reinforcement)
64Controversial 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?
65Medication 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
66Cognitive Theories
What are the unspoken rules in your family of
origin?
- Core beliefs
- Schema
- Rule of Laws
- Cognitive distortions
- Internal dialogue (self-talk)
67Spiral of Self-Esteem(from M. Basch,
Understanding Psychotherapy)
68Drugs Combined with Therapy Work Best
69Socio-cultural Factors
- Culture - Norms, gender roles, marginalization
- Socioeconomic factors
- Political environment
- Social systems
70Erik Erikson
We are shaped by our social interactions.
71Family 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.
72The Hunter Family
Janie 39
Ed 38
Erin 16
Jimmy 13
Sammy 9
School phobic
73Dad 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
74Individual Choice Self-Determination
How much does our personal history determine who
we are?