abnormal psychology

Abnormal PsychologyAbnormal PsychologyUnit 7

What are we studying?What are we studying? Abnormal Behavior Classifying Psychological

Disorders Anxiety and avoidance

Disorders Affective Disorders Schizophrenia Dissociative Disorders Personality Disorders Treating Psychological

Disorders Cognitive Therapies Family Systems Theory General Trends in

Psychotherapy Community and

Preventive Approaches

Why study abnormal Why study abnormal psychology?psychology?Abnormal behaviour is part of our

common experienceLots of unanswered questions

and complexitiesPreparation for future careers

◦www.apa.org/students/

Abnormal Behavior Abnormal Behavior Behavior that

results in:◦ Stress◦ Pain◦ Impairs

functioning ◦ An increased risk

of death or loss of freedom

Let individuals decide for themselves

Abnormal Behavior Abnormal Behavior Cultural Influences Normal or abnormal Abnormal based on time or placeParticular worldviewMiddle Ages: Deviant behavior meant

you were possessed by demons,

Abnormal Behavior- Bio Abnormal Behavior- Bio Psychosocial Model Psychosocial Model Biological:

◦ Genetic Factors ◦ Neurotransmitter deficiency activities◦ Hormonal abnormalities

Further behavior can be affected by: Brain damage, malnutrition, infectious disease and drug overuse

Abnormal Behavior- Bio Abnormal Behavior- Bio Psychosocial Model Psychosocial Model Psychological:

◦ People’s reactions to events◦ Reaction depends on the circumstances

of the event as well individuals own vulnerabilities to the event

◦ A important component is: individuals past history, or genetic predisposition relating to a person’s reactions

Abnormal Behavior- Bio Abnormal Behavior- Bio Psychosocial Model Psychosocial Model Social:

◦ Cultural Perspective ◦ People are influenced both by how

others act towards them and by the expectations of others

Classifying Psychological Classifying Psychological Disorders Disorders Diagnostic Statistics Manual

(DSM) - A list of accepted labels for psychological diagnosis ◦ Currently in it’s 4th edition, revised (DSM-

IV-Tr)5 Separate Axes

Diagnostic Statistics Manual Diagnostic Statistics Manual DSMDSM

Current diagnostic system Axis I: Clinical, mental, and learning disorders

◦ Childhood Disorders (ADD)

◦ Stuttering

◦ Substance abuse,

◦ Eating disorders,

◦ Anxiety and mood disorders

◦ Sleep disorders◦ Impulse control disorders ◦ Autism◦ Mental Retardation


Current diagnostic system Axis II: Personality disorders and intellectual disabilities.

Classifies those disorders that last a lifetime: ◦ Personality disorders

◦ Impaired effectiveness in getting along with others

◦ Mental Retardation

◦ Narcissism

Axis III: Evaluation of general medical conditions, as these can contribute to overall mental functioning.

Diabetes Cirrhosis of the liver

Axis IV: Psychosocial and environmental problems, particularly stress.


Current diagnostic system Axis V: Global Assessment of Functioning

Score Description

91-100 No Problems

81-90 Few or no symptoms

71-80 Temporary & expected reactions to stressors

61-70 Mild symptoms, maintaining relationships



Score Description

51-60 Moderate symptoms or difficulty functioning

41-50 Serious symptoms or impairment to functioning

31-40 Some impairment in reality testing and communication or serious impairment in functioning



Score Description

21-30 Presence of hallucinations or delusions which influence behavior

11-20 Some danger of harm to self or others or occasional failure to maintain hygiene, or incoherent/mute

1-10 Persistent danger to self or others or inability to maintain hygiene or has made a serious attempt at suicide

Anxiety and Avoidance Anxiety and Avoidance DisordersDisorders

According to DSM-IV Anxiety Disorders: ◦ Are lingering,◦ Almost constantly present,◦ Cause thoughts or environmental triggers to

induce psychological and physiological symptoms of distress

◦ Those who feel helpless to control major life events are most prone to severe anxiety

Anxiety and Avoidance Anxiety and Avoidance DisordersDisorders

Examples of DSM-IV Anxiety Disorders: ◦Panic Disorder (PD): 2% of all adults in US

with more woman than men. Panic attack causes one to experience sudden expected anxiety at an almost unbearable level. The person sweats, trembles, gasps for air, experience dizziness and accelerating pulse rate. Perceive the world as unreal to themselves Sense of personalization Catastrophic thoughts, they feel out of control, may

wind up in the hospital , last several minutes but can consume several hours.

◦ Social Phobia: Fear of anything public and avoidance of people

◦ Agoraphobia: An excessive fear of public areas

General Anxiety DisordersGeneral Anxiety Disorders

Generalized Anxiety Disorder (GAD): Excessive and exaggerated anxiety ◦ Areas: Worry; include work, family, money and health◦ Extreme pervasiveness of the worry is what labels the

condition and generalizes anxiety disorder◦ Cognitive and physiological difficulties◦ Difficulty with decision making ◦ Difficulty remembering commitments◦ Individual experiences muscle tension, heightened arousal of

the nervous system◦ Headaches, nervous twitches, indigestion and insomnia

GAD is frequently accompanied by Depression◦ Antidepressant drugs are an effective treatment providing

immediate results ◦ Relaxation training provides more long lasting than drug

therapy

Phobias (Phobic Disorder)Phobias (Phobic Disorder)

Phobia: Characterized by intense fear of specific object or situation that actually poses no threat to the individual.◦ Interferes with daily living,◦ Confrontation may lead to sweating, trembling, rapid heart

rate and breathing ◦ Difference in phobic reactions are established based on

severityWe are born with some fears however most

are learned and can be traced to a certain event.

Therapeutic Phobia treatments include:Flooding: Sudden exposure to the feared objectSystematic Desensitization: Gradual, repeated exposure

to the feared object The most successful

Obsessive-Compulsive Obsessive-Compulsive DisorderDisorder

Obsessive-Compulsive Disorder aka “OCD”: Characterized by repetitive obsessions and/or compulsions.◦ Obsession: Repetitive thought that exists and

continues to invade an individuals conscious mind◦ Compulsion: Repetitive action that an individual

has no conscious desire to repeat (an almost irresistible action) Obsessions continue even when an individual tries to repress them;

obsessions surround themes of violence, sex or contamination

◦ Two Common Compulsions Checking Rituals: Interruption of their daily activities continually

checking to make sure then performed what was required Cleaning Rituals: Involve an obsession with the idea of

contamination, IN the most severe form, obsessive-compulsive disorders can be completely disabling

Obsessive-Compulsive Obsessive-Compulsive DisorderDisorder

Exposure Therapy: Normally perform a ritual however they are prevented form performing it

Drug Therapy: Clomipramine (Anafranil) is helpful for about half of obsessive- compulsive patients

Post-Traumatic Stress Post-Traumatic Stress DisorderDisorder

(PTSD): Acute reactions to significantly traumatic eventsInclude: War, Assault, Rape, Floods,

Earthquakes, accidents and fires. Numbness to the world Relive the trauma and experience anxietySymptoms appear shortly after the traumaDSM-IV: acute or chronic?Fear, helplessness or horror

Affective Disorders Affective Disorders

Affective Disorders: Extreme moods and swingsNormal functioning may experience an episode of despair or mania Major Depressive Disorder: One or more major depressive

episodes without a history of manic, hypomanic, or mixed episodesDepressed individuals often feel helpless and hopelessSuffer from loss of pleasure or interest in regular activities Disturbance in eating habitsSleep disturbanceLoss of energyFeeling of worthlessness or guilt, difficulties in thinking,

concentration, and memory and recurrent thoughts of death and suicide.

DSM-IV- Symptoms must persist most every day for at least two weeks

Distress in social, occupational or areas important to functioning

Affective Disorders Affective Disorders Dysthymia: A “flat affect” and inability to connect.

Introverted Morose Over conscientious Low energy level Low self-esteem Suicidal Ideation Disturbances of Eating, Sleeping and Thinking Also associated with major depression Do not experience symptoms chronic enough for a diagnosis of major

depression Heredity and family influences

Adolescent boys and girls suffer from depression equally After adolescence woman suffer from depression about

twice as often as men

Affective Disorders Affective Disorders Depression usually involves an unpleasant

event It occurs most often among people with

little or no social support Seasonal Affective Disorder (SAD)

Depression with seasonal pattern of the yearSleep and eat excessively during depressed timeFall asleep late and awaken lateGet sleepy early and wake up early Depressive mood swing Elevated mood swing

Bipolar DisorderBipolar Disorder Depressive as well as manic episodes Appear late in adolescence in the form of a manic

episode Variety of patterns Initial manic episode may be followed by a normal

period, then a depressed period Bipolar disorder is much less common than major

depression Women are twice as likely to be diagnosed with

depression Bipolar disorder occurs in both sexes at the same

frequency Bi-polar disorder is more prevalent among higher

socioeconomic groups

Causes of Mood Causes of Mood Disorders Disorders

Biological disorders Heredity Neurobiological Abnormalities Neurotransmitter Deregulation Hormones Learned Helplessness: A response to prolonged stress

over which the individual has no control, where apathy and helplessness may lead to depression and cognitive explanations

Sociocultural factors include interpersonal relationships, socioeconomic and ethnic factors, cultural variations and gender

Treatments Treatments Severe and debilitating Responds well to both psychotherapy and drug

therapy Common Antidepressant drugs:

Tricyclics: Blocks reabsorption of neurotransmitters dopamine, norepinephrine and serotonin. Side effects: dry mouth, heart irregularities, difficulty urinating and drowsiness

Selective Serotonin Reuptake inhibitors (SSRIs)—block reputake of neurotransmitter SerotoninFewer and milder side effects than Tricyclics that

include nausea and headaches. Ex: Zoloft, Luvox, and Paxil

Monoamine Oxidase Inhibitors: Block metabolic breakdown of released dopamine, norepinephrine and serotonin

Treatments Treatments Electro conclusive Therapy (ECT): A brief electrical shock administered across the patients head to induce convulsionECT became poplar in 1940’s as a treatment for

schizophrenia and depression More antidepressant drugs became more

readily available, ECT lost favorSince 1970’s however ECT is being used for

severely depressed patients who fail to respond to drug therapy

Mood Disorders and Mood Disorders and Suicide Suicide

Severely depressed people with bipolar disorder consider suicide and may attempt it

Feelings of guilt or disgrace Cult leader tells them that death is a route to salvation Records are not always accurate; people sometimes

disguise their suicide to look like accidents More than 13% of adults had considered suicide and more

than 4% had survived a suicide attempt Differences in suicide rates as function of age, country and

gender Most men use a gun or other violent means Woman try poison, drugs or other no-violent methods that

are fatal Warning signs are given in advance

SchizophreniaSchizophreniaPositive (Present) Symptoms

Behaviors that are notable due to their presence and include: Hallucinations, Delusions Thought disorders

Negative (Absent) Symptoms: Notable due to their absence, such as…

Speech deficits,Lack of emotional expression Inability to care for one’s self

SchizophreniaSchizophreniaTypes of Schizophrenia Undifferentiated Schizophrenia: Deterioration

of daily functioning plus a combination of hallucinations, delusions, inappropriate emotions and thought disorders

Catatonic Schizophrenia: Prominent movement disorder; either rigid inactivity or excessive activity

Disorganized Schizophrenia: Incoherent speech, extreme lack of social relationships, and odd behavior

Paranoid Schizophrenia: Elaborate hallucinations and delusions around feelings of persecution and delusions of grandeur

Causes of Schizophrenia Causes of Schizophrenia Due to geneticsPredisposition toward schizophreniaNeurodevelopment Hypothesis:Abnormal brain development before or

at the time of birth due to difficult pregnancy, mothers poor nourishment, small birth weight or an Rh-negative mother with an RH positive baby

Season of birth effect where people born in the winter moths slightly more likely to develop schizophrenia than people born at other times

Therapies for Therapies for SchizophreniaSchizophrenia

Antipsychotic Drugs◦ Take effect gradually◦ Have some unwelcome side affects◦ Tardive Dyskinesia: Tremors and involuntary movements

Types of Antipsychotic Drugs◦ Chlorpromazine◦ Throazine-1st Schizophrenic drug◦ Haloperidol (Haldol)- helps to control schizophrenia and allow

people to leave mental hospitalsSuccessful drug therapy

◦ Sudden relapses Family therapy

◦ Reduces hostile comments improves chance of recovery

Dissociative DisordersDissociative DisordersPsychogenic AmnesiaPsychogenic FugueDissociative Identity Disorder

(DID)Depersonalization DisorderDerealization

Dissociative DisordersDissociative DisordersIn general, the concept of

“mental disorder” can be defined as:◦A biomedical, culturally independent,

value-free concept◦Or as a social, culturally relative,

value-based concept.

DissociationDissociationIs a splitting apart of normally

integrated components of personality

Screening out of identity and memory

Exists w/o recognized damage to the brain

A way of coping with psychological stress

Amnesia Amnesia Forgetting past events and

experiencesConfusion and disorientationMay result because of organic

brain damage not alwaysA result of psychological stressTwo Forms:

◦Retrograde Amnesia◦Anterograde Amnesia

Psychogenic Amnesia Psychogenic Amnesia Often appears suddenly after

psychological stress May suddenly disappearForgotten and screened out

consciousness Hypnosis may help in recovering

events that are lost

Psychogenic Fugue Psychogenic Fugue Sudden, unexpected excursion,

then the individual forgets their true identity only to assume a new identity

Purposeful in their movements Occurs suddenly Individuals wake up experiencing

complete amnesia concerning events that occurred

Dissociate Identity Dissociate Identity DisorderDisorder

DID aka Multiple Personality DisorderAlienation between two distinct

personalitiesEach personality exists as well-

integrated and developedEach has it’s own tastes, memories,

learned behaviorsMany different patterns of personalities Increase in personalities leads to

increase complexity

Depersonalization Depersonalization DisorderDisorder

Disruption in personal identity Disruption exists w/o amnesiaCut off from selves as if they are

viewing themselves from the outside

Strangeness of self leads to strangeness of the world

Depersonalization Depersonalization DisorderDisorder

Derealization: Episodes of…◦Déjà vu (already seen) ◦Jamasis vu- (never seen) ◦Familiar place of never having

experienced the location before

HypochondriasisHypochondriasis

Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms

Somatization DisorderSomatization Disorder

Formerly known as Briquet’s syndrome Recent and numerous physical

complaints Can persist for several years and cause

one to seek medical help; no medical basis for complaints can be found

Symptoms are explained in a vague and exaggerated way

Several medical symptoms for a diagnosis

Conversion DisorderConversion Disorder

Actual impairment of motor and sensory function

Conversion Symptoms include: blindness, deafness and paralysis

Sometimes mimic epilepsy or cancer DSM-IV conversion disorder specifies

deficit affect is voluntary motor or sensory function

Paranoid Personality Paranoid Personality DisorderDisorder

Paranoid personality disorder is characterized by a distrust of others and a constant suspicion that people around you have sinister motives.

Paranoid Personality Paranoid Personality DisorderDisorder

They search for hidden meanings in everything and read hostile

intentions into the actions of others. •They are quick to challenge the loyalties of friends and loved ones and often appear cold and distant to others. They usually shift blame to others and tend to carry long grudges.

Schizotypal Personality Schizotypal Personality DisorderDisorder

Detachment from social relationshipsOdd thinkingNeglect of normal grooming Restricted range of emotional

expression in interpersonal situationsDifficult to get along with - often

have problems in close relationships

•.

Antisocial Personality Antisocial Personality DisorderDisorder

Antisocial personality disorder is characterized by a lack of conscience ◦People with this disorder are prone to

criminal behavior, believing that their victims are weak and deserving of being taken advantage of

◦They tend to lie and steal ◦They are careless with money and take

action without thinking about consequences

◦They are often aggressive and are much more concerned with their own needs than the needs of others

Borderline Personality DisorderBorderline Personality Disorder

Characterized by mood instability and poor self-image ◦People with this disorder are prone to

constant mood swings and bouts of anger.

◦They will take their anger out on themselves, causing themselves injury

◦Suicidal threats and actions are not uncommon

◦They are quick to anger when their expectations are not met.

Narcissistic Personality Narcissistic Personality DisorderDisorder

Characterized by self-centeredness ◦They exaggerate their achievements,

expecting others to recognize them as being superior

◦They tend to be choosy about picking friends, since they believe that not just anyone is worthy of being their friend

◦They are generally uninterested in the feelings of others and may take advantage of them.

Histrionic Personality DisorderHistrionic Personality Disorder

Pervasive, excessive emotionality and attention seeking behavior

Exaggerated displays of manipulative emotion

Attracting attention and sympathy Lively & dramaticDraws attention to oneselfCharmin with new acquaintances Enthusiasm and flirtatiousness Qualities wear thin and demanding of

center stage continues

Dependent Personality DisorderDependent Personality Disorder

Characterized by a pervasive psychological dependence on other people. ◦Has difficulty making everyday

decisions without an excessive amount of advice and reassurance from others

Obsessive Compulsive Obsessive Compulsive Personality DisorderPersonality DisorderCharacterized by a general

psychological inflexibility, rigid conformity to rules and procedures, perfectionism, and excessive orderliness.

People with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things aren't "right".

Treating Psychological Treating Psychological DisordersDisorders

Types of Therapy◦Psychotherapy◦Psychoanalysis◦Humanistic Therapies ◦Behavioral Therapies◦Cognitive Therapies◦Family System Therapy◦General Trends in Psychotherapy◦Community and Preventative

Approaches


Types of Therapy◦Psychotherapy◦Treatment of Psychological Disorders◦Relationship between mental health

professional and client


Types of Therapy◦Psychoanalysis◦Psychodynamic: Uncovers and resolves

peoples underlying drive and motives ◦Sigmund Freud's View: Underlying

sexual motives & unconscious thoughts ◦Cathartic: Releasing pent up emotions

associated with dreams, unconscious thoughts and memories


Types of Therapy◦Psychoanalysis: Developed by Freud◦Free Association: Thinking about a

specific problem and reports everything that comes to mind without omitting or censoring anything

◦Dream Analysis: Latent content – A form of wish fulfillment Wish remains hidden


Types of Therapy◦Humanistic Therapies◦Power surrounding peoples choices◦Full potential ◦ Insight therapy ◦Conscious and deliberate decision making

abilities to achieve ◦Distress when people don’t like or

criticize them◦ Incongruence: Mismatch of self-concept

and ideal self


Types of Therapy◦Resistance: Repression of material that

gets in the way of therapy


Types of Therapy◦ Person Centered Therapy

Carl Rogers Best know version of humanistic therapy Person centered Non-directive Therapists listens to the client sympathetically with

acceptance and unconditional positive regard Parent/Child Atmosphere freely explored, feelings

conveyed to client Constructively resolve their problems


Types of Therapyo Behavioral TherapiesoBehavior is learned oChange behavior rather than

considering underlying motivesoBegins with a clearly established

behavioral goal oSetting of goals helps evaluate

therapies effectiveness


Types of Therapy◦Aversion Therapy Punishment To teach dislike or aversion Ex: quit smoking – depleted oxygen


Types of Therapyo Systematic desensitizationoList of anxiety-evoking situations oListing the most anxiety producing lastoDeep relaxation oImaging of situation that arouse from

least to most


Types of Therapyo Cognitive TherapiesoChanging thought or beliefs oREToPeoples emotions are dependent on their

internal cognition oRational Emotive: Thoughts that are

rational and lead to emotionso Irrational beliefs and move toward

contradiction


Types of Therapyo Cognitive Behavior Therapy: oCombination of cognitive and

behavioraloEstablishment of explicit goals for

changing behaviorsoMore focus on interpretation of their

particular situation


Types of Therapyo Family Systems Therapy oFamily with difficultiesoMarriage counseling oPsychoanalysis oBehavior therapyoTalks with more than one family at a

time


Types of Therapyo Gestalt Psychology

o Ability to perceive overall patterns

o Not broken down into component parts

o Visual perception is an active creation

o Separate, figure and ground object is separate from the background

o Proximity: Tendency perceive object close together belonging to group

o Similarity: Objects resemble each other

o Continuation: Lines are interrupted


Community and Preventative Approaches ◦ Focus of the needs of large groups than those of

individuals ◦ Primary Prevention: Target at-risk groups ◦ Secondary Prevention: Identification of disorder in

early stages, keeping it from becoming more seriousAssistance Programs

◦ Ban Toxins: Lead based paint ◦ Prenatal education◦ Job placement◦ Provide childcare◦ Improve educational opportunities

abnormal psychology

Documents

deviant behavior

abnormal behaviour

abnormal psychologyunit

psychological diagnosis

overall mental functioning

serious impairment

serious symptoms

mild symptoms