ABNORMAL PSYCHOLOGY

MODULE 65 INTRODUCTION TO PSYCHOLOGICAL DISORDERS MODULE 66 ANXIETY DISORDERS, OBSESSIVE COMPULSIVE DISORDER, AND POST TRAUMATIC DISORDER MODULE 67 MOOD DISORDERS MODULE 68 SCHIZOPHRENIA MODULE 69 OTHER DISORDERS

• What is NORMAL anyway?

• What is ABNORMAL? How do you know when a person has gone off the edge or is “crazy?” What are some examples?

L E T ’ S S TA R T W I T H T H E S E Q U E S T I O N S :

• How should we define psychological disorders?

• How should we understand disorders? How do underlying biological factors contribute to disorders? How do troubling environments influence our well-being? And how do these effects of nature and nurture interact?

• How should we classify psychological disorders? And can we do so in a way that allows us to help people without stigmatizing them with labels?

P S Y C H O L O G I C A L D I S O R D E R

a syndrome marked by a clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.

D E F I N I N G A B N O R M A L B E H AV I O R

IMPORTANT: we all do abnormal things once in awhile. If someone saw what you did in private, they’d probably think you were crazy, but true problems are defined as follows…

S C E N A R I O T O F O L L O W :

Every morning, a woman who lives in a Boston suburb asks her husband to bring in the morning newspaper, which the carrier throws just inside their fence. She does this because she is terribly afraid of encountering a poisonous snake. Her husband, concerned about her behavior, repeatedly tells her that there are no poisonous snakes living in their town. Nevertheless, she is afraid to leave the house.

P S Y C H O L O G I C A L D I S O R D E R C R I T E R I A

*A psychological disorder is any behavior that is considered maladaptive, unjustifiable, disturbing, and atypical.

Maladaptive

• “destructive to oneself or others”

• example: woman whose fear of snakes prevented her from leaving her home

Unjustifiable

• “without a rational basis”

• example: it is not rational to refuse to leave your home to avoid a snakebite in an area that has no poisonous snakes

Disturbing

• “troublesome to other people”

• example: the woman’s fear of snakes disturbs at least her husband, who worries about her

Atypical

• “so different that they violate a norm”

• example: the woman who can’t leave her suburban home because of her fear of nonexistent snakes is definitely behaving different;y from almost all people in her culture

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CAUSES OF ABNORMAL BEHAVIOR (DIFFERENT PERSPECTIVES)

▸ Behavior: maladaptive responses learned through reinforcement of the wrong kinds of behaviors.

▸ Psychoanalytic: results from internal conflicts in the unconscious stemming from early childhood traumas.

▸ Humanistic: results from conditions society places on the individual

▸ Evolutionary: harmful evolutionary dysfunctions that occur when evolved psychological mechanisms do not perform their naturally selected functions effectively.

▸ Biological: neurochemical or hormonal imbalances, genetic predispositions, damage to brain.

▸ Cognitive: irrational and illogical perceptions

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II. HISTORY OF PSYCHOPATHOLOGY:

▸ Was mental illness always viewed as it is today?

a. Hippocrates: symptoms of mental illness was due to an imbalance of four bodily fluids: blood, yellow bile, black bile, phlegm.

b. Middle Ages: (Medieval Church)- psychopathology was caused by the devil.

c. Phillipe Pinel: 1745-1826) Led a reform in the treatment of psychological disorders, stated that psychological disorders are due to a biological abnormality and therefore these patients should be treated with care, instead of the harsh treatments that were the norm..

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III. MEDICAL MODEL VS BIOPSYCHOSOCIAL MODEL:

▸ Explaining Psychological Disorders

Medical Model:

the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and in most cases, cured, often through treatment in a hospital.

B I O P S Y C H O S O C I A L M O D E L

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III. MEDICAL MODEL VS BIOPSYCHOSOCIAL MODEL:

▸ Medical Model- According to Pinel…

▸ Mental illness is due to biological causes.

▸ Nature not nurture.

▸ Treatments: use of medication to treat mental illness.

▸ Terms: Psychopathology, Etiology, Prognosis

▸ Biopsychosocial Model (Bio+Psycho+Social) :

▸ Mental illness is due to nature and nurture.

▸ Treatments may consists of medication, however Psychologists would look at how negative thought patterns and social influences factor into the equation.

I V. D S M - 5

1. describe the disorder

2. predict the future course of the disorder

3. treat the disorder appropriately

4. provide a springboard for research into the disorder’s cause

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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)

▸ The DSM-5 classifies all psychological disorders by their symptoms

▸ Lots of changes!

▸ a. Basic Features:

▸ In 1952, the American Psychiatric Association agreed upon a system for classifying abnormal symptoms.

▸ For a person to be diagnosed with a particular disorder a person must meet the Diagnostic Criteria of the DSM-V.

▸ Identifies prevalence, course, gender, cultural features, symptoms, etc… Basically everything but treatment.

▸ In multi-axial diagnosis, professionals look at the entire person, not just their “abnormal” behavior.

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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)

▸ b. Changes in the DSM-5:

▸ Autism and Asperger syndrome are combined into the Autism spectrum disorder.

▸ Mental retardation becomes an intellectual disability.

▸ New categories include hoarding disorder and binge eating disorder.

▸ OCD and PTSD are no longer anxiety diagnosis.

▸ Axis I, II, and III, are no longer used for diagnosis.

▸ There are no more subtypes for diagnosis of schizophrenia (paranoid, disorganized, catatonic, undifferentiated). All that is needed for a diagnosis is to have one of three positive symptoms namely delusions, hallucinations, or disorganized speech.

▸ Fugue is no longer used but is not dissociative amnesia.

▸ For substance abuse disorder, there is no longer a difference between abuse vs dependence.

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IV. DSM-5 (DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)

▸ c. Strengths:

▸ Pretty reliable

▸ Used for insurance purposes

▸ d. Weaknesses:

▸ Too vague (many people fit the criteria)

▸ i.e. ADHD

▸ Leads to the development of stigmas:

▸ i.e. Presidential election of 1972

▸ Labeling (David Rosenhan study)

▸ i.e. Eight Stanford students check themselves into a mental institution claiming they were having auditory hallucinations, all eight admitted.

▸ As soon as they were admitted, all eight students acted normal. Regular behaviors were considered abnormal. It took students 19 days to be let out.

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IV. DSM-5(DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS)

▸ e. Evaluation and Criticism of the DSM-5:

▸ Criticized for being too detailed and extensive.

▸ i.e. Temper tantrums and bereavement.

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V. ANXIETY DISORDERS

▸ a. Generalized Anxiety Disorder:

▸ A constant, low-level, free floating anxiety without any external cause. Such a person feels nervous and out of sorts.

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V. ANXIETY DISORDERS

▸ b. Panic Disorder:

▸ A disturbance marked by panic attacks that have no obvious connection with events in the person’s present experience.

▸ Constant worry about another panic attack can complicate problems.

▸ Symptoms include: Palpitations, increased heart rate, trembling, dizziness, hands become clammy and sweaty.

▸ PET scans of the amygdala and hypothalamus show abnormal activity in patients w/ panic.

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V. ANXIETY DISORDERS

▸ c. Agoraphobia:

▸ Fear of open places. Often people with panic develop symptoms of agoraphobia.

▸ Panic and Agoraphobia affect about 2% of the population.

▸ d. Phobias:

▸ Fear of specific object, activity, or situation. Common ones include: Social phobias, Specific phobia, Acrophobia, and Claustrophobia.

▸ Preparedness hypothesis, heredity, and learning are often the cause of phobias.

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VI. OBSESSIVE COMPULSIVE DISORDERS (OCD)

▸ Disorder that affects thoughts and actions

▸ Compelled to do the same pointless routine over and over and over again.

▸ Have irrational ideas of germs, or being hurt.

▸ Traps people in endless cycles of repetitive thoughts (obsessions) and behaviors (compulsions).

▸ These behaviors are prompted by unwanted ideas, images and impulses.

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VII. POST TRAUMATIC STRESS DISORDER (PTSD)

▸ Mental Disorder that follows experiencing or seeing a traumatic event.

▸ Reaction to a psychologically traumatic event that is outside the range of usual human experience

▸ Usually will have constant frightening thoughts.

▸ They don’t respond to people, lost of interest in life, sleepiness, lack of motivation, night terrors

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VIII. MOOD DISORDERS

▸ a. Major Depression:

▸ depression lasting at least two weeks. Symptoms include: depressed mood, diminished interest in activities, weight loss, insomnia, fatigue, feeling of worthlessness, recurrent thoughts of death.

▸ b. Dysthymia:

▸ depressed mood for more days than not. Moderate depression.

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VIII. MOOD DISORDERS

▸ c. Seasonal Affective Disorder:

▸ form of depression caused by sunlight deprivation.

▸ Caused by the light-sensitive hormone Melatonin. Therapy consists of exposing patients to bright artificial light.

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VIII. MOOD DISORDERS▸ d. Bi-polar Disorder:

▸ mania and depression.

▸ In the manic state, symptoms include:

▸ grandiosity

▸ decreased need for sleep

▸ pressured speech

▸ flight of ideas

▸ distractibility

▸ increase in goal directed behavior

▸ excessive involvement in pleasurable activities that have a high potential for painful consequences.

*Must meet criteria for major depressive episode

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VIII. MOOD DISORDERS▸ e. Classifications of Bi-polar Disorder:

▸ Mania- severe mania

▸ Hypomania- same symptoms, less severe.

▸ Bipolar I- severe mania and depression. Might be accompanied with psychotic symptoms.

▸ Bipolar II- less severe mania and depression.

▸ Cyclothymic Disorder- less severe mania and depression, more long-term.

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VIII. MOOD DISORDERS▸ f. Facts about Depression:

▸ Cross-cultural studies: most prevalent disorder in the world and in women.

▸ Martin Seligman “Common Cold of Abnormal Behavior.”

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VIII. MOOD DISORDERS▸ g. Causes of Depression:

▸ Genetics

▸ Neurotransmitters: Serotonin, Norepinephrine, and Dopamine

▸ Lower brain wave activity in left frontal lobe

▸ Viral infections

▸ Traumatic events

▸ Learned Helplessness (Martin Seligman)

▸ Cultural Pressures

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IX. SCHIZOPHRENIA

▸ a. Schizophrenia:

▸ a psychotic disorder involving distortions in thoughts, perceptions, and or emotions. Schizophrenia means “split mind.”

▸ Prevalence: 1%

▸ Course: Men before 25, Women 25-45 years of age

▸ 40% of all patient admissions to public hospitals

▸ 1/3 of patients will never get better despite treatment.

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IX. SCHIZOPHRENIA

▸ b. Symptoms of Schizophrenia

▸ Positive- refer to active processes because they add to a person’s life. Examples include: hallucinations, delusions, and disorganized thoughts.

▸ Negative- passive processes because they subtract from a person’s life. Examples include: lack of speech and flat affect.

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IX. SCHIZOPHRENIA

▸ c. Causes of Schizophrenia

▸ Methamphetamines- cause hallucinations and delusions.

▸ Dopamine Hypothesis- too much of the neurotransmitter causes Schizophrenia.

▸ Strong Genetic Link- 48% concordance rate of identical twins.

▸ Diathesis-Stress Hypothesis— genetic factors put the individual at risk, while environmental stress factors transform this into a schizophrenic disorder.

▸ E.G. homeless

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IX. SCHIZOPHRENIA

▸ c. Causes of Schizophrenia (continued)

▸ Enlarged ventricles

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X. DISSOCIATIVE DISORDERS:

▸ a. Dissociative Amnesia (Fugue):

▸ a psychologically induced loss of memory for personal information, such as one’s identity or residence.

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X. DISSOCIATIVE DISORDERS:

▸ b. Depersonalization Disorder:

▸ an abnormality involving the sensation that mind and body have separated, as in an out of body experience.

▸ c. Dissociative Identity Disorder:

▸ a condition in which an individual displays multiple identities, or personalities. Also known as multiple personality disorder.

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XI. CHILDHOOD DISORDERS

▸ a. Autism:

▸ a disorder marked by disabilities in language, social interaction, and the ability to understand another person’s state of mind. Prevalence: 1 in 500.

▸ Autistic children lack a theory of mind.

▸ Difficulty in social relationships and language lead to social isolation.

▸ Repetitive behaviors are also evident.

Theory of Mind Problem

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XI. CHILDHOOD DISORDERS

▸ b. ADHD:

▸ a disorder involving inattention, hyperactivity, and impulsivity.

▸ Prevalence: 3-5%

▸ Overdiagnosis is a problem

▸ Occurs in more boys than girls

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XII. EATING DISORDERS

▸ a. Anorexia Nervosa:

▸ persistent loss of appetite

▸ Prevalence higher in western cultures

▸ Women mostly affected

▸ b. Bulimia Nervosa:

▸ binge and purge syndrome through self-induced vomiting and use of laxatives.

Eating Disorders are associated with other forms of psychopathology

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XIII. SOMATOFORM DISORDERS

▸ a. Conversion Disorder:

▸ paralysis, weakness, or loss of sensation- with no discernible cause. Used to be known as “hysteria.”

▸ b. Hypochondriasis:

▸ involves excessive concern about health and disease

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XIV. PERSONALITY DISORDERS

▸ a. Paranoid Personality Disorder:

▸ a pattern of distrust and suspiciousness.

▸ b. Schizoid Personality Disorder:

▸ a pattern of detachment from social relationships and a restricted range of emotional expression.

▸ c. Schizotypal Personality Disorder:

▸ a pattern of acute discomfort in close relationships, cognitive or perceptual distortions.

▸ d. Anti-social Personality Disorder:

▸ a pattern of disregard for, and violation of, the rights of others.

▸ e. Borderline Personality Disorder:

▸ a pattern of instability in interpersonal relationships, self image, and marked impulsiivity.

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XIV. PERSONALITY DISORDERS (CONTINUED)

▸ f. Histrionic Personality Disorder:

▸ a pattern of excessive emotionality and attention seeking.

▸ g. Narcissistic Personality Disorder:

▸ a pattern of grandiosity, need for admiration, and lack of empathy.

▸ h. Avoidant Personality Disorder:

▸ a pattern of social inhibition, feeling of inadequacy, and hypersensitivity to negative evaluation.

▸ i. Dependent Personality Disorder:

▸ a pattern of submissive and clinging behavior related to an excessive need to be taken care of.

▸ j. Obsessive-Compulsive Personality Disorder:

▸ a pattern of preoccupation with orderliness, perfectionism, and control.

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XV. INSANITY

▸ a. M’Naughten Case (1843)

▸ not guilty of reason of insanity. Insanity is a legal term, not a psychological one.

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XVI. MENTAL ILLNESS IS JUST A MYTH

▸ a. Thomas Szasz

▸ symptoms of mental illness seen as a way to repress people who violate social norms.

▸ Only medical labels used to justify their repression.