Psychopathology

1. Psychopathology Reasons for Studying Abnormal Behavior Prevalence – estimates of 10% to 20% of American population will require hospitalization or treatment for psychological disorder at some point in their life. In-patient populations have declined dramatically over the last 50 years Probably due almost exclusively to the development of psycho-active drugs which can control symptoms

2. Psychopathology Reasons for Studying Abnormal Behavior Prevalence Insight into Normal Behavior – Even if our primary interests are in normal behaviors, we can gain insight into how behavior normally works by looking at how behavior may break down

3. Indicators of Abnormality Statistical – abnormal behaviors are any behaviors that deviate from what an average (or “normal”) person might display. Legal – definitions of what constitutes abnormality developed by legislators shaped by public opinion. Psychological Indicators of Abnormality Indisposition – is the individual uncomfortable with their own behavior (physical discomfort, emotional discomfort, cognitive disturbance) Bizarreness – does the individual display behavior patterns which deviate sharply from others Cultural Relativism – Nonconformity Failures to Correspond Behaviors to Reality Hallucinations – failures of perception Delusions – misinterpretation of events (misbeliefs) Disorientation – loss of contact with surroundings or identity Inefficiency– individual fails to live up to potential, unable to accomplish

4. Classification of Abnormal Behaviors American Psychiatric Association – has promulgated a system of classification called DSM-4 (Diagnostic and Statistical Manual of Mental Disorders). Normal Well-Adjusted Behavior Neurotic Behavior Psychotic Behavior Positive Highly-Adaptive Behavior Exaggerated, Driven, Anxiety Plagued Unrealistic, Disconnected, Dangerous

5. Neurosis • Broad array of psychological problems which are characterized by nonsevere but exaggerated patterns of behavior. • Anxiety is almost always one of the symptoms • Neurotics are generally able to function in society (noninstitutionalized, often nontreated). • Symptoms can occur at any age but are most common between the ages of adolescence and age 30.

6. Generalized Anxiety Disorder This condition is characterized by a vague, persistent fear or uneasiness which is not tied to any specific situation. “Free-Floating Anxiety” Individual feels as though there is some dire event impending but does not know what it is. Physical symptoms may include perspiration, blushing, diarrhea, palpitations of the heart, pressure in the chest, breathlessness, loss of appetite or exaggerated appetite, weakness, fatigue, pain in neck or shoulders, dizziness, tremors Accompanying psychological symptoms might include inability to concentrate, irritability, excitability, and depression.

7. Most Widely Prescribed Anti-Anxiety Medications SSRI (selective serotonin reuptake inhibitors) Prozac, Paxil, Zoloft, Lexapro and Celexa SNRI (serotonin norepinephrine reuptake inhibitors) Effexor and Cymbalta. Benzodiazepines used to be the most prescribed anti-anxiety medicine, but their addictive nature generated too much public backlash. Valium and Xanax

8. Phobia This condition is characterized by a strong and irrational fear of objects or situations which are usually not thought of as frightening. Anxiety is highly specific. Some of the most common phobias: Claustrophobia (enclosed spaces) Zoophobia (animals) Acrophobia (heights) Hydrophobia (water) Agoraphobia (social situations)

9. Panic Disorder A panic Disorder is characterized by recurrent attacks of overwhelming anxiety that usually occur suddenly and unexpectedly. Most likely to occur in situations where we lose our ability to control our own immediate fate. (Boarding an airplane, being stuck in an unmoving stream of traffic, being crushed into a crowd of people).

10. Obsessive-Compulsive Disorder Obsession is a recurrent thought that an individual can not put out of his mind, even though, the person may be troubled by the thought. Compulsion is where an individual feels compelled to perform an act repeatedly, even though the act is senseless, doesn’t accomplish anything useful, or even is repugnant. Many compulsions take the form of ritualistic behaviors (avoiding germs, hand washing, kleptomania, pyromania). People with this disorder often come to feel as though they have lost control of their own minds or actions.

11. Somatoform Disorders Hysteria (Conversion Reaction) - Disorder where some system or part of the body stops working properly in the complete absence of any physiological condition. (Hysterical Blindness, Hysterical Crippling, Hysterical Muteness). Hypochondriasis is an abnormal preoccupation with one’s health. The person complains of one ailment after another, visits one physician after another. Symptoms have no physical basis. Neurasthenia is where the person has extreme chronic fatigue, fearing one disease after another that might account for the condition.

12. Dissociative Reactions Disorders where one part of the personality become dissociated (or disconnected) with other parts. Psychogenic Amnesia – person loses sense of identity and ability to recall his past Fugue – Amnesia coupled with flight. Person relocates to somewhere they are unknown and creates a new identity for himself Multiple Personality Disorder – individual displays two or more well organized personalities that function independently of each other. These personalities usually differ from each other in important respects. An extremely rare disorder.

13. Affective Disorders (Mood) • Major Depressive Disorder – persistent feeling of extreme despondency or despair and a loss of interest in previous sources of pleasure. • The most common treated psychological disorder (1/4 of all women and 1/8 of all men may experience). • Bipolar Disorder (Manic-Depressive Disorder) – periods of depression are interspersed with episodes of mania (euphoric optimism and excitement).

14. Psychotic Disorders • The most serious forms of psychological disturbance. The most extreme and dramatic departures from normal behavior. • - Psychotics are likely to be severely detached from reality (often confuses internal feelings and memories with the perception of the outer world • Most institutionalized patients have been diagnosed as psychotic. • Individual has no insight into the fact that their behavior is abnormal or irrational • No Anxiety present • Interference with normal thought processes is present to some degree (may range from an inability to speak to an irrational mode of thought)

15. Psychotic Disorders • Schizophrenia is the most frequent form of psychosis, 70% of all institutionalized patients are classified as schizophrenic. • A family of disorders marked by delusions, hallucinations, disorganized speech, and deterioration of adaptive behavior • Simple Schizophrenia is characterized by a progressive deterioration in normal functioning and a gradual withdrawal from reality. Individual becomes hermit-like, no need for social interaction. Hebephrenia – individuals appear to be immature and childish, giggling, silly mannerisms, emotional responses that are inappropriate to the circumstances. Display a symptom called “word salad” where words are spoken without any apparent coherence or logical connection. In the hebephrenic, virtually all aspects of the personality and the intellect are jumbled. He jumps from word to word or image to image with little unification of words or ideas.

16. Psychotic Disorders Paranoid Schizophrenia is characterized by an array of hallucinations and delusions, but unlike the jumble of the hebephrenic, these are well-organized into one or more unifying themes. Four common delusions: Delusions of Persecution – the paranoid believes that some person or group is determined to bring about his destruction, downfall, or death Delusions of Self-Reference – the individual believes that anything going on around him, no matter how coincidental or apparently unrelated, actually is directed at or refers to him Delusions of Control – the individual may see his behavior as subject to the control of external forces – electric currents, radio transmissions, brain implants, voices, demons, God Delusions of Grandeur – the person believes himself to be more gifted, famous, influential, important than others (“chosen”) These delusions are usually coupled with hallucinations which are typically auditory. The voices direct his actions and warn of dangers that must be responded to. Paranoid Schizophrenic is the most dangerous of all psychotics (mass murders).

17. Psychotic Disorders Catatonic Schizophrenia is a disorder focused on the mobility of the subject. Peculiar postures or gestures are repeated endlessly. Catatonic Stupor – patient assumes one position and maintains it for prolonged periods (hours). During the stupor, patient is mute and seemingly unaware of any activity around him. However, afterward patients can relate in great detail what occurred around them. “Waxy Flexibility” is characteristically displayed. Catatonic Excitement – extremely brief but very violent outburst of energy coupled with hallucinations and feelings of great power.