Abnormal Psychology and Therapy Project

Abnormal Psychology and Therapy Project By: Victoria Davell, Mary Curtis, Colin Burdette, Anthony Bates, Connor Myers

Abnormal Behavior behavior that is deviant, maladaptive, or personally distressful over a relatively long period of time • deviant- when atypical behavior deviates from what is acceptable in a culture, is considered abnormal (girl washes hands 4 times an hour and takes shower 7 times a day) • maladaptive- maladaptive behavior interferes with a person’s ability to function effectively in the world; behavior that presents a danger to the person or those around him or her • personal distress- the person engaging in the behavior finds it troubling (binge and purging-feels guilty)

only one of the three criteria needs to be present for the behavior to be labeled “abnormal” • when abnormal behavior persists, it may lead to the diagnosis of a psychological disorder http://www.youtube.com/watch?v=0Y8EyIY-_I0

Biological Approach to Abnormal Behavior • attributes psychological disorders to internal causes • focuses on the brain, genetic factors, and neurotransmitter functioning as the sources of abnormality • B.A. is evident in the medical model-psychological disorders are medical diseases with a biological origin abnormalities are called mental illnesses

Sociocultural Approach to Abnormal Behavior • emphasizes the individual’s gender, ethnicity, socioeconomic status, family relationships and culture ex. low-income, high rates of psychological disorders • cultures influence the understanding and treatment of psychological disorders

Biopsychosocial Model • many interacting factors from each of the domains of experience determine if disorders develop or not • biological, psychological, and social factors are all significant in producing behavior

Classifying Abnormal Behavior • Classifying psychological disorders provides a common basis for communicating • a classification system can also help clinicians make predictions about how likely it is that a particular disorder will occur, which individuals are most susceptible to it, how the disorder progresses, and what the outcome for treatment is • it can also be a comfort to the patient knowing that their disorder has a name • on the other hand, have a name for a disorder might create stigma, or make the person feel ashamed

DSM-IV (V) Diagnostic and Statistical Manual of Mental Disorders -it is the major classification of psychological disorders in the U.S. -published first version in 1952 and the latest revision was last year, known as the DSM-V -first one listed 112 disorders; DSM-IV includes 374

DSM-IV (V) -classifies individuals on the basis of five dimensions, or axes, that take into account the individual’s history and highest level of functioning in the previous year Axis I: All diagnostic categories except personality disorders and mental retardation Axis II: Personality disorders and mental retardation Axis III: General medical conditions Axis IV: Psychosocial and environmental problems Axis V: Current level of functioning

Critiques of the DSM-IV • it continues to reflect the medical model, which is independent from environmental factors • focuses strictly on pathology and problems • use people-first language like saying “a person with schizophrenia” instead of “schizophrenic” • emphasizes strengths as well as weaknesses

Disorders include... Anxiety disorders Somatoform disorders Factitious disorders Mood disorders Eating disorders Personality disorders

Anxiety Disorders • anxiety disorders- Psychological disorders involving fears that are uncontrollable, disproportionate to the actual danger the person might be in, and disruptive of ordinary life. • 5 types of anxiety disorders include: Generalized anxiety disorder, panic disorder, phobic disorder, OCD,and PTSD • anxiety disorders can disrupt motor tension, hyperactivity, and apprehensive expectations or thoughts.

Are Psychological Disorders a Myth? • Psychological disorders are indeed real • The treatment of psychological disorders is highly criticized • Thomas Szasz said that psychological illness should be labeled “problems of living” • If a persons bizarre beliefs do nothing more than offend or frighten other people, what right do we have to label him “mentally ill” and to administer drugs to him • EX: ADHD diagnosis. are parents, teachers, and psychiatrists just labeling normal childhood behavior as being caused by ADHD (just for the record yes ADHD is a real psychological disorder not a myth and is recognised as such)

Generalized Anxiety Disorder (GAD) -A psychological disorder marked by persistent anxiety for at least six months and which the individual is unable to specify the reasons for the anxiety. -symptoms: constantly nervous, worry about work, relationships, or health, leads to physical fatigue, muscle tension, insomnia, and stomach problems

case study:A recent 2005 case study on a woman (Nancy) with GAD was found. Nancy from a young age suffered from separation anxiety and shyness manifesting in elementary school. Her anxiety got much worse when at the age of 18 she left home and enrolled in college. Nancy sought help at the universities health center and was given a prescription for diazepam which she took for the next 4 years as-needed. After a breakup with her boyfriend Spring of her freshman year she fell into depression again and was prescribed imipramine, which she discontinued after a couple of months due to the side affects. She was persistently plagued with anxiety associated with insomnia, irritability, tension, and fatigue. Her husband reported that her constant anxiety was “exhausting” and that he noticed himself withdrawing from her, causing some significant tension between them. She performed very well at work and due to her high quality of work she was well compensated financially, however she still constantly worried about her performance. She was even passed over for a promotion to team leader because her constant anxiety made everyone else too nervous. In the last 25 years she has had 5 or 6 episodes of depression lasting from 3 to 4 months to over a year sometimes but not always due to situational stressors. Videohttp://www.youtube.com/watch?v=IaPN9KQoYbs

Treatment/seeking help for GAD • muscle relaxation • deep breathing • meditation • healthy eating • regular exercise • MOST IMPORTANTLY SEE A DOCTOR!!!

Panic disorder • An anxiety disorder in which the individual experiences recurrent, sudden onsets of intense apprehension or terror, often without warning and with no specific cause • symptoms: extreme shortness of breath, chest pains, trembling, dizziness, and feeling of helplessness

Case Study: Janet had her first extreme panic attack at 43, it was only the beginning. She had a second attack while on the road with her husband that was so bad he pulled over and called 911. Janet saw practically every doctor she could to find out what was wrong with her, the attacks even became so bad that she didn’t leave the house for almost anything at all. Janet then was convinced by her husband to go see his doctor who pinpointed the exact cause of the panic attacks and in a short while she was back to normal. This was actually really interesting with what the cause was so if your name is Mr.Schlecht click on this link to read about it its really neat: http://www.vitamincoach.com/index.php?option=com_content&view=article&id=37&Itemid=10

Treatment of Panic Disorder • therapy sessions • cognitive behavioral therapy • avoid smoking and caffeine • learn to control breathing

Phobic Disorders • anxiety disorders that are characterized by an irrational, overwhelming, persistent fear of a particular object or situation • symptoms- a situation is dreaded to such a point that one will go to almost any length to avoid it - inability to do certain things due to the extreme fear • Unlike GAD the cause of a phobic disorder can be pinpointed

Case study: Jim was a man in his thirties, who had a social phobia. His wife did almost all things that required social interaction including ordering fast food. Jim had been like this since he was little. The only time Jim was ever social was at his job where he needed to be. At his job Jim was a manager, and often had to make phone calls, to him this was dreadful, his voice would be shaky and weak, and if the customer didn’t understand him the first time, he would have to repeat it and to him it was horribly embarrassing. All the while his wife would allow him to be unsociable at restaurants etc. Jim had no friends of his own aside from the couples his wife knew from work. Due to Jim’s constant self-negativity that he would never do well in a social situation, he did just that, his negativity fueled the fire that was his social anxiety. The way Jim was treated was by putting him in a social situation and rather than worrying about not goofing up and not being awkward, but rather over exaggerating and, trying to be awkward and goof up even to the extent that Jim thought it was funny. VIDEO:http://www.youtube.com/watch?v=XbXlgNhWbxA

Treatment for Phobic disorders • Exposure (facing your fears) • Relaxation techniques • pharmacotherapy • psychotherapy

OCD obsessive-compulsive disorder • OCD- An Anxiety disorder in which the individual has anxiety provoking thoughts that will not go away and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation. • Some symptoms are: Excessive checking, cleansing, and counting • most individuals do not enjoy their ritualistic behavior but feel extraordinarily anxious when they do not carry it out.

Case study:Bess is a 27 year old, that suffers from OCD. She was raised by her single mother as her parents were divorced. Bess’s mom spent time with her and loved her but when they spent time together her mother would often focus on things she could improve on and emphasize cleanliness and neatness and would nag if things were not in order in her room. She was very successful in school but did not have a social life because she wasn’t very popular with the other kids. When Bess went to college she became sexually involved with someone who within a few weeks got her pregnant, her mom in turn forced her to get an abortion. She became very anxious about relationships, starting a family and getting married. She then concentrated even more so on work and eventually developed a thorough cleansing ritual much like that of her mother. Video:http://www.youtube.com/watch?v=KOami82xKec

treatment for OCD • see a properly trained therapist • Cognitive behavior therapy • medicine • DOCTOR!!

Post-Traumatic Stress Disorder(PTSD) • an anxiety disorder that develops through exposure to a traumatic event that has overwhelmed the individuals ability to cope • symptoms - uncontrolled flashbacks to the event, reduced ability to feel emotions, excessive arousal, difficulties with memory and concentration, feelings of apprehension, impulsive outbursts of behavior

Case study:Mick is 41 and was diagnosed with PTSD. He fought in vietnam and while in vietnam he had not cared much, he just followed orders. But he then got sent on a mission to a village where he killed some villagers that were collaborators with the militia. The experience was so traumatic that when he came back he still had the same images from the village stuck in his head. Due to his PTSD he was very irritable, he shouted at his wife, was short tempered with his children and said “Just wanted to lock myself away and draw the curtains”.

treatment for PTSD • Psychotherapy • cognitive behavioral therapy • eye movement desensitization and reprocessing

Personality Disorders Personality disorders are chronic, maladaptive cognitive behavioral patterns that are thoroughly integrated into an individuals personality. In a study of a representative U.S. sample, researchers found that 15% had a personality disorder. The two most studied personality disorders are Antisocial personality disorder and borderline personality disorder. These disorders are associated with consequences such as a criminal activity and violence.

Antisocial Personality disorder ASPD- is a psychological disorder characterized by guiltlessness law-breaking exploitation of others irresponsibility and deceit. Individuals with ASPD do not obey rules and often lead a life of crime and violence. ASPD is far more common in men compared to women and this is related to criminal behavior, vandalism, substance abuse, and alcoholism. Generally ASPD is not diagnosed unless a person has shown persistent antisocial behavior before the age of 15. Not all individuals with ASPD engage in criminal activity some even can have successful careers but still these individuals exploit others and lack empathy. http://www.youtube.com/watch?v=0qyCR9tPDgM

Antisocial Personality disorder Criteria for ASPD include • Failure to conform to social • Deceitfulness, Lying, using aliases or or conning others for personal profit or pleasure. • Impulsivity or failure to plan ahead. • Irritability the aggressiveness, getting into physical fights or perpetrating assaults. • Reckless disregard for the safety of self and others. • Consistent irresponsibility, inconsistent work behavior, not paying bills. • Lack of remorse, showing indifference to pain of others or rationalizing having hurt or mistreated another. Treatments: Psychotherapy for people with ASP should focus on helping the individual understand the nature and consequences of his disorder so he can be helped to control his behavior. Exploratory or insight-oriented forms of psychotherapy are generally not helpful to people with ASP.

Antisocial Personality Disorder Case Study:Ani was referred to therapy by the court, as part of a rehabilitation program. He is serving time in prison, having been convicted of grand fraud. The scam perpetrated by him involved hundreds of retired men and women in a dozen states over a period of three years. All his victims lost their life savings and suffered grievous and life-threatening stress symptoms. He seems rather peeved at having to attend the sessions but tries to hide his displeasure by claiming to be eager to "heal, reform himself and get reintegrated into normative society". When I ask him how does he feel about the fact that three of his victims died of heart attacks as a direct result of his misdeeds, he barely suppresses an urge to laugh out loud and then denies any responsibility: his "clients" were adults who knew what they were doing and had the deal he was working on gone well, they would all have become "filthy rich." He then goes on the attack: aren't psychiatrists supposed to be impartial? He complains that I sound exactly like the "vicious and self-promoting low-brow" prosecutor at his trial. http://www.youtube.com/watch?v=U5MczRcn6Ns&list=UU9CuvdOVfMPvKCiwdGKL3cQ

Borderline Personality disorder BPD- is a pervasive pattern of instability in interpersonal relationships, self-image, and emotions and of marked impulsivity beginning by early adulthood and present in various contexts. Individuals with BPD are insecure, impulsive, and emotional. BPD is related to self harming behaviors such as cutting but without suicidal intent. BPD is more common in women than men, women make up to 75 percent of those with the disorder. Individuals with BPD are prone to wild mood swings and are very sensitive to how others treat them. They tend to see the world in a black and white viewing people as enemies or friends.

Borderline Personality disorder BPD symptoms: • Frantic Efforts to avoid being abandoned • Unstable and intense interpersonal relationships characterized by extreme shifts between idealization and devaluation • Markedly and persistently unstable self image or sense of self • Impulsivity in at least two areas that are potentially self-damaging • Recurrent suicidal behavior gestures or threats of self mutilating behavior • Unstable and extreme emotional responses • Chronic feelings of emptiness • Inappropriate, intense anger or difficulty controlling anger Treatment: Counseling and therapy, Medicines such as antidepressants, mood stabilizers, and antipsychotics.

Borderline Personality disorder Case Study: Even when Jordan was a tiny infant, it seemed that there was something very different about her. She was an intense baby; she seemed to always be easily upset, she didn't adjust very easily to new circumstances, and she was hard to comfort. Her parents assumed that all babies are different, and that this was just a phase. In fact, they knew of plenty of other parents with kids who had started off like this, but that had ended up being easy-going adults. However, as Jordan grew, she didn't seem to "just grow out of it." She continued to be easily upset and difficult to comfort, and she had very severe separation anxiety. If her mother left the room, Jordan would scream until she returned. Still, her parents were not too concerned. Separation anxiety is pretty typical for kids to go through. And Jordan had so many sweet qualities; at times she could be the most loving child. They often had really wonderful times together. http://bpd.about.com/od/livingwithbpd/a/case1.htm

Dissociative Disorders • Dissociative amnesia • Dissociative fugue (fugue means flight) • Dissociative identity disorder

Dissociative Amnesia • Definition- Dissociative disorder characterized by extreme memory loss that is caused by extensive psychological stress • Symptoms- Aspects of own identity and autobiographical experiences forgotten (things like how to use a phone are not forgotten)

Dissociative Amnesia Case Study A 28 year old women had given birth to her sixth child four months before. After giving birth to the child, the family noticed that the mother did not acknowledge the child as her own. She did not remember giving birth at all. Her family advised her to still take care of her child so she did even though she did not believe she gave birth to it. The women was given sodium pentathol or “truth serum” (it renders people talkative and likely to share information) and she described how she did not want to continue her pregnancy, but her husband refused to give consent to an abortion. She was under great stress and was physically drained by the pregnancy. She eventually recovered her autobiographical memory through hypnosis and memory exercises.

Dissociative Amnesia Treatment • In the case study hypnosis and memory exercises helped the women recover her autobiographical memory • Treatment usually depends upon the individual • Treatments include • Psychotherapy-encourages communication of conflicts • Cognitive therapy-changing dysfunctional thinking patterns • Medication-no medication itself but helps with depression • Family therapy-help recognize symptoms • Creative therapies (art therapy, music therapy)-express feelings • Clinical hypnosis-allows people to explore thoughts in collective unconscious

Dissociative Fugue • Definition- Dissociative disorder in which the individual not only develops amnesia but also unexpectedly travels away from home and sometimes assumes a new identity • Symptoms- Same as dissociative amnesia but also involves a tendency to run away

Dissociative Fugue Case Study Recently there has been a case study of a middle school teacher in New York City. Hannah Up a 23 year old disappeared while out on a run on August 28, 2008. Her family, friends, and roomates put flyers around the city and messages on the internet. On September 16 she was found floating face down in the New York harbor. She was sunburned and dehydrated, but alive. She had no recollection of her experiences. She remembered going out for a run and then all of a sudden she was being pulled in from the harbor. She still does not remember anything that happened to her in those two and a half weeks. At one point she was approached by a man asking if she was the women everyone was looking for and she said no.

Dissociative Fugue Treatment • Goal is to help the person come to terms with the stress that caused the fugue • Depends on the individual • Treatments include • Psychotherapy-encourages communication of conflicts • Cognitive therapy-changing dysfunctional thinking patterns • Medication-no medication itself but helps with depression • Family therapy-help recognize symptoms • Creative therapies (art therapy, music therapy)-express feelings • Clinical hypnosis-allows people to explore thoughts in collective unconscious

Dissociative Identity Disorder • Definition- Formerly called multiple personality disorder, a dissociative disorder in which the individual has two or more distinct personalities or identities each with its own memories, behaviors, and relationships • Symptoms- Wall of amnesia separates different identities, research suggests that memory does transfer across different identities.

Dissociative Identity Disorder Case Study The most famous case study involves the “three faces of Eve.” Eve White was the original personality. Eve had no knowledge of her second personality, Eve Black. Eve White was very serious and quiet, but Eve Black was carefree and mischievous. Eve Black would emerge at inappropriate times and leave Eve White with hangovers, and unexplainable reputations in local bars. During Eve’s treatment Jane, the third personality emerged. Jane was more mature than the other two and developed as a result of the therapy. http://www.imdb.com/video/screenplay/vi751895577

Dissociative Identity Disorder Treatment • Long term treatment is successful if patient stays committed • Treatment includes • talk therapy or psychotherapy-encourages communication of conflicts • medications-antidepressant or anxiety • hypnotherapy • adjunctive therapies (art or movement therapy)

Therapy- Antianxiety Antianxiety drugs: Commonly known as tranquilizers, drugs that reduce anxiety by making the individual calmer and less excitable. Benzodiazepines: anti anxiety drugs that that generally offer the greatest relief for anxiety symptoms • fast-acting medication • Most Frequently prescribed: include Xanax, Valium, and Librium • side effects: drowsiness, loss of coordination, fatigue and mental slowing. Nonbenzodiazepines: commonly used to treat generalized anxiety disorder • Must be taken 2 to 3 weeks to feel some benefit • Frequently prescribed: Buspirone and BuSpar

Therapy- Antianxiety • Antianxiety medications are best used only for temporary symptomatic relief. • Often overused and can become addictive

Therapy- Antidepressant antidepressant drugs: drugs that regulate mood Four main classes of antidepressant drugs include: 1. tricyclics (ex. Elavil)- • shown to reduce the the symptoms of depression in approximately 60% to 70% of cases • usually take two to four weeks to improve mood, • Side Effects include restlessness, faintness, trembling, sleepiness, and memory difficulties. 2. Tetracyclics (Ex. Avanza)- • Also called noradrenergic and specific serotonergic antidepressants, or NaSSAs. • Proven to be most effective in reducing depression than any other antidepressant drug.

Therapy- Antidepressant 3. Monoamine Oxidase (MAO) inhibitors (Ex Nardil) • Not widely used because they are potentially harmful to an individual's body • Risky because of their certain interactions with fermented food (such as cheese), and drugs. • Interactions could possibly lead to high blood pressure and risk of stroke 4. Selective Serotonin Reuptake Inhibitors (Ex. Prozac) • Increasingly being prescribed by Psychiatrists and general practitioners • widely prescribed: Prozac, Paxil and Zoloft • Side effects: Insomnia, anxiety, headaches. Also can impair sexual functioning and produce severe withdrawal symptoms when abruptly stop taking them.

Therapy- Antidepressant • # of Americans who have ever been prescribed an antidepressant has doubled between 1996 and 2005 - with 10% of Americans taking an antidepressant at some point in their life • Antidepressant drugs are also effective for a number of anxiety disorders, including generalized anxiety disorder, panic disorder, obsessive compulsive disorder (OCD) , social phobia, post traumatic stress disorder, and some eating and sleep disorders. - Antidepressants are also prescribed for sleeplessness and chronic pain Critical controversy: It is still debated to whether these type of drugs are included in suicide; Prozac is the only known drug that isn't involved.

Abnormal Psychology and Therapy Project