Abnormal Psychology

1. Abnormal Psychology Studying disorders of the brain that disrupt feelings, thinking, mood, ability to relate to others and behavior Bio psychosocial Model

2. How do you know you have a mental illness? AXIS I: Current clinical syndrome (focus) AXIS II: Personality disorder/Intellectual delay AXIS III: General medical condition AXIS IV: Life problems (legal, family, etc.) AXIS V: Global functioning scale (0-100) Diagnostic Statistical Manual 1st Edition: 1952- had 120 disorders 5th Edition: May, 2013- will have greater than 375 disorders No classification system is 100% Multi Axis System

3. The “other” criteria…… • The behavior is disturbing to others • The behavior violates cultural standards • The behavior is disturbing to the individual • The behavior is irrational or indefensible • The behavior is maladaptive

4. Be Cautious with labels….Labels hurt people Do these “labels” cause more harm then good? David Rosenhan study.

5. Anxiety • Anxiety is the body’s reaction to stress • Anxiety is universal • Flight-Fight-Fear-Faint • Each person responds to anxiety differently • All ages • Symptoms: Some we feel, some we cannot feel, some are chronic • Multiple treatments available- Cultural differences in symptoms and treatments

6. Phobia= Intense, irrational fear that interferes with everyday activities. • Fear can be of objects or events • Can have fear of fear (panic) • Most common phobia= Social Phobia (13% in lifetime, 8% within past year) • Early childhood fears frequently disappear without treatment. (study of 482 children; 40% have 7+ fears) • Phobias in children that continue until adulthood rarely disappear without treatment

7. Agoraphobia= Fear of open spacesGreek translation= fear of the marketplace • Cause is unknown • Typically begins after a stressful experience or change • Begins with panic attack that is not associated with the earlier stressful event • Increases in panic • Lose freedom to move around- some become isolated

8. Phobia Causes Treatment Desensitization Therapy Anxiety medication Over exposure • Genes • Classical conditioning • Overactive Limbic system • Misinterpretation of body signals

9. Panic=Intense anxiety NOT activated by an even or object • Attack comes on suddenly • Attack reaches peak within minutes (lingering effects can last several hours) • Unpredictable (some exceptions) • Symptoms: racing heart, chest pain, sweating, dizzy, feeling of unreality, fear of loosing control, tingling, feeling of dying, feel they are loosing mind, oxygen drowning) • Onset: 25% of population will experience at least one panic attack. Typical onset is mid-late teens, early 20’s. • Effects more women than men (2x) • 3% of US population has panic diagnosis. (1.2% severe) • Approximately 20% of people with panic will experience depression during lifetime.

10. Panic Causes Treatment Chemical benzodiazepine (short vs. long term) SSRI Cognitive/Behavior Talk therapy(change thinking) with desensitization techniques. (high success rate) Acceptance based therapy • Genetic Influence (increases with immediate family member) • Learned-Cognitive & Behavioral

11. Obsessive-Compulsive Disorder/OCD= Unwanted, repetitive thoughts, ideas, images (obsessions) that cannot be prevented without engaging in specific behaviors (compulsions) Compulsions= in the beginning they reduce anxiety- stop working Obsessions= Come from what you care about- cause anxiety Common Thoughts Germs Dirt Something undone Violence Religion Health May not know where the anxious thoughts come from Common Behaviors • Need to touch, tap, rub, count, check, clean • Mental rituals • Superstitious behavior • Excessive list making • Trichotillomania • Hoarding/collecting

12. Who has OCD? • Many/most have some symptoms of OCD (1-3% lifetime) • 2-3% (1 in 50) are diagnosed with OCD • Ratio boys/girls about the same • Typically begins in adolescent/young adults • Typically begins after a very stressful event • Y-BOCS Checklist (over 16) used for diagnosis

13. OCD Causes Treatment • Brain dysfunction: cingulate gyrus, basil ganglia, thalamus (create trouble regulating impulse control) • Reduced serotonin • PANDAS (age 3-puberty) • Classical Conditioning • Genes (none identified- strong family relationship)

14. Treatment • SSRI (anti-depressant/anxiety) • Cognitive Behavior Therapy • Psycho Surgery

15. Post Traumatic Stress Disorder (PTSD) Persistent re-experience of a traumatic event(s) in thoughts/dreams- Natural or unnatural events • Difficulty sleeping • Outburst of anger • Irritability • Difficulty concentrating • Depression • Recurring nightmares • Intrusive thoughts • Alcohol/drug abuse

16. Not all persons that experience trauma develop PTSD- Why? • Social Support (Vietnam vs Sept. 11th) • Coping strategies • Some personality characteristics increase likelihood- such as passive, sensitive

17. Treatment • SSRI (anti-depressant/anti anxiety) • Cognitive-Behavior Therapy (based on the idea that anxiety comes from a misinterpretation of bodily sensations AND the person has not found healthy ways of coping to stresses in life) • Eye Movement Desensitization Therapy • Rational Emotive Behavior Therapy (Albert Ellis) Focus on changing irrational beliefs • Exposure therapy • Antibiotic

18. Dissociative Disorders...Controversial/Rare • Dissociative Identify Disorder (formerly multiple personality disorder) • Dissociative Amnesia • Dissociative fugue Disorders of identify or sense of self. Involve memory loss and trauma

19. Somatoform Disorders • Conversion disorder • Hypochondriasis Physical symptoms without apparent physical cause