Abnormal psychology

1. Abnormal psychology

2. In Ancient times, disorders were thought to have been caused by movements of the sun and moon (lunacy is full moon) or by evil spirits. Treatments for people with mental illness were very inhumane even up until the mid 1900’s. Patients were often chained like animals, beaten, burned, castrated, etc. History of Understanding Psychological Disorders

3. Conditions for Psychologically Disabled European Trephines “released evil spirits.” Ancient Greek Trephines

4. Conditions for Psychologically Disabled

5. Eventually the medical model came to dominate understandings of mental illness. The medical model assumes that diseases have physical causes that can be diagnosed based on their symptoms and be treated and in most cases cured. Assumption of medical model drastically improves conditions in mental hospitals. BUT, the medical model often times promotes the myth that disorders are brought on by single causes. Medical Model Improves Conditions

6. Starting in the 1950s and 1960s more and more drugs began being used to “cure” psychological disorders. Because of this there was a policy of deinstitutionalization instituted where patients were removed from mental institutions to live in family based or community based environments. Historical Trend of Deinstitutionalization

8. Atypical (deviant) Disturbing (distressing) Maladaptive (dysfunctional) Unjustifiable Psychological DisordersPsychological behaviors run a continuum from very mild to extreme. Everyone has these behaviors to one degree or another. It is not until a behavior or feeling interferes with your quality of life that they become a disorder.Psychological Disorders are:

9. What is “insane”? Insanity is a legal definition, not a psychological one. The term of insanity is applied to someone who is incapable of determining if an act is wrong and cannot control their behavior. The insanity defense is rarely used – just 0.9% of the time (9 times in 1000). The success rate is less than 20% of the time it is used. People who are declared not guilty by reason of insanity generally spend more time institutionalized than they would have been imprisoned. Being declared insane is not the same as being declared not competent to stand trial – this simply means you are unable to understand the charges against you and the proceedings of the court (could apply to very young children, for example).

10. Defining DisordersDSM IV-Diagnostic and statistical manual vol. 4.: attempts to describe psychological disorders, without explaining the causes, predicts the future course, and suggests treatments. It focuses on observable behaviors to make diagnoses. Categorizes 400+ disorders, in 17 categories. Axis I: refers to clinical disorders which need clinical attention. Includes most mental disorders Ex: Depression, Schizophrenia, Phobia, etc. Axis II: Includes personality disorders and mental retardation. Ex: Antisocial, Narcissistic, Avoidant, etc. Axis III: relates to physical conditions which may contribute to mental illness. Ex: brain injury, cancer, HIV, etc. Axis IV: relates to psycho-social events in a persons life which may contribute to mental illness. Ex: death of a loved one, divorce, new job, etc. Axis V: relates to a rating clinician gives patient on how well they are functioning in life presently and within the last year.

11. Advantages of Diagnosis and the DSM-IV • Diagnosis can facilitate communication • Diagnosis can provide etiology (study of causation) clues • Diagnosis provides prognosis (likely outcome) • Diagnosis can give direction for treatment plans Disadvantages of Diagnosis and the DSM-IV • Diagnosis is not theoretically neutral • No clear line between normal and abnormal in many cases • Reliability is still a problem (if 5 psychologists examine a patient will they all come up with the same diagnosis?) • Diagnostic labels may take on a life of their own and are hard to remove – LABELING THEORY – Rosenhan – this can lead to self-fulfilling prophecy.

12. Description of Rosenhan’s study: He had colleagues attempt to fake symptoms to get into mental hospitals. Each pseudopatient told the hospitals they had been hearing voices. Apart from that they told no lies other than fake names, addresses, etc. After being admitted, the fake patients acted completely normal. Hospital staff failed to identify the fakers and interpreted all of their normal behavior in terms of mental illness. Ex: guy taking notes was said to have “writing behavior” which seemed pathological. What does this say about the impact of labeling? David Rosenhan Tests Power of Labeling and Its Reliability

13. Psychological Disorders: Causes Are not usually caused by a single factor. The bio-psycho-social school argues that most disorders are caused by a biological predisposition, physiological state, psychological dynamics, and social circumstances.

14. + = DISORDER Biological / genetic predisposition Stress (environment) The diathesis-stress model The model looks at the diathesis or genetic/biologic vulnerability to a disorder/disease and the stress(or)s that may trigger it. The diathesis-stress model uses the analogy of a "walking time bomb" to help explain why, for example, not 100% of identical twins both get schizophrenia. It also helps to explain why a large percent of people in traumatic situations (post 9/11, rape, etc.) never develop PTSD. The model further talks about a balance -- the greater the diathesis or predisposition, the less the stress required for the disorder to "appear" and visa versa. 

15. Biological (Evolution, individual genes, brain structures and chemistry) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Sociocultural (Roles, expectations, definition of normality and disorder) Bio-Psycho-Social Perspective: assume biological, psychological, and socio-cultural factors interact to produce disorders. Most Mental Health Professionals Assume Disorders Have Interlocking Causes

16. Categories of Disorder: 1. Anxiety 2. Mood 3. Dissociative 4. Schizophrenia (No Need in IB) 5. Personality 6. Somatoform (Not in Book) 7. Facticious (Not in Book) WHAT are the Categories DISORDERs FIT INTO?

17. Anxiety Disorders Anxiety Disorders in general refer to disorders that involve persistent and distressing nervousness and apprehension OR maladaptive behaviors which reduce anxiety (defenses against anxiety). General Characteristics of Anxiety: • Constant worrying, fear, or uncertainty • Feels inadequate • Oversensitive • Difficulty concentrating • May suffer insomnia

18. Anxiety Disorders General Anxiety Disorder: person is tense, apprehensive, and in a state of autonomic nervous system arousal (Sympathetic N.S.). Persistent symptoms: sweating, heart racing, dizziness, shaking accompanied by persistent negative feelings and fear…not triggered by specific events.

19. Anxiety Disorders Panic Disorder: unpredictable, minutes long intense anxiety attack, as if you're going to be killed any second, but no specific, real threat is apparent. “Panic Attacks.” Usually accompanied by chest pain or other frightening sensations.

20. Anxiety Disorders Obsessive-Compulsive Disorder (OCD): Obsessions: intrusive thoughts or fears. Compulsions: repetitive behaviors that soothe the fears example of OCD ritual behavior “As Good As It Gets”

22. Phobias: Anxiety Disorders i. Specific: persistent, irrational fear of a specific object of situation. Very common. Spiders, snakes, heights, water, enclosed spaces are all very common phobias. ii. Social: Fear of being embarrassed in public. Example: public speaking • iii.Agoraphobia: Fear of public spaces • Copycat – Sigourney Weaver

23. Anxiety Disorders Phobias:

24. Specific Phobias • Triskaidekaphobia

25. Phobias • Santa Claustrophobia

26. Phobia • Trichophobia

27. Anxiety Disorders Post Traumatic Stress Disorder (PTSD): caused by prolonged or intensely stressful situations, like war or rape. Symptoms: difficulty sleeping, nightmares; anxiety attacks or Generalized Anxiety Disorder (GAD); intrusive memories; Guilt associated with event; US Military awareness campaign- PTSD& mTBI (mild traumatic brain injury)

28. Anxiety Disorder (NOT IN BOOK) Tourette’s Syndrome: involves involuntary twitching and the making of unusual sounds. dopamine which helps control movement and norepinephrine, which helps body respond to stress seems to be involved in Tourette’s Syndrome. Marc Elliott – Tourette’s Tolerance

29. Causes of Anxiety Disorders from Learning Perspective (Behavioral) 1. Fear Conditioning :ex: rape victim may develop fear of being alone in apartment. 2. Stimulus Generalization: ex: fear of heights leads to fear of flying even without flying. 3. Reinforcement (ENCOURAGES behavior): avoiding places you have phobia about rewards you by lessening your anxiety. 4. Observational Learning/Modeling ex: monkeys with snakes.

30. Causes of Anxiety Disorders from Biological Perspective 1. Evolution: certain fears help us survive. 2. Genes: correlations with identical twins and phobias. 3. Physiology: brain chemistry. Often see increased brain activities in brain areas involving impulse control. Ex: picture overactive frontal lobe activity involved in directing attention.

31. Causes of Anxiety Disorders from Cognitive Perspective • An individual interprets (or misinterprets) a harmless situation as a dangerous or threatening situation.

32. Somatoform Disorders: Various disorders that have no medical cause They must happen before age 30 – rules out aches and pains of aging. Examples: Conversion Disorder: A person develops symptoms such as paralysis, numbness or blindness. Yet, there is no medical reason for the symptoms. Hypochondriasis: Preoccupation or worry about having a serious illness ex. My headache is a sign I have a brain tumor. Somatization Disorder: Repeated complaints about vague and unverifiable medical conditions: dizziness, nausea, conscious awareness of an irregular heartbeat (too fast, too slow, etc).

33. The disorders are repressed emotions that get transformed into physical symptoms Causes of Somatoform Disorders from the Psychoanalytic Perspective

34. Operant conditioning is responsible because the patient gets rewarded for his/her complaints (medicine, attention) Causes of Somatoform Disorders from the Behavioral Perspective

35. Patients pay too much attention to their health which results in sensations that are more easily perceived (patients notice every little ache or spot on their skin, etc.) Causes of Somatoform Disorders from the social cognitive Perspective

36. Dissociative Disorders Dissociation is the feeling that you are outside of yourself, looking at yourself. That your mind is separate from your body. A person’s memories and emotions are somehow separated from his/her conscious awareness. This is a controversial disorder. Many experts do not believe it is real. Dissociative Amnesia Selective memory loss of a specific traumatic event (not a brain injury). The amnesia vanishes as abruptly as it begins and rarely reoccurs. Ex. A woman who gives birth to a stillborn baby might not remember that she was even pregnant.

37. Dissociative Disorders Fugue-state This type of dissociation involves a person who just leaves one’s home and starts on new life, with no memory of one’s past life. The memory may reoccur and the person may return home, only to leave again. Dissociative Identity Disorder: This is a disorder wherein your mind partitions itself into two or more distinct personalities that may or may not know about each other. One “personality” emerges to handle stressful situations that the whole psyche or other parts cannot handle. Caused by traumatic event or events where the mind represses parts of itself that can’t handle the pain. Repressed from a psychoanalytical point of view.The Debate Over Multiple Personalities (DID)

38. Repression of a traumatic event Causes of Dissociative Disorders from the Psychoanalytic Perspective

39. Psychotic Period In any given 1-year period, 9.5% of the population, or about 18.8 million American adults, suffer from a depressive illness. Mood Disorders

40. depression • A depressive disorder is an illness that involves the body, mood and thoughts. • It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. • Nearly everyone will experience at least some type of mild depression in their life often due to some external sad event. • A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. • People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

41. symptoms of depression • Persistent sad, anxious, or "empty" mood • Feelings of hopelessness, pessimism • Feelings of guilt, worthlessness, helplessness • Loss of interest in hobbies and activities that were once enjoyed • Decreased energy, fatigue, being "slowed down” • Difficulty concentrating, remembering, making decisions • Insomnia, early-morning awakening, or oversleeping • Changes in appetite and weight loss or weight gain • Thoughts of death or suicide; suicide attempts • Restlessness, irritability • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

42. types of mood disorders • Major Depressive Disorder • Combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. • Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. 5 (or more) of the symptoms have been present during the same 2-week period • Dysthmia • A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives. Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Less severe than major depressive disorder.

43. gender differences in rates of depression • Women experience depression about twice as often as men. • Although men are less likely to suffer from depression than women, 3 to 4 million men in the United States are affected by the illness. Men are less likely to admit to depression, and doctors are less likely to suspect it. • The rate of suicide in men is four times that of women, though more women attempt it. In fact, after age 70, the rate of men's suicide rises, reaching a peak after age 85.

44. Around the world women are more susceptible to depression 20 15 10 5 0 Percentage of population aged 18-84 experiencing major depression at some point In life USA Edmonton Puerto Paris West Florence Beirut Taiwan Korea New Rico Germany Zealand Gender and Depression

45. 10% 8 6 4 2 0 Percentage depressed Females Males 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+ Age in Years Gender and Depression

46. explaining depression • Psychoanalytic • Negative events that occur in adulthood evoke memories of childhood traumas OR unresolved anger or sadness in your unconscious from your childhood are turned inward. • Social-cognitive • “attributional theory” • the depressed person tends to think: internal • ("it's my fault"), • stable • ("things can't change") • global • ("this affects everything") • Biological • Norepinephrine • Serotonin • (people suffering from depression tend to have low levels of both of these neurotransmitters) • Genetics • (if an identical twin suffers from major depressive disorder or bipolar disorder the chances that the other twin will experience symptoms is higher than those with a fraternal twin who is suffering) • Behavioral • Learned helplessness

47. symptoms of bipolar disorder • Cycling mood changes: severe highs (mania) and lows (depression) • Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. Mania, left untreated, may worsen to a psychotic state. • Symptoms of Mania:Abnormal or excessive elation • Overactive / overtalkative • Unusual irritability • Decreased need for sleep • Grandiose notions • Increased talking Racing thoughts Increased sexual desire Markedly increased energy Poor judgment Inappropriate social behavior

48. Seasonal Affective Disorder • regularly occurring symptoms of depression (excessive eating and sleeping, weight gain) during the fall or winter months • full remission from depression occur in the spring and summer months • symptoms have occurred in the past two years, with no nonseasonal depression episodes • seasonal episodes substantially outnumber nonseasonal depression episodes. • a craving for sugary and/or starchy foods CAUSE OF SAD? Melatonin is normally released by the pineal gland in the evening as sunlight is diminishing. Melatonin causes us to feel tired and withdraw. This helps us to sleep, but if we have to be awake when melatonin is in our system, we become lethargic, disoriented, irritable and moody. Almost everyone with a mood disorder suffers worse in the winter because of excess melatonin in his or her system.

49. Personality and Facticious Disorders

50. Personality Disorders are a diagnostic category which describes inflexible behavior patterns that impair social relationships and functioning. Types of Personality Disorders: Paranoid Personality Disorder Histrionic Personality Disorder Borderline Personality Disorder Narcissistic Personality Disorder Antisocial Personality Disorder