Psychological Disorders/ Abnormal Psychology

1. Psychological Disorders/Abnormal Psychology Mods 45 thru 49 Pgs. 623 – 665

2. What is normal? • If someone is too depressed to get out of bed for weeks, do they have a disorder? • What if they just experienced a severe loss? • How long is okay? • What if, the day after experiencing a severe loss, they went out partying? Is that wrong too?

3. Most “abnormals” depicted on TV with severe problems are usually inaccurate. • Only a handful of the disturbed are dangerous. • The average mental patient is confused, withdrawn and will bother no one. • Statistically, mental patients are less violent than the general public.

4. If you choose an emotionally disturbed person at random, odds are that they won’t be much different from you or your friends in most areas except for an exaggeration in certain areas. • Medical Students Syndrome: there are many instances when reading about lung collapses that med students get pains in their chest. Don’t let this happen to you here.

5. How can we define psychological disorders? • Does being different from everybody else make one have a disorder? • Not necessarily but, being atypical is part of the definition of a disorder.

6. To be considered disordered, other people must find the atypical behavior disturbing. • These standards vary depending on cultural and historical context. • Killing during wartime vs. peace. • Burping at the end of a meal is a compliment in some countries. • 200 years ago, everyone walked around England and America with white wigs on. • If you’re afraid of a tiny mouse and jump on tables screaming, it’s ok; if you have agoraphobia (fear of public places) you have a disorder.

7. Would you agree that there is something abnormal in all of us? There must be something you’ve done that you would rather not have others know about. • Winning! • Historically, madness = supernatural forces

8. Disorders are behaviors that are maladaptive. Like when a smoker’s nicotine dependence produces physical damage. • Abnormal behavior is most likely to be considered disordered when others find it rationally unjustifiable. If you can justify it or no one is disturbed by it, it’s acceptable. “she’s an entertainer”

9. So, mental health workers label behavior psychologically disordered when they judge it 1. atypical, 2. disturbing, 3. maladaptive and 4. unjustifiable. • Manson Clip - Saved • http://www.youtube.com/watch?v=o2oZWpqtNi4&safety_mode=true&persist_safety_mode=1

10. The current authoritative scheme for classifying psychological disorders is the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders -- DSM IV-R • Most health insurance companies require a DSM IV diagnosis before paying for therapy.

11. Anxiety Disorders • We all feel it at one time or another: Before the game, match, show or event. Looking down from a ledge. Speaking in front of people, etc. But, for some people, two thirds of whom are women, anxiety becomes so distressing and persistent that they suffer an anxiety disorder.

12. 3 Types • Generalized Anxiety Disorder – in which a person feels unexplainably tense and uneasy. • Phobic Disorder – in which a person feels irrationally afraid of a specific object of situation • Obsessive Compulsive Disorder – in which a person is troubled by repetitive thoughts and/or actions.

13. Generalized Anxiety Disorder • Sufferers are continually tense and jittery, apprehensive about bad things that might happen, and experiencing all the symptoms of autonomic nervous system arousal (racing heart, clammy hands, stomach butterflies).

14. One of the worst characteristics of GAD is that the person cannot identify, and therefore cannot avoid, it’s cause.

15. Panic Attack • For no apparent reason, the anxiety may at times suddenly escalate into a terrifying panic attack – an episode of intense dread, usually lasting several minutes. Chest pain, choking or smothering sensations, trembling, dizziness, or fainting typically accompany the panic. • The experience is unpredictable and so frightening that the sufferer may then avoid situations where the attacks have occurred. • Anxiety attack on plane • http://www.youtube.com/watch?v=9_JjUER_r08&playnext=1&list=PLA1ADBF0A6333DAA6&safety_mode=true&persist_safety_mode=1 • How not to help a person having an anxiety attack • http://www.youtube.com/watch?v=i0GW0Vnr9Yc&feature=related&safety_mode=true&persist_safety_mode=1

16. Phobic Disorders • Phobic anxiety focuses on some specific object, activity or situation. Phobias are irrational fears. • List of phobias -- http://www.alphadictionary.com/articles/phobias.html • Deliberately forcing a person to overcome their fears can be very dangerous. Throwing a person in the ocean who has thalassophobia can be harmful. • Phobia clip – 3:32 Saved • http://www.youtube.com/watch?v=9rl7Lr6eDLc&safety_mode=true&persist_safety_mode=1 • Pop up phobia book

17. Agoraphobia • Fear of open places and/or public situations. • How can it start? • Perhaps suffering a panic attack in a specific place will trigger a fear of being in that situation again. • More agoraphobics are women. Society? • Most have a specific boundary they cannot cross, whether it be the doorway, a certain street, the town border etc.

18. Obsessive-Compulsive Disorder/OCD • At times, we may all be obsessed with senseless or offensive thoughts that will not go away. • We sometimes engage in rigid behavior like rechecking the locked door, stepping over cracks in the sidewalk, lining up our books and pencils “just right” before studying or whatever…..

19. Obsessivethoughts and compulsive behaviorscross the fine line between normality and disorder when they become so persistent that they interfere with the way we live or when they cause distress. • Obsession – an endless preoccupation with an urge or thought. • Ex. What happens when you hear a song just as you’re leaving your house or car. • Multiply that 100x – when thoughts will not leave the person alone.

20. Compulsion • A ritualized behavior that a person must act out. Each time he/she does so, anxiety is decreased. • A compulsive handwasher is obsessed with cleanliness. • The compulsion is the action, the obsession is the thought. • Howie Manel clip 2:18 • http://www.youtube.com/watch?v=eg14F72pY-4&safety_mode=true&persist_safety_mode=1 • As Good As It Gets clip – 1:07 • http://www.youtube.com/watch?v=44DCWslbsNM&feature=related&safety_mode=true&persist_safety_mode=1

21. Explaining Anxiety Disorders • Don’t write, just read. • Psychoanalytic perspective – assumes that, beginning in childhood, intolerable impulses, ideas and feelings get repressed. Repetitive hand washing, for instance, may help suppress anxiety over one’s “dirty” urges. Learning perspective – links general anxiety with learned helplessness. Some fears arise from stimulus generalization. Fear of heights may lead to a fear of airplaines without ever being on a plane. Biological perspective – explains our anxiety-proness in evolutionary, genetic and physiological terms. Maybe a lack of serotonin?

22. Brain scans of people with obsessive compulsive disorder reveal unusually high activity in an area of the frontal lobes just above the eyes. Antidepressant drugs control OC behavior by dampening this activity

23. Somatoform Disorders • Psychological issues are expressed in bodily symptoms, but there is no actual physical problem. • We all feel a little worse when life isn’t going so well, but this is dramatic. • 2 types • 1. Conversion Disorder: another name is hysterical blindness. (More common in Freud’s day than now) • Ex. A person who has witnessed a terrible human torture or slaughter (the Holocaust) may have their visual system shut down. • Or, a person who was in a car accident was unable to help others because of fear – may develop a sort of paralysis. • These people are not faking it. Doctors would stick them with needles and they have no reaction. • http://www.youtube.com/watch?v=_2NbEV8cFzs&safety_mode=true&persist_safety_mode=1 Band Brothers 3:00

24. 2. Hypochondriasis: Less unusual. Overly concerned about their health. • A slight headache is interpreted as brain cancer, or the sniffles as pneumonia. • Often, when children only got attention and support from other people when they were sick.

25. Dissociative Disorders (rare) • When a person experiences a sudden loss of memory or change in identity. • Part of one’s life become disconnected with other parts. • Only when these experiences are severe and prolonged do they suggest a dissociative disorder.

26. 1. Amnesia: • The failure to recall events, can be caused by head injury or alcoholic intoxication. But psychogenic amnesia usually begins as a response to intolerable psychological stress. • The memories are still inside of the person, but they are cut off from consciousness. • Patients usually exhibit Selective Forgetting: remembering how to drive, talk, type etc. • Combat soldiers blot out certain parts of the horror, but still remember childhood memories.

27. 2. Psychogenic Fugue (complicated) • Also involves forgetting, but it also involves fleeing one’s home and identity for days, months or years. • When “awakening” from a fugue state, people remember their old identities but typically deny remembering what occurred during the fugue. • Can also be caused by severe stress. Maybe conflict with spouse.

28. 3. Multiple Personality Disorder • Controversial. Massive dissociation of self from ordinary consciousness. • Instead of forgetting events, they forget a portion of themselves. That portion begins to live a life of their own. • Usually a good and bad person. Possibly caused by a history of escaping from problems. • Perhaps a history of severe child abuse or traumatic experience. • There have been cases where the different personality would write with the opposite hand, be able to play an instrument or speak a different language. • Sybil

29. Mood Disorders • The mood of an individual is his/her emotional state – angry, depressed, happy etc. • A mood disorder is an exaggerated “up mood”, depressed state, or an alternation between up and down. • There is a mild disorder called dysthymic disorder which is the “common cold” of mental health. • A moderate depression and can clear up without treatment. Lack of energy, unhappiness, loss of interest in activities, no sense of humor etc. • In many cases, as in the loss of a loved one, it serves a purpose. If it appears out of nowhere, there may be a problem.

30. Mood disorders come in two principal forms: • 1. Major Depression: the person experiences the hopelessness and lethargy of prolonged depression until eventually rebounding to normalcy. • Feelings of worthlessness, slow speech, thoughts of death or suicide. • Many patients have trouble with everyday tasks. Some can lie motionless for hours. • Usually there is a great deal of anger inside (sometimes directed at the self) • Affects many more women than men. • http://www.youtube.com/watch?v=IeZCmqePLzM&safety_mode=true&persist_safety_mode=1

31. Mania is the opposite of depression. • Extreme up moods. Doesn’t seem so bad. But this is restlessness, no concentration, very rapid speech. • Thoughts are moving so quickly, they get out of control and get confused. • Ex. “I went to the store where I kept the containers of milk which all babies should have in order to survive which not everyone can do because of the threat of nuclear war between countries which are divisions of various parts of the land which is filled normally with rock and dirt.” • Grandiose optimism and self esteem.

32. 2. Bipolar Disorders: swings between ups and downs -- mania and depression. • Used to be called manic depression. Causes: 80-90% of the time, they disappear by themselves within six months. However, they usually reoccur. Maybe a lifetime of loss, setbacks, poor self image. Chemical imbalance – serotonin, norepinephrine. Possibly inherited. Depression is also contagious. Constantly being around people that are down or depressed will affect you. Vicious cycle. Combination of psychological factors, physical factors and chemical factors.

33. Schizophrenic Disorders • A major/serious disorganization of the thought process. Distorted perceptions of the world. Roses are red • 4 Major Symptoms – all four need not be present, but at least two. • 1. Thought disorder: distortion of the thinking process. • 2. Hallucinating: seeing or hearing things that are not there. • http://www.youtube.com/watch?nomobile=1&v=0vvU-Ajwbok (oral hallucinations link) • 3. Delusions: inaccurate beliefs. “Prophets” or avenging angels etc. • 4. Inappropriate emotional response: no rsponse to something interesting. Then laugh at tragic events. They don’t really think it’s funny, they are confused, a malfunction of the brain. • Affects 1% of the population.

34. It almost never appears earlier than adolescence or early adulthood. So it is probably caused by a chemical imbalance. • It may not be psychologically caused because psychological problems occur at any age. • They speak in what is called word salad. Incoherent, no sense and often try to rhyme words.

35. Types of Schizophrenia • Catatonic schizophrenia – disturbance of movement. Usually say very little. Won’t move for hours. • Paranoid Schizophrenia – feelings of suspiciousness or the opposite – grandiose beliefs. In and out of Psychotic Episodes – schizophrenics are not out of touch with reality all of the time. They go in and out of “episodes.” • One chemical key to schizophrenia is the neurotransmitterdopamine. Too much of it. • May be genetic. • http://www.youtube.com/watch?v=uJOT45wXErk&safety_mode=true&persist_safety_mode=1

36. Personality Disorders • Originally called psychopaths or sociopaths. • Inflexible and enduring patterns of behavior that impair one’s social functioning – sometimes coexist with one of the other psychological disorders, but need not involve anxiety, depression or loss of contact with reality. • Typically a male whose lack of conscience becomes plain before the age 15, as he begins to lie, steal, fight or display unrestrained sexual behavior • In adulthood, he may be unable to keep a job, be irresponsible as a spouse and parent, and be assaultive or otherwise criminal.

37. They may be intellectual and charming. • Most criminals show responsible concern for their family and friends; antisocial personalities feel little and fear little. • Clip 10:00 Mind of a Psychopath – saved. • No concern, guilt or anxiety. • Drugs and/or psychological treatment do not help. • They will want to help and cooperate, but as soon as they’re out, they repeat behavior. • Manson :12 • http://www.youtube.com/watch?v=XREnvJRkif0&feature=related&safety_mode=true&persist_safety_mode=1 • Many have a history of rough family treatment, abuse or neglect.