Abnormal Psychology

1. Abnormal Psychology The diagnosis and treatment of mental disorders

2. Criteria for disordered behavior • Distress • Are they upset about their behavior? • Deviance • Is their behavior outside of what is culturally normal? • Dysfunction • Does their behavior interfere with or impair daily functioning? Do they have a job? Normal relationships? • Danger • To themselves or others; made threats to harm themselves or harm others

3. History of mental illness • People presumed that maladaptive behavior was due to: • Lunar cycles (“full moon brings out the crazy”) • Evil spirits (possession) • People with god-like powers (witches) • Placed great emphasis on exorcising demons • “Therapies” included: • Beatings • Burnings • Castration • Pulling teeth • “Cauterizing” or burning of the clitoris • Transfusions of animal blood or removal of ones own blood to restore “a balance of the humors”

6. History of Mental Illness • Medical model- the assumption that mental illness is a sickness • Mental illness is diagnosed by its symptoms and cured through therapy which may or may not include treatment in a psychiatric hospital • More recently the field of psychology has moved towards the medical perspective because????? • Cant argue genetics/biology. It’s a natural science with LAWS instead of THEORIES which are debatable and subject to interpretation

7. Bio-psycho-social Approach • Disordered behavior is a combination of various factors that stem from: • Genetic predisposition (Bio) • Stress, trauma, environ. issues (psycho) • Social expect., norms, environ. issues (social)

8. Bio Psycho Sociological Approach

9. Classifying Psychological Disorders • DSM IV TR • Diagnostic Statistical Manual of Mental Disorders 4th ed. (text revision) • Benefits of diagnostic labeling include: • A uniform method of identifying/classifying maladaptive behavior • Introduces a homogenized method of effective treatment • Encourages appropriate research to identify causality

10. Critics of the DSM IV TR and diagnostic labeling cite: • DSM views almost every behavior as abnormal in some capacity • Leads to over/misdiagnosis of “normal” people • Stigmatizing power of labels • Perceive people differently that have been diagnosed with a mental disorder • Instead of perceiving mental illness as a disease of the brain its viewed as a fault in character • Diagnostic labeling can also alter reality in that the “victim” becomes a self-fulfilling prophesy

12. Schizophrenia

14. Schizophrenia • Out of touch with reality • Two or more of the following during a one month period • Positive Symptoms (an ADDITION to your sensory experience) • Delusions • Hallucinations • Disorganized speech • Disorganized or catatonic behavior

15. Negative Symptoms • Negative Symptoms (a LOSS or defect of your sensory experience) • Alogia • Decrease in speech or speech content (empty or absent replies) • Flat affect • Show little to no emotions • Avolition • Apathy or feeling drained of energy • Social withdrawal • Distancing oneself from their environment and becoming preoccupied with their ideas and fantasies

16. Schizophrenia • The onset of schizophrenia usually happens in late adolescence and in the early 20’s • 1% of the population is schizophrenic • More positive symptoms Type I • More negative symptoms Type II • Males tend to get it earlier; gender ratio is 1:1 • Drug use can “spark” schizophrenia; especially hallucinogens

17. Pathology • Enlarged brain ventricles, underdeveloped frontal area of the brain (mostly Type II) • Excessive sensitivity to dopamine • Prenatal exposure to influenza virus during the second trimester of pregnancy • Overwhelming biological evidence linking schizophrenia

19. Types of Schizophrenia • Catatonic schizophrenia • More catatonic behavior than anything else • Paranoid schizophrenia • More delusions than anything else • Disorganized schizophrenia • More disorganized speech than anything else • Undifferentiated schizophrenia • Waste bin of schizophrenia

20. Delusions • Delusions are false beliefs • Delusions of persecution • Threats of harm from someone • Delusions of reference • Assumptions that outside stimuli is being sent to you about ways to live your life • Delusions of control • Assume others are controlling you through some form of telepathy • Delusions of grandeur • Thoughts that you are an important person or figure ex. Hitler, Satan, Jesus, Virgin Mary, etc.

21. Disorganized Speech • Neologism • Made up words ex. hexklemp • Perseveration • Saying the same word over and over • Clanging • Rhyming words into an incoherent phrase • “He raged at the hypocrisy of aristocracy democracy!!” • Word salad • Tossing words in randomly; jibberish • Loose associations • Bouncing from one topic of conversation in an incoherent fashion

22. Hallucinations • Hallucinations are false perceptions within your senses • Auditory hallucinations are by far the most common • Hear sounds and voices that come from outside their heads • Auditory hallucinations are most likely to occur during times of idleness or inattention • Visual hallucinations • Vague perceptions of color; seeing people or objects that aren’t there • Tactile hallucinations • Tingling, burning, electrical shock sensations, or bugs crawling all over one’s body or beneath the skin • Somatic hallucinations • An organ shifting inside the body or a snake inside one’s stomach

23. Catatonic behavior • Catatonic stupor • Totally unaware of and unresponsive to their environment • Catatonic rigidity • Maintaining rigid, upright posture for hours and resisting efforts to be moved • Catatonic posturing • Assuming awkward bizarre positions for long periods of time • Catatonic excitement • Hyperactivity, uncontrollable wild behavior; wildly waving arms and legs

24. Treatments for Schizophrenia • Electroconvulsive Therapy (ECT) • Patient is shocked with up to 100 volts of electricity • SIDE EFFECTS: memory loss, extremely painful, clinicians don’t know why it works • Convulsive Therapy • Drugs are administered to cause a seizure to “re start” the brain ending hallucinations and delusions • SIDE EFFECTS: clinicians don’t know why it works, kidney and liver damage

25. Phenothiazines (Anti psychotic medication) • Haldol, Thorazine, Mellaril • A derivative of antihistamines; diminish positive symptoms and negative symptoms with time • SIDE EFFECTS: tardive dyskinesia (uncontrollable shaking), dystonia (involuntary muscle contractions, uncontrollable movement of the face, neck, & tongue), diminished sexual activity, nausea

26. Bipolar Disorder

27. Bipolar Disorder

28. Mania • Mania- a distinct period of abnormally elevated mood, lasting at least 1 week • 3 or more of the following • Inflated self esteem • Decreased need for sleep • More talkative than usual • A flight of ideas or thoughts are racing • Excessive involvement in pleasurable activities that have a high potential for painful consequences (ex. Excessive gambling) • Maniacs tend to be hypersexual or drink to come down from a manic episode • Men tend to present as manic; females present as depressive and have more dep. Episodes, men =

29. Depression • 5 or more of the following in a 2 wk period • Depressed mood most of the day nearly every day • Diminished interest • Significant weight loss or decrease in appetite • Insomnia or loss of energy • Feelings of worthlessness or excessive guilt • Recurrent thoughts of death or suicide

30. Treatments • Lithium to delay or prevent episodes of mania and depression • SIDE EFFECTS: Nausea, impaired kidney function, vertigo, muscle weakness • For 20-40% of manic depressives lithium doesn’t work so we treat the mania (anti convulsives) and depression (anti depressants) separately

31. Bipolar Disorder • Whites tend to be more at risk than minorities • Native Americans also have a higher risk than other minorities • 1% of the population is manic depressive • Effects men and women equally • 15% commit suicide • Artists, writers, poets and musicians show a higher incidence of manic depression • Strong genetic link; tends to run in families

32. Anxiety Disorders • Most common disorders in the US • 15-17% of the US population suffer • Generalized Anxiety Disorder • Phobia • Panic disorder • Obsessive Compulsive Disorder • Post Traumatic stress Disorder • Social Anxiety Disorder

33. Generalized Anxiety Disorder • Excessive anxiety or worrying about numerous events or activities • Sufferers live in a constant state of fear and dread • Women outnumber men 2:1 • Typically called “worriers”

34. Symptoms • Restlessness • Fatigue • Difficulty concentrating • Irritability • Muscle tension • Insomnia

35. GAD • As job income decreases the incidence of GAD increases • SSRI’s (Select Serotonin Reuptake Inhibitors) are the most common treatment • Prozac • Paxil • Zoloft

36. Phobia A persistent unreasonable fear of particular objects, activities, or situations

37. Phobia • Are different from everyday fears • Phobic fear is more intense and persistent • The desire to avoid the object or situation is more compelling (stronger) • Phobic fear interferes with personal, social, and occupational functioning

38. Phobia • DSM IV criteria • Marked and persistent fear that is excessive or unreasonable. Cued or caused by the presence or anticipation of the specific object or situation • Exposure to the phobic stimulus provokes an immediate response • The person recognizes that the fear is unreasonable • Avoidance, anxious anticipation or distress interferes with normal functioning

39. Phobia • 10-15 million in the US suffer • The most common phobias fall into 1 of 5 categories or FAMILIES • Blood born or injection • Animal • Natural environment • Situational • other

40. Phobia • 2:1 female to male • The earlier the onset the easier to cure • Tends to run in families

41. Treatments • Flooding • Forcing a subject to come in contact with the phobic stimulus • Systematic Desensitization • Slowly exposing the subject to the phobic stimulus to extinguish the fear • High risk for re-traumatization with flooding; but its quicker • Systematic Desensitization takes more time