Abnormal Psychology and Therapy

1. Abnormal Psychology and Therapy Mychal Ellis, Izzy Dawes, and Stacy Schonhardt

2. Defining Abnormal Behavior - Behavior that is deviant, maladaptive, or personally distressful over a relatively long period of time. -Deviant: Strays from what is acceptable. -Maladaptive: Interferes with a person’s ability to function. -Personal Distress: Behavior is found to be troubling to the person. -American Psychiatric Association defines as a mental illness that affects a person’s brain and can affect the way the individual thinks, behaves, and interacts with others

3. Approaches to Abnormal Behavior Biological Approach -organic internal causes -focus on brain, genetic factors, and neurotransmitter functioning as source -medical model: psychological disorders are medical diseases with a biological origin Psychological Approach -contributions of experiences, thoughts, emotions, and personality characteristics -rewards and punishers in environment -social cognitive focus on observational learning, cognitions, and beliefs

5. Approaches to Abnormal Behavior Sociocultural Approach -emphasize social contexts -gender, ethnicity, socioeconomic status, family relationships, and culture -socioeconomic plays stronger role than ethnicity Biopsychosocial Approach -can be influenced by ~biological (genes) ~psychological (experience) ~sociocultural (gender) -factors can act alone but often they work in combination -none more important than another

6. Classifying Abnormal Behavior - Universal understanding - Easier to predict the diagnosis of a certain disorder, who is susceptible, stages of the disorder, and the outcome of treatment - Giving the disorder a name can provide comfort to the victim ~However labeling disorders can create an unnecessary stigma - a mark of shame that may cause others to avoid or to act negatively toward an individual -Critiques ~Based on the medical model ~Lack of focus on strengths DSM-IV Classification System...What is that? - It’s the Diagnostic and Statistical Manual of Mental Disorders of course! -DSM-IV:the major classification of psychological disorders in the United States. ~Published by the American Psychiatric Association ~Basis of classification: individual's history and highest level of functioning in the previous year ~Five axes of classification -A1: All diagnostic categories except personality disorders and mental retardation -A2: Personality disorders and mental retardation -A3: General medical conditions -A4: Psychosocial and environmental problems -A5: Current level of functioning

7. List of Disorders

9. 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

10. Are Psychological Disorders a Myth? -Are these diseases all made up in your head? Or are they real illnesses that need drugs to be treated -ADHD was used to debate that question -a “consensus statement” signed by 75 psychiatrists and psychologists, declaring that ADHD is a real psychological disorder with a biological basis in the brain, associated with a number of problems, including dropping out of school, teen pregnancy, and antisocial behavior -critics argued that the biological basis of ADHD is not unique to ADHD but is a pattern shared with other childhood disorders -No definite answer to this question

11. Generalized Anxiety Disorder -Generalized anxiety disorder: Psychological disorder marked by persistent anxiety for at least 6 months and in which the individual is unable to specify the reasons for the anxiety -Worried most of the time -Biological causes: genetic predisposition, deficiency in the neurotransmitter GABA, sympathetic nervous system activity, and respiratory system abnormalities -Other causes: harsh self-standards, overly strict and critical parents, automatic negative thoughts when stressed, history of uncontrollable traumas or stressors (such as an abusive parent)

13. Panic Disorder -Panic disorder: Individual experiences recurrent, sudden onsets of intense apprehension or terror, often without warning and with no specific cause -Outcomes: severe palpitations, extreme shortness of breath, chest pains, trembling, sweating, dizziness, and helplessness -Charles Darwin suffered from intense panic disorder -Biological causes: genetic predisposition, overly active autonomic nervous system, problems with norepinephrine or GABA -In US women are twice as likely as men to have panic attacks

14. Phobic Disorder (Phobia) -Phobia: Anxiety disorder characterized by an irrational, overwhelming, persistent fear of a particular object or situation -Pinpoint the source of anxiety -Fear becomes phobia when a situation is so dreaded individual goes to any length to avoid it -Social phobia: an intense fear of being humiliated or embarrassed in social situations -Phobia is largely considered a learned fear

16. Obsessive-Compulsive Disorder (OCD) -OCD: 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 -https://www.youtube.com/watch?v=dSZNnz9SM4g (2:28)

17. Post Traumatic Stress Disorder (PTSD) -PTSD: disorder that develops through exposure to a traumatic event that has overwhelmed the person’s ability to cope -Symptoms ~Flashbacks ~Difficulties with memory ~Feelings of apprehension ~Reduced emotions

19. Defining Dissociative Disorders -Dissociative Disorders: Psychological disorders that involve a sudden loss of memory or change in identity due to the dissociation (separation) of the individual’s conscious awareness from previous memories and thoughts ~dissociation: psychological states in which the person feels disconnected from immediate experience -Through dissociation, an individual mentally protects his or her conscious self from the traumatic event. -Have a problem in pulling together emotional memories.

20. Dissociative Amnesia and Dissociative Fugue -Dissociative Amnesia: Dissociative disorder characterized by extreme memory loss that is caused by extensive psychological stress. ~Person only forgets aspects of their own identity and autobiographical experiences. - 28-year-old didn’t acknowledge her newborn after giving birth, and she didn’t know her own identity. -Dissociative Fugue: Dissociative disorder in which the individual not only develops amnesia but also unexpectedly travels away from home and sometimes assumes a new identity. ~Different because of the tendency to run away. -http://www.youtube.com/watch?v=QajubDsCcrw

21. Dissociative Identity Disorder -Dissociative Identity Disorder (DID): Formerly called multiple personality disorder, a dissociative disorder is which the individual has two or more distinct personalities or identities, each with its own memories, behaviors, and relationships. -most dramatic and least common dissociative disorder -One identity dominates one time, and another takes over at another time. ~the shift occurs during distress, or sometimes the person can control it. -Research suggests it’s a coping mechanism to deal with extremely traumatic events, where the person creates a new identity to protect the original. ~http://www.youtube.com/watch?v=6nfoyoTxpn0 ~http://www.youtube.com/watch?v=jIxEmd-CDNY

23. Schizophrenia -Schizophrenia: Severe psychological disorder characterized by highly disordered thought processes, referred to as psychotic because they are so far removed from reality. -Symptoms: ~Positive symptoms (added beyond normal behavior): -Hallucinations: sensory experiences in the absence of real stimuli -Delusions: false, unusual, and sometimes magical beliefs that are not part of an individual's culture -Incoherent thoughts -Referential thinking: ascribing personal meaning to completely random events -Catatonia: State of immobility and unresponsiveness lasting for long periods of time ~Negative symptoms (social withdrawal or behavior defects): -Flat affect: the display of little or no emotion- a common negative symptom of schizophrenia -Inability to set goals ~Cognitive symptoms: -Difficulty paying attention -Difficulty remember information

24. Causes-Biological -Heredity: Partially caused by genetic factors ~Children of a parent affected= 13% ~Identical twins= 48% -Structural Brain Abnormalities: ~Enlargement of brain ventricles ~Small prefrontal cortex (thinking, planning, etc. ~Indicates problems in prenatal development -Neurotransmitter Regulation ~Excess Dopamine (“Feel Good”) ~Psychotic thoughts don’t go away immediately with drop in Dopamine

25. Causes- Psychological -Stress can contribute -Diathesis-stress model: View of Schizophrenia emphasizing that a combination of biogenetic disposition and stress causes the disorder

27. Causes- Sociocultural -Not a cause, effects course ~Developing nations have a better outcome for individuals affected with Schizophrenia ~Keeping normalcy leads to better outcomes (marriage, kids, holding a job)

28. Video A sample of a Schizophrenic episode: http://www.youtube.com/watch?v=qb8wQjwVu2g

30. Case Study From: Linda My son, was diagnosed as a parnoid/disorganized schizophrenic in Sept of 1995. The first signs we saw were: 1. He wouldn't eat, everything tasted "funny" or he thought I was putting something in the food to make it taste "funny". He wouldn't even eat McDonalds food, which he always loved. Below are the the first signs that we saw over a 9 - 10 month period, before he received treatment. 2. He lost 50 lbs during this time (6 - 7 months). I took him to our family doctor who did a series of tests, including a drug test, all came back negative. (Started in Jan 95) 3. He then started to zone out for long periods of time (1 - 2 hours). He wouldn't blink very often or change his expression. I would ask him if anything was wrong and he'd just shake his head no. He then started to laugh during these times for no reason.(Started in May 95) 4. He would sit and stare at his hands for hours, when I would ask him what was wrong with his hands, he would say they are different then they use to be. 5. During this entire period, his grades in school went from C's - D's to all F's. The school would call and say he would get up and walk out of class and just roam the halls. 6. Starting in June 95, he started getting very aggressive, talking to himself and laughing in his room. He would get very upset and run out of his room, down the stairs and outside. He started doing this everyday. It started really going downhill from there. 7. He would never say he was hearing voices, but it was very apparent he was. God told him what numbers to play for the lottery, if I bought a ticket I would win millions. He heard other voices, I would hear him talking to them. 8. He started talking in a language we did not understand, after research I found these to be called "word salads". He would call me by a name that no one understood, he said I was from a different planet sent here to kill him. He told his siblings they were from his planet and they were here to protect him from me. He would come out of his room, scream at all of us in the foreign language, and tell us we all were going to die. 6. Would no longer watch T.V., just listened to Pink Floyd "The Wall" over and over again. In fact he broke his cd player by doing this. 9. Paced constantly or do just the opposite not get out of bed for hours during the day. (he would not sleep at night) 8. Started to hallucinate. The walls had bugs on them, we all looked different, my eyebrows were pointed upward and my ears had grown. He said things were moving when they were not. During this time I was totally freaking out. The above are a brief summary of what was happening, so many things occured during this period I can't remember or have blocked some of it out. I was able to admit him to the hospital by telling him we were just going to the doctor for a check up. The psychiatrist we saw here in St. Louis only treats Schizophrenics and I had faxed him a long letter explaining Rhett's behavior before our first visit. He had 3 security guards come to his office and escort Rhett to the ICU locked floor. When we arrived in the locked unit, Rhett did sign himself in "Thank God".

31. Antianxiety Drugs -Antianxiety drugs: Commonly known as tranquilizers, drugs that reduce anxiety by making individuals calmer and less excitable ~Benzodiazepines: relief from symptoms of anxiety -Xanax -Valium -Librium ~Nonbenzodiazepine: treat generalized anxiety disorder -Buspirone -BuSpar -Provide temporary relief from anxiety and allow individuals to cope

32. Antidepressant Drugs -Antidepressant drugs: drugs that regulate mood - Tricyclics ~ three-ringed molecular structure ~ increase the level of a certain neurotransmitter ~ reduce symptoms in 60-70% of cases -Tetracyclics ~ four-ringed structure ~ noradrenergic and specific serotonergic antidepressants ~ enhance brain levels of norepinephrine and serotonin - MAO Inhibitors ~ block the enzyme monoamine oxidase ~ this enzyme breaks down serotonin and norepinephrine ~ more potentially harmful to the body - Selective Serotonin Reuptake Inhibitors ~ interfere with the reabsorption of serotonin in the brain ~ Prozac, Paxil, Zoloft ~ reduce depression symptoms with fewer side effects. -Lithium: The lightest of the solid elements in the periodic table of elements, widely used to treat bipolar disorder.

34. Antipsychotic Drugs -Antipsychotic Drugs: powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals with a severe psychological disorder, especially schizophrenia ~Neuroleptics: Most commonly used -Used to treat Schizophrenia -Block Dopamine -Do not cure Schizophrenia, mute the symptoms -Severe side effects ~Tardive dyskinesia: a neurological disorder characterized by involuntary random movements of the facial muscles, tongue, and mouth, as well as twitching of the neck, arms, and legs ~Atypical antipsychotic medications -Less side effects -Impact Dopamine and Serotonin -Treat Schizophrenia -Clozaril (clozapine) and Risperdal (risperidone) -Effective if taken in small doses overtime -Effective with the combination of drug therapy and psychotherapy

35. Electroconvulsive Therapy -Electroconvulsive therapy: also called shock therapy, a treatment, commonly used for depression, that sets off a seizure in the brain ~Still given to approx. 100,000 people/ year to treat depression ~Little to no discomfort today ~Applied to a specific part of the brain ~As effective as cognitive and drug therapy ~Memory loss is sometimes a side effect -Deep brain stimulation: A procedure for treatment-resistant depression that involves the implantation of electrodes in the brain that emit signals to alter the brain's electrical circuitry. ~Treat OCD and depression

36. Antidepressants Increase Suicide Risk? -Teen suicides seemed unplanned -FDA study: 4,300 teens were given and antidepressant or placebo ~Increase in“adverse event reports” in treatment group—spontaneous statements of thoughts about suicide reported by the participants or their parents -FDA requires antidepressants to warn of the potential for adolescent suicide ~Doctors prescribed less antidepressants -90% of people who attempt suicide have a psychological disorder with depression being a characteristic -Less suicidal thoughts were reported in a study of people taking Prozac -Study showed a reduction in suicidal thoughts from 29% to 10% in adolescents taking Prozac and completing drug therapy

38. Drug Chart

39. Psychosurgery - Psychosurgery: A biological therapy, with irreversible effects, that involves removal or destruction of the brain tissue to improve the individual’s adjustments. - An instrument is inserted into the brain and rotated, severing the frontal lobe’s connections with the thalamus (Antonio Moniz). ~worked for some, but left some in a vegetable-like state -Walter Freeman started performing prefrontal lobotomies throughout the country. - May be performed for patients with OCD, major depression, or bipolar disorder. - Only used for EXTREME cases.

40. -Classifying Abnormal Behavior -All slides about Schizophrenia -Antianxiety Drugs -Antipsychotic Drugs -Therapy Critical Controversy -Electroconvulsive Therapy -Pictures and GIFS Izzy Stacy -Anxiety Disorders -Approaches to Abnormal Behavior -Guided notes -Drug chart -List of disorders -DSM-IV (V) -Critics of DSM Mychal -Defining Abnormal Behavior - All of the dissociative disorder slides -Antidepressant drugs -psychosurgery