Abnormal Psychology

1. Abnormal Psychology A Power Point With Stiles

2. Welcome to 1-800-PSYCH • Hello, welcome to the Psychiatric Hotline. • If you are obsessive-compulsive, please press 1 repeatedly. • If you are co-dependent, please ask someone to press 2. • If you have multiple personalities, press 3,4,5, and 6. • If you are paranoid-delusional, we know who you are and what you want. Just stay on the line so we can trace the call. • If you are schizophrenic, listen carefully and a little voice will tell you which number to press.

3. Mental Health Statistics • 450 million world wide are in need of psychological assistance • 2 million “in-patient” in psychiatric units • 2.4 million group home residents • 15% utilize treatments for psychological disorders

4. Understanding Psychological Disorders Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood. Trephination (boring holes in the skull to remove evil forces)

5. Circulating Swing • Tranquilizing Chair – Benjamin Rush • The Crib

6. Medical Perspective Philippe Pinel (1745-1826) from France, insisted that madness was not due to an ailment of the mind. When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders. 1. Etiology & Prognosis Cause and development of the disorder. Forecast 2. Diagnosis: Identifying (symptoms) and distinguishing one disease from another. 3. Treatment: Treating a disorder in a psychiatric hospital. Dance in the madhouse.

7. Is Mr. Thompson Abnormal? • The city of San Diego evicted 54 year old Richard Thompson and all his belongings from his home. His belongings included shirts, pants, dozens of shoes, several bibles, a cooler, a tool chest, lawn chairs, a barbecue grill, tin plates, bird-cages, two pet rats, and his self fashioned bed. For the previous 9 months Thompson had lived happily and without any problems in a downtown storm drain (sewer). Because the city does not allow people to live in storm drains, Thompson was evicted from his underground storm-drain home and forbidden to return. Although Thompson later lived in several care centers and mental hospitals, he much preferred the privacy and comfort of the sewer. (Grimaldi, 1986) • Is Thompson’s living in the sewer abnormal?

8. efining Abnormality D-D-D • Deviant (nudity) changes w/ culture and time • Distressful • Dysfunctional (key) interfering with work and leisure Wodaabe Tribe

9. Modern Perspectives of Psychological Disorders Biological (evolution, individual genes, brain structures and chemistry) • Bio-psycho-social Model • Eclectic Psychological (stress, trauma, learned helplessness, mood-related, perceptions and memories) Sociocultural (roles, expectations, definition of normality and disorder

10. Andrea Yates: Evil or Ill? • Should Andrea be held responsible for the death of her 5 children?

12. Labeling Psychological Disorders • Labels may stigmatize individuals. • Labels can alter perceptions (videotaped interviews) • Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy. 4. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes.

13. David Rosenhan: Pseudo-Patient Experiment • Investigated reliability of psychiatric diagnoses • Eight healthy people entered psychiatric hospitals complaining of hearing strange voices • Once admitted to the hospital, they behaved normally and claimed that the voices had disappeared

14. Rosenhan: Implications • Psychiatrists disputed the results • Prompted changes in psychiatric diagnosis • The DSM-IV • Describe criteria of disorders • Prevalence • Offers reliability for similar diagnoses.

15. Classifying Psychological Disorders The American Psychiatric Association rendered a Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe psychological disorders. The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s.

16. Multiaxial Classification Axis I Is a Clinical Syndrome (childhood, anxiety, mood Psychotic, somatoform, etc.) present? Axis II Is a Personality Disorder present? (enduring, maladaptive, inflexible, impaired functioning) Axis III Is a General Medical Condition (diabetes, hypothyroidism) present? Axis IV Are Psychosocial or Environmental Problems (social isolation, traumatic event) also present? Axis V What is the Global Assessment of the person’s Functioning? (physical, social, occupational) 1-100

17. Rosenhan: Results • Staff treated patients as if they were really ill • Staff noted “abnormal” symptoms • Kept patients for an average of 19 days • Discharged with diagnosis of “schizophrenia in remission”

18. Rosenhan: Nonexistent Impostor Experiment • Told hospital staff to expect pseudo-patients (“impostors”) • No pseudo-patients were actually sent, but staff identified 41 anyway (these were, in fact, real patients)

19. Cognitive Model OH NO! I only got 98%. • Cognitive Therapy (Aaron Beck) • Assumed Problem: People engage in (negative) self talk that is false. (interpretation) • Change in belief  change in emotion • Goals: Confront irrational thought processes. Replace neg./false thinking patterns. • Rational Emotive Therapy- RET (Albert Ellis) Challenge the validity of clients statements. 98%

20. Psychoanalytic Model • Inspired by Freud • Assumed Problem: unconscious forces, childhood experiences • Goals: Reduce anxiety through self-insight “Talking Cure” • Insight Therapy • Long Term • Free Association • Dream Analysis Dream Symbols

21. Biological/Biomedical • Emphasizes the brain, brain structures, neurotransmitters. • Therapy: • Drugs • ECT • Lobotomy

22. Humanistic Model • Assumed Problem: Barriers to self understanding and self acceptance. • Goals: Personal growth through self insight, congruence • Components: Unconditional Positive Regard, Empathy, genuineness • Client Centered Therapy (non-directive) • Client can express themselves without worry of judgment. • Carl Rogers-active listening, empathy, genuineness

23. Behavioral Model • Assumed Problem: maladaptive behaviors based on the principals of learning. • Goals: extinction and replacement of maladaptive behaviors. • Systematic Desensitization (exposure) • Aversion Therapy • Token Economies (operant) + =