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Abnormal Psych AP Colley 2009. Classifying Psychological Disorders Psychological Disorder: – A “harmful dysfunction” in which behavior is judged to be

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Abnormal Psych

Abnormal PsychAPColley 2009Classifying Psychological DisordersPsychological Disorder:A harmful dysfunction in which behavior is judged to be atypical, disturbing, maladaptive, and unjustifiableNeurotic Disorder: A psychological disorder that is usually distressing, but that allows one to think rationally and function sociallyPsychotic Disorder: A psychological disorder in which a person loses contact with reality, experiencing irrational ideas and distorted perceptions

Psychopath v SociopathThe traits of the psychopath and sociopath are largely similar. Both psychopaths and sociopaths have a complete disregard for the feelings and rights of others. This often surfaces by age 15 and may be accompanied by cruelty to animals. These traits are distinct and repetitive, creating a pattern of misbehavior that goes beyond normal adolescent mischief.Both the psychopath and sociopath fail to feel remorse or guilt. They appear to lack a conscience and are completely self-serving. They routinely disregard rules, social mores and laws, unmindful of putting themselves or others at risk. Psychopath v SociopathSociopath: Some argue the sociopath to be less organized in his or her demeanor, nervous and easily agitated someone likely living on the fringes of society, without solid or consistent economic support. A sociopath is more likely to spontaneously act out in inappropriate ways without thinking through the consequences.Psychopath: Some argue that the psychopath tends to be extremely organized, secretive and manipulative. The outer personality is often charismatic and charming, hiding the real person beneath. Though psychopaths do not feel for others, they can mimic behaviors that make them appear normal. Upon meeting, one would have more of a tendency to trust a psychopath than a sociopath.

Psychopath v SociopathSociopathLess educated; most likely due to inability to focus or lack of attentionUnlikely to have a family or a steady jobLacks the skills and drive to mimic normal behaviorMore apt to leave ample evidence in their explosions of violencePsychopathMight be better educatedCan fly under the radar due to their ability to maintain families and steady workCrimes are well planned out and organizedHarder to catchClassifying Psychological DisordersDSM-IV: The American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)Contains 17 major categories of mental disorderDescribes the disorders and their symptomsDoes not mention causesMost health insurance policies require a DSM-IV diagnosis before they will pay for therapy

Methods of DiagnosisMedical Model of Diagnosis and Treatment:The concept that diseases have physical causes that can be diagnosed, treated, and, in most cases, cured. Mental illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital.Bio-Psycho-Social Perspective:A contemporary perspective which assumes that biological, psychological, an socio-cultural factors combine and interact to produce psychological disorders.

Labeling Once we label a person, we view that person differentlyRosenhan demonstration of diagnostic labelingLabels can create preconceptions that unfairly stigmatize people and bias our perceptions of their past and present behavior

Anxiety DisordersPsychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxietyGeneralized Anxiety Disorder: An anxiety disorder in which a person is continually tense, apprehensive, and in a state of autonomic nervous system arousal (on edge)May cause twitching, fidgeting, perspiration, and tremblingConcentration is very difficultWorst characteristic is that the person cannot identify the cause of the anxietyFree-floating anxiety

Anxiety DisordersPanic Disorder: An anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensationsIt strikes suddenly, wreaks havoc, and disappears1 in 75 people suffer from this disorderTypically misperceived as a heart attackPeople can develop a fear of the panic disorder, thereby developing a panic disorder based on the fear of having another attack

Anxiety DisordersAgoraphobia: fear or avoidance of situations in which escape might be difficult or help unavailable when panic strikesPeople avoid being outside the home, being in a crowd, being on a bus, or even on an elevator

Anxiety DisordersPhobias: An anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object or situation Focus the anxiety on a specific object or situationCommon psychological disorder that many people accept and live withSome specific phobias are incapacitatingEspecially Social phobiasAn intense fear of being scrutinized by others These people will avoid social situations, speaking up, eating out, going to parties, etcShyness taken to an extreme

Anxiety DisordersObsessive-Compulsive Disorder: An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)Common Obsessions and CompulsionsObsessions:Concern dirt, germs, toxinsSomething terrible happening (Death, fire, illness)Symmetry, order, or exactnessCompulsions:Excessive hand washing, bathing, tooth brushing, or groomingRepeating rituals (in/out of a door, up/down from a chair)Checking doors, locks, appliances, car brake, homework

TreatmentsTreatmentsBehavior TherapyMedicationRelaxation techniquesHypnotherapyAcupuncture

Explaining AnxietyLearning PerspectiveFear ConditioningWhen bad events happen unpredictably and uncontrollably, anxiety often developsLink between general anxiety and the classical conditioning of fearVictims of post-traumatic stress disorder feel a swell of anxiety with any reminder of their traumaPossible explanation for why anxious people are hyper-attentive to possible threats and how panic-prone people come to associate anxiety with certain cues58% of people with a social phobia experienced their disorder after a traumatic event

Explaining AnxietyStimulus GeneralizationConditioned fears may remain long after we have forgotten the experiences that produced themSome fears arise from stimulus generalizationPerson who fears heights may be afraid of airplanes without ever having flownReinforcementHelps to maintain phobias and compulsionsAvoiding the feared situation reduces anxiety, thus reinforcing the phobic behaviorCompulsive behaviors reduce anxiety as wellObservational LearningLearn fear through observing others fears

Mood DisordersMood disorders come in two principal forms:Major Depressive DisorderPerson experiences prolonged hopelessness and lethargy until usually rebounding to normalityBipolar Disorder (formally known as manic depressive disorder)Person alternates between depression and mania (an overexcited, hyperactive state)

Mood DisordersMajor Depressive Disorder:A mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activitiesDepression is the #1 reason why people seek mental health servicesLeading cause of disability worldwideDepression is often a response to past and current loss

DepressionA sort of psychic hibernationIt slows us downWe temporarily grind to a halt and ruminateReassess ones life when we are feeling threatenedLine between normal downs and major depression is blurryDifference between a blue mood and a mood disorder is like the difference between gasping for breath for a few minutes and constantly being short of breathWith or without therapy, episodes of major depression usually end and people temporarily or permanently return to their previous behavior patterns

Mood DisordersDysthymic DisorderA down-in-the-dumps mood that fills most of the day, almost every day, for two years or morePeople experience chronic low energy and self-esteemDifficulty concentrating or making decisionsSleep and eat too much or too little

Mood DisordersBipolar Disorder: A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of maniaManic Episode:A mood disorder marked by a hyperactive, wildly optimistic stateOvertalkative, overactive, elatedHas little need for sleepShows fewer sexual inhibitionsExperience grandiose optimismCan lead to reckless behaviorsBut, can also fuel creativity and energyWalt Whitman, Ernest Hemingway, Margot Kidder all had bipolar disorder

Explaining Mood DisordersFive facts that any theory of depression must explainMany behavioral and cognitive changes accompany depressionSensitive to negative happenings, expect negative outcomes, etcNearly half the time depressed people exhibit symptoms of another disorderDepression is widespreadCauses must be common thenWomen are twice as vulnerable to major depression, even more so if they have been depressed beforeWomen are most vulnerable to passive disordersWhen women get sad, they get sadder than men doMost major depressive episodes self-terminateMost people return to normal without professional helpStressful events related to work, marriage, and close relationships often precede depression

Explaining Mood DisordersThe Biological PerspectiveDepression is a whole body disorderInvolves genetic predispositions, biochemical imbalances, melancholy mood, and negative thoughtsGenetic InfluencesMood disorders run in familiesRisk increases if you have a parent or sibling who suffers from depression (bipolar disorder)15 groups worldwide are searching the genes that make one vulnerable to bipolar disorderLinkage analysis

The Depressed BrainThe Depressed BrainGenes act by directing biochemical events that influence behaviorBiochemical key is neurotransmittersNorepinephrine increases arousal and boosts moodOverabundant during mania, but scarce during depressionSerotonin is also scarce during depressionDrugs that relieve depression increase norepinephrine or serotonin by blocking either their reuptake or chemical breakdownLeft frontal lobe is likely to be inactive in depressed statesMRIs have shown frontal lobes to be 7% smaller in severely depressed patients

Mood DisordersVicious Cycle of DepressionNegative, stressful events are interpreted throughA pessimistic explanatory style, which createsA hopeless, depressed state thatHampers the way the person thinks and acts, which, in turn, fuelsMore negative experiences (back at step 1)

Dissociative DisordersDisorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelingsMost intriguing and rare disordersIn which a person appears to experience a sudden loss of memory or change in identity

Dissociative DisordersDissociative Identity DisorderA rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities.Also known as multiple personality disorderA person with this disorder may be prim and proper one moment, and loud and flirtatious the nextEach personality has its own voice and mannerismsOriginal personality typically denies awareness of the other(s) existence

Dissociative DisordersCriticism of the disorders existence is quite loudThe average number of cases per decade was 2 between the 1930s and 1960sRocketed to 20,000 in the 1980sThe Three Faces of Eve and Sybil were movies that depicted multiple personalities and came out in the 1980sThe diagnosis is rare in Britain and virtually nonexistent in India and JapanOften seen as a way of dealing with anxietyDefenses against anxiety caused by unacceptable impulses

SchizophreniaA group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actionsLiterally means split mindSplit from realitySchizophreniaDisorganized ThinkingThe thinking of a person with schizophrenia is fragmented, bizarre, and distorted by false beliefs Delusions: False beliefs, often of persecution or grandeurOften accompany psychotic disordersSchizophrenics cannot give undivided attention to anythingEasily distractedDisturbed PerceptionsA person with schizophrenia may perceive things that are not thereHallucinationsSensory experiences without sensory stimulationUsually auditory (hearing voices)May make insulting comments or give ordersWhen the unreal seems real, the resulting perceptions are at best bizarre, at worst terrifyingSchizophreniaInappropriate Emotions and ActionsEmotions of schizophrenia are often utterly inappropriateLaughing while recalling death, crying when others laugh, becoming angry for no apparent reason, etcOther victims may lapse into flat affectZombie-like state of apathyMotor behavior may also be inappropriateRocking, rubbing, senseless compulsive actsCatatoniaMay remain motionless for hours on end and then become agitated

Subtypes of SchizophreniaSchizophrenia is actually a cluster of disordersPatients with positive symptoms may experience hallucinations, are often disorganized, may exhibit inappropriate laughter, tears, or ragePatients with negative symptoms have toneless voices, expressionless faces, rigid and mute bodiesChronic SchizophreniaSlow-developing processRecovery is doubtfulAcute SchizophreniaDeveloped rapidly out of the blue, recovery is much more likely

Subtypes of SchizophreniaParanoid SchizophreniaPreoccupation with delusions or hallucinationsOften with themes of persecution or grandiosityDisorganized SchizophreniaDisorganized speech or behavior, ORFlat or inappropriate emotionCatatonic SchizophreniaImmobility, extreme negativism, and/or parrot-like repeating of anothers speech or movementsUndifferentiated SchizophreniaMany and widely varied symptomsResidual SchizophreniaWithdrawal, after hallucinations and delusions have disappeared

Understanding SchizophreniaBrain AbnormalitiesDopamine OveractivityOne key to schizophrenia involves the neurotransmitter dopamineSixfold excess of dopamine receptors have been found in the brains of deceased schizophrenic patientsSpeculate that such a high level may intensify brain signals, creating positive symptomsDrugs that block the receptors, often limit the symptomsHave little effect on persist negative symptoms

Understanding SchizophreniaBrain AnatomyMany people with chronic schizophrenia have abnormal brain activitySome have abnormally low brain activity in the frontal lobesMany studies have found enlarged, fluid-filled areas and a shrinkage of cerebral tissue in schizophrenic patientsStudies have also shown the thalamus to be smaller-than-normal in schizophrenicsMay explain why patients have a difficulty filtering sensory input and focusing attention

Understanding SchizophreniaSchizophrenia involves not a single brain abnormality, but problems in several regions and their interconnectionsOne possible cause is low birth weight and oxygen deprivationAnother possible cause is mid-pregnancy viral infection that impairs fetal brain developmentPeople are at an increased risk of schizophrenia if during the middle of their development, their country experiences a flu epidemicBorn in densely populated areas where viral diseases spread more easilyBorn during the winter and spring months, after the fall-winter flu seasonA childs mother is sick with the flu during pregnancyDuring pregnancy, your mother is fighting some sort of virus

Understanding SchizophreniaGenetic FactorsOdds are 1 in 10 that one will be diagnosed with schizophrenia if a sibling or parent is afflicted (1 in 100 otherwise)1 in 2 if that person is an identical twinResearchers have yet to find the specific genes that might predispose someone to having schizophrenia-inducing brain abnormalities

Personality DisordersPsychological disorders characterized by inflexible and enduring behavior patterns that impair social functioningAvoidant personality disordersCluster of disorders that express anxietyEx. Fearful sensitivity to rejection that predisposes a withdrawn behaviorSchizoid personality disordersExpresses eccentric behaviorsHistrionic personality disordersExhibits dramatic or impulsive behaviorsDisplays shallow, attention-getting emotions and go to great lengths to gain others praise and reassurance

Personality DisordersNarcissistic personality disordersExaggerate your own importanceAided by success fantasiesFind criticism harder to accept, often reacting with rage or shameBorderline personality disorderHave an unstable identity, unstable relationships, and unstable emotions

Personality DisordersAntisocial personality disorderDisorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and familyMay be aggressive and ruthless or a clever con artistThe most troubling of impulsive personality disordersFormerly called a sociopath or psychopathAround 15 or so years old, begin to lie, steal fight, have unrestrained sexual urgesCombine with a keen intelligence and the results can be horrifyingFeel little and fear little

Personality DisordersAntisocial personality disorder is composed of both biological and psychological factorsBiological relatives of certain individuals are at increased risk for antisocial behaviorGenetic vulnerability appears as a fearless approach to lifeShow little autonomic nervous system arousal to aversive eventsReact with lower levels of stress hormones than do others of their age (as children)If channeled in a more productive direction, this may lead to courageous heroism, adventurism, or star-level athleticismHowever, lacking a feeling of social responsibility may produce a con artist or killer

TreatmentsAntipsychotic DrugsThe revolution in drug therapy began with the accidental discovery of drugs that calmed psychotic patientsChlorpromazine (Thorazine) dampens responsiveness to irrelevant stimuliCan produce sluggishness, tremors, and twitchesTwitches are similar to those of Parkinsons disease patientsProvide the most help to schizophrenia patients experiencing positive symptomsNot as much of a help to patients with negative symptomsClozapine (Clozaril) has been sometimes shown to enable awakenings in some patients

TreatmentsAnti-anxiety DrugsXanax and Valium depress the central nervous system activity Like alcoholUsed in combination with other therapy, these drugs can help a person learn to cop with frightening situations and fear-triggering stimuliCriticism is that these drugs reduce symptoms without resolving underlying problemsPeople can develop a psychological dependence on the drugs

TreatmentsAntidepressant DrugsSometimes lift people from a state of depressionMost work by increasing the availability of the neurotransmitters norepinephrine or serotoninElevates arousal and moodFluoxetine (Prozac) partially blocks the re-absorption and removal of serotonin from synapsesProzac, Paxil, and Zoloft all do thisKnown as selective-serotonin-reuptake-inhibitor drugs (SSRIs) One side effect is decreased sexual appetite

TreatmentsOther antidepressants block the re-absorption of both norepinephrine and serotonin or by blocking the enzyme that breaks down serotoninHave more potential side effectsDry mouth, weight gain, hypertension, dizzy spellsThe full effects of these drugs often takes about four weeks