Abnormal PsychologyPsychological Disorders

A harmful dysfunction in which thoughts, feelings, or behaviors are maladaptive, unjustifiable, disturbing, and

atypical.

Criteria for Psychological Disorders

• Maladaptive – destructive to oneself or others.• Unjustifiable – without a rational basis.• Disturbing – troublesome to other people.• Atypical – so different that it violates a norm.

• “MUDA” (mnemonic).

Early Theories• Abnormal behavior was evil

spirits trying to get out.• Trephining was often used.

Trephening

Early Theories• Another way to deal with the demons

was to make the body extremely uncomfortable.

History of Mental Disorders• In the 1800’s,

disturbed people were no longer thought of as madmen, but as mentally ill.

Did this mean better treatment?

They were first put in hospitals.

Early Mental Hospitals• They were nothing more than

barbaric prisons.

•The patients were chained and locked away.

•Some hospitals even charged admission for the public to see the “crazies”, just like a zoo.

Philippe Pinel• French doctor worked

to eliminate the institutional brutality (and declare that these people are sick and “a cure must be found”).

Medical Model• Late 1800’s - it was believed that mental

illness had a physical or organic cause.

General Paresis and Syphilis examples.

But it doesn’t emphasize environmental explanations like stress or upbringing.

Many disorders are psychogenic: the origin is psychological, not physical.

Current Perspectives• Bio-psycho-social model: assumes

biological, psychological and socio-cultural factors interact to produce specific psychological disorders. Most common view today.

Some disorders occur worldwide (schizophrenia) while others are culture-bound (i.e. “anorexia” & “susto” – fear of black magic in Latin America).

DSM-V• Diagnostic

Statistical Manual of Mental Disorders: the big book of disorders.

• DSM will classify disorders.

• Critics say it’s biased towards the medical model.

Two Major Classifications in the DSM

Neurotic Disorders

• Distressing but one can still function in society and act rationally.

Psychotic Disorders

• Person loses contact with reality, experiences distorted perceptions.

John Wayne Gacy

Danger of Diagnostic Labels• In Rosenhan’s study his associates were

faking symptoms of hearing voices.• They were ALL admitted for

schizophrenia.• None were exposed as imposters.• They all left diagnosed with

schizophrenia in remission.• What did this study show?• 1.) It showed the biasing power of

diagnostic labels.

Childhood Disorders• ADHD:• Hyperactive behavior;

can’t stay on task long.• 3-5% of children.• Mostly boys.• Ritalin, Adderall, and

Concerta – treatments.

Childhood Disorders• Autism – often severely

incapacitating, developmental disability appearing in the first 3 years.

• 1 out of 110.• Trouble forming attachments

with people.

Anxiety Disorders• A group of conditions

where the primary symptoms are anxiety or defenses against anxiety.

• The patient fears something awful will happen to them.

• They are in a state of apprehension or nervousness.

• Are they a neurosis or psychosis?

Taylor Manifest Anxiety Scale1. F2. T3. F4. F5. T6. T7. T8. T9. F10.T11.T12.F13.T14.T15.F16.T17.T

18.F19.T20.F21.T22.T23.T24.T25.T26.T27.T28.T29.F30.T31.T32.F33.T34.T

35.T36.T37.T38.F39.T40.T41.T42.T43.T44.T45.T46.T47.T48.T49.T50.F

Taylor Manifest Anxiety Scale

• Mean 14.5– True indicate anxiety related to that item

• Learning theorist explain anxiety in terms of classical conditioning.

• Psychoanalysts believe, unresolved conflict that occurs when defense mechanisms are weak.

The Human Experience

GAD, Panic, Phobias

Generalized Anxiety Disorder (GAD)• Marked by disruptive levels

of persistent feelings of apprehension and tenseness.

• Symptoms include restlessness, feeling on edge, irritability, sleep disturbance.

• 2 out of 3 – women.

Panic Disorder• Disorder marked by a sudden

bout of intense, unexplained panic. Person experiences terror and accompanying chest pain, choking and other frightening sensations.

• Can cause secondary disorders like agoraphobia.

Phobias• Marked by disruptive, irrational

fears of objects, activities, or situations.

• Specific phobias – like arachnophobia.

• Agoraphobia – fear of public places.

Examples of PhobiasName of the phobia: Fear of:

Xenophobia Strangers

Ophidiophobia Snakes

Panaphobia Everything

Santa Claustrophobia Stuck in chimneys

Numerophobia Numbers

Arachnophobia Spiders

Murophobia Mice

Mikrophobia Germs

Social Anxiety Thoughts (SAT)

• Add #s in front of each item.

• Range 21 – 105

• Mean 42.3

• Higher scores reflect greater social anxiety

Social Anxiety Thoughts (SAT)

• Four General Categories:– Thoughts of general discomfort and social

inadequacy.– Concerns with others’ awareness of distress– Fear of negative evaluations– Perceptions of autonomic arousal and

performance anxiety.

• Which category do you think your score is highest from?

Social Anxiety Thoughts (SAT)• Socially Anxious people:

– Seek to avoid potentially embarrassing social situations– If they cannot avoid eye contact experience psychical

symptoms– Fear of detection– Early signs start late childhood/early adolescence; fear

of public speaking or eating in public– Fear of criticism and of making a mistake– Feel like imposters.

• Are any of the these things true for you?

Guidelines for dealing with Social Phobia:1. In dealing with symptoms of anxiety, respond with

approach rather than avoidance.

2. Greet people with eye contact.

3. Create a list of possible topics of conversation and listen carefully to others.

4. Initiate conversations by asking questions.

5. Speak clearly with out mumbling.

6. Be willing to tolerate some silence.

7. Wait for cues from others.

8. Learn to tolerate criticism and be willing to introduce a controversial topic at an appropriate point.

Obsessive-compulsive disorder

• Persistent unwanted thoughts (obsessions) cause someone to feel the need to engage in a particular repetitive action (compulsion) .

Common Examples of OCD

Common Obsessions:Common

Compulsions:

Contamination fears of germs, dirt, etc.

Washing

Imagining having harmed self or others

Repeating

Imagining losing control of aggressive urges

Checking

Intrusive sexual thoughts or urges

Touching

A need to have things "just so" Hoarding or saving

The Obsessive-Compulsive Scale

• Score 1 point for “true” responses on questions: 1, 2, 4, 6, 7 8, 16, 17, 18 and 21.

• Score 1 point for “false” responses on questions: 5, 9, 10, 11, 12, 13, 14, 19, 20 and 22.

• Range 0-20, higher scores reflecting greater compulsivity.

• Male mean = 11.15

• Female mean = 11.24

The Obsessive-Compulsive Scale

• Approx. 20% have only obsession or compulsion.

• Victims may even realize faulty logic of obsession, but cannot stop.

• 4 Million Americans; Children – Adult

• Generally appears before age 25, linked to stressful event and affects boys more than girls.

• 80% involve washing rituals

• Runs in families, up to 20%

What’s the difference?• Obsession – endless cycle of repetitive thoughts.• Compulsion – feeling that you they must repeat

certain actions again and again.– Obsession: A young woman is continuously terrified

by the thought that cars might careen onto the sidewalk and run her over 

– Compulsion: She always walks as far from the street pavement as possible and wears red clothes so that she will be immediately visible to an out of control car. 

What’s the difference?• Obsession: A mother is tormented by the concern that she

might inadvertently contaminate food as she cooks dinner for her family.

• Compulsion:  Every day she sterilizes all cooking utensils in boiling water, scours every pot and pan before placing food in it, and where's rubber gloves while handling food.

• Obsession: A woman cannot rid herself of the thought that she might accidentally leave her gas stove turned on, causing her house to explode.

• Compulsion: Every day she feels the irresistible urge to check the stove exactly 10 times before leaving for work.

What’s the difference?• Obsession: a college student has the urge to shout

obscenities while sitting through lectures in class.• Compulsion: carefully monitoring his watch, he bites his

tongue every 60 seconds to ward off the inclination to shout.

•  Obsession: a young boy worries incessantly that something terribly might happen to his mother while sleeping at night.

• Compulsion: on his way to bed each night, he climbs the stairs accordingly to a fixed sequence of three steps up, followed by two steps down to ward off danger.

Post-traumatic Stress Disorder (PTSD)• Flashbacks or

nightmares following a person’s involvement in or observation of an extremely stressful event.

• Memories of the event cause anxiety.

• War veterans and “shell shock.”

Biological Causes of Anxiety Disorders

• Heredity or predisposition -(twin studies).

• Brain function - (PET scans of OCD patients show higher frontal lobe activity).

• Evolution – likely to fear situations that posed threat to early humans.

Learning Factors and Anxiety Disorders• Conditioning - remember

Little Albert?• Observational learning –

seeing someone else respond with fear (i.e. a sibling).

• Reinforcement – learning to associate emotions with actions and the results that follow those actions.

Journal # 29

Write a past experience associated with each word:

train shoe road

ice window machine

wood sign rain

letter meeting roam

house travel water

race reading tunnel

Mood Disorders• Psychological disorders characterized by

emotional extremes (i.e. depression, mania, or both).

The Zung Self-rating Depression Scale

• Reverse #s: 2, 5, 6, 11, 12, 14, 16, 17, 18 and 20 ( 1=5, 2=4, 3=3, 4=2, 5=1)

• Range 20 -100

• 50-59 Mild to Moderate Depression

• 60-69 moderate to Severe Depression

• 70 and above indicates severe depression

Major Depressive Disorder• Most common disability in the

world (6% of men & 10% of women).

• Unhappy for at least two weeks with no apparent cause.

• Feelings of worthlessness and diminished interest in most activities.

• May have suicidal thoughts.

Journal # 30How would you know if a friend was suicidal? What would you do if they were?

The Automatic Thoughts Questionnaire

Identify the covert self-statements reported by depressive as being representative of the kinds of cognitions that depressed persons experience.•Personal maladjustment and desire for change (14 and 20)•Negative expectations (3 and 24)•Low self-esteem (17 and 18)•Helplessness (29 and 30)

The Automatic Thoughts Questionnaire

Total Score Range 30 -150– 30 little or no depression– 150 maximum depression

Mean Scores– 79.6 depressed samples– 48.6 nondepressed samples

The Revised Facts on Suicide Quiz

1. F 10. F 19. A 28. C

2. T 11. F 20. C 29. A

3. T 12. T 21. B 30. C

4. F 13. T 22. A 31. C

5. F 14. T 23. B 32. B

6. F 15. F 24. A 33. B

7. T 16. F 25. B 34. A

8. F 17. T 26. C 35. B

9. T 18. T 27. A 36. C

SuicideSuicide rates increase with age.

SuicideBut teen suicide rates increased from 1960to 1990, but have dropped since 1990.

10 Common Characteristics of Suicidal People

1. Unendurable psychological pain

2. Frustrated psychological needs

3. The search for a solution

4. An attempted to end consciousness

5. Helplessness and hopelessness

6. Constriction of options

7. Ambivalence

8. Communication of intent

9. Departure

10. Lifelong coping patterns

Journal #31

Name 5 people you could go to if you needed to talk to somebody about negative

feelings you may have.

Bipolar Disorder• Formally called manic

depression.• Involves periods of depression

and manic episodes.• Manic episodes may involve

long periods of little sleep, racing thoughts, and set impossible goals.

• May have bursts of creative energy during manic states (like van Gogh).

Famous People with Bipolar

Bipolar Brain

Postpartum Depression• Depression after

childbirth (“baby blues”).

• Sadness, fatigue, insomnia, reduced libido, etc.• Usually the first few

months after giving birth.

• 5% to 10% of women.

Seasonal Affective Disorder• Experience

depression during the winter months.

• Based not on temperature, but on amount of sunlight.

Biological Causes of Mood Disorders

• Heredity – twin studies.• Brain function – PET scans have

shown lower brain activity during depressed states.

• Serotonin and Norepinephrine are lacking during times of depression (Prozac helps restore these neurotransmitter levels).

Social-Cognitive Factors and Mood Disorders

• Learned helplessness.• Attributions (explanatory

style) – Stable, internal and global.

Dissociative Disorders

Dissociative Disorders• Disorders in which

the sense of self has become separated (dissociated) from previous memories, thoughts, or feelings.

Dissociative Amnesia• A partial or total

forgetting of past experiences, without organic cause.

• Usually in reaction to a traumatic event.

Organic Amnesia (not a dissociative disorder)

• Results from other medical trauma (e.g. a blow to the head, stroke, alcoholism).

Dissociative Fugue• A form of dissociative amnesia

characterized by physical relocation and the assumption of a new identity with amnesia for the previous identity. (“Traveling amnesia”).

•These journeys can last hours, even several days, months or years.

Dissociative Identity Disorder (D.I.D.)• Used to be known as Multiple

Personality Disorder.• Rare & controversial disorder

where the person exhibits two or more distinct and alternating personalities.

• Number of cases increased dramatically during the 1980’s (popular book “Sybil”).

• Claims of child sexual abuse.

Somatoform Disorders• Disorders in which

symptoms take a bodily form without apparent physical cause.

• Two types…

Hypochondriasis• Characterized by

imagined symptoms of illness.

• They usually believe that the minor issues (headache, upset stomach) are indicative of more severe illnesses.

Conversion Disorder• Loss or impairment

of some motor or sensory function due to a psychological conflict.

• Formerly known as hysteria.

• Many of Freud’s patients suffered from this.

Sigmund Freud

Psychotic Disorders

Schizophrenia

• Is not one disorder but a group of disorders.

• It is not “split personality.”• Typically develops in late

adolescence.

Schizophrenia• About 1% of people are

diagnosed with schizophrenia.

3 Symptoms of Schizophrenia:

1.Disorganized thinking.2.Disturbed Perceptions.3.Inappropriate Emotions and

Actions.

1.) Disorganized Thinking• The thinking of a person

with schizophrenia is fragmented and bizarre.

• Disorganized thinking comes from a breakdown in selective attention - they cannot filter out information.

• Often causes . . .

Delusions (false beliefs)• Delusions of Persecution

(people are out to get you).

• Delusions of Grandeur (belief that you are more important than you really are).

2.) Disturbed Perceptions• Hallucinations –

(usually auditory) is a false perception.

3.) Inappropriate Emotions and Actions

• Laugh at inappropriate times.• Flat Effect (emotionless).• Senseless, compulsive acts.• Catatonia - motionless waxy

flexibility.

Types of Schizophrenia

Paranoid Schizophrenia• Preoccupied with

delusions of persecution or grandeur as well as hallucinations.

• Always looking over your shoulder like somebody is out to get you!

• http://www.youtube.com/watch?v=gGnl8dqEoPQ&feature=results_main&playnext=1&list=PL135E3BF70B9D590C

Catatonic Schizophrenia• Flat emotion.• Waxy flexibility.• Little movement, or

speech.

Disorganized Schizophrenia• Disorganized speech or behavior, or

flat or inappropriate emotion.• Clang associations: speaking in

rhyme.• “I’m the worst

systematic, sympatheticquite pathetic, apologetic, paramedic.“

• Word salad: nonsense talk.• “It’s all over for a squab true tray

and there ain’t no music. I’ve got to travel all the time to keep my energy alive.”

Undifferentiated Schizophrenia• Doesn't match any of

the established types of schizophrenia. (i.e. paranoid, catatonic, or disorganized)

Biological Causes of Schizophrenia • No known single

cause. • Possible causes:• Excess of dopamine

receptors (6x).• Low activity in frontal

lobes.• Genetics (50% chance

for identical twins).

Biological Causes of Schizophrenia

• Possible causes:• Enlarged ventricles (fluid

filled spaces) in the brain.

• Shrinkage of brain tissue in limbic system.

• Prenatal viruses.

Psychological Causes of Schizophrenia

• There is NO proof that any social or psychological factors “cause” schizophrenia.

• We don’t know what role stress or disturbed family communications play.

• The just appear to be correlated.

Personality Disorders• Characterized by rigid and

lasting behavior patterns that disrupt social functioning.

• 3 main clusters:• A.) Related to anxiety• B.) Odd or Eccentric

Behaviors• C.) Dramatic or Impulsive

Behaviors

A.) Related to Anxiety

• Avoidant Personality Disorder – sensitive about being rejected so relationships become difficult.

• Dependent Personality Disorder – are clingy and submissive.

B.) Odd or Eccentric Behaviors

• Paranoid Personality Disorder – show deep distrust of other people.

• Schizoid Personality Disorder – are detached from social relationships (true hermits).

C.) Dramatic or Impulsive Behaviors

• Borderline Personality Disorder (following slides).

• Antisocial Personality Disorder (following slides).

Borderline Personality Disorder• Characterized by unstable emotions

and relationships.

People with this disorder are prone to constant mood swings and bouts of anger.

Borderline Personality Disorder

• They will take their anger out on themselves, causing themselves injury (cutting).

Suicidal threats and actions are not uncommon.

Antisocial Personality Disorder• Antisocial personality disorder is

characterized by a lack of conscience.

• People with this disorder are prone to criminal behavior never feel sorry for harming others.

Antisocial Personality Disorder• Also known as “sociopaths”. Examples

would be Charles Manson & Hannibal Lecter.

They are often aggressive and are much more concerned with their own needs than the needs of others.