Abnormal PsychologyAbnormal Psychology

The diagnosis and treatment of The diagnosis and treatment of mental disordersmental disorders

Criteria for disordered behaviorCriteria for disordered behavior

DistressDistress Are they upset about their behavior?Are they upset about their behavior?

Deviance Deviance Is their behavior outside of what is culturally normal?Is their behavior outside of what is culturally normal?

DysfunctionDysfunction Does their behavior interfere with or impair daily Does their behavior interfere with or impair daily

functioning? Do they have a job? Normal functioning? Do they have a job? Normal relationships?relationships?

DangerDanger To themselves or others; made threats to harm To themselves or others; made threats to harm

themselves or harm othersthemselves or harm others

History of mental illnessHistory of mental illness People presumed that maladaptive behavior was due to:People presumed that maladaptive behavior was due to:

Lunar cycles (“full moon brings out the crazy”)Lunar cycles (“full moon brings out the crazy”) Evil spirits (possession)Evil spirits (possession) People with god-like powers (witches)People with god-like powers (witches)

Placed great emphasis on exorcising demonsPlaced great emphasis on exorcising demons ““Therapies” included:Therapies” included:

Beatings Beatings BurningsBurnings CastrationCastration Pulling teethPulling teeth ““Cauterizing” or burning of the clitorisCauterizing” or burning of the clitoris Transfusions of animal blood or removal of ones own blood to Transfusions of animal blood or removal of ones own blood to

restore “a balance of the humors”restore “a balance of the humors”

History of Mental IllnessHistory of Mental Illness

Medical model- the assumption that mental Medical model- the assumption that mental illness is a sicknessillness is a sickness

Mental illness is diagnosed by its symptoms and Mental illness is diagnosed by its symptoms and cured through therapy which may or may not cured through therapy which may or may not include treatment in a psychiatric hospitalinclude treatment in a psychiatric hospital

More recently the field of psychology has moved More recently the field of psychology has moved towards the medical perspective because?????towards the medical perspective because????? Cant argue genetics/biology. It’s a natural science Cant argue genetics/biology. It’s a natural science

with LAWS instead of THEORIES which are with LAWS instead of THEORIES which are debatable and subject to interpretationdebatable and subject to interpretation

Bio-psycho-social ApproachBio-psycho-social Approach

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

Genetic Predisposition

(Biological)

Social expect.,Social expect., norms, norms,

environ. Issuesenviron. Issues (sociological)(sociological)

Stress, Trauma, Environmental issues

(Psychological)

Bio Psycho Sociological Bio Psycho Sociological ApproachApproach

Classifying Psychological DisordersClassifying Psychological Disorders

DSM IV TRDSM IV TRDiagnostic Statistical Manual of Mental Diagnostic Statistical Manual of Mental

Disorders 4Disorders 4thth ed. (text revision) ed. (text revision) Benefits of diagnostic labeling include:Benefits of diagnostic labeling include:

A uniform method of identifying/classifying A uniform method of identifying/classifying maladaptive behaviormaladaptive behavior

Introduces a homogenized method of Introduces a homogenized method of effective treatmenteffective treatment

Encourages appropriate research to identify Encourages appropriate research to identify causality causality

Critics of the DSM IV TR and diagnostic Critics of the DSM IV TR and diagnostic labeling cite:labeling cite:DSM views almost every behavior as DSM views almost every behavior as

abnormal in some capacityabnormal in some capacityLeads to over/misdiagnosis of “normal” Leads to over/misdiagnosis of “normal”

peoplepeopleStigmatizing power of labelsStigmatizing power of labels

Perceive people differently that have been Perceive people differently that have been diagnosed with a mental disorderdiagnosed with a mental disorder

Instead of perceiving mental illness as a disease of Instead of perceiving mental illness as a disease of the brain its viewed as a fault in characterthe brain its viewed as a fault in character

Diagnostic labeling can also alter reality in that the Diagnostic labeling can also alter reality in that the “victim” becomes a self-fulfilling prophesy“victim” becomes a self-fulfilling prophesy

SchizophreniaSchizophrenia

SchizophreniaSchizophrenia

Out of touch with reality Out of touch with reality Two or more of the following during a one Two or more of the following during a one

month period month period Positive Symptoms (an ADDITION to your Positive Symptoms (an ADDITION to your

sensory experience)sensory experience)DelusionsDelusionsHallucinations Hallucinations Disorganized speechDisorganized speechDisorganized or catatonic behaviorDisorganized or catatonic behavior

Negative SymptomsNegative Symptoms

Negative Symptoms (a LOSS or defect of Negative Symptoms (a LOSS or defect of your sensory experience)your sensory experience) AlogiaAlogia

Decrease in speech or speech content (empty or absent Decrease in speech or speech content (empty or absent replies)replies)

Flat affectFlat affect Show little to no emotionsShow little to no emotions

AvolitionAvolition Apathy or feeling drained of energyApathy or feeling drained of energy

Social withdrawalSocial withdrawal Distancing oneself from their environment and becoming Distancing oneself from their environment and becoming

preoccupied with their ideas and fantasies preoccupied with their ideas and fantasies

SchizophreniaSchizophrenia

The onset of schizophrenia usually happens The onset of schizophrenia usually happens in late adolescence and in the early 20’sin late adolescence and in the early 20’s

1% of the population is schizophrenic1% of the population is schizophrenic More positive symptoms Type IMore positive symptoms Type I More negative symptoms Type IIMore negative symptoms Type II Males tend to get it earlier; gender ratio is 1:1Males tend to get it earlier; gender ratio is 1:1 Drug use can “spark” schizophrenia; Drug use can “spark” schizophrenia;

especially hallucinogensespecially hallucinogens

PathologyPathology

Enlarged brain ventricles, Enlarged brain ventricles, underdeveloped frontal area of the brain underdeveloped frontal area of the brain (mostly Type II)(mostly Type II)

Excessive sensitivity to dopamineExcessive sensitivity to dopamine Prenatal exposure to influenza virus Prenatal exposure to influenza virus

during the second trimester of during the second trimester of pregnancypregnancy

Overwhelming biological evidence Overwhelming biological evidence linking schizophrenialinking schizophrenia

Types of SchizophreniaTypes of Schizophrenia

Catatonic schizophreniaCatatonic schizophrenia More catatonic behavior than anything elseMore catatonic behavior than anything else

Paranoid schizophreniaParanoid schizophrenia More delusions than anything elseMore delusions than anything else

Disorganized schizophreniaDisorganized schizophrenia More disorganized speech than anything elseMore disorganized speech than anything else

Undifferentiated schizophreniaUndifferentiated schizophrenia Waste bin of schizophreniaWaste bin of schizophrenia

DelusionsDelusions

Delusions are false beliefsDelusions are false beliefs Delusions of persecutionDelusions of persecution

Threats of harm from someoneThreats of harm from someone Delusions of referenceDelusions of reference

Assumptions that outside stimuli is being sent to you about Assumptions that outside stimuli is being sent to you about ways to live your lifeways to live your life

Delusions of controlDelusions of control Assume others are controlling you through some form of Assume others are controlling you through some form of

telepathytelepathy Delusions of grandeurDelusions of grandeur

Thoughts that you are an important person or figure ex. Thoughts that you are an important person or figure ex. Hitler, Satan, Jesus, Virgin Mary, etc.Hitler, Satan, Jesus, Virgin Mary, etc.

Disorganized SpeechDisorganized Speech NeologismNeologism

Made up words ex. hexklempMade up words ex. hexklemp PerseverationPerseveration

Saying the same word over and overSaying the same word over and over ClangingClanging

Rhyming words into an incoherent phraseRhyming words into an incoherent phrase ““He raged at the hypocrisy of aristocracy democracy!!”He raged at the hypocrisy of aristocracy democracy!!”

Word saladWord salad Tossing words in randomly; jibberishTossing words in randomly; jibberish

Loose associationsLoose associations Bouncing from one topic of conversation in an Bouncing from one topic of conversation in an

incoherent fashionincoherent fashion

HallucinationsHallucinations

Hallucinations are false perceptions within Hallucinations are false perceptions within your sensesyour senses Auditory hallucinations Auditory hallucinations are by far the most commonare by far the most common

Hear sounds and voices that come from outside their headsHear sounds and voices that come from outside their heads Auditory hallucinations are most likely to occur during times of Auditory hallucinations are most likely to occur during times of

idleness or inattentionidleness or inattention Visual hallucinationsVisual hallucinations

Vague perceptions of color; seeing people or objects that aren’t Vague perceptions of color; seeing people or objects that aren’t therethere

Tactile hallucinationsTactile hallucinations Tingling, burning, electrical shock sensations, or bugs crawling all Tingling, burning, electrical shock sensations, or bugs crawling all

over one’s body or beneath the skinover one’s body or beneath the skin Somatic hallucinationsSomatic hallucinations

An organ shifting inside the body or a snake inside one’s stomachAn organ shifting inside the body or a snake inside one’s stomach

Catatonic behaviorCatatonic behavior Catatonic stuporCatatonic stupor

Totally unaware of and unresponsive to their Totally unaware of and unresponsive to their environmentenvironment

Catatonic rigidityCatatonic rigidity Maintaining rigid, upright posture for hours and Maintaining rigid, upright posture for hours and

resisting efforts to be movedresisting efforts to be moved Catatonic posturingCatatonic posturing

Assuming awkward bizarre positions for long periods Assuming awkward bizarre positions for long periods of timeof time

Catatonic excitementCatatonic excitement Hyperactivity, uncontrollable wild behavior; wildly Hyperactivity, uncontrollable wild behavior; wildly

waving arms and legs waving arms and legs

Treatments for Schizophrenia Treatments for Schizophrenia

Electroconvulsive Therapy (ECT)Electroconvulsive Therapy (ECT) Patient is shocked with up to 100 volts of electricityPatient is shocked with up to 100 volts of electricity SIDE EFFECTS: memory loss, extremely painful, SIDE EFFECTS: memory loss, extremely painful,

clinicians don’t know why it worksclinicians don’t know why it works

Convulsive TherapyConvulsive Therapy Drugs are administered to cause a seizure to “re Drugs are administered to cause a seizure to “re

start” the brain ending hallucinations and delusionsstart” the brain ending hallucinations and delusions SIDE EFFECTS: clinicians don’t know why it works, SIDE EFFECTS: clinicians don’t know why it works,

kidney and liver damagekidney and liver damage

Phenothiazines (Anti psychotic medication) Phenothiazines (Anti psychotic medication) Haldol, Thorazine, MellarilHaldol, Thorazine, Mellaril

A derivative of antihistamines; diminish positive A derivative of antihistamines; diminish positive symptoms and negative symptoms with timesymptoms and negative symptoms with time

SIDE EFFECTS: tardive dyskinesia (uncontrollable SIDE EFFECTS: tardive dyskinesia (uncontrollable shaking), dystonia (involuntary muscle contractions, shaking), dystonia (involuntary muscle contractions, uncontrollable movement of the face, neck, & uncontrollable movement of the face, neck, & tongue), diminished sexual activity, nausea tongue), diminished sexual activity, nausea

Bipolar Disorder

Bipolar Disorder

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 =

DepressionDepression

• 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

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

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

Anxiety DisordersAnxiety Disorders

• Most common disorders in the USMost common disorders in the US• 15-17% of the US population suffer15-17% of the US population suffer

– Generalized Anxiety DisorderGeneralized Anxiety Disorder– PhobiaPhobia– Panic disorderPanic disorder– Obsessive Compulsive DisorderObsessive Compulsive Disorder– Post Traumatic stress DisorderPost Traumatic stress Disorder– Social Anxiety DisorderSocial Anxiety Disorder

Generalized Anxiety Generalized Anxiety DisorderDisorder

• Excessive anxiety or worrying about Excessive anxiety or worrying about numerous events or activitiesnumerous events or activities

• Sufferers live in a constant state of Sufferers live in a constant state of fear and dreadfear and dread

• Women outnumber men 2:1Women outnumber men 2:1

• Typically called “worriers”Typically called “worriers”

SymptomsSymptoms

RestlessnessRestlessness FatigueFatigue Difficulty concentratingDifficulty concentrating IrritabilityIrritability Muscle tensionMuscle tension InsomniaInsomnia

GADGAD

As job income decreases the As job income decreases the incidence of GAD increasesincidence of GAD increases

SSRI’s (Select Serotonin Reuptake SSRI’s (Select Serotonin Reuptake Inhibitors) are the most common Inhibitors) are the most common treatmenttreatment– ProzacProzac– PaxilPaxil– ZoloftZoloft

PhobiaPhobiaA persistent unreasonable fear of A persistent unreasonable fear of

particular objects, activities, or particular objects, activities, or situationssituations

PhobiaPhobia

• Are different from everyday fearsAre different from everyday fears

• Phobic fear is more intense and Phobic fear is more intense and persistentpersistent

• The desire to avoid the object or The desire to avoid the object or situation is more compelling situation is more compelling (stronger)(stronger)

• Phobic fear interferes with personal, Phobic fear interferes with personal, social, and occupational functioningsocial, and occupational functioning

PhobiaPhobia

• DSM IV criteriaDSM IV criteria– Marked and persistent fear that is Marked and persistent fear that is

excessive or unreasonable. Cued or excessive or unreasonable. Cued or caused by the presence or anticipation of caused by the presence or anticipation of the specific object or situationthe specific object or situation

– Exposure to the phobic stimulus provokes Exposure to the phobic stimulus provokes an immediate responsean immediate response

– The person recognizes that the fear is The person recognizes that the fear is unreasonableunreasonable

– Avoidance, anxious anticipation or Avoidance, anxious anticipation or distress interferes with normal functioningdistress interferes with normal functioning

PhobiaPhobia

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

PhobiaPhobia

2:1 female to male 2:1 female to male The earlier the onset the easier to cureThe earlier the onset the easier to cureTends to run in familiesTends to run in families

TreatmentsTreatments

FloodingFlooding Forcing a subject to come in contact with the phobic Forcing a subject to come in contact with the phobic

stimulus stimulus

Systematic DesensitizationSystematic Desensitization Slowly exposing the subject to the phobic stimulus to Slowly exposing the subject to the phobic stimulus to

extinguish the fear extinguish the fear

High risk for re-traumatization with flooding; but High risk for re-traumatization with flooding; but its quickerits quicker

Systematic Desensitization takes more timeSystematic Desensitization takes more time