Chapter 14: Psychological Disorders (Abnormal Psychology)

Defining Abnormality Defining abnormality is not simple, it appears to be more a

matter of degree of behavioral change & distress rather than the presence or absence of a behavioral change or distress

Some criterion seem helpful in defining abnormality: • Behavior is outside of social norms

(shouting at strangers…*shows what is “normal” is culturally dependent)

• Inability to function (being unable to go to work due to alcohol abuse)

• Personal Distress (trouble sleeping, worry all the time, thoughts of suicide)

• Prolonged Suffering (depression that lasts months rather than days)

Normality-Abnormality Continuum

DSM IVDiagnostic and Statistical Manual (DSM IV) 1952- First edition 1994- 4th edition 2000- 4th revised 2013- Planned release for 5th edition

Five axis criteria for diagnostic classification of psych. disordersAxis 1- Principal diagnosis - 16 categoriesAxis 2- Personality or developmental disordersAxis 3- Medical conditionsAxis 4- Recent sources of stressAxis 5- Global Assessment of Functioning (GAF)

Schizophrenic Disorders Group of disorders marked by disturbances in

thought patterns. These disorders can be accompanied by distortions in perception and abnormal emotional responses.

1% of population in every culture 30% resistant to drugs Gradual vs. Sudden onset

Subtypes of Schizophrenia Paranoid: marked by delusion of persecution and/or

grandeur, and frequent auditory hallucinations

Disorganized: marked by inappropriate affect, disorganized speech

Catatonic: marked by motor disturbances ranging from immobility to excessive, purposeless activity

Undifferentiated: mixtures of symptoms from other subtypes

Potential Causes of Schizophrenia Physiological Explanations

• neurochemicals- excess dopamine • enlargement of the ventricles of the brain

(genetics- there is a 46% concordance rate for identical twins with one twin suffering schizophrenia

Environmental Explanations• Stress- can precede the onset of schizophrenia and precede

subsequent relapses• Unhealthy Family Dynamics- high expression of emotion and

communication difficulties in a family • Date of birth- maybe flu season during time in womb? (see next

slide)

Risk Month Born

Relatives of ppl with schizophrenia

Anxiety Disorders Generalized Anxiety Disorder: chronic anxiety that is not

caused by a specific stimulus Panic Attacks: recurrent attacks of anxiety not due to a specific

event Phobias: chronic, irrational fear of a specific object or situation agoraphobia (open spaces), social phobia

Obsessive-Compulsive Disorder: persistent obtrusive thoughts (obsessions) & need to engage in unnecessary rituals (compulsions)

Post Traumatic Stress Disorder (PTSD): after traumatic life event person has severe anxiety, helplessness, fear, flashbacks

Common Phobias

Less Common (but entertaining)…phobias list

Some Potential Causes of Anxiety Disorders

Behavioral explanations: Classically conditioned phobic responses

Neuro-chemical: decreases in GABA activity and serotonin activity are associated with anxiety disorders

Cognitive: people who suffer from anxiety disorders may chronically overestimate the severity of a perceived threat

Mood Disorders Depressive Disorder: persistent feelings of

sadness and a loss of interest in finding pleasure (Major, dysthemic (two years +), post-partum, seasonal affective disorder)

Bipolar Disorder: marked by chronic experience of manic and depressive episodes

Episodic Patterns in Mood Disorders

Some Potential Causes of Depression

Cognitive and Behavioral Mechanisms• Behavioral: ”learned helplessness” believe outcomes in their life

are out of their control (external locus of control)

• Cognitive: negative self-talk is associated with depressive episodes

Physiological Mechanisms• Neurotransmitters: decreased norepinephrine and serotonin is

associated with depression

• Genetics: there is a 65% concordance rate between identical twins

Mood Disorders chart

Somatoform Disorders

Physiological issues without cause Hypochondriasis: excessive preoccupation with

becoming ill Conversion Disorder: significant loss of function

in one single organ system without a physiological cause

Dissociative Disorders Dissociative Amnesia: sudden loss of memory for personal

information that is not due to normal forgetfulness Dissociative Fugue: a loss of memory and forming a new

identity

Dissociative Identity Disorder (DID): the coexistence of more than one personality in an individual

Depersonalization: Feelings of unreality concerning the self and environment. Anxiety producing. Many young adults have felt this.

Personality Disorders- a few examples Antisocial Personality Disorder (sociopath): marked

by impulsive, callous, manipulative, aggressive, and irresponsible behavior that lacks conscience (often charming)

Narcissistic: exaggerated feelings of self-worth and constant need for affirmation

Histrionic: OVERLY emotional/seductive Borderline: irrational fear of abandonment, self injury Avoidant: Dependent: Schizotypical: Obsessive-Compulsive:

Insanity Pleas Does not know right from wrong A disorder alone does not absolve responsibility John Hinkley - President Reagan Ted Kaczynski, Jeffrey Dahmer, Andrea Yates, Kip

Kinkel- all found guilty by juries

Some Potential Causes of Somatoform Disorders Personality Factors: people with histrionic and

neurotic personality traits seem to be more susceptible to the somatoform disorders

Behavioral Factors: people who have previously received a lot of attention because of illness may begin to find reward in the somatoform disorders

Problems with DSM/disease model Thomas Szasz- no such thing as mental ill Rosenhan- empty, hollow, thud- 19 days Labeling theory Not easy to classify- crossover Infers more understanding than actual Everyday problems Insurance

Suicide White > Black,

Men > Women (China), Woman attempts > Men attempts

Spike for men after 65 Alcoholics and depression very high rate Few who talk about it do it, but most who do it

give clues ahead of time Arizona over 1000 suicides last year- Mesa 60,

Chandler 30

Suicide facts

Take all threats seriously Most suicidal people are ambivalent and

want help Asking a person can minimize anxiety and

act as a deterrent An attempter is often upset or depressed

Clues and Warning Signs

Change in interest or mood (including extremely happy or peaceful.

Change in lifestyle, eating, sleeping Change in perception of the world Change in attitude about personal property-

giving away prized possessions

Teen Sex and Depression

2800 14 to 17 year-olds 25% of sexually active girls feel depressed

all, most, or a lot of the time vs 8% 14% of sexually active girls have attempted

suicide vs 5% 6% of sexually active boys vs less than 1%