Abnormal Psychology

1. Abnormal Psychology

2. Psychological DisordersHow common are they? • 1994: Michigan Institute for Social Research • Nearly ½ of people age 15-54 have experienced at least one bout with psych disorder • Psych disorders peak between ages 25 and 34 • Only 1 out of 4 ever receive help • Many are mild, thus recover without help • Most common disorders • Major depressive episode, alcohol dependence, social phobia, simple phobia

3. Psych Disorders in the U.S. …. • Psych disorders are often culturally based… • Examples p. 8 • Michigan study… • ¼ of Americans met criteria for mental illness within prior year • ¼ of those had serious disorder • U.S. posed to rank #1 in mental illness… • So what is a mental illness and what criteria qualify somehow as mentally ill…?

4. What is Abnormal Psych?? • Abnormal Psychology • Study of people who suffer from psychological disorders • Behavior and or thoughts • From depression, substance abuse, learning difficulties to schizophrenia and bipolar disorder

5. What constitutes Abnormal? • 4 Criteria to characterize as abnormal • Unjustifiable (irrational) : can’t justify / doesn’t make sense • Maladaptive: Harmful / disturbing to the individual • Atypical (unusual): not shared by members of population • Disturbing (irrational): Disturbing to others • All or most not required to be diagnosed OR….. • “Deviant, Distressful, Dysfunctional”

6. DSM-IV • Diagnostic and Statistical Manual of Mental Disorders • Resource to diagnose patients (only) • Symptoms of everything considered to be psychological disorder • 16 clinical syndromes • Weakness: assumption / labeling of mental illness based on symptoms…

7. Rosenhan Study • Dangers of labeling patients with disorders • 8 participants who faked symptoms • All acted completely normal except for testifying to hearing voices (3 words) • All diagnosed with Schizophrenia and discharged as “Schizophrenia in remission” • Average stay in institutions- 18 days

8. Perspectives on Causes… • Psychoanalytic theorists • Unconscious conflicts (traumatic events during psychosexual stages) • Behaviorists • History of reinforcement • Cognitive theorists • Maladaptive ways of thinking • Humanistic theorists • A person’s feelings, self-esteem, self-concept • Biomedical theorists • Hormonal / neurotransmitter imbalances, brain structure, genetic abnormalities

9. An Eclectic Approach • Specific fields are not exclusive to their theories • Consider any/ all theories as potential influence to a specific illness

10. 6 Major Types of Disorders… • Anxiety Disorders • Somatoform disorders (psych issue causes physiological problem) • Dissociative disorders (disruption in conscious processes) • Mood / affective disorders (extreme / inappropriate emotions) • Schizophrenic disorders: (Disordered, distorted thinking) • Personality Disorders: (Maladaptive behavior that affects functioning)

11. Don’t Get Paranoid… • Intern’s Syndrome • Tendency to see in oneself the characteristics of a disorder one is studying.

12. Anxiety Disorders • When do we classify it as a disorder? • Distressing, persistent anxiety or maladaptive behaviors to reduce anxiety • Think of one of one of the most stressful moments or events in your lifetime. Choose three adjectives to describe how you felt and three physical characteristics that you experienced. • Heart palpitations, sweaty palms, dizziness, ringing in ears, muscular tension, sleeplessness....

13. Types of Anxiety Disorders • Generalized Anxiety Disorder (GAD) • Constant low-level anxiety (nervousness) • 2/3 are women • Patient can’t identify its cause and thus can’t deal with or avoid it. • Often accompanied by depression • Tense, jittery, muscular tension, agitation, sleeplessness, difficulty concentrating (fidgeting, twitching, trembling)

14. Panic Disorders • Acute episodes of intense anxiety without provocation (panic attack) • Tend to increase in frequency (minutes long) • 1 in 75 (smokers 2-4 x more likely) • Heart palpitations, shortness of breath, choking sensations, trembling, dizziness… • “feels like a heart attack” • Charles Darwin (age 28)

15. Phobias • Focuses anxiety on a specific object, activity or situation. • Irrational fear that disrupts behavior • Identify these phobias: • Agoraphobia • Social phobia • Androphobia • Coulrophobia • Cynophobia • Didaskaleinophobia

16. Obsessive-Compulsive Disorder • OCD • Persistent obsessive (uncontrollable) thoughts lead to compulsive (uncontrollable) actions • Obsession creates anxiety / reduced by compulsive behavior • Cleanliness, security, symmetry, organization • Often late teens, early twenties (2-3%) • Howard Hughes

17. Post-Traumatic Stress Disorder • PTSD • Cause: experiencing / witnessing a traumatic event (fear, helplessness, horror) • Nightmares, flashbacks, social withdrawal, insomnia • Combat veterans, disaster or accident survivors, sexual assault victims, 2/3 of prostitutes • Basic trust erodes, sense of hopelessness • 15% of Vietnam vets (45% for heavy combat) • 1 in 6 Iraqi combat infantry veterans

18. Theories Explaining Anxiety Disorders • Brainstorm with a partner. • How would the Psychoanalytic theorist explain the cause of anxiety disorders? • Create an example. • Unconscious conflict • Conflict of id, ego, superego • Anxiety disorder is the outward manifestation of an internal, unconscious conflict

19. Theories Explaining Anxiety Disorders • How would the behavioral theorist explain the cause of anxiety disorders? • Learned response: Classical, or Operant learning • Provide an example for each. (Pick a specific anxiety disorder for the example.) • Chronically anxious, ulcer-prone rats by unpredictable electric shock

20. Theories Explaining Anxiety Disorders • How would the cognitive theorist explain the cause of anxiety disorders? • Dysfunctional , maladaptive ways of thinking • Example: • GAD the result of unreasonably high standards set for oneself: thus constant anxiety from impossibility of meeting goals

21. Theories Explaining Anxiety Disorders • Biological Perspective • Natural Selection • Fear of spiders, snakes, storms, heights etc. increase survival (genetic) • Genes • Twin studies (together and apart) • The Brain • OCD: Anterior cingulate cortex: monitors actions, checks for errors (hyperactive region- like a hiccup…)

22. Theories Explaining Anxiety Disorders • Two biggest perspectives today: • Behavioral (learning) and biological

23. Mood Disorders • Experiencing extreme or inappropriate emotions. • Two major forms: • Major depression (unipolar depression) • Bipolar Disorder (manic depression)

24. Major Depressive Disorder • “common cold” of psychological disorders • Biggest cause of therapy (mental health services) • 2 weeks or more (with absence of clear reason) • Fatigue, loss of appetite, feelings of worthlessness, hopelessness, disinterestedness, changed sleeping patterns • SAD: Seasonal-Affective Disorder

25. Facts about Major Depressive Disorder • Women are nearly 2 x more likely to have it • Leading cause of disability worldwide (5.8 % of men, 10.5% of women) • Most major depressive episodes self-terminate • Stressful events often precede depression • Rate is increasing with each new generation

26. Bipolar Disorder • Depressed and manic episodes (alternate) • Depression- typical characteristics • (1% of pop. , equal between genders, yrs. 20-30) • Manic- high energy (and often highly illogical) • Overly active, elated, outspoken, less sexual inhibition • Often reckless, poor judgment • Mild cases can produce creative genius

27. Depression Abraham Lincoln Winston Churchill Meriwether Lewis Emily Dickenson Isaac Newton Mozart Woody Allen Buzz Aldrin Drew Carey Harrison Ford Beyonce Knowles Bipolar Walt Whitman Ernest Hemingway Virginia Wolf Mark Twain Edgar Allen Poe Kurt Cobain Mel Gibson Ozzy Osbourne Robert Downey Jr. “Famous Folks with Disorders”

28. Explaining Mood Disorders Biological Perspective • Whole-body disorder • Genetic predispositions (runs in families), biochemical imbalances • Neurotransmission • Norepinephrine (increases arousal, mood) • Too little = depression • Too much = mania • Serotonin • Too little = depression (Prozac, Zoloft, Paxil) / Exercise!

29. Explaining Mood Disorders Social-Cognitive Perspective(Cognitive-Behavioral) • Aaron Beck: Cognitive Triad • Depression stems from unreasonably negative ideas about oneself, one’s setting and one’s future • (Thus depression is mostly cognition based, not mood based) • Martin Seligman • Learned Helplessness (prior events convince a person of the inability to control future) = passivity and depression • More prevalent in Western societies • Epidemic hopelessness due to individualism and decline of commitment to family and religion

30. Explanatory Styles and Depression

31. The Social-Cognitive Dilemma • Chicken and Egg Argument • Does learned hopelessness, self-defeating beliefs and negative explanatory styles cause depression, or does depression cause them…???

32. Multiple Factors…

33. Depression’s Vicious Cycle • Characteristics, factors of depression tend to promote each other in a wicked cycle… • helplessness, lethargy, sorrow, isolation, dismissal, failure

34. Somatoform Disorders • “soma” = body • Psychological problem manifested in a physiological symptom (IOW: physical problem without a physical cause) • Common among those claiming disability • Two major disorders: • hypochondriasis: imagined or exaggerated illnesses (no medical cause) • Conversion disorder: involves motor or sensory problems with no biological explanation / cause • Conversion blindness, conversion paralysis

35. Explaining Somatoform • Psychoanalytic • Outward manifestations of unconscious conflict • Behaviorists • Reinforcement for behavior (can’t work or sympathy / attention)

36. Clinical Distinction… • Somatoform patient: unconscious of psychological causes (does not seek to maintain role of patient) • factitious patient: Consciously creating the symptoms, …prolonging role of patient • Malingering patient: consciously creating symptoms,…end goal (often financial)

37. Dissociative Disorders • Disruption in conscious processes (lose identity) • Usually from traumatic event • Famous films: Sybil, Three Faces of Eve, Dr. Jekyll and Mr. Hyde

38. Types of Dissociative Disorders • Psychogenic Amnesia: Amnesia with no physiological basis • biologically induced amnesia = organic amnesia) • Fugue = Psychogenic Amnesia + unfamiliar environment (fugue = flight / loss of identity and flee)

39. Types of Dissociative Disorders • Dissociative Identity Disorder (DID) • AKA Multiple Personality Disorder • Usually from traumatic event / overwhelming stress(high % report child abuse) • often at young age (3-5 years) • Self-protection / coping mechanism • Distinctive identities for different events (toddler to adult) • Norm- 3-6 identities (2 to qualify) • Almost entirely confined to N. America • Very controversial as medical diagnosis

40. Explaining Dissociative Disorders • Psychoanalytic theorist: • Extremely traumatic event so repressed that causes split in consciousness • Behaviorist • putting event out of mind is reinforcing (to feel better)

41. Schizophrenia

42. Schizophrenia • Disordered / distorted thinking • Breakdown in selective attention (Can’t filter out information) • Disturbed perceptions • Delusions: beliefs that have no basis in reality • Delusions of persecution = paranoia • Delusions of grandeur = greatness • Hallucinations: Perceptions in the absence of sensory stimulation • Inappropriate actions / emotions

43. Things to consider… • Most severe of psych disorders • Usually starts in late teens / early twenties • 1 out of every 100 people have Schizophrenia

44. Types of Schizophrenia • Disorganized Schizophrenia • Paranoid Schizophrenia • Catatonic Schizophrenia • Undifferentiated Schizophrenia • Acute vs. Chronic Schizophrenia • What’s the difference? • Acute: Abrupt display of symptoms- can be short duration and never return or become longterm issue • Chronic: Long-term struggle with Schizophrenia

45. Disorganized Schizophrenia • Odd use of language (Word Salad = fragmented speech • Neologisms: made up words • Clang associations: string together nonsense words that rhyme • Inappropriate effect: • Laugh in sorrowful setting • Flat effect: no emotional response at all

46. Paranoid Schizophrenia • Delusions of persecution • “out to get me”

47. Catatonic Schizophrenia • Engage in odd movements • Remain motionless for hours (odd positions / poses / Waxy flexibility • parrot-like repeating of speech, movement

48. Undifferentiated Schizophrenia • Disordered thinking, but no symptoms of other types of Schizophrenia

49. Positive Symptoms Excesses in behavior, thought, mood Negative Symptoms Deficits, such as flat effect, or catatonia. (Absence of normal behavior) Schizophrenic Symptoms: 2 Types

50. Explaining Schizophrenia • Biological • Dopamine hypothesis • Excessive levels = Schizophrenia (average 6x normal levels) • Enlarged brain ventricles • Genetic predispositions • Abnormality of 5th chromosome • Social-Cognitive • Double binds: contradictory messages = distorted ways of thinking