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Abnormal Psychology. CS 8: The SW examine how psychological disorders are diagnosed, classified and treated. Class Activity. Students will get in groups of four and develop a definition for “psychological disorder”

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Abnormal psychology

Abnormal Psychology

CS 8: The SW examine how psychological disorders are diagnosed, classified and treated


Class activity
Class Activity

  • Students will get in groups of four and develop a definition for “psychological disorder”

  • Be specific, identify criteria for the line between normality and abnormality


Who has a mental disorder
Who has a mental disorder?

  • The World Health Organization (WHO, 2008) reports approximately 450 million people suffer from a mental or behavior disorder


Perspectives on psychological disorders
Perspectives on Psychological Disorders

  • Psychological Disorder:

    • Deviant, distressful, and dysfunctional patterns of thoughts, feelings or behaviors


Abnormal psychology
MUDA

  • Four attributes of a psychological disorder

    • Maladaptive

    • Unjustifiable

    • Disturbing

    • Atypical

      www.ghaps.org


Maladaptive
Maladaptive

  • An exaggeration of normal, acceptable behaviors

  • Destructive to oneself or others

    www.ghaps.org


Unjustifiable
Unjustifiable

  • A behavior which does not have a rational basis

    www.ghaps.org


Disturbing
Disturbing

  • A behavior which is troublesome to other people

    www.ghaps.org


Atypical
Atypical

  • A behavior so different from other people’s behavior that it violates a norm

  • Norms vary from culture to culture

    www.ghaps.org


Cultural connections
Cultural Connections

  • Hissing is a polite way to show respect for superiors in Japan

  • Among the Karaki of New Guinea, a man is considered abnormal if he has not engaged in homosexual activity before marriage

  • Public displays of affection between men and women in Thailand are unacceptable

    • Men holding hand is considered a sign of friendship

    • Using straws is considered vulgar


Cultural connection
Cultural Connection

  • Statistically speaking, any behavior is atypical if it is NOT exhibited by 68% of the people in a particular group or culture

    • What behaviors would be considered normal if we followed this definition of abnormality?

    • Who would suffer discrimination?

      • Religious practices

      • Ways of life would be abnormal? Single-parent households? Two-parent households?

      • What ethnic groups would be considered abnormal?

      • Styles of dress, music preferences, post-high school choices?


Abnormal psychology
ADHD

  • US: Controversy with ADHD

    • (ADHD) Attention-deficit hyperactivity disorder:

      • A psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: Extreme inattention, hyperactivity and impulsivity


The devil made me do it
“The Devil Made Me Do It”

  • Middle Ages:

    • Trephination


Understanding psychological disorder
Understanding Psychological Disorder

  • The Medical Model:

    • The concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated and in most cases, cured often through treatment


The biopsychosocial approach
The Biopsychosocial Approach

Biological Influences:

Evolution

Individual Genes

Brain Structure and Chemistry

Psychological Influences:

Stress

Trauma

Learned Helplessness

Mood-Related Perceptions and Memories

Psychological Disorder

Social-Cultural Influences:

Roles

Expectations

Def. of Normality and Disorder


Classifying psychological disorder
Classifying Psychological Disorder

  • DSM-IV-TR:

    • The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders; a widely used system for classifying psychological disorders (2000)


How are psychological disorders diagnosed
How are psychological disorders diagnosed?

  • Five “Axis” diagnostic criteria used in DSM

    • Helps doctors determine not only the type of mental illness a person has, but also some contributing factors that probably need to be dealt with in order to get the primary mental illness symptoms under control


Axis five
“Axis” Five

  • Axis I: Is a clinical syndrome present?

  • Axis II: Is a personality disorder or mental retardation present?

  • Axis III: Is a General Medical Condition, such as diabetes, hypertension, or arthritis, also present?

  • Axis IV: Are psychosocial or environmental problems, such as school or housing issues, also present?

  • Axis V: What is the Global Assessment of this person’s functioning?

  • http://faculty.fortlewis.edu/burke_b/Abnormal/Abnormalmultiaxial.htm


Labeling psychological disorders
Labeling Psychological Disorders

Insurance companies and DSM


Ask yourself
Ask Yourself

  • How would you draw a line between sending disturbed criminals to prisons or to mental hospitals? Would the person’s history (child abuse) influences your decisions?

  • What is the biopsychosocial perspective and why is it important in our understanding of psychological disorders?


Critical thinking
Critical Thinking

  • Does well being refer to the absence of a disorder?

  • Are people mentally sound if they do not suffer from anxiety, depression, or other forms of psychological symptomology?

  • What characteristics mark psychological well-being?


Carol d ryff
Carol D. Ryff

  • Psychologist who argues we must define mental health in terms of positive


Six core dimensions of well being
Six Core Dimensions of Well-Being

  • Self-Acceptance: A person not only has a positive attitude toward the self the self but accepts multiple aspects of the self-good and bad, past, present, and future

  • Positive relations with other people: Healthy people have warm, satisfying, and trusting interpersonal relationships

  • Autonomy: The person is independent, self-determining, and self-controlled


Six core dimensions of well being1
Six Core Dimensions of Well-Being

  • Environmental Mastery: The healthy are able to choose or create contexts that are supportive of personal needs or values

  • Purpose in life: The person has both goals and a sense of directedness

  • Personal growth: Healthy people see themselves as growing and expanding



Anxiety disorders
Anxiety Disorders

  • At some point we all become anxious; speaking in front of an audience, playing a big game. Usually these feelings go away after event is over

  • For some, they do not

  • Anxiety Disorder:

    • Marked by distressing, persistent anxiety or dysfunctional anxiety reducing behaviors


Anxiety disorder
Anxiety Disorder

  • Generalized Anxiety Disorder:

    • Person is continually tense, apprehensive and in a state of autonomic nervous system arousal

      • Jittery, agitated and sleep-derived

  • Panic Disorder:

    • Marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking or other frightening sensations

      • 1 in 75 people

      • Panic Attack: minute long episode of intense fear that something horrible is about to happen

      • Smokers Double risk


Anxiety disorder1
Anxiety Disorder

  • Phobias:

    • An anxiety disorder marked by a persistent, irrational fear and avoidance of a specific object, activity, or situation

    • Social phobias: animals, insects, heights, etc (may hide in fear)

    • Agoraphobia: Fear or avoidance of situations

  • Obsessive-Compulsive Disorder:

    • An anxiety disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions)


Anxiety disorders1
Anxiety Disorders

  • Post-Traumatic Stress Disorder:

    • Characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience

  • Post-Traumatic Growth:

    • Positive psychological changes as a result of struggling with extremely challenging circumstances and life crisis


Critical thinking1
Critical Thinking

  • Today 24- hour news channels show up-to-date-minute coverage of war and disaster. People can watch violence as it happens. While it represents advance in TV journalism, it exposes everyday people to experiences that could lead to PTSD

  • http://www.youtube.com/watch?v=-mNFqqB6EPU

  • http://www.youtube.com/watch?v=umatZvJnvFM

  • http://www.youtube.com/watch?v=3aEvzuA4f0c


Critical thinking2
Critical Thinking

  • How does view trauma on TV affect people who haven’t experienced the tragedy or conflict firsthand?

  • Can people develop PTSD vicariously? How different are experiences with PTSD from those who developed it vicariously compared to those who developed it through firsthand experience with trauma?

  • How did coverage of the events of September 11, 2001 attacks and Hurricane Katrina affect the viewing public?

  • Were lessons learned from coverage of the first Gulf War applied to coverage of the Iraq War? Why or Why not?


Understanding anxiety disorder
Understanding Anxiety Disorder

  • The Learning Perspective:

    • Fear Conditioning

    • Observational Learning

  • The Biological Perspective:

    • Natural Selection

    • Genes

    • The Brain: Anterior Cingulate Cortex


Critical thinking3
Critical Thinking

  • Can you recall a fear you have learned? What role was played by fear conditioning and by observational learning?

  • How do generalized anxiety disorder, panic disorder, phobias, obsessive-compulsive disorder and post-traumatic stress disorder differ?


Somatoform disorders
Somatoform Disorders

Often people come to the doctor’s office with

“medically unexplained illnesses”

  • Somatoform Disorder:

    • Psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause


Somatoform disorders1
Somatoform Disorders

  • Conversion Disorder:

    • A rare somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found

  • Hypochondriasis:

    • A somatoform disorder in which a person interprets normal physical sensations as symptoms of a disease


Other somatoform disorders
Other Somatoform Disorders

  • Body Dysmorphic Disorder

  • Pain Disorder

  • Somatization Disorder

    • P/T under 30 will exhibit a variety of unexplained physical symptoms


Ask yourself1
Ask Yourself

  • Describe a time when you have fretted needlessly over a normal bodily sensation?

  • In your own words, what does somatoform mean?


Dissociative disorders
Dissociative Disorders

  • Disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings

    • Disorder of the consciousness

    • A person appears to experience a sudden loss of memory or change in identity in response to an overwhelmingly stressful situation

    • “I was not myself at the time”

    • Driving in a car and driving to some unintended location while your mind was preoccupied elsewhere


Dissociative identity disorder
Dissociative Identity Disorder

  • DID:

    • A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder


Dissociative disorder
Dissociative Disorder

  • Dissociative Amnesia:

    • Patients suffer from a complete loss of identify. They forget who they are due to a trauma

  • Dissociative Fugue:

    • Patients suffer the identity loss as in dissociative amnesia, but these patients also travel away from home, often showing up as a “John/Jane Doe” in another community far away


Understanding dissociative identity disorder
Understanding Dissociative Identity Disorder

  • Outside US, DID is rare

    • Other countries it is viewed as “possessed”

    • Britain considers it an “American Fad”

    • India and Japan do not recognize

  • Included under umbrella of post-traumatic disorders

    • Symptoms are ways of dealing with anxiety


Chris sizemore
Chris Sizemore

  • “The Three Faces of Eve” gave early visibility to what is now called DID

  • http://www.youtube.com/watch?v=SOxxf8zJt9M

  • 14:10-25:29


Ask yourself2
Ask Yourself

  • In a normal way, do you ever flip between displays of different aspects of your personality?

  • The psychoanalytic and learning perspectives argue that dissociative identity disorder symptoms are ways of dealing with anxiety. How do their explanations differ?


Mood disorders
Mood Disorders

Psychological disorders characterized by emotional extremes

Two Principle Forms

1) Major depressive disorder: prolonged

hopelessness and lethargy

2) Bipolar Disorder: A person alternates between depression and mania, an overexcited, hyperactive state


Mood disorders1
Mood Disorders

  • Seasonal Affective Disorder

  • Postpartum Depression


Major depressive disorder
Major Depressive Disorder

  • Major Depressive Disorder:

    • Mood disorder in which a person experiences in the absence of drugs or a medical conditions, two or more weeks of significantly, depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities


Bipolar disorder
Bipolar Disorder

  • Mania:

    • A mood disorder marked by a hyperactive, wildly optimistic state

  • Bipolar Disorder:

    • A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania

    • Walt Whiman, Virginia Woolf, Samuel Clemens (Mark Twain), and Ernest Hemingway


Bipolar disorder1
Bipolar Disorder

  • Bipolar Disorder I: The classic diagnosis of this disorder. Patients experience periods of inflated mood followed by depressive episodes occurring in cycles

  • Bipolar Disorder II: A milder form; patients experience at least one episode of hypomania and at least one major depressive episode


Understanding mood disorders
Understanding Mood Disorders

Help students see that depression following a traumatic even (death of a loved one, failure, serious physical injury) are considered normal. Depression without a known stressor or causal event may be due to biological or psychological reasons.


Understanding mood disorders1
Understanding Mood Disorders

  • Many behavior and cognitive changes accompany depression

  • Depression is widespread

  • Compared with men, women are nearly twice as vulnerable to major depression

  • Most major depressive episodes self-terminate

  • Stressful events related to work, marriage and close relationships often precede depression

  • With each new generation, depression is striking earlier


Class activity1
Class Activity

  • SW divide into groups and create a continuum of the different types of moods (depression on one extreme and mania on the other)

    • Come up with at least five different levels of mood between the two extremes

    • Could groups come to a consensus about what the different types of moods were called? Why or why not?

    • What were the different names they came up with for each type of mood?

      EX:

      Depression------------------------------------------------------Mania


The biological perspective
The Biological Perspective

  • Genetic Influences:

    • Emotions are “postcards from our genes”

    • The risk of major depression and bipolar disorders increases if you have a parent or sibling with the disorder

    • Linkage Analysis:

      • Linkage studies seek to identify abnormal genes in family members suffering a disorder


Important to remember
Important to Remember

  • Being genetically predisposed to a condition such as depression does not mean one if guaranteed to get the disease

    • It is important to take into account environment


Suicide
Suicide

Struggling with questions of life’s purpose and these feelings are normal. Any indication of someone contemplating suicide should be taken seriously


Suicide1
Suicide

  • National Differences: Europe; most suicide prone people

  • Racial Differences: Whites are nearly twice as likely

  • Gender Differences: Women twice more likely than men

  • Age Differences and Trends: In late adulthood, rates increase among men


What reasons do people give for being lonely
What reasons do people give for being lonely?

  • Being unattached

  • Alienation

  • Being Alone

  • Forced Isolation

  • Dislocation


Help is available
Help is Available

  • National Hopeline Network

    • 1-800-784-2433

  • National Suicide Prevention Lifeline

    • 1-800-273-8255

  • Open 24 Hours a Day/ 7 Days a week


The depressed brain
The Depressed Brain

  • People with severe depression have shown their frontal lobes 7% smaller than normal

  • Hippocampus is vulnerable to stress-related damage


Biochemical influences
Biochemical Influences

  • Norepinephrine:

    • Increases arousal and boots mood

    • Scarce during depression and overabundant during mania

  • Serotonin:

    • Scarce during depression

  • Drugs that relieve depression are Prozac, Zoloft and Paxil

  • Exercise increases serotonin


The social cognitive perspective
The Social-Cognitive Perspective

Self-defeating beliefs and a negative explanatory style feed depression’s vicious cycle


Depression vicious cycle
Depression Vicious Cycle

  • Stressful Experiences

  • Negative Explanatory Style

  • Depressed Mood

  • Cognitive and Behavioral Changes


Test yourself
Test Yourself

What does it mean to say that “depression is the common cold of psychological disorders”?


Schizophrenia
Schizophrenia

  • If depression is the common cold or psychological disorders, schizophrenia is the cancer

    • Nearly 1 in 100 people will develop schizophrenia

    • Approximately 24 million across the world suffer from this disease

  • http://www.youtube.com/watch?v=UTUMt05_nCI


Schizophrenia1
Schizophrenia

  • Children as young as 12 have developed symptoms of schizophrenia

    • The onset of the disorder typically occurs during the late teen and early adult years

    • Full-Blown psychotic episodes (where patients lose touch with reality) may not occur until the patient is out on his or her own, away from family and friends who have supported that person in the past


Symptoms of schizophrenia
Symptoms of Schizophrenia

  • “Split Mind”

  • It refers to not a multi-personality, but to a split from reality that shows itself in disorganized thinking, disturbed perceptions and inappropriate emotions and actions


Symptoms of schizophrenia1
Symptoms of Schizophrenia

  • “This morning, when I was at Hillside, I was making a movie. I was surrounded by movie stars…I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday”.

    • Fragmented, bizarre, and often distorted by false beliefs


Symptoms
Symptoms

  • Delusions:

    • False beliefs

    • Dysfunction of our cognitive systems

    • Those with paranoid tendencies are particularly prone to delusions of persecution

    • Selective Attention


Disturbed perceptions
Disturbed Perceptions

  • Hallucinations

    • False perceptions

    • Dysfunction of our perceptual systems

    • Seeing, feeling, tasting, smelling things that are not there


Inappropriate emotions and actions
Inappropriate Emotions and Actions

  • Emotions are split off from reality

    • Laughing at funeral

    • Cry when others laugh or anger for no apparent reason

  • Others my become emotionless state of flat affect

  • Motor behavior may also be inappropriate

    • Senseless, compulsive acts such as continually rocking or rubbing an arm


Onset and development of schizophrenia
Onset and Development of Schizophrenia

  • For some, it may appear suddenly (reaction to stress)

  • Others, it may appear gradually

    • Social Inadequacy

      • Socioeconomic levels


Onset and development of schizophrenia1
Onset and Development of Schizophrenia

  • Cluster of disorders

    • Subtypes share common features

  • Positive Symptoms:

    • Hallucinations, talk in disorganized deluded ways and exhibit inappropriate laughter, tears or rage

  • Negative Symptoms:

    • Toneless voices, expressionless faces or mute, and rigid bodies


Positive and negative
Positive and Negative

  • Positive Symptoms refer to those that are in excessive or in addition to normal behavior (outlandish)

  • Negative Symptoms refer to those that are deficient or less than normal behaviors (flat affect)


Onset and development of schizophrenia2
Onset and Development of Schizophrenia

  • When it is slow developing (chronic), recovery is doubtful

  • When developed rapidly (acute), recovery is much more likely


Understand schizophrenia
Understand Schizophrenia

  • Brain Abnormalities:

    • Dopamine Overactivity

    • Abnormal Brain Activity and Anatomy

      • Multiple brain areas: Frontal lobes, decline of brain waves, out-of-sync neurons, increased activity in amygdala, fluid filled areas, shrinkage of cerebral tissue, smaller than normal cortex, thalamus

  • Maternal Virus during pregnancy

    • Flus, viral disease, Hemisphere, season

    • Genetic Factor

    • Psychological Factor


Write about it
Write about It

  • Do you think the media accurately portrays the behavior of people suffering from schizophrenia? Why or why not?

  • How do researchers believe that biological and environmental factors interact in the onset of schizophrenia?


Personality disorder
Personality Disorder

Some dysfunctional behavior patterns impair people’s social functioning without depression or delusions

  • Personality Disorders:

    • Psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning


Differences
Differences

Paranoid Personality Disorder and Schizoid Personality Disorder are different from schizophrenia only by a matter of degree. While people with schizophrenia experience psychotic episodes when they lose touch with reality, people with these personality disorders do not have these extreme experiences. Their behavior is odd, eccentric and disturbing, but it does not impair daily life in the way that schizophrenia does


Personality disorders
Personality Disorders

  • Clusters of personality disorders:

    • One cluster of these disorders expresses anxiety, such as fearful sensitivity to rejection that predisposes the withdraw avoidant personality disorder

    • Second cluster expresses eccentric behavior such as emotionless disengagement of schizoid personality disorder

    • Third cluster exhibits dramatic or impulsive behaviors, such as attention-getting histrionic personality disorder and the self-focused and self-inflating narcissistic personality disorder


Antisocial personality disorder
Antisocial Personality Disorder

  • A personality disorder in which the person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.


Antisocial personality disorder1
Antisocial Personality Disorder

  • While all serial killers are antisocial, not all those with antisocial disorder are serial killers.

  • Harvey Cleckley identifies the following characteristics of antisocial personality disorders:

    • Superficial charm and high intelligence

    • Poise, rationality, absence of neurotic anxiety

    • Lack of sense of personal responsibility

    • Untruthfulness, insincerity, callousness, manipulativeness

    • Antisocial behavior without regret or shame

    • Poor judgment and failure to learn from experience

    • Inability to establish lasting, close r/t with others

    • Lack of insight into personal motivations


Understanding antisocial personality disorder
Understanding Antisocial Personality Disorder

  • Genetic Influence:

  • AndrianRaine (1999, 2005)

    • Reduced activity in frontal lobes, an area in cortex that helps control impulses

    • 11% less frontal lobe tissue than normal

    • Respond less to facial displays of others’ distress


Rates of psychological disorders
Rates of Psychological Disorders

  • The U.S. National Institute of Mental Health estimates 26% of adult Americans “suffer from a diagnosable mental disorder in a given year”

  • WHO:

    • US has highest rate

    • Immigrants have better than average mental health

    • Minority born in US are at a greater risk

    • Those at most risk: Poverty, cross ethnic and cross gender lines


Critical thinking4
Critical Thinking

  • Blue text psy book:

    • P 485 1-4 (Min of 3 sentence responses for each)