Abnormal Psychology PSY 120 Prof. South 11/21/08

1. Abnormal PsychologyPSY 120Prof. South11/21/08 • What is abnormal? • Categories and Causes • Mood Disorders • Anxiety Disorders

2. Social Cognitive Theory • Approach to personality that suggests it is human experiences • and interpretations of these experiences, that determine growth and development of personality

3. Social-Cognitive Perspective

4. Culture • Kind of culture you are from will greatly affect your personality • different cultures value different things • If you have what the culture values, life will be less stressful

5. Defining Abnormal Behavior • A clinically significant behavioral or psychological syndrome with: • Present distress • Disability • An increased risk of suffering pain, death, disability, or loss of freedom • DSM-IV-TR • 200+ diagnostic categories • 18 primary headings

6. Not included • Expected & culturally sanctioned response • Deviant behavior • Conflicts between individual & society

7. Difficulties in Diagnosis • Is this person’s behavior abnormal? • Example: A woman does not like to throw away plastic bags and religiously cleans them and stores them away. She has hundreds of plastic bags but rarely uses them. She gets very angry if anyone suggests she should get rid of them.

8. Difficulties in Diagnosis • If a relative or friend: • No. • If a stranger: • Yes.

9. “Uncle George’s Pancakes Fallacy” (Meehl, 1973) • People tend to compare the patient’s behavior to that of a friend or relative (e.g., good ole Uncle George) • The assumption is: your friend or relative is not mentally ill (because you couldn’t have any crazy friends or relatives…) • Proper conclusion is that your friend or relative also evidences abnormal behaviors

10. The Five DSM-IV Axes

11. Axis I • Mood Disorders • Anxiety Disorders • Substance-Related Disorders • Schizophrenia and Other Psychotic Disorders • Eating Disorders • Somatoform Disorders • Dissociative Disorders • Sexual and Gender Identity Disorders • Sleep Disorders • Impulsive-Control Disorders • Adjustment Disorders • Factitious Disorders • Delirium, Dementia, and Amnestic and other Cognitive Disorders

12. Axis II • Disorders usually first diagnosed in infancy, childhood, or adolescence • Personality Disorders

13. Current System of Classification • Disorders grouped together under broader categories • E.g. Mood Disorders • Depressive Disorders • Depressive Disorder • Dysthymic Disorder • Depressive Disorder NOS • Bipolar Disorders • Bipolar I • Bipolar II • Cyclothymic Disorder • Bipolar Disorder NOs • To qualify for a diagnosis, meet certain number of criteria for each disorder • Thus, a “categorical” system of diagnosis • Is this the best way?

15. Major Depression 1 or more Major Depressive Episodes Symptoms Behavior Affective Cognitive Physiological Anhedonia Episodic Course

16. Major Depressive Episode(5 or more for 2 weeks) #1. depressed mood most of day (sad, empty) #2 loss of interest or pleasure #3 weight #4 sleep #5 body #6 fatigue #7 worthless/ guilt #8 thinking #9 recurrent thoughts of death, suicide

17. Bipolar I Disorder • Alternates between full manic episodes and depressive episodes • Average age of onset is 18 years, but can begin in childhood • Tends to be chronic Bipolar II • Alternates between depressive episodes and hypomanic episodes

18. Manic Episode • Elevated, expansive, or irritable mood (>1 week), plus 3 or more of: • Grandiosity/inflated self-esteem • Decreased need for sleep • Pressured speech • Flight of ideas • Easily distracted to irrelevant stimuli • Increase in goal-directed activity • Excessive involvement in activities with potential for harmful consequence

19. Mood Disorders Among Twins

20. Causes of Mood Disorders Biological Stress Learned Helplessness Social and Cultural Cognitive Theory

21. Beck’s Cognitive Triad for Depression

22. An Integrative Model of Mood Disorders

23. Anxiety Disorders • Panic Disorder • Agoraphobia • Specific Phobia • Social Phobia • Obsessive-Compulsive Disorder • Post-traumatic Stress Disorder • Acute Stress Disorder • Generalized Anxiety Disorder

24. Difference between “Normal & Abnormal” Anxiety Normal • Everyone experiences anxiety from time to time • Often important to have low to moderate levels of anxiety for optimal performance • A little anxiety motivates you to “go the extra mile

25. Abnormal • intense anxiety where there is no danger • Overwhelmed with anxiety is not adaptive

26. Generalized Anxiety Disorder Defining Features • Excessive uncontrollable worry about life events • Strong, persistent anxiety • Somatic symptoms • Persists for 6 months or more

28. Panic Disorders Episode in which intense anxiety & physiological symptoms are suddenly experienced… recurrent, unpredictable Panic attack symptoms include: • Shortness of breath • Chest pain & discomfort • heart palpitations • Feeling of choking • Numbness or tingling • Chills or hot flushes • Sweating • Shaking

29. Panic Misappraisal of what’s happening • Catastrophic conclusion • I feel flush, fast heart beat.. I must be having a heart attack vs. I am a little over excited today

30. Specific Phobias Defining Features • Extreme and irrational fear of specific object/situation • Interferes with one's ability to function • Recognize fears are unreasonable, but avoids phobic objects

31. Social Phobia Defining Features • Fear of being scrutinized by others • Interferes with functioning • Avoids social situations

32. Obsessive-Compulsive Disorder • Recurrent obsessions and/or compulsions that are severe enough to be time consuming or cause marked distress and/or significant impairment. • At some point, person has recognized that the obsessions or compulsions are excessive or unreasonable. • Common: cleaning or checking rituals

33. Obsessions #1 Violence is MOST common theme #2 Contamination, 2nd common theme • shaking hands • touching a public door knob • or toilet

34. Compulsions • Most common manifestations: • Hand washing (cleaning) • Checking behavior • Counters & Perfectionists

35. Post Traumatic Stress Disorder • WW II military gave greater recognition to the condition they termed "shell shock“ (PTSD) • PTSD follows a traumatic event • Symptoms: Re-experiencing Avoidance Arousal

36. Summary of Anxiety Disorders One of the largest domains of psychopathology From normal to disordered • Multiple factors • Fear & anxiety persist to non-dangerous cues • Significant distress

37. Addictive Disorders: one of country’s major mental and health problem

38. Substance Use Disorders • Abuse • Interference with ability to fulfill major role obligations and/or legal difficulties associated with use • Dependence • Pattern of use that results in tolerance, withdrawal, and compulsive drug-taking behavior

39. Types of psychoactive substances • Alcohol • Amphetamines • Caffeine • Marijuana/hashish • Cocaine • Hallucinogens • Inhalants • Nicotine • Opiates • Phencyclidine • Sedatives, hypnotics, anxiolytics

40. midbrain: nucleus accumbens • All drugs which people become dependent upon act on the • “pleasure pathways” • internal reward centers, made up of dopamine-sensitive neurons

41. Ethnic Differences Rates of alcoholism among Asian populations are lower than among European people This fact may be related to a mutant enzyme that leads to hypersensitive reactions to alcohol in Asians

42. Mental health resources • Center for Counseling and Psychological Services (CAPS) – 494-6995. Offices at PUSH and in Psychological Sciences Building. • Urgent care after hours at PUSH 494-1724. • Crisis Center 742-0244 • Mental Health American of Tippecanoe County 742-1800, http://www.mhalafayette.org/ • NAMI West Central Indiana 423-6939, http://www.nami-wci.org/