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“Abnormal” Psychology

“Abnormal” Psychology. mental disorders mental illness psychopathology. Diagnosing Mental Disorders. Symptom vs.Syndrome Diagnostic & Statistical Manual of Mental Disorders (DSM-IV, 2000). Diagnosis – other features. producing distress severely interfering with daily function frequency

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“Abnormal” Psychology

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  1. “Abnormal” Psychology • mental disorders • mental illness • psychopathology

  2. Diagnosing Mental Disorders • Symptom vs.Syndrome • Diagnostic & Statistical Manual of Mental Disorders (DSM-IV, 2000)

  3. Diagnosis – other features • producing distress • severely interfering with daily function • frequency • involuntary • general way of responding

  4. Growth of DSM

  5. Gender differences in mental disorders

  6. Gender bias in diagnosis study Ford & Widiger (1989) Diagnosis: histrionic Diagnosis: Antisocial

  7. Perspectives on Mental Illness • Biological - disruption of biological processes - genetic factors - differences in brain function - treatment – biological intervention

  8. Biological Perspective (cont’d)

  9. Biological Treatment: DepressionSelective Serotonin Reuptake Inhibitors - SSRIs

  10. 2. Cognitive/Behavioral Perspective • learned ways of responding • Treatment – “restructuring” thought processes • relaxation therapies - phobias • rational-emotive therapies – OCD • social learning - alcoholism

  11. 3. Sociocultural Perspective • social influences on behavior - homosexuality • “culture bound” syndromes • Koro • Pibloktoq Depression vs. Dhat syndrome

  12. Eating Disorders: Anorexia Nervosa • refusal to maintain normal body weight • disturbance in evaluating weight and shape • late adolescence or early adulthood • high SES females

  13. Bulemia Nervosa • episodes of binge eating • compensatory behaviors to prevent weight gain (purging, laxatives, exercise) • late adolescence or early adulthood • high SES females

  14. Anxiety Disorders • excessive feelings of anxiety • behavioral response to ward off anxiety • “less severe” • relatively common

  15. Anxiety Disorders • Panic disorder • Generalized anxiety disorder • Phobias • Post traumatic stress disorder (PTSD) • Obsessive compulsive disorder (OCD)

  16. Panic disorder • discrete period of intense fear • symptoms develop suddenly • symptoms tied to autonomic NS

  17. Generalized anxiety disorder • excessive anxiety or concern over a number of events • symptoms – restless, irritable, fatigued, can’t concentrate, muscle tension • Is it a subtype or predisposition?

  18. Comorbidity Rates for Anxiety Disorders

  19. Phobias • intense, persistent fear to an object or situation • avoidance of phobic stimulus acrophobia claustrophobia “social phobia”

  20. Post Traumatic Stress Disorder • intense fear, helplessness, or horror • linked to traumatic, painful event • Symptoms: • reoccurring nightmares, flashbacks • avoid situations that remind them of event • dissociative symptoms • insomnia, irritability

  21. Factors related to recovery of PTSD • Trauma 2. Person 3. Post-trauma environment

  22. Obsessive Compulsive Disorder (OCD) • Obsessions vs. Compulsions • e.g., checking, cleaning

  23. Cognitive/Behavioral Treatments • Phobias - systematic desensitization (Wolpe) - “flooding” • OCD - exposure + response prevention

  24. Biological Treatment • SSRIs

  25. Beck Depression Inventory • I do not feel sad. • I feel sad. • I am sad all the time and I can’t snap out of it. • I am so sad or unhappy that I can’t stand it. • I do not feel like a failure. • I feel I have failed more than the average person. • As I look back on my life, all I can see is a lot of failures. • I feel I am a complete failure as a person.

  26. Mood Disorders • episodic nature • Unipolar vs. Bipolar “If what I feel were equally distributed to the whole human family, there would not be one cheerful face on earth.”

  27. What constitutes depression? • depressed mood, sadness • diminished interest or pleasure • weight loss or weight gain • insomnia • psychomotor retardation or agitation • loss of energy • feelings of worthlessness, excessive guilt • diminished ability to concentrate • suicidal ideations

  28. Epidemiology of depression • More women than men • Peak age of onset for women 15-19, men 25-29 • 2nd only to schizophrenia for hospital admissions • 17% of Americans will experience in lifetime • Since WWII, higher rates for each generation • 80% of cases will have reoccurring episode

  29. Bipolar Disorder vs. Depression • far less common (1-2 %) • same gender distribution • history of hyperactivity • bipolar episodes are briefer and more frequent • higher genetic risk • poorer prognosis

  30. Symptoms of Mania • appears in late adolescence as manic episode • inflated self-esteem or grandiosity • decreased need for sleep • more talkative • thoughts are racing • easily distractible • excessive involvement in pleasurable activities

  31. Biological Perspective: • Genetic component: - depression – 1.5-3x greater risk - bipolar – 10x greater risk

  32. Kendler et al (1995) study:

  33. “Triangle” of Depression pp Depressed thinking Depressed mood Depressed action Depressed mood Depressed mood

  34. Biological Treatment • SSRIs • Tricyclics • Monoamine oxidase inhibitors (MAOs) • ECT

  35. Suicide Rates across Life Span

  36. Common Elements of Suicide(Schneidman, 1996) • seek solution; cease consciousness • unbearable psychological pain • hopelessness or helplessness • “tunnel vision” • communication of intention

  37. Schizophrenia – “split mind” • 1% of population • highest hospital admissions • 40% of homeless • same gender distribution women – 25-45 yrs. men – 18-25 yrs.

  38. Symptoms of Schizophrenia: • Positive symptoms: • hallucinations • delusions

  39. Symptoms (cont’d): • Negative symptoms: • blunted affect • anhedonia • social withdrawal • avolition

  40. Symptoms (cont’d): • Disorganization • disorganized speech (thought) • bizarre, disorganized behavior • catatonia

  41. Subtypes? • catatonic type • paranoid type • disorganized type • undifferentiated • residual

  42. Biological Factors: • Genetics: 2 parents 46% MZ twins 48% DZ twins 17% 1 parent 13% Sibling 9% Grandparent 5% First cousin 2%

  43. Denmark study (1976)

  44. Other Congenital Factors: • prenatal viral infections • birth trauma – oxygen deprivation • prenatal nutrition – Netherlands

  45. Brain Imaging • enlarged ventricles • reduced size of temporal lobe structures

  46. Treatment: Antipsychotic drugs • decrease dopamine • reduce positive symptoms, not negative • side effects – “Parkinson” symptoms

  47. Family support:“Expressed Emotion”

  48. Dissociative Disorders • disruption in integration of “identity” • assume new identity • co-existing identities • may be linked with trauma • very rare

  49. Dissociate Identity Disorder (DID) • “multiple personality disorder” • Eve (1957) • Sybil (1973) • childhood trauma? • misdiagnosis? • role playing? • “Hillside strangler”

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