Psychological Disorders: What is Normal?

1. Chapter 16 Psychological Disorders

2. Quiz • Social nonconformity is the failure to conform to societal norms or the usual minimum standards for social conduct, culturally specific. • Mood disorder is a major disturbance in mood or emotion, such as depression or mania or bipolarity. • Schizophrenia means having a split personality • Everyone who experiences the same traumatic event will experience PTSD. • Once someone is diagnosed with a major mental health disorder, they are considered crazy and there is not much that can be done to help them.

3. What is Normal? • Psychopathology: Scientific study of mental, emotional, and behavioral disorders; abnormal or maladaptive behavior • Subjective Discomfort: Subjective feelings of pain, unhappiness, or emotional distress • Statistical Abnormality: Having extreme scores on some dimension, such as intelligence, anxiety, or depression

4. What is Normal? Continued • Social Nonconformity: Disobeying societal standards for normal conduct; usually leads to destructive or self-destructive behavior • Situational Context: Social situation, behavioral setting, or general circumstances in which an action takes place • Is it normal to walk around strangers naked? If you are in a locker room and in the shower area, yes!

5. Cultural Relativity • Prepare a list of normal behaviors that involve interacting with other people • Who are they normal or abnormal for? • A man? A woman? A culture emphasizing passivity? A culture emphasizing aggression? • Judgments are made relative to the values of one’s culture

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7. Statistical Abnormality • Estimate the number of parties you have attended in the last month. • Estimate the number of hours you have spent watching TV or using the computer (not for homework) in the last week • Estimate the number of hours you have spent with your family in the last week • What should define compulsive partying? Or other compulsive behavior? • What is the cutoff for being addicted to any of these behaviors?

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9. Clarifying and Defining Abnormal Behavior (Mental Illness) • Maladaptive Behavior: Behavior that makes it difficult to function, to adapt to the environment, and to meet everyday demands • Mental Disorder: Significant impairment in psychological functioning • Those with mental illness lose the ability to adequately control thoughts, behaviors, or feelings

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11. General Risk Factors for Contracting Mental Illness • Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions • Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems • Psychological Factors: Low intelligence, stress, learning disorders • Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability

12. Insanity • Definition: A legal term; refers to an inability to manage one’s affairs or to be aware of the consequences of one’s actions • Those judged insane (by a court of law) are not held legally accountable for their actions • Can be involuntarily committed to a psychiatric hospital • Some movements today are trying to abolish the insanity plea and defense; desire to make everyone accountable for their actions • How accurate is the judgment of insanity?

13. Insanity • How do you define insanity? • DSM-IV TR definition: Interferes with daily functioning on the following 2 out of 5 of the following categories. • (page 312) • Legal Defense: When an accused person in a criminal prosecution to avoid liability for the commission of a crime because, at the time of the crime, the person did not appreciate the nature or quality or wrongfulness of the acts.

14. Antisocial Personality Disorder (APD) • A person who lacks a conscience (superego?); typically emotionally shallow, impulsive, selfish, and manipulative toward others • Oftentimes called psychopaths or sociopaths • Many are delinquents or criminals, but many are NOT crazed murderers displayed on television • Create a good first impression and are often charming • Cheat their way through life (e.g., Scott Peterson)

15. APD: Causes and Treatments • Possible Causes: • Childhood history of emotional deprivation, neglect, and physical abuse • Underarousal of the brain • Very difficult to effectively treat; will likely lie, charm, and manipulate their way through therapy

17. Anxiety-Based Disorders • Anxiety: Feelings of apprehension, dread, or uneasiness • Adjustment Disorders: When ordinary stress causes emotional disturbance and pushes people beyond their ability to effectively cope • Usually suffer sleep disturbances, irritability, and depression • Examples: Grief reactions, lengthy physical illness, unemployment

18. Panic Disorder without Agoraphobia • A chronic state of anxiety with brief moments of sudden, intense, unexpected panic (panic attack) • Panic Attack: Feels like one is having a heart attack, going to die, or is going insane • Symptoms include vertigo, chest pain, choking, fear of losing control

19. Specific Phobias • Irrational, persistent fears, anxiety, and avoidance that focus on specific objects, activities, or situations • People with phobias realize that their fears are unreasonable and excessive, but they cannot control them

20. Obsession • Recurring images or thoughts that a person cannot prevent • Cause anxiety and extreme discomfort • Enter into consciousness against the person’s will • Most common: Being dirty, wondering if you performed an action (turned off the stove), or violence (hit by a car) • Obsessive-Compulsive Disorder (OCD) : Extreme preoccupation with certain thoughts and compulsive performance of certain behaviors

21. Compulsion • Irrational acts that person feels compelled to repeat against his/her will • Help to control anxiety created by obsessions • Checkers and cleaners

23. Stress Disorders • Occur when stresses outside range of normal human experience cause major emotional disturbance • Symptoms: Reliving traumatic event repeatedly, avoiding stimuli associated with the event, and numbing of emotions

24. Acute Stress Disorder • Psychological disturbance lasting up to one month following stresses from a traumatic event • What does a nervous breakdown look like? • What has broken down? • What nerves are being referred to?

25. Post Traumatic Stress Disorder (PTSD) • Lasts more than one month after the traumatic event has occurred; may last for years • Typically associated with combat and violent crimes (rape, assault, etc.) • Terrorist attacks on September 11th, 2001, likely led to an increase of PTSD

26. Dissociative Disorders • Dissociative Amnesia: Inability to recall one’s name, address, or past • Dissociative Fugue: Sudden travel away from home and confusion about personal identity • Usually triggered by highly traumatic events

27. Split Personality • What does split personality mean? • What is split? • What would it look like? • How would you treat it?

28. Dissociative Identity Disorder (DID) • Person has two or more distinct, separate identities or personality states; previously known as Multiple Personality Disorder • “Sybil” or “The Three Faces of Eve” are good examples • Often begins with horrific childhood experiences (e.g., abuse, molestation, etc.) • Therapy often makes use of hypnosis • Goal: Integrate and fuse identities into single, stable personality

29. Hypochondriasis • Person is preoccupied with having a serious illness or disease • Interpret normal sensations and bodily signs as proof that they have a terrible disease • No physical disorder can be found

30. Somatization Disorder • Person expresses anxieties through numerous physical complaints • Many doctors are consulted but no organic or physical causes are found

31. Glove Anesthesia • Loss of skin sensitivity in areas normally covered by a glove

32. Theoretical Causes of Anxiety Disorders: Psychodynamic (Freud) • Anxiety caused by conflicts among id, ego, and superego • Forbidden id impulses for sex or aggression are trying to break into consciousness and thus influence behavior; person fears doing something crazy or forbidden • Superego creates guilt in response to these impulses • Ego gets overwhelmed and uses defense mechanisms to cope

33. Psychosis • Loss of contact with shared views of reality • Delusions: False beliefs that individuals insist are true, regardless of overwhelming evidence against them

34. Hallucinations • Imaginary sensations, such as seeing, hearing, or smelling things that do not exist in the real world • Most common psychotic hallucination is hearing voices • Note that olfactory hallucinations sometimes occur with seizure disorder (epilepsy)

35. Some More Psychotic Symptoms • Flat Affect: Lack of emotional responsiveness; face is frozen in blank expression • Disturbed Verbal Communication: Garbled and chaotic speech; word salad • Personality Disintegration: When an individual’s thoughts, actions, and no longer connected

36. Other Psychotic Disorders • Organic Psychosis: Psychosis caused by brain injury or disease • Dementia: Most common organic psychosis; serious mental impairment in old age caused by brain deterioration • Archaically known as senility

37. Alzheimer’s Disease • Symptoms include impaired memory, mental confusion, and progressive loss of mental abilities • Ronald Reagan most famous Alzheimer’s victim

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40. Delusional Disorders • Marked by presence of deeply held false beliefs (delusions) • May involve delusions of grandeur, persecution, jealousy, or somatic delusions • Experiences could really occur! • Paranoid Psychosis: Most common delusional disorder • Centers on delusions of persecution

41. Schizophrenia: The Most Severe Mental Illness • Psychotic disorder characterized by hallucinations, delusions, apathy, thinking abnormalities, and “split” between thoughts and emotions • Does NOT refer to having split or multiple personalities

42. Four Subtypes of Schizophrenia • Disorganized: Incoherence, grossly disorganized behavior, bizarre thinking, and flat or grossly inappropriate emotions • Catatonic: Marked by stupor, unresponsiveness, posturing, mutism, and sometimes, by agitated, purposeless behavior • Paranoid type: Preoccupation with delusions; also involves auditory hallucinations that are related to a single theme, especially grandeur or persecution • Undifferentiated: Any type of schizophrenia that does not have specific paranoid, catatonic, or disorganized features or symptoms

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44. Causes of Schizophrenia • Psychological Trauma: Psychological injury or shock, often caused by violence, abuse, or neglect • Disturbed Family Environment: Stressful or unhealthy family relationships, communication patterns, and emotional atmosphere • Deviant Communication Patterns: Cause guilt, anxiety, anger, confusion, and turmoil

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50. Biochemical Causes of Schizophrenia • Biochemical Abnormality: Disturbance in brain’s chemical systems or in the brain’s neurotransmitters • Dopamine: Neurotransmitter involved with emotions and muscle movement • Works in limbic system • Dopamine overactivity in brain may be related to schizophrenia • Glutamate: A neurotransmitter; may also be involved