2Discuss:What is your definition of “abnormal behavior”? Or, what constitutes abnormal behavior?What is “normal behavior”?
3Instructions: Write "A" over the blank if you think that the behavior being described can be classified as abnormal, and "N" if you believe that it is reasonably normal.1. A pregnant woman is so afraid of sleeping near a window as she believes that a manananggal will come to take her unborn baby away. She is able to sleep well for as long as she stays away from any opening in their house.N Although this behavior may constitute delusional thinking in some cultures, it is a widespread folk belief in our culture. Most Filipino professionals will not consider this abnormal for as long as there is no impairment in functioning, and the pregnant woman is not preoccupied with the thought that her unborn child will be taken.2. When he was a young child, Kenneth witnessed a violent fight between his father and mother, which eventually led into their separation. At that point, a bird flew right before him. Since then, he would tremble in fear at the sight of any kind of bird. In other situations, however, he seems to function like everyone else.A This is an example of a phobia. Many irrational fears like this are strictly confined to the target object, which have been associated with the traumatic event.3. Whenever he comes home, Jon has the routine of going through each room in his house cleaning and fixing every single fixture. His routine often takes him about 2 hours although he has a domestic helper who cleans his house everyday.A Some people who suffer from obsessive compulsive disorder may manifest this behavior. They feel that they need to be clean, and their surroundings neat at all times, even if their routines take up so much of their time. They just can't help themselves.
44. Ben is only 7 years old. He saw a nice, expensive ballpen lying around the living room of his uncle's house. He took it home without asking permission. When asked by his parents where he got the pen, he casually (and guiltlessly) answered where.N Although many parents may consider this stealing, it is actually not. A child developmentally needs to learn a sense of proprietorship, and can have some lapses like this. Children who steal habitually usually fear being reprimanded, and so lie about the origin of the object in question.5. Henry is now 10 years old. He has been having school problems since he was younger, as he cannot keep still in his seat. While listening to the teacher's lecture, Henry's attention cannot be sustained, so he starts talking to his seatmates, draws on his notebook, or stands up and goes around the classroom. During a 40-item test, Henry was only able to complete 10 items in the test, despite demonstrating adequate understanding of the instructions. A Henry shows some symptoms of a child suffering from Attention-Deficit/Hyperactivity Disorder: inattention, hyperactivity and impulsiveness. 6. Jenny firmly believes that there is a family of duwendes living in her backyard. She often leaves toys and food outside for them to enjoy.N Belief in duwendes is accepted in our culture. Moreover, for as long as this belief does not disrupt the everyday functioning of the people in her household, this may not be considered a delusion.
57. Gina is devastated and attempts to commit suicide by slashing her wrists with a blade after her boyfriend broke up with her.A Although this attempt appears to be a call for attention, it is an act characterizing a person who is highly unstable. While suicides are usually associated with people who are feeling depressed, it is also a symptom of people who suffer from Borderline Personality Disorder.8. Troy often forgets his things. He usually comes to school without his homework, and often loses his ballpens and notebooks.N Although this forgetfulness can be a form of cognitive loss that may be due to another medical condition, it cannot be considered a mental illness on its own. There are some techniques that can be used by Troy in order to overcome his absent-mindedness.9. Everyday for the past 2 months, after coming home from work, Ronnie locks himself in his bedroom and takes shabu while watching television. All his salary goes to the drugs. He then wakes up early to go to work the next day and takes pains to ensure that no one finds out about his drug abuse. A Although Ronnie's work may not seem to be affected by his drug abuse, other areas of his life are already negatively affected by his addiction: his inability to stop spending his salary all on drugs, his social isolation by spending all his free time alone in his room, and lying to others about his drug abuse by making sure that no one finds out.
610. When she is in a bad mood, which is almost every day, Tina cannot help but exhibit temper tantrums. A This volatile emotionality can be seen among many people suffering from Borderline Personality Disorder or an impulse control problem. They are easily provoked, and have difficulty controlling their anger. 11. When asked what her name was, Abel answered that the "moon jumped together with the sun over the rainbow". A This shows disorganized thought as a disturbance in the form of thought of a person suffering from Schizophrenia. 12. Without any effort to diet, Lily loses at least 5% of her body weight every month for a period of about 3 months. A Depression usually brings about either a sudden weight gain or loss.
7Abnormal behavior What is abnormal behavior? Deviation from statistical normsEx. Extremely low IQ scoresDeviation from social normsMaladaptiveness of behaviorIneffective, unproductive, unlawfulAffect daily functioning/relationshipsLevel of personal distress
8Abnormal behavior What is normal behavior? (“well-adjusted”) Efficient perception of realityAbility to exercise voluntary control over behaviorAbility to form affectionate relationshipsProductivity
9Attention deficit in an 8-year old child – A) statistical deviation – a behavioral symptom of AD/HD in children, 8-year olds are developmentally expected to be able to focus on tasks for at least 15 minutes, so this is an atypical lag for a child this age Depression – D) personal distress – a person suffering from depression may feel anxious, numb, have loss of appetite, and may have some aches and pains. Loss of memory of one’s childhood – A) statistical deviation – A symptom of DID, this may not cause personal distress and may not be maladaptive, but it is certainly statistically uncommon for people not to remember whole chunks of their childhood
10Frequent alcohol intoxication – Frequent alcohol intoxication –A) social norms - Social norms encourage drinking only in moderation; frequently getting intoxicated from alcohol is unacceptablePreference to be alone and avoid any social contact –C) maladaptive behavior – “No man is an island” as the song goes; human beings are also social beings as they contribute something to keep society progressive and productive; by preferring to be alone and avoiding social contact, the person deprives oneself and society of maximizing his or her gifts and talentsBelief that one is sick and needs medical attention even when there are no physical evidence to support this –C) maladaptive behavior – only persons who are truly sick will seek intervention for their illness
11Early Explanations of Mental Illness In ancient times holes were cut in an ill person’s head to let out evil spirits in a process called trepanning.In the Middle Ages, the mentally ill were labeled as witches.Menu
12Understanding Psychological Disorders Theoretical Approaches to Psychological DisordersThe Biological ApproachMedical ModelStructural ViewsBiochemical ViewsGenetic ViewsMedical Model A biological approach that describes psychological disorders as medical diseases with a biological origin.1-
13Understanding Psychological Disorders Theoretical Approaches to Psychological DisordersThe Psychological ApproachPsychoanalytic PerspectiveBehavioral and Social Cognitive PerspectiveHumanistic Perspective1-
14Understanding Psychological Disorders The Causes of Psychological DisordersSociocultural FactorsAn Interactionist Approach: Bio-Psycho-Social
18DSM: Classifying Abnormal Behavior DSM-IVStands for Diagnostic and Statistical Manual of Mental Disorders, fourth edition; the most recent major classification of psychological disorders.Classifying Abnormal BehaviorAxis I: All Categories Except Personality Disorders and Mental Retardationprimary diagnosisAxis II: Personality Disorders and Mental Retardationother long-standing psych conditionAxis III: General Medical ConditionsphysicalAxis IV Psychosocial and Environmental Problemspersonal difficulties/stressful events that precipitated disorderAxis V Current Level of FunctioningOn a scale of 100: assess general level of functioning
19DSM Diagnostic Categories Disorders usually first diagnosed in infancy, childhood, or adolescenceMental RetardationIQ testsUsually genetic factors, head trauma, infection, toxic substancesLearning Disorderslag in reading, writing, mathPervasive Developmental Disorderssevere impairment, odd behaviorEx. Autism – hand-flapping, poor eye contact, prefer to play aloneHigh-functioning autistic – may attend regular schoolsSavantAttention-Deficit/Hyperactivity Disorder (ADHD)Lack of focus, hyperactivity, poor impulse control
20DSM Delirium, dementia, amnestic, & other cognitive disorders Impairment of brain functioning (aging etc.)Mental disorders due to a general medical conditionConsequence of a medical conditionSubstance-related disordersEffects of meds, drug abuse, toxic substancesSchizophrenia and other psychotic disordersImpairment of reality testing, bizarre behavior, highly disordered thought processesDelusions (false beliefs)“I am Napoleon!”Hallucinations (false sensory perceptions)
24Schizophrenia Causes of Schizophrenia Biological Factors HeredityStructural Brain AbnormalitiesNeurotransmitter DeregulationPsychological FactorsDiathesis-Stress ModelSociocultural FactorsDiathesis-Stress View Argues that a combination of biogenetic disposition and stress cause schizophrenia.1-
26DSMMood disordersPsychological disorders in which there is a primary disturbance in mood. Prolonged emotion that colors the individuals entire emotional state. Two main types are the depressive disorders and bipolar disorder.Depressive disorder – sadness, loss of gratification, negative thoughts, lack of motivationBipolar disorder – alternate bouts of depression & mania
27DSMMajor Depressive Disorder – must have 5 of the 9 symptoms during a 2 week periodDepressed mood for most of the dayReduced interest or pleasure in most activitiesSignificant weight loss or gain, significant decrease or increase in appetiteTrouble sleeping or sleeping too muchPsychomotor agitation or retardationFatigue or loss of energyFeeling worthless or guilty in an excessive or inappropriate mannerProblems thinking, concentrating, or making decisionsRecurrent thought of death or suicide
28DSM Depression/Mood Disorders Psychoanalytic Reaction to loss; anger towards selfBehavioralLack of positive reinforcementNegative experiences throughout lifeLearned HelplessnessCognitiveHow people view themselves or the worldBiologicalHeredityNeurophysiological AbnormalitiesNeurotransmitter DeregulationHormonesSociocultural FactorsInterpersonal RelationshipsSocioeconomic and Ethnic FactorsCultural VariationsGender
29Mood Disorders Major Depressive Disorder Gender Differences in Depression Across Cultures
31PANIC! PANIC! PANIC! PANIC! Anxiety Disorderssweatingracing heartchest painshortness of breathdizzinessnauseahot flashes/chillstremblingterrordesire to escapePANIC! PANIC! PANIC! PANIC!Menu
32Anxiety disordersinclude these features: motor tension, hyperactivity, and apprehensive expectations and thoughts.Generalized Anxiety Disorder An anxiety disorder that consists of persistent anxiety for at least one month; the individual with this disorder cannot specify the reasons for the anxiety.Panic Disorder An anxiety disorder marked by the recurrent sudden onset of intense apprehension or terror.Agoraphobia A cluster of fears centered around public places and being unable to escape or find help should one become incapacitated.Phobic Disorder Commonly called phobia, an anxiety disorder in which the individual has an irrational, overwhelming, persistent fear of a particular object or situation.Obsessive-Compulsive Disorder (OCD) An anxiety disorder in which the individual has anxiety-provoking thoughts that will not go away (obsession) and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation (compulsion).DSM
33Anxiety Disorders Post-Traumatic Stress Disorder (PTSD) PTSD Symptoms Combat and War-Related TraumasAbuseNatural and Unnatural DisastersPost-Traumatic Stress Disorder (PTSD) An anxiety disorder that develops through exposure to a traumatic event, such as a war; severely oppressive situations, such as the holocaust; severe abuse, as in rape; natural disasters, such as floods and tornados; and accidental disasters, such as plane crashes.1-
36DSM Anxiety disorders Psychoanalytic Punitive disciplining strategy while toilet-trainedBehavioralPhobia was a learned responseCognitiveThoughts? Overestimation of the feared event. Belief that rituals will prevent disaster.Biological
37DSM Somatoform disorders Factitious disorders Dissociative disorders Physical symptoms with no biological basisFactitious disordersIntentionally feigning symptoms with no apparent gainDissociative disordersPsychological disorders that involve a sudden loss of memory or change in identity.
39DSM Dissociative disorders Dissociative Amnesia A dissociative disorder involving extreme memory loss caused by extensive psychological stress.Dissociative Fugue A dissociative disorder in which the individual not only develops amnesia but also unexpectedly travels away from home and establishes a new identity.Dissociative Identity Disorder (DID) Formerly called multiple personality disorder, this is the most dramatic but least common dissociative disorder; individuals suffering from this disorder have two more distinct personalities or selves.
40DSM Dissociative disorders Many have experienced sexual or physical abuse as childrenWhy create new identities in such a situation?
41DSM Sexual & gender identity disorder Eating disorders Sleep disorders Distress over sexual identity, sexual performanceEating disordersSelf-induced starvation, binge eating, innaccurate perception of body imageSleep disordersImpulse control disordersAnger, gamble, set things on fire, pull one’s hair, steal
42DSM Adjustment disorders psychological response from an identifiable stressor or group of stressors that causes significant emotional or behavioral symptoms that does not meet criteria for more specific disorderslike loss of a boyfriend, a poor report card, or moving to a new
43DSM Personality disorders Chronic, maladaptive cognitive-behavioral patterns that are thoroughly integrated into the individual's personality.ParanoidSensitivity to rejection, resentfulness, distrust, as well as the inclination to distort experienced events. Neutral and friendly actions of others are often misinterpreted as being hostile or contemptuous.Histrionicattention-seeking and excessively dramatic behaviorsNarcissisticgrandiose sense of self-importance; preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love ; sense of entitlement
44DSM Personality disorders Antisociallack of remorse, morality commit crimesPassive-aggressivePattern of negativistic attitude, passive resistance to perform adequatelyProcrastination, stubbornness, and forgetfulnessBorderlinepsychological instability, fear of abandonment; have unstable moods, relationships; high number experienced abuse as childrenOther conditions that may be the focus of clinical attention
45Neurotic? Or Psychotic? Neuroses – feelings of anxiety etc. Psychoses – loss of contact with realityDelusions (false beliefs)Hallucinations (false sensory perceptions)Ex. Dr. John NashEx. Psychotic depression, Neurotic depression
46DSMEvaluationUse of LabelsThe medical modeldiseaseCulture
47Explaining Abnormal Behavior Biological perspectiveEx. Depression (Psychiatrist, Psychologist)Psychoanalytic perspectiveUnconscious conflicts/ maladaptive use of defense mechanismsBehavioral perspectiveLearnedCognitive perspectivemental processesBiopsychosocial approachinteractionist
48SUICIDEDiscuss:What do you think of people who think of committing suicide or have actually committed suicide?Have you ever had to deal with a friend with suicidal thoughts?What did you say to the person?Have you personally ever thought of committing suicide?If so, how far did you go in terms of thought process or behavior?
50Suicide Usually after a fight with family or boyfriend/girlfriend Not all intend to dieHurt someoneGain attentionRelease tensionIn the U.S., suicide has quadrupled since 1950Girls: 3x more attempts than boysCompleted suicides: 5x higher among boys than girls
51Suicide 1. People generally think about suicide. Instructions: Write "T" over the blank if you think that the behavior being described is true and “F” if you think it is false.1. People generally think about suicide.Ordinarily, people think about suicide at one point in time in their lives. This may happen especially during stressful moments.2. A person who talks about committing suicide may seriously do it.While there are people who talk about suicide but do not attempt it at all, those who have a history of attempts are more likely to do it again. Moreover, if the person has detailed plans of how one will kill oneself and has easy access to materials to implement it, the more likely the attempt will be made.3. A person who commits suicide usually warns others about it.Usually, a person warns others that he or she is thinking of committing suicide. It may be as clear as a threat or may be so subtle (i.e. said in a joking manner) such that it was easily dismissed and realized only in hindsight.4. A number of people who commit suicide do not actually intend to die.While there are a number of people who intend to die when they commit suicide, others do it impulsively to cope with a stressful situation, to gain attention, to hurt someone back, or to relieve themselves of pain.
52Suicide5. If one has a history of previous suicide attempts, he may likely do it again. Those who have attempted suicide in the past are more likely to do so again especially if proper aftercare and treatment was not given and the person has not learned better and healthier coping skills needed. 6. It is difficult to identify a person who is likely to commit suicide. Sudden changes in a person's behavior especially a display of depressive symptoms may be a warning that he or she wants to commit suicide. At other times, however, one can barely see any change in behaviors as the person who later attempts went normally about his or her daily routine right before it. 7. Talking with the person about his or her suicidal thoughts and plans may help the person abandon his or her plans of actually putting these thoughts into action. During this stressful moment, a person who thinks of suicide may be in great need of someone who shows compassion and care. Being able to talk about it to someone may also relieve him or her of anxiety and may make him or her feel understood. 8. A person who commits suicide may suffer from a mental disorder. Studies show that a number of people who commit suicide are diagnosed to have depression, borderline personality disorder, schizophrenia, or substance abuse. With the correct diagnosis, proper treatment may be given to them. Note: All answers on the worksheet are T for True
54Instructions: For each of the following brief case studies, identify the disorder. 1. Edwina is worried, anxious, and sure that something terrible is going to happen to her. She’s not sure what it would be, but she “just knows.” The feeling occurs on almost a daily basis and frequently keeps her awake at night. In addition, for the last few weeks, she has been plagued with chronic headaches, upset stomachs, and upper back pain.2. Last week, Roger suddenly quit his job. He told his family he had decided to learn carpentry. He purchased a truckload of wood and nails, which now sits in his driveway because he changed his mind and decided to enroll in a school for massage therapy. The school confirms that he registered but that he has not attended class. Roger claims that he can learn all he needs simply from reading the books. For the last three days, he has not slept. He started to read the massage therapy books but became so upset by the lack of quality photos in the texts that he bought a camera. Today, he is taking photos for his new career as a photojournalist.3. George enters the clinic with his wife who says she “can’t take it anymore!” She states that George is carrying around a notebook in which he is constantly scribbling cryptic notes about everyone that he meets. He is parking his car a few blocks away from the house so he can watch who drives down the street and past his home. Yesterday, he came home early and taped all the shades down over the windows in the house.
554. Susanna appears in court this morning on check forgery charges 4. Susanna appears in court this morning on check forgery charges. She is dressed in a black leather miniskirt, thigh-high black boots, a bright red, low-cut tank top, and earrings with bells that jingle when she moves. Throughout the proceedings, Susanna methodically files her fingernails. She adamantly states that she is not to blame for writing the bad checks despite the fact that she admits to stealing them from her father and signing his name. She makes it clear that her father owes her the money because he refused to pay for medical school (despite the fact that she never graduated from college) and ruined her career as a brilliant physician.5. Anichka was walking her dog when suddenly and without warning, her heart began to pound, her legs began to tremble, and she became very dizzy. She was convinced she was having a heart attack right there on the street.6. Noah is having trouble staying awake at work. Throughout the night he hears someone that tells him something is on fire in the house. He has been getting up 15 to 20 times during the night to check for smoke and to check the smoke alarm.
567. John is seen in the emergency room because his mother brought him in. He is dressed in a blue baseball cap, red striped pajamas, army combat boots, and large women’s clip-on earrings. He claims he has been “swatting sprocketgens” and “pounding the batjunkins with rose perfume.”8. Maurice is sleeping 12 to 16 hours a day. Over the last two months, his weight has dropped 10 pounds, and he feels as if it takes all his effort to fix a simple bowl of soup. He feels as if he is sitting at the bottom of a hole and simply can’t climb out.