1. Abnormal Psychology A.K.A. Psychological Disorders Deviant, distressful, dysfunctional patterns of thoughts, feelings or behaviors

2. Early Theories Abnormal behavior was caused by demon possession Led to harsh, ineffective remedial treatments – Trephining, beatings, burnings, etc.

3. History of Mental Disorders Medical Model (Pinel)– psychological disorders are a biologically based…a “sickness”/disease that needs to be diagnosed and cured – Neglects the importance of social circumstances and psychological factors.

4. History of Mental Disorders Biopsychosocial Model– current approach – Interaction of nature and nurture – Adds influence of culture and psych to Medical model

5. Perspectives and Disorders Psychological School/PerspectiveCause of the Disorder Psychoanalytic/PsychodynamicInternal, unconscious drives HumanisticFailure to strive to one’s potential or being out of touch with one’s feelings. BehavioralLearning : classical or operant (rewards and punishments) conditioning, modeling CognitiveIrrational, dysfunctional thoughts or ways of thinking. SocioculturalDysfunctional Society, family Biomedical/NeuroscienceOrganic problems, biochemical imbalances, genetic predispositions.

6. DSM IV Diagnostic Statistical Manual of Mental Disorders: – used to identify and diagnose disorders – Diagnoses only observable patterns of behavior Facilitates reliability – Answer questions from 5 levels DSM will NOT explain the causes or possible cures. Criticism: classifies an excessively broad range of human behaviors as psychologically disordered.

8. Classifying Psychological Disorders

9. Two Major Classifications in the DSM Neurotic Disorders Distressing but one can still function in society and act rationally. Psychotic Disorders A mental state that impairs thought, perception and judgment John Wayne Gacy

10. The Rosenhan Study Rosenhan’s associates were feigning symptoms of hearing voices. ALL 8 normal people were misdiagnosed with schizophrenia. What are some of the questions raised by this study? Labeling Advantage - allows mental health professionals to quickly communicate complex symptoms Disadvantages biasing power - make false assumptions about the person self fulfilling prophecy- process by which one’s expectations about another person eventually lead the other person to behave in ways that confirm these expectations

11. ADHD Symptoms: – Inattention/distraction – Hyperactivity – Impulsivity Causes: – Biological Normal but delayed thinning of frontal cerebral cortex Genetic – Social Watching lots of TV as a toddler (correlational)

12. ADHD Assessing: – Eye Tracking device Gender: – 2-3X more in Boys Prevalence: – 4% of all children (10% US)

13. ADHD Treatment Treatment – Biological – assume problem is organic requires drug treatment therapy Stimulant drugs – help calm hyperactivity and increase focus – Aderall – Ritalin – Behavioral – assume problem behaviors are the problem and apply operant and classical conditioning principles Token economy –earn token for exhibiting desired behavior, that can later be exchanged for privileges or treats

14. Anxiety Disorders Anxiety Disorders - a group of conditions where the primary symptoms are persistent or distressing anxiety or maladaptive defenses against anxiety. Examples: – Generalized anxiety disorder – Panic disorder – Phobias – Obsessive compulsive disorder – Post-traumatic stress disorder

15. Generalized Anxiety Disorder GAD - An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal. – Fearful most of the time accompanied by heart palpitations, fatigue, dread, difficulty concentrating, sweating, or icy cold hands – Often accompanied by depression – Free Floating – person can’t identify, deal with or avoid cause

16. Panic Disorder Panic Disorder - An anxiety disorder marked by a minutes-long episode of intense dread that something terrible will happen – Panic attack - chest pain, choking, heart palpitations, trembling, or dizziness

17. Phobias Phobia - irrational fear causes person to avoid an activity or situation – Animals, insects, heights, blood, closed spaces – Social Phobia – fear of being scrutinized by others…avoid embarrassing social situations – Agoraphobia – fear of open spaces…having a panic attack with no way to escape…may accompany panic disorder – Phobia List Phobia List

18. Obsessive-compulsive disorder OCD - Persistent Obsessions – repetitive thoughts Compulsions – repetitive actions Examples – hoarders, checkers, counters, cleaners Causes Evolutionary - Exaggerated behaviors of ancestors – checking territorial boundaries Biological insufficient serotonin Anterior cingulated cortex Learned – anxiety reduction reinforces behavior

19. Post-traumatic Stress Disorder PTSD – Flashbacks, nightmares, withdrawal, anxiety, insomnia for more than 4 weeks following extremely stressful event. – Greater emotional distress the higher the risk for PTSD – Cause: Sensitive limbic system increases vulnerability by flooding body with stress hormones Genes Survival resiliency - ability to survive dozens of episodes of trauma Post-traumatic growth – increased personal growth due to trauma

20. Causes of Anxiety Disorders Learned Perspective – Conditioned Classically conditioned by associating stimuli (i.e. a traumatic event) with anxiety – Example: Rats who received unpredictable shocks in a lab become fearful when they return to the lab Stimulus generalization – fear stimuli that are associated with the original CS – Example: Fear all dogs after bitten by Maui Reinforcement (operant) – helps maintain phobias and compulsions after they arise – Avoiding or escaping the feared situation reinforces the behavior – Example: After feeling anxious you go inside your house which calms you down – Observational Learning Observing others’ fears – Example: Monkeys transmit fear of snakes to offspring

21. Causes of Anxiety Disorders Biological Perspective – Natural Selection/evolutionary perspective Biological predisposition to fear: spiders, snakes, close spaces, heights, storms and darkness Compulsive acts exaggerate fears that contribute to survival: – Examples: » Washing up = ritual hand washing » Checking boundaries = checking and rechecking locks – Genes High strung temperament – Anxiety disorders: high correlation in identical twins – 17 genes expressed with Anxiety Neurotransmitters – Anxiety gene affects brain levels of serotonin – Too much glutamate : brain’s alarm centers overactive – Brain Anterior Cingulate Cortex monitors actions and checks for errors – elevated activity in OCD Amygdala – fear circuits created in traumatic experiences – Neurotransmitters Serotonin low Glutamate High

22. Causes of Anxiety Disorders Psychoanalytic Perspective – Produced by repressed memories, hidden wishes, unconscious conflicts Example: Afraid to go out on dates because sexually abused by father

23. Think Pair Share A variety of specific psychological disorders are categorized as anxiety disorders in the DSM-IV-TR. List at least three specific anxiety disorders, and identify elements they have in common and those that are unique to each disorder.

24. Somatoform Disorders Somatoform Disorders - psychological problem that presents itself through physical symptoms – Examples Conversion Disorder Hypochondrias – Cause: socio-cultural Cultural expectations about what symptoms/diseases are socially acceptable More common in Freud’s day China – depression not acceptable = more somatoform disorders

25. Conversion Disorder Conversion Disorder – anxiety is converted to a physical symptom with no physiological basis. – Examples: blindness or paralysis. – 12 teenage girls in LeRoy, NY report uncontrollable body movements, tics and verbal outbursts

26. Hypochondriasis Hypochondriasis – normal sensations are interpreted as a symptoms of a dreaded disease Patients go from physician to physician seeking medical attention, but fail to find a biological root. Example: Headache= brain tumor

27. Dissociative Disorders Dissociative Disorders – involve – disruption to conscious awareness – sudden loss of memory – change in identity, Two types – Dissociative Fugue, Dissociative Identity Disorder Symptoms in common – Memory loss of time periods, events, people – Distorted perception of people and things watch self with sense of attachment – Blurred sense of identity

28. Dissociative Fugue Conscious awareness is separated from painful memories or feelings Patients find themselves in an unfamiliar environment with no knowledge of past life - create physical distance from real identity Triggered by stress

29. Dissociative Identity Disorder Dissociative Identity Disorder (DID) - 2 or more distinct personalities control a person’s behavior – Used to be known as Multiple Personality Disorder. – Patients commonly have a history of childhood abuse or trauma.

30. DID Controversy AGAINST 1.Could be extreme version of our capacity to vary the “selves” we present in different situation 2.Constructive memory – leading questions may lead to constructing false memories of childhood trauma 3.Role-playing (Spanos) of fantasy-prone patients in response to leading questions 4.Increase in DID in last 20 years (Outside US disorder is much less prevalent) FOR 1.Distinct brain and body states associated with differing personalities 2.Heightened brain activity in areas associated with control and inhibition of traumatic memories

31. DID Causes Psychoanalytic – defense against anxiety caused by unacceptable impulses Learning – behaviors reinforced by anxiety reduction

32. Mood Disorders Characterized by emotional extremes – 2 typical forms Major Depressive Disorder Bi-polar The Common Cold of Psych Disorders Inhibits aggression and risk taking, slows us down More prevalent in women

33. Causes of Mood Disorders Biological – Genes Increased risk if have parent or sibling with disorder Identical twins – Major Depression = 1 in 2 chance – Bipolar = 7 in 10 chance (2 in 10 for Fraternal) Linkage analysis – isolating genes across generations – Not one single gene found Heritablity – 35 to 40% in major depression – Brain Less activity in brain during depressed states, more activity during mania Left frontal lobe (positive emotions ) is inactive during depression Hippocampus – vulnerable to stress related damage – Biochemical Norepinephrine – scarce: depression; abundant: mania Serotonin – scarce; abundant: mania Drugs used to block reuptake of norepinephrine and serotonin relieve symptoms – SSRI – Selective Serotonin Reuptake Inhibiter (Zoloft/Prozac)

34. Causes of Mood Disorders Social Cognitive – Cognition increased expectations of negative outcomes Self defeating beliefs Learned helplessness Negative explanatory style - tend to explain events in stable (forever), global (affects everything) and internal (my fault) terms Women : greater emotional memory to recall negative events, more likely to sense a lack of personal control, and over think in response to stressful situations – Social Stressful life experiences Individualistic countries Psychoanalytical – Internalization of anger

35. Suicide Risk highest when rebounding from depression Higher risk if abuse alcohol Social suggestion may trigger suicide Talk about suicide – attempt suicide – few succeed

36. Major Depression Major Depressive Disorder – at least 5 signs of depression and lasts 2 or more weeks Signs of depression: – lethargy – feelings of worthlessness – loss of interest in family/friends – Loss of interest in activities – Withdrawn – Self-defeating beliefs With or without therapy, episodes usually end

37. Bipolar Disorder Bipolar Disorder – alternating between depression and mania. Mania – euphoric, hyperactive/high energy, over- talkative, overactive, require less sleep, take more risks, and are wildly optimistic state Formally manic depression.

38. Seasonal Affective Disorder Seasonal Affective Disorder - Experience depression during the winter months. Based not on temperature, but on amount of sunlight. Treated with light therapy.

39. Personality Disorders Personality Disorders - Well- established, maladaptive ways of behaving that negatively affect people’s ability to function. 3 clusters – Anxious/fearful Avoidant personality disorder – Eccentric/Odd Schizoid personality disorder – Impulsive/erratic/Emotional Histrionic personality disorder Narcissistic personality disorder Antisocial personality disorder

40. Antisocial Personality Disorder Antisocial Personality Disorder – Lack of conscience = antisocial behavior (lying, cheating, stealing, sexual promiscuity Feel and fear little May be aggressive and ruthless or a clever con artist Usually Male Called Conduct disorder in children

41. Causes of Antisocial Personality Disorder Biological – Little or no physical reaction No autonomic nervous system arousal (low levels of adrenaline)to adverse events May lead to fearless behaviors – Low levels of stress hormones – Reduced frontal lobe activity and tissue – Genes – Prone to alcohol and drug addiction Social – poverty and family instability, child abuse

42. Histrionic Personality Disorder Histrionic Personality Disorder – attention seeking behaviors

43. Narcissistic Personality Disorder Narcissistic Personality Disorder – self involvement/obsession with self Thinking that you are the center of the universe.

44. Schizoid Personality Disorder Schizoid Personality Disorder – lack of interest in social events and relationships

45. Avoidant Personality Disorder Anxiety personality disorder Lifelong pattern of feeling very shy, inadequate, and fear social rejection.

46. Schizophrenic Disorders Schizophrenia – meaning split mind and characterized by 1.Disorganized thinking. 2.Disturbed Perceptions 3.Inappropriate Emotions and Actions 2 General Types – Reactive (acute) schizophrenia – develops rapidly, but more likely recovery – Chronic (process) schizophrenia– slow to develop and less likely to recover Prevalence 1/100 Gender – Men slightly more than women

47. Disorganized Thinking Thinking that is fragmented, bizarre and distorted with false beliefs (delusions). Speech is fragmented and full of unrelated words = word salad May be caused by breakdown in selective attention –inability to filter out information.

48. Delusions (false beliefs) Delusions of Persecution Example: “The police are trying to get me and take me to prison” Delusions of Grandeur Example: “I am Jesus and can walk on water”

49. Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation. Example: – Hear voices saying “You are bad and should burn yourself with a cigarette”

50. Inappropriate Emotions and Actions Laugh at inappropriate times. Flat Effect – no emotion Senseless, compulsive acts. Catatonia- remain motionless for hours

51. Positive v. Negative Symptoms Positive Symptoms Presence of inappropriate symptoms Hallucinations, disorganized thoughts, delusion, inappropriate emotions Negative Symptoms Absence of appropriate ones. Toneless voices, expressionless faces, mute, rigid bodies

52. Subtypes of Schizophrenia Disorganized - disorganized speech or behavior, or flat or inappropriate emotion. Paranoid – preoccupation with delusions or hallucinations, often with themes of persecution or grandiosity Catatonic – immobility, extreme negativism, parrot-like repeating of speech and movement Undifferentiated – many and varied symptoms Residual – Withdrawal after hallucinations and delusions have disappeared.

53. Causes of Schizophrenia Brain Abnormalities – Dopamine Hypothesis – excess dopamine receptors May intensify brain signals creating positive symptoms – Abnormal Brain Activity and Anatomy Low brain activity in frontal lobes critical for planning and reasoning Out of synch neurons Smaller thalamus (difficulty filtering info) and increased activity (hallucinations) Increased activity in amygdala (paranoia) Enlarged fluid filled areas and shrinkage of cerebral tissue

54. Causes of Schizophrenia – Maternal Virus during Pregnancy Affects fetal brain development – Flu epidemics increase risk – Born during winter and spring months after fall/winter flu season have greater risk – Abnormal levels of anti-bodies Genetic Factors – 1 in 10 chance if sibling or parent has – 6 in 10 in identical twins Some genes influence the effects of dopamine Some genes affect the production of myelin