1. Abnormal Psychology Psychological Disorders Chapter 14

2. Defining Psychological Disorders
Mental health workers view psychological disorders as persistently harmful thoughts, feelings, and actions.
When behavior is deviant, distressful, and dysfunctional psychiatrists and psychologists label it as disordered (Comer, 2004).
Intern’s Syndrome - diagnose yourself or those around you while studying a particular disorder
OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.

3. Deviant, Distressful & Dysfunctional
Deviant behavior (going naked) in one culture may be considered normal, while in others it may lead to arrest.
Deviant behavior must accompany distress.
If a behavior is dysfunctional it is clearly a disorder.
Maladaptive
Carol Beckwith
In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal.

4. Abnormality Statistically rare Deviant from social norms
Situational context - the social or environmental setting of a person’s behavior.
Subjective discomfort - emotional distress or emotional pain.
Maladaptive - anything that does not allow a person to function within or adapt to the stresses and everyday demands of life.

5. Abnormality vs. Insanity
Insanity is a legal term
The insanity defense is used to argue that a mentally ill person should not be held responsible for his or her actions.
Not everyone diagnosed with a mental disorder would be able to claim insanity – that designation is determined by judges and juries.
Not defined in DSM-IV-TR

6. Understanding Psychological Disorders
Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.
OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)

7. Medical Perspective
Philippe Pinel ( ) from France, insisted that madness was not due to demonic possession, but an ailment of the mind.
George Wesley Bellows, Dancer in a Madhouse, © 1997 The Art Institute of Chicago
Dance in the madhouse.

8. Medical Model
When physicians discovered that syphilis led to mental disorders, they started using medical models to review the physical causes of these disorders.
Etiology: Cause and development of the disorder.
Diagnosis: Identifying (symptoms) and distinguishing one disease from another.
Treatment: Treating a disorder in a psychiatric hospital.
Prognosis: Forecast about the disorder.

9. Biopsychosocial Perspective

10. DSM IV
Diagnostic Statistical Manual of Mental Disorders: the big book of disorders.
Operational definitions of each disorder
DSM will classify disorders and describe the symptoms.
DSM will NOT explain the causes or possible cures.
400 psychological disorders compared to 60 in 1950’s

11. Goals of DSM
Describe (400) disorders.
Determine how prevalent the disorder is.
Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar.
Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”

12. Labeling Psychological Disorders
Critics of the DSM-IV argue that labels may stigmatize individuals.
David Rosenhan “pseudopatient” study 1970
OBJECTIVE 4| Discuss the potential dangers and benefits of using diagnostic labels.
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, Cornell University Press.
Asylum baseball team (labeling)

13. Labeling Psychological Disorders
3. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.
4. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes (STIGMA)
Elaine Thompson/ AP Photo
Theodore Kaczynski
(Unabomber)

14. Anxiety Disorders
A group of conditions where the primary symptoms are anxiety or defenses against anxiety.
the patient fears something awful will happen to them.
They are in a state of intense apprehension, uneasiness, uncertainty, or fear.
Important that their behavior is maladaptive

15. Phobias A person experiences sudden episodes of intense dread.
Must be a deep seated, irrational fear.
3 Basic Categories
Specific
Social
Agoraphobia
Phobia List

16. Generalized Anxiety Disorder GAD
An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal.
The patient is constantly tense and worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia.
No specific stimulus
Free Floating

17. Panic Disorder
An anxiety disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations.
Can be recurrent; unexpected
Symptoms: chest pain, muscle tightness, numbness and dizziness

18. Obsessive-compulsive disorder
Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action.
Interfere with everyday living and cause the person distress
Example: Obsession about dirt and germs may lead to compulsive hand washing.

19. Obsessive-Compulsive Disorder
OBJECTIVE 8| Describe the symptoms of obsessive-compulsive disorder.

20. Post-Traumatic Stress Disorder
Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD) after a deeply troubling event:
Haunting memories
2. Nightmares
3. Social withdrawal
OBJECTIVE 9| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.
4. Jumpy anxiety
5. Sleep problems
Bettmann/ Corbis

21. Resilience to PTSD
Only about 10% of women and 20% of men react to traumatic situations and develop PTSD.
Survivor Resilience- Holocaust survivors show remarkable resilience against traumatic situations.
Post-traumatic Growth- All major religions of the world suggest that surviving a trauma leads to the growth of an individual and a new positive view on life.

22. Somatoform Disorders
Occur when a person manifests a psychological problem through a physiological symptom without a physiological cause
Two types……

23. Hypochondriasis
Has frequent physical complaints for which medical doctors are unable to locate the cause.
They usually believe that the minor issues (headache, upset stomach) are indicative are more severe illnesses.

24. Body Dysmorphic Disorder
Intense anxiety about perceived physical deformity or defect
Flaw is usually minor or imagined
Western Civilization and its effect…

25. Dissociative Disorders
These disorders involve a disruption in the conscious process.
Separated from previous memories, thoughts, and feelings in response to a stressful situation

26. Dissociative Identity Disorder
Used to be known as Multiple Personality Disorder.
A person exhibits two or more distinct and alternating personalities
May not know about one another
People with DID commonly have a history of childhood abuse or trauma.

27. DID Critics
Critics argue that the diagnosis of DID increased in the late 20th century. DID has not been found in other countries.
Critics’ Arguments
Role-playing by people open to a therapist’s suggestion.
2. Learned response that reinforces reductions in anxiety.
Psychoanalytic Viewpoint – protect us against a painful memory

28. Mood Disorders Experience extreme or inappropriate emotion.
Also known as Affective Disorders

29. Major Depression A.K.A. unipolar depression
Unhappy for at least two weeks with no apparent cause.
Sadness, hopelessness and worthlessness, loss of energy, changes in appetite and sleep
Depression is the “common cold” of psychological disorders.
5.8% Men vs. 9.5% Women

30. Theory of Depression Gender differences
Women get sadder, men get madder.

31. Neurotransmitters & Depression
A reduction of norepinephrine and serotonin has been found in depression.
Drugs that alleviate mania reduce norepinephrine.
Pre-synaptic
Neuron
Serotonin
Norepinephrine
Post-synaptic
Neuron

32. The Depressed Brain & Genetic Influences
PET scans show that brain energy consumption rises and falls with manic and depressive episodes. (Left Frontal Lobe)
Identical Twins- 1 in 2 will have depressive disorder; 7 in 10 will have bipolar disorder

33. Bipolar Disorder Formally manic depression.
Involves periods of depression and manic episodes.
Manic episodes involve feelings of high energy, euphoria, inflated self esteem
but they tend to differ a lot…some get confident and some get irritable
Engage in risky behavior during the manic episode.

34. Bipolar Disorder
Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase.
Whitman
Wolfe
Clemens
Hemingway
George C. Beresford/ Hulton Getty Pictures Library
Earl Theissen/ Hulton Getty Pictures Library
The Granger Collection
Bettmann/ Corbis

35. Personality Disorders
Well-established, maladaptive ways of behaving that negatively affect people’s ability to function.
Dominates their personality.
Hard to tell apart and treat

36. Antisocial Personality Disorder
Lack of empathy.
Little regard for other’s feelings.
View the world as hostile and look out for themselves.
Manipulative, rebellious, hurtful
Sociopath/ (psychopath)
Conduct Disorder

37. Understanding Antisocial Personality Disorder
PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat offenders had 11% less frontal lobe activity compared to normals (Raine et al., 1999; 2000).
Courtesy of Adrian Raine,
University of Southern California
Normal
Murderer

38. Histrionic Personality Disorder
Needs to be the center of attention and a tendency toward highly emotional behavior.
Whether acting silly or dressing provocatively.
Needs reassurance they are worth something

39. Narcissistic Personality Disorder
Having an unwarranted sense of self-importance and an extreme preoccupation with themselves.
Thinking that you are the center of the universe.
Needs reassurance they are better

40. Paranoid Personality Disorder
Persistent suspicion marked by the chronic sense of being observed and persecuted
Highly suspicious of others

41. Borderline Personality Disorder
Sudden and intense rages, deep insecurity and fear of abandonment, and general instability in relationships
Impulsive
High suicide risk group

42. Schizophrenic Disorders
If depression is the common cold of psychological disorders, schizophrenia is the cancer.
About 1 in every 100 people are diagnosed with schizophrenia.
Schizophrenia strikes young people as they mature into adults.
It affects men and women equally, but men suffer from it more severely than women.
Symptoms of Schizophrenia
Disorganized thinking.
Disturbed Perceptions
Inappropriate Emotions and Actions

43. Disorganized Thinking
The thinking of a person with Schizophrenia is fragmented and bizarre and distorted with false beliefs.
Word Salad
Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information.

44. Disturbed Perceptions
hallucinations- sensory experiences without sensory stimulation.
Usually auditory
They do not exist!

45. Disturbed Perceptions
Delusions- false beliefs
Delusions of Persecution or Paranoia
Delusions of Grandeur
Delusions of Reference
Beautiful Mind

46. Inappropriate Emotions and Actions
Apathy
Laugh at inappropriate times.
may laugh at the news of someone dying
Flat Effect- show no emotion at all
Catatonia
motionless Waxy Flexibility
senseless, compulsive acts.
may continually rub an arm, rock a chair, or remain motionless for hours

47. Types of Schizophrenia

48. Positive and Negative Symptoms
Positive Symptoms
Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals.
(presence)
Negative Symptoms
Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals.
(absence)

49. Subtypes

50. Understanding Schizophrenia: Biological Model
Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.
OBJECTIVE 18| Outline some abnormal brain functions and structures associated with schizophrenia, and discuss the possible link between prenatal viral infections and schizophrenia.

51. Abnormal Brain Activity
Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions.
Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro
Imaging and Judith L. Rapport, National Institute of Mental Health

52. Abnormal Brain Morphology
Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.
Effects frontal lobes and temporal lobes
Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

53. Genetic Factors
The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991).
Identical
Both parents
Fraternal
One parent
Sibling
Nephew or niece
Unrelated
46x
OBJECTIVE 19| Discuss the evidence for a genetic contribution to the development of schizophrenia. 6x

54. Genetic Factors
The following shows the prevalence of schizophrenia in identical twins as seen in different countries. Averages out to about 1 in 2

55. Early warning signs of schizophrenia include:1.
A mother’s long lasting schizophrenia. 2.
Birth complications, oxygen deprivation and low-birth weight. 3.
Short attention span and poor muscle coordination. 4.
Disruptive and withdrawn behavior. 5.
Emotional unpredictability. 6.
Poor peer relations and solo play.