2 What is Abnormal Behavior? UnusualnessSocial DevianceEmotional DistressMaladaptive BehaviorDangerousnessFaulty Perception of RealityHallucinationsDelusions
3 Mental or Psychological Disorder Any behavior or emotional state thatcauses a person to suffer, is self-destructive; seriously impairs the person’s ability to work or get along with others; or endangers others or the community.
4 InsanityLegal term that depends on whether the person is aware of the consequences of behavior and is able to control it.
5 Culture-Bound Syndrome Psychological disorders found only among specific cultural groups.
6 Culture-Bound Syndrome Dhat SyndromeIntense fear of losing semen (India).Ataque de NerviosUncontrollable shouting, crying, trembling, and verbal or physical aggression. Prevalent among women (Latin America).Brain FagDifficulties in concentration, memory & thinking among HS & college students in responses to the challenges of schooling ( West Africa).KoroIntense anxiety that the sexual organs will recede into the body and possibly cause death (Malaysia).AmokBrooding followed by violent outburst; often precipitated by an insult; seems to be prevalent only among men (Malaysia).
7 Culture-Bound Syndrome Ghost SicknessPreoccupation with death and the dead, with bad dreams, fainting, appetite loss, fear, & hallucinations (Native Americans).PibloktoqEpisodes of extreme excitement of up to 30 minutes, during which the individual behaves irrationally or violently (Artic Inuit Communities).Qi-gong psychotic reactionShort episode of mental symptoms after engaging in the Chinese folk practice of qi-gong, or “exercise of vital energy” (China).Tajin kyofushoIntense fear that the body, its parts, or its functions displease, embarrass, or are offensive to others (Japan).ZarBelief in possession by a spirit, causing shouting, laughing, head banging, weeping & withdrawal (North Africa & Middle East).
8 Models of Abnormal Behavior Early BeliefsMedical ModelPsychological ModelsSociocultural ModelBiopsychosocial Model
9 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) The “bible” of psychological and psychiatric diagnosis.Primary aim of the DSM is descriptiveprovide clear criteria for diagnostic categories.
10 Advantages of the DSMWhen used correctly it improves the reliability of the diagnosis making it more accurate.Creates uniformity among cliniciansCorrect labeling of the disorder may help people identify the source of their condition that may lead to proper treatment.
11 Limitations of the DSM May foster over diagnosis. May increase risk of creating self-fulfilling prophecies.Label will follow the individual.May confuse serious mental disorders with normal problems.Diagnoses reflect prevailing attitudes and prejudice.Create illusion of universality.
13 Multiaxial Assessment Axis I: Clinical DisordersOther conditions that may be a focus of clinical attentionAxis II: Personality DisordersMental RetardationAxis III: General medical conditionsAxis IV: Social and environmental stressorsAxis V: Global assessment of overall functioning
14 DSM-IV –TR (Axis I)Disorders first diagnosed in Infancy, childhood, or adolescenceDelirium, dementia, and amnesic and other cognitive disordersSubstance related disordersSchizophrenia and other psychotic disordersAnxiety disordersSomatoform disordersFastidious disordersDissociative disordersSexual and gender identity disordersEating disordersSleep disordersImpulse control disordersAdjustment disordersOther conditions that may be a focus of clinical attention
16 Disorders First Diagnosed in Infancy, Childhood, or Adolescence Learning disorders (Learning disabilities)Pervasive developmental disordersAutism, Asperger's Disorders, etc.Attention-deficit and disruptive disordersADHD, Conduct Disorder, Oppositional Defiant Disorder, Disruptive Behavior Disorder, etc.Feeding & eating disorders of infancy or early childhoodPica, Rumination Disorders, etc.Tic disordersTourette’s Disorder, Chronic Motor or Vocal Tic Disorder, etc.Elimination disordersEncopresis, Enuresis, etc.Other disorders of infancy, childhood or adolescence
17 Delirium, Dementia, Amnestic and other Cognitive Disorders Acute and relatively sudden decline in attention-focus, perception, and cognition. Delirium is not the same as dementia, though it commonly occurs in demented patients.DementiaProgressive decline in cognitive function due to damage or disease in the body beyond what might be expected from normal aging. Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood.Amnestic Disorders
18 SchizophreniaA psychosis or mental condition involving distorted perceptions of reality and an inability to function in most aspects of life.Severity and duration of symptoms vary.Onset can be abrupt or gradual.Prognosis is unpredictable when onset is gradual.
19 Schizophrenia and other Psychotic Disorders Paranoid TypeDisorganized TypeCatatonic TypeUndifferentiated TypeResidual TypeSchizophrenic DisorderSchizoaffective DisorderDelusional DisordersErotomanic TypeGrandiose TypeJealous TypePersecutory TypeSomatic TypeMixed TypeShared psychotic disorders (Folie a Deux)Other
20 Symptoms of Schizophrenia Active or positive symptomsDelusions--false beliefs about realityHallucinations and heightened sensory awarenessvisual, auditory, olfactory, gustatory, tactile, etc.Disorganized, incoherent speech--illogical jumble of ideasGrossly disorganized and inappropriate behavior ranging from childlike silliness to violent agitationNegative symptomsLoss of motivationPoverty of speech--brief, empty replies reflecting diminished thoughEmotional flatness--unresponsive facial expressions, poor eye contact, diminished emotionalityTend to occur before and last after positive symptoms
21 Origins of Schizophrenia Biological factors Genetic predispositionsRisk of schizophrenia for general population is 1-2 %Risk is about 50 % if identical twin has schizophreniaRisk is 12 % for people with one schizophrenic parentRisk is % for people with two schizophrenic parentsNo specific genes for schizophrenia have been identifiedStructural brain abnormalitiesMay have decreased brain weight, reduced volume in specific brain areas, or reduced number of neurons in certain brain areasMay have enlarged ventriclesMore likely to have abnormalities in the thalamusAntipsychotic medications might affect the brainNeurotransmitter abnormalitiesSchizophrenics may have low levels of serotonin and high levels of dopamine activityPrenatal abnormalitiesDamage to fetal brain may increase likelihood of schizophreniaSevere malnutrition during pregnancyInfectious viruses, such as influenza, especially during second trimester of gestation
23 Panic DisorderCharacterized by sudden attacks of intense fear, with feelings of impending doom.SymptomsHeart palpitations, dizziness, and faintness.Often related to stress, prolonged emotion, or traumatic experiences.Are not uncommon; whether it develops into a disorder depends on how the bodily reactions are interpreted.Culture influences the particular symptoms.
24 Phobias Unrealistic fear of a specific situation, activity, or object. Social phobiaPersistent, irrational fear of situations in which one will be observed by others.AgoraphobiaFear of being alone in a public place from which escape might be difficult or help unavailable.The most disabling phobia--most common phobia for which people seek treatment.May begin with panic attacks--sudden onset of intense fear, then avoiding situations that might provoke another attack.
25 Obsessive Compulsive Disorders ObsessionsRecurrent, persistent, unwished-for thoughts.May be frightening or repugnant.CompulsionsRepetitive, ritualized behaviors that the person feels must be carried out to avoid disaster.People feel a lack of control over the compulsion.Common compulsions include repeated hand washing, counting, touching, and checking things.Most OCD sufferers do not enjoy the rituals and realize the behavior is senseless, but if they try to break off the ritual, they feel mounting anxiety.Several parts of the brain are overactive in OCD sufferers, resulting in the person experiencing a constant state of danger.
26 Posttraumatic Stress Disorder (PTSD) Can occur as a result of uncontrollable and unpredictable danger such as rape, war, or natural disasters.SymptomsReliving the trauma in thoughts or dreams“Psychic numbing”Increased physiological arousalReaction may be immediate or delayed with PTSDSymptoms of PTSD may recur for 10 years or more
27 Generalized Anxiety Disorder SymptomsContinuous, uncontrollable anxiety or worryFeelings of foreboding and dreadRestlessness, difficulty concentrating, irritability, and jitterinessDuration of at least 6 monthsPredisposing factorsPhysiological tendencyUnpredictable environment in childhood
28 MOOD DISORDERS Depressive Disorders Bipolar Disorders Major Depressive DisordersDysthymic DisordersBipolar DisordersBipolar I DisorderBipolar II DisorderCyclothymic DisorderSubstance Induced Mood DisorderPostpartum Onset
29 Major Depressive Disorder Disrupts ordinary functioning for at least six months.Symptoms: emotional, cognitive & behavioral changes.EmotionalFeelings of despair and hopelessness.Loss of pleasure in usual activities.Thoughts of death or suicide.CognitiveExaggerate minor failings, discount positive events, interpret things that go wrong as evidence that nothing will ever go right.Low self-esteem, losses interpreted as sign of personal failure.Memory and concentration difficulties.BehavioralUnable to do everyday activities (e.g., takes tremendous effort to get up and get dressed).May stop eating or overeat, have difficulty falling asleep or staying asleep, feel tired all the time.
30 Bipolar Disorder Depression alternates with mania Bipolar I Bipolar II One or more manic episodes.Bipolar IIOne or more depressive episodes with at least one hypomanic episode
31 Manic EpisodeA distinct period of abnormally and persistently elevated , expansive or irritable mood lasting at least 1 week.Inflated self esteem or grandiosityDecrease need for sleepMore talkativeDistractibilityExcessive involvement in pleasurable activities
32 Origins of Mood Disorders Biological Explanations Focus on genetics and brain chemistryLow norepinephrine and/or serotonin levels implicated in depressionMania may be caused by excessive production of norepinephrineDrugs help to bring the levels of neurotransmitter into balanceBrain scans show reduced frontal lobe activity in depressed people
33 Other Explanations for Depression Social explanations--focus on stressful conditions of people’s livesMarriage and employment associated with lower rates of depression.In women, having more children is associated with higher rates of depressionA history of exposure to violence is related to depressionAttachment explanations--focus on disturbed relationships and separations and a history of insecure attachmentsDisruption of a primary relationship most often sets off a depressive episodeCognitive explanations--propose that depression results from particular habits of thinking and interpreting eventsLearned helplessness theory held that people become depressed when their efforts to avoid pain or control the environment fail--however, not all depressed people have actually experienced failure“Ruminating response style” may also lead to longer, more intense periods of depressionWomen more likely to adopt this style than men
36 Sexual Disorder Sexual Dysfunctions Paraphilias I Male erectile disorderPremature ejaculationFemale orgasmic disorderHypoactive sexual desireothersParaphiliasExhibitionismFetishismFrotteurismPedophiliaVoyeurismSexual masochismSexual sadismI
41 Axis IV Psychosocial & Environmental Problems Problems with primary support groupProblems related to social environmentEducational problemsOccupational problemsHousing problemsEconomic problemsProblems with accese to heath careLegal problemsOther psychosocial problems
42 Axis V Global Assessment of Functioning Scale (GAF) 100 Superior functioning90 Minimal symptoms80 Transient symptoms70 Mild symptoms60 Moderate symptoms50 Serious symptoms40 Some impairment of reality30 Serious impairment20 Dangerous symptoms10 Extremely severe & dangerous symptoms
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