Presentation on theme: "Chapter 17 Abnormal Behavior: Deviance and Disorder."— Presentation transcript:
1Chapter 17Abnormal Behavior: Deviance and Disorder
2Key QuestionsHow is normality defined, and what are the major psychological disorders?What is a personality disorder?What are the most common sexual disorders?What problems result when a person suffers high levels of anxiety?How do psychologists explain anxiety-based disorders?Is psychiatric labeling damaging?What role does the concept of insanity play in criminal trials?
3Facts on Psychopathology During their lifetimes, 1 out of every 100 people will become so severely disturbed as to require hospitalizationSome 3-6% of the aged suffer from organic psychosesIn any given week, 7% of the population is experiencing an anxiety-related disorder1 out of every 8 school-aged children is seriously maladjusted10-20% or more of all adults will suffer a major depression in their lifetimeEach year over 2 million people in North America are admitted or readmitted for psychiatric treatment in hospitals
4Andy Wilf Self-portraits The self-portraits shown here were painted by Andy Wilf between 1978 and During that time, Wilf is said to have increasingly abused drugs and alcohol. This dramatic series of images is a record of his self- destructive descent into a private hell. The third painting shows a shrouded skull-and foretells the artists fate.Wilf died of a drug overdose early in Drug abuse is but one of the many psychopathologies, or “problems in living,” psychologists seek to alleviate
5What is Normal? Psychopathology: Scientific study of mental, emotional, and behavioral disorders
6Defining Abnormality Subjective Discomfort: Statistical Abnormality: Feelings of unhappiness, anxiety, depression, or emotional distress (psychosis is exception)Statistical Abnormality:Having extreme scores on some dimension, such as anxiety or depression, see normal curve figure 17-1Social Nonconformity:Disobeying societal standards for normal conduct; usually leads to destructive or self-destructive behavior, note personal eccentricities can be charming and perfectly healthy
7Fig The number of people displaying a personal characteristic may help define what is statistically abnormal. Social non-conformity does not automatically indicate psychopathology.
8Does social non- conformity automatically indicate psychopathology?
9What is Normal? (cont.) Situational Context: Social situation, behavioral setting, or general circumstances in which an action takes place must be consideredCultural Relativity:Judgments are made relative to the values of one’s culture
10Clarifying and Defining Abnormal Behavior (Mental Illness) Maladaptive Behavior:Behavior that makes it difficult to function, to adapt to the environment, and to meet everyday demandsTable 17-1Levels of functioning (page 561)
11DSM - IV The first axis incorporates clinical disorders. The second axis covers personality disorders The remaining axes cover medical, psychosocial, environmental, and childhood factors functionally necessary to provide diagnostic criteria for health care assessments.The DSM evolved from systems for collecting census and psychiatric hospital statistics, and from a United States Army manual. The DSM was substantially revised in The five revisions since its first publication in 1952 incrementally added to the number of mental disorders, though also removing those no longer considered to be mental disorders. The last major revision was the fourth edition ("DSM-IV"), published in 1994,
12DSM-IVCommon Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, and schizophrenia (disorders you defined for homework, with exception of pxy disorder)Common Axis II disorders include personality disordersCommon Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.
13Axis IV: Severity of Psychosocial Stressors Events in a persons life, such as death of a loved one, starting a new job, college, unemployment, and even marriage can impact the disorders listed in Axis I and II. These events are both listed and rated for this axis.Axis V: Highest Level of FunctioningOn the final axis, the clinician rates the person's level of functioning both at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected.
14Shades of AbnormalityBob is a very intelligent, 25 year old member of a religious organization that is based on Buddhism. Bob's working for this organization caused considerable conflict between him and his parents, who are devout Catholics. Recently Bob experiences acute spells of nausea and fatigue that prevent him from working and which have forced him to return home to live with his parents. Various medical tests are being conducted, but as yet no physical causes of his problems have been found.RATE each of these people using the following scale:1 = Basically O.K. Psychotherapy is not necessary.2 = Mild disturbance. Psychotherapy should be considered.3 = Significant disturbance. Psychotherapy is definitely required.4 = Severe disturbance. Hospitalize!
15Shades of AbnormalityJim was vice president of the freshman class at a local college and played on the school's football team. Later that year he dropped out of these activities and gradually became more and more withdrawn from friends and family. Neglecting to shave and shower, he began to look dirty and unhealthy. He spent most of his time alone in his room and sometimes complained to his parents that he heard voices in the curtains and in the closet. In his sophomore year he dropped out of school entirely. With increasing anxiety and agitation, he began to worry that the "Nazis" were plotting to kill his family and kidnap him.RATE each of these people using the following scale:1 = Basically O.K. Psychotherapy is not necessary.2 = Mild disturbance. Psychotherapy should be considered.3 = Significant disturbance. Psychotherapy is definitely required.4 = Severe disturbance. Hospitalize!
16Shades of AbnormalityMary is a 30 year old musician who is very dedicated and successful in her work as a teacher in a local high school and as a part-time member of local musical groups. Since her marriage five years ago, which ended in divorce after six months, she has dated very few men. She often worries that her time is "running out" for establishing a good relationship with a man, getting married, and raising a family. Her friends tell her that she gets way too anxious around men, and that she needs to relax a little in generalRATE each of these people using the following scale:1 = Basically O.K. Psychotherapy is not necessary.2 = Mild disturbance. Psychotherapy should be considered.3 = Significant disturbance. Psychotherapy is definitely required.4 = Severe disturbance. Hospitalize!
17Shades of AbnormalityLarry, a homosexual who has lived for three years with a man he met in graduate school, works as a psychologist in a large hospital. Although competent in his work, he often feels strained by the pressures of his demanding position. An added source of tension on the job is his not being able to confide in all his co-workers about his private life. Most of his leisure activities are with good friends who belong to the gay subcultureRATE each of these people using the following scale:1 = Basically O.K. Psychotherapy is not necessary.2 = Mild disturbance. Psychotherapy should be considered.3 = Significant disturbance. Psychotherapy is definitely required.4 = Severe disturbance. Hospitalize!
18Clarifying and Defining Abnormal Behavior (Mental Illness) Mental Disorder:Significant impairment in psychological functioningThose with mental illness lose the ability to adequately control thoughts, behaviors, or feelings
19Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Psychological problems can be grouped into broad categories.DSM-IV is not the only system for classifying mental disorders. Nevertheless, most activities in mental health settings-from diagnosis to therapy to billing of insurance companies- are influenced by the DSM. DSM-IV is both a scientific document and a social one. Major disorders are well-documented problems. Some problems, however, have little to do with “mental illness.” Instead, they are primarily socially disapproved behaviors.
20Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Major DSM-IV CategoriesPage
21Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) Psychotic Disorder:Severe psychiatric disorder characterized by hallucinations and delusions, social withdrawal, and a move away from realityOrganic Mental Disorder:Mental or emotional problem caused by brain pathology (i.e., brain injuries or diseases)Substance Related Disorders:Abuse or dependence on a mind- or mood-altering drug, like alcohol or cocainePerson cannot stop using the substance and may suffer withdrawal symptoms if they do
23Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) Mood Disorder:Disturbances in mood or emotions, like depression or maniaAnxiety Disorder:Feelings of fear, apprehension, anxiety, and behavior distortions
25Alice in WonderlandVideo (Johnny Depp)Video (Disney)
26Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) Somatoform Disorder:Physical symptoms that mimic disease or injury (blindness, anesthesia) for which there is no identifiable physical causeDissociative Disorder:Temporary amnesia, multiple identity, or depersonalization (like being in a dream world, feeling like a robot, feeling like you are outside of your body)Personality Disorder:Deeply ingrained, unhealthy, maladaptive personality patterns
27Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.) Sexual and Gender Identity Disorder:Problems with sexual identity, deviant sexual behavior, or sexual adjustmentNeurosis:Archaic; once used to refer to anxiety, somatoform, and dissociative disorders, also used to refer to some kinds of depression
28Personality Disorders: Blueprints for Maladjusted Paranoid person-Overly suspicious, mistrustingNarcissistic person-Pre-occupied with their own self-importance. Absorbed in fantasies of power, wealth, brilliance, beauty, and loveBorderline-Very unstable relationships, erratic emotions, self-damaging behavior, impulsiveHistrionicOverly dramatic, attention seekers, easily angered, seductive, vain, shallow and manipulativeTABLE 17-5 (Page 568)
29Personality Disorders BorderlineGirl InterruptedNarcissisticThere Will be BloodHistrionicGone With The Wind
30Let’s Have A PartyImagine a party where all the people had a personality disorder
31General Risk Factors for Contracting Mental Illness Social Conditions: Poverty, homelessness, overcrowding, stressful living conditionsFamily Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problemsPsychological Factors: Low intelligence, stress, learning disordersBiological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability
32Focus on a Controversy Are the Mentally Ill Prone to Violence? Jeffrey DahmerPage 565
33Personality Disorders: Antisocial Personality Disorder (APD) A person who lacks a conscience (superego?); typically emotionally shallow, impulsive, selfish, and manipulative toward othersOftentimes called psychopaths or sociopathsMany are delinquents or criminals, but many are NOT crazed murderers displayed on televisionCreate a good first impression and are often charmingCheat their way through life (e.g., Dr. Michael Swango, Scott Peterson)
34APD: Causes and Treatments Possible Causes:Childhood history of emotional deprivation, neglect, and physical abuseUnderarousal of the brainVery difficult to effectively treat; will likely lie, charm, and manipulate their way through therapy
37Anxiety-Based Disorders Feelings of apprehension, dread, or uneasinessAdjustment Disorders:When ordinary stress causes emotional disturbance and pushes people beyond their ability to effectively copeUsually suffer sleep disturbances, irritability, and depressionExamples: Grief reactions, lengthy physical illness, unemployment
38Anxiety-Based Disorders (cont.) Generalized Anxiety Disorder (GAD):Duration of at least six months of chronic, unrealistic, or excessive anxietyFree-Floating Anxiety:Anxiety that is very general and persuasive
40Panic Disorders 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 insaneSymptoms include vertigo, chest pain, choking, fear of losing controlPanic Disorder (with Agoraphobia):Panic attacks and sudden anxiety still occur, but with agoraphobia
41Agoraphobia Agoraphobia (with Panic Disorder): Intense, irrational fear that a panic attack will occur in a public place or in an unfamiliar situationIntense fear of leaving the house or entering unfamiliar situationsCan be very cripplingLiterally means fear of open places or market (agora)Agoraphobia (without Panic Disorder):Fear that something extremely embarrassing will happen away from home or in an unfamiliar situation
42Specific PhobiasIrrational, persistent fears, anxiety, and avoidance that focus on specific objects, activities, or situationsPeople with phobias realize that their fears are unreasonable and excessive, but they cannot control themExamples: (Table 17-7 page 573)Animal type: Fear of a specific typeNatural environment: Fear of heights, storms, ocean…Blood, injection, injury: Fear of blood, injections, treatmentsSituational: Fear of situations, airplanes, elevators, enclosed spacesOther: Fear of other situations that lead to choking, vomiting, sick
43Social PhobiaIntense, irrational fear of being observed, evaluated, humiliated, or embarrassed by others (e.g., shyness, eating, or speaking in public)Celebrities with Anxiety Disorders
45Obsessive-Compulsive Disorder (OCD) Extreme preoccupation with certain thoughts and compulsive performance of certain behaviorsObsession:Recurring images or thoughts that a person cannot preventCause anxiety and extreme discomfortEnter into consciousness against the person’s willMost common: Being dirty, wondering if you performed an action (turned off the stove), or violence (hit by a car)Compulsion:Irrational acts that person feels compelled to repeat against his/her willHelp to control anxiety created by obsessionsCheckers and cleaners
46Obsessive-Compulsive Disorder (OCD) Cinema EducationThe Odd CoupleMatchstick MenAs Good As It Gets
47OCD & Profile of a Neurotic Worksheet( )Obsession/Compulsion and HysteriaThe Case of A.H./Profile of a Neurotic
48Stress DisordersOccur when stresses outside range of normal human experience cause major emotional disturbanceSymptoms: Reliving traumatic event repeatedly, avoiding stimuli associated with the event, and numbing of emotionsAcute Stress Disorder:Psychological disturbance lasting up to one month following stresses from a traumatic eventPost Traumatic Stress Disorder (PTSD):Lasts more than one month after the traumatic event has occurred; may last for yearsTypically associated with combat and violent crimes (rape, assault, etc.)Terrorist attacks on September 11th, 2001, likely led to an increase of PTSD
49Dissociative Disorders Dissociative Amnesia:Inability to recall one’s name, address, or pastDissociative Fugue:Sudden travel away from home and confusion about personal identity
50Dissociative 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 examplesOften begins with horrific childhood experiences (e.g., abuse, molestation, etc.)Therapy often makes use of hypnosisGoal: Integrate and fuse identities into single, stable personality
51Dissociate Identity Disorder (DID) Sybil3 Faces of EveFight Club
52Somatoform Disorders Hypochondriasis: Somatization Disorder: Person is preoccupied with having a serious illness or diseaseInterpret normal sensations and bodily signs as proof that they have a terrible diseaseNo physical disorder can be foundSomatization Disorder:Person expresses anxieties through numerous physical complaintsMany doctors are consulted but no organic or physical causes are found
53Somatoform Disorders (cont.) Pain Disorder:Pain that has no identifiable organic, physical causeAppears to have psychological originConversion Disorder:Severe emotional conflicts are “converted” into physical symptoms or a physical disabilityCaused by anxiety or emotional distress but not by physical causes
54Fig (left) “Glove” anesthesia is a conversion reaction involving loss of feeling in areas of the hand that would be covered by a glove (a). If the anesthesia were physically caused, it would follow the pattern shown in (b). (right) To test for organic paralysis of the arm, an examiner can suddenly extend the arm, stretching the muscles. A conversion reaction is indicated if the arm pulls back involuntarily. (Adapted from Weintraub, 1983.)
55Theoretical Causes of Anxiety Disorders: Psychodynamic Psychodynamic (Freud):Anxiety caused by conflicts among id, ego, and superegoForbidden id impulses for sex or aggression are trying to break into consciousness and thus influence behavior; person fears doing something crazy or forbiddenSuperego creates guilt in response to these impulsesEgo gets overwhelmed and uses defense mechanisms to cope
56Other Theoretical Causes of Anxiety Disorders Humanistic:Unrealistic self-image conflicts with real self-imageExistential:Anxiety reflects loss of meaning in one’s lifeBehavioristic:Anxiety symptoms and behaviors are learned, like everything elseConditioned emotional responses that generalize to new situations
57More Theoretical Causes of Anxiety Disorders Avoidance Learning:When making a particular response delays or prevents the onset of a painful or unpleasant stimulusAnxiety Reduction Hypothesis:When reward of immediate relief from anxiety perpetuates self-defeating avoidance behaviors
58Cognitive Approach Cognitive: When distorted thinking causes people to magnify ordinary threats and failures, leading to anxiety and distress
59Insanity Insanity: Expert Witness: A legal term; refers to an inability to manage one’s affairs or to be aware of the consequences of one’s actionsThose judged insane (by a court of law) are not held legally accountable for their actionsCan be involuntarily committed to a psychiatric hospitalSome movements today are trying to abolish the insanity plea and defense; desire to make everyone accountable for their actionsHow accurate is the judgment of insanity?Expert Witness:Person recognized by a court of law as being qualified to give expert testimony on a specific topicMay be psychologist, psychiatrist, and so on
60InsanityInsanity Defense: Person was incapable of knowing right from wrong while committing a crimeM’Naghten Rule: Standard for judging legal insanity in English common lawMust understand wrongfulness of actions to be held responsible for themIf suffering from mental disease preventing person from knowing right from wrong, can be deemed insaneTaking of a life due to insanity is not murderIrresistible Impulse: Uncontrollable urge to actDiminished Capacity: Temporary loss of ability to control actions or to know right from wrong