Abnormal Psychology & Treatment Chapter 14 & 15 Abnormal Psychology & Treatment

Abnormal 4 Components of Abnormality Unusual – against majority Maladaptive – interferes with ability to function Labeled as abnormal by society it occurs in Perceptual or cognitive dysfunction

Theories of Psychopathology Psychoanalytic Result: Freud problems between Id, Ego, Super Ego lead to abnormalities Unconscious drive Humanistic Result: Too sensitive to criticisms/judgments of others Cognitive Result: Faulty illogical thoughts Behavioral Result: All behavior is learned Biological Result: Brain function due to structural/chemical abnormalities Sociocultural Result: Society/culture decide what is acceptable behavior

DSM-IV-TR Axis I: clinical disorders, including major mental disorders, as well as developmental and learning disorders Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, phobias, and schizophrenia.

DSM-IV-TR Axis II: underlying pervasive or personality conditions, as well as mental retardation Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.

DSM-IV-TR Axis III: Acute medical conditions and physical disorders. Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

DSM-IV-TR Axis IV: psychosocial and environmental factors contributing to the disorder. Negative life events, an environmental difficulty, family or interpersonal stress.

DSM-IV-TR Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children under the age of 18. (on a scale from 100 to 1) 100- superior functioning in a wide range of activities. 50-serious symptoms or difficulty in social, occupational, or school functioning. 20-some danger of hurting self or others, occasional failure to maintain minimal personal hygiene, or gross impairment in communication.

David Rosenhan (1973) Dangers of labeling – labels behavior as disorders and because labeling is not an exact science it can have adverse effects on how a person is judged. Rosenhan along with seven others reported hearing voices however responded to question showed no evidence of pathology . . . Still diagnosed mentally ill

Anxiety Based Disorders Anxiety – tension/nervousness/panic attacks overwhelming sense of panic, fear and desire to escape Panic Disorder General Anxiety Disorder (GAD) Obsessive-Compulsive Disorder (OCD) Post-Traumatic Stress Disorder Phobias

Somatoform Disorders Somatoform – disorder characterized by physical symptoms without any actual physical cause Conversion Disorder – Paralysis or blindness (no physical cause) Freud Hysteria Hypochondriasis Factitious Disorders – person inflects injury to self to produce symptoms

Mood Disorders Mood Disorders – extreme disturbance of emotional balance Unipolar (major depression) 2 or more weeks Bipolar Disorder Primarily Depressive Primarily Manic – rear Normal – Manic – Depressive Seasonal Affective Disorder Sunlight not weather!

Schizophrenia Schizophrenia – disordered thoughts/behaviors which include delusions/hallucinations/inappropriate response Disorganized – incoherent speech, inappropriate emotion Catatonic – stupor, rigid boy postures fixed position Paranoid – auditory hallucinations, secret codded messages hidden for them Undifferentiated – Multiple symptoms not easily categorized Residual – Some schizoid tendencies/traits but not profoundly schizophrenic Dopamine hypothesis - excess dopamine receptors in brain

Organic Disorders Organic Disorders – caused by damage to brain tissue Mostly result of disease or chemicals: Dementia, Alzheimer’s disease, and some drug/alcohol dependence

Personality Disorders Personality Disorders – extreme abnormal personality that conflicts with social functioning Paranoid – extreme distrust, suspicion of others Antisocial – disregard for the rights/interests of others Narcissistic – Self-preoccupation and focus on self Dependent – need to be cared for Histrionic – excessive emotional reactions and excitability, need for attention

Dissociative Disorders Dissociative Disorders – dysfunction of memory or altered sense of identity Amnesia – sudden memory loss caused by trauma Anterograde amnesia – loss of memories occurring after traumatic event Retrograde amnesia – loss of memory prior to event Fugue – sudden complete loss of identity, caused by stress, create new identity Dissociative Identity Disorder (DID) – Multiple personality disorder

Attention Deficit & Disruptive Behavior Disorder Attention Deficit Hyperactivity Disorder (ADHD) – inattentiveness, difficulty paying attention, organization, forgetfulness, distractible Need for attention Conduct disorder Oppositional Defiance Disorder

Chapter 15 Treatment

Psychoanalysis Free association Manifest Content – subject of dream Patient reports any and all conscious thoughts Hypnosis – unconsious Manifest Content – subject of dream Latent Content – symbols Transference – patient shifts thoughts/feelings about people/events onto therapist Countertransference – therapist transfers their feelings onto their patient

Humanistic Client-Centered Therapy Carl Rogers (invented) Understand client through their own reality Nondirectional approach – focus on clients perception and how that effects them Goal of therapy: self-actualization (full potential) Genuineness – active listener and relate to client Unconditional Positive Regard – show complete acceptance of client no matter what Accurate empathic understanding – therapist ability to view world from clients eyes (empathy)

Gestalt Therapy Fritz Perls Combines both physical/mental therapies Client maybe asked to act out conflict in order to make them aware of their interactions between body and mind

Behavioral Therapy v. Insight Therapy Behavioral Therapy – short-term process, no deep underlying cause of problem, abnormal behavior is the problem and symptom Insight Insight into the cause is the processes of getting better Psychoanalysis

Behavioral Therapy Counterconditioning Conterconditioning – response to a given stimulus is replaced by a different response Alcoholic – replace good feelings while drinking, with feelings concerning alcohol Aversion Therapy – Administer punishment while stimulus Drink alcohol get slapped! Systematic Desensitization – replace anxiety with relaxation

Behavioral Psychology Extinction Procedures – weaken maladaptive responses Flooding – expose client to stimulus that causes undesirable response Fear spiders, here’s a Camel spider have fun! Implosion – client imagines stimulus rather than confront it

Behavioral Psychology Operant Conditioning Behavior-control technique Behavioral contracting Patient and client draw up a contract both agree to follow. Follow behavior, rewarded if do the right thing Modeling Bandura’s social learning theory Vicarious learning – watch and learn

Cognitive Therapy Rational-emotive behavior therapy (REBT) also called Rational-emotive therapy (RET) Albert Ellis – when confronted with situations, people recite statements to themselves that express maladaptive thoughts Change thoughts by facing it Aaron Beck – focus on maladaptive schemas Negative triad – negative view of self, world, future Maladaptive inference – person draws conclusions without evidence Dichotomous thinking – all-or-none conceptions of situations “If I don’t get this job, I’ll be a complete failure.”

Biological Therapies Electroconvulsive Therapy (ECT) Psychosurgery High voltage electricity pass through head Causes temp amnesia, possible seizures Success with depression (last option) Possible memory loss Psychosurgery Prefrontal lobotomy – patient left catatonic state

Biological Therapies Psychopharmacology - treatment of psychological and behavioral maladaptations with drugs Psychotropic (psychologically active drugs) 4 classes of psychotropic/psychologically active drugs: Antipsychotics Antidepressants Anxiolytics Lithium salts Antipsychotics – Clozapine, Thorazine, Haldol Reduce schizophrenia symptoms blocking neural receptors for dopamine Tardive dyskinesia – shaking (side effect)

Biological Therapies Antidepressants – Monoamine oxidase (MAO) inhibitors, tricyclics, selective reuptake inhibitors MAO – like Eutron increase amount of serotonin, norepinephrine in synaptic cleft Tricyclics – like Norpramin, amitriptyline, impiramine Increase amount of serotonin/norepinephrine Selective reuptake inhibitors (selective serotonin reuptake inhibitors or SSRIs) – block reuptake mechanism of cell that released the neurotranmitters. Prozac (fluoxetine) Fewer side effects

Biological Therapies Anxiolytics – depress CNS and reduce anxiety, increase feelings of well-being, and reduce insomnia Common anti-anxiety is Xanax, also include barbiturates (rarely used) Benzodiazepines – Valium (diazepam) and Librium (chlordiazepoxide) cause muscle relaxation Lithium Carbonate A salt effective in treatment of bipolar disorder

Modes of Therapy Group therapy 12 Step programs Couples therapy Family therapy