Chapter 14: Psychological Disorders (Abnormal Psychology)

Defining Abnormality w Defining abnormality is not simple, it appears to be more a matter of degree of behavioral change & distress rather than the presence or absence of a behavioral change or distress w Some criterion seem helpful in defining abnormality: Behavior is outside of social norms (shouting at strangers…*shows what is “normal” is culturally dependent) Inability to function (being unable to go to work due to alcohol abuse) Personal Distress (trouble sleeping, worry all the time, thoughts of suicide) Prolonged Suffering (depression that lasts months rather than days)

Normality-Abnormality Continuum

DSM IV Diagnostic and Statistical Manual (DSM IV) First edition th edition th revised Planned release for 5 th edition Five axis criteria for diagnostic classification of psych. disorders Axis 1- Principal diagnosis - 16 categories Axis 2- Personality or developmental disorders Axis 3- Medical conditions Axis 4- Recent sources of stress Axis 5- Global Assessment of Functioning (GAF)

Schizophrenic Disorders w Group of disorders marked by disturbances in thought patterns. These disorders can be accompanied by distortions in perception and abnormal emotional responses. w 1% of population in every culture w 30% resistant to drugs w Gradual vs. Sudden onset

Subtypes of Schizophrenia w Paranoid: marked by delusion of persecution and/or grandeur, and frequent auditory hallucinations w Disorganized: marked by inappropriate affect, disorganized speech w Catatonic: marked by motor disturbances ranging from immobility to excessive, purposeless activity w Undifferentiated: mixtures of symptoms from other subtypes

Potential Causes of Schizophrenia w Physiological Explanations neurochemicals- excess dopamine enlargement of the ventricles of the brain ( genetics- there is a 46% concordance rate for identical twins with one twin suffering schizophrenia w Environmental Explanations Stress- can precede the onset of schizophrenia and precede subsequent relapses Unhealthy Family Dynamics- high expression of emotion and communication difficulties in a family Date of birth- maybe flu season during time in womb? (see next slide)

Risk Month Born

Relatives of ppl with schizophrenia

Anxiety Disorders w Generalized Anxiety Disorder: chronic anxiety that is not caused by a specific stimulus w Panic Attacks: recurrent attacks of anxiety not due to a specific event w Phobias: chronic, irrational fear of a specific object or situation agoraphobia (open spaces), social phobia w Obsessive-Compulsive Disorder: persistent obtrusive thoughts (obsessions) & need to engage in unnecessary rituals (compulsions) w Post Traumatic Stress Disorder (PTSD): after traumatic life event person has severe anxiety, helplessness, fear, flashbacks

Common Phobias Less Common (but entertaining)…phobias list

Some Potential Causes of Anxiety Disorders w Behavioral explanations: Classically conditioned phobic responses w Neuro-chemical: decreases in GABA activity and serotonin activity are associated with anxiety disorders w Cognitive: people who suffer from anxiety disorders may chronically overestimate the severity of a perceived threat

Mood Disorders w Depressive Disorder: persistent feelings of sadness and a loss of interest in finding pleasure (Major, dysthemic (two years +), post-partum, seasonal affective disorder) w Bipolar Disorder: marked by chronic experience of manic and depressive episodes

Episodic Patterns in Mood Disorders

Some Potential Causes of Depression w Cognitive and Behavioral Mechanisms Behavioral: ”learned helplessness” believe outcomes in their life are out of their control (external locus of control) Cognitive: negative self-talk is associated with depressive episodes w Physiological Mechanisms Neurotransmitters: decreased norepinephrine and serotonin is associated with depression Genetics: there is a 65% concordance rate between identical twins

Mood Disorders chart

Somatoform Disorders Physiological issues without cause w Hypochondriasis: excessive preoccupation with becoming ill w Conversion Disorder: significant loss of function in one single organ system without a physiological cause

Dissociative Disorders w Dissociative Amnesia: sudden loss of memory for personal information that is not due to normal forgetfulness w Dissociative Fugue: a loss of memory and forming a new identity w Dissociative Identity Disorder (DID): the coexistence of more than one personality in an individual w Depersonalization: Feelings of unreality concerning the self and environment. Anxiety producing. Many young adults have felt this.

Personality Disorders- a few examples w Antisocial Personality Disorder (sociopath): marked by impulsive, callous, manipulative, aggressive, and irresponsible behavior that lacks conscience (often charming) w Narcissistic: exaggerated feelings of self-worth and constant need for affirmation w Histrionic: OVERLY emotional/seductive w Borderline: irrational fear of abandonment, self injury w Avoidant: Dependent: w Schizotypical: w Obsessive-Compulsive:

Insanity Pleas w Does not know right from wrong w A disorder alone does not absolve responsibility w John Hinkley - President Reagan w Ted Kaczynski, Jeffrey Dahmer, Andrea Yates, Kip Kinkel- all found guilty by juries

Some Potential Causes of Somatoform Disorders w Personality Factors: people with histrionic and neurotic personality traits seem to be more susceptible to the somatoform disorders w Behavioral Factors: people who have previously received a lot of attention because of illness may begin to find reward in the somatoform disorders

Problems with DSM/disease model w Thomas Szasz- no such thing as mental ill w Rosenhan- empty, hollow, thud- 19 days w Labeling theory w Not easy to classify- crossover w Infers more understanding than actual w Everyday problems w Insurance

Suicide w White > Black, Men > Women (China), Woman attempts > Men attempts w Spike for men after 65 w Alcoholics and depression very high rate w Few who talk about it do it, but most who do it give clues ahead of time w Arizona over 1000 suicides last year- Mesa 60, Chandler 30

Suicide facts w Take all threats seriously w Most suicidal people are ambivalent and want help w Asking a person can minimize anxiety and act as a deterrent w An attempter is often upset or depressed

Clues and Warning Signs w Change in interest or mood (including extremely happy or peaceful. w Change in lifestyle, eating, sleeping w Change in perception of the world w Change in attitude about personal property- giving away prized possessions

Teen Sex and Depression w to 17 year-olds w 25% of sexually active girls feel depressed all, most, or a lot of the time vs 8% w 14% of sexually active girls have attempted suicide vs 5% w 6% of sexually active boys vs less than 1%