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 th edition

Personality Disorders- a few examples w Antisocial Personality Disorder (sociopath): marked by impulsive, callous, manipulative, aggressive, 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 Schizotypical and schizoaffective

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

Schizophrenia Spectrum and Other Psychotic Disorders w Group of disorders marked by disturbances in thought patterns (distortions in perception and abnormal emotional responses). w Catatonia: marked by motor disturbances ranging from immobility to excessive, purposeless activity w Schizophrenia: must have at least one of these three “positive symptoms” (delusions, hallucinations, or disorganized speech) 1% of population in every culture 30% resistant to drugs Gradual vs. Sudden onset

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 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 Generalized Anxiety Disorder: chronic anxiety that is not caused by a specific stimulus w Selective Mutism: child can’t speak and communicate effectively in select social settings

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

Somatoform Disorders w significant loss of function in one single organ system without a physiological cause w Conversion Disorder (Functional Neurological Symptom Disorder)

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

Obsessive-Compulsive Disorder w Obsessions: persistent obtrusive thoughts w Compulsions: need to engage in unnecessary rituals w Body Dysmorphic Disorder w Hoarding Disorder w Trichotillomania (Hair-Pulling Disorder) w Excoriation (Skin-Picking) Disorder

Trauma- and Stressor-Related Disorders w Acute Stress Disorder: immediate reaction to trauma w Adjustment Disorders: adjusting after trauma w Posttraumatic Stress Disorder (PTSD): after traumatic life event person has severe anxiety, helplessness, fear, flashbacks w Reactive Attachment Disorder: result of social neglect or other situations that limit a child’s opportunity to form attachments

Depressive Disorders w Major Depressive Disorder: persistent feelings of sadness and a loss of interest in finding pleasure (more than 2 weeks) w Persistent Depressive Disorder (more than two years) w Post-partum Depression w Premenstrual Dysphoric Disorder w Seasonal Affective Disorder (cloudy weather) w Disruptive Mood Dysregulation Disorder: kids who exhibit persistent irritability and frequent episodes of extreme behavioral dyscontrol

Bipolar Disorder w Bipolar Disorder: marked by chronic experience of manic and depressive episodes w Mania = increased activity w Depression = decreased activity

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

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

Insanity Pleas w Does not know right from wrong Standard = Would the person have committed the crime if a cop was in the room? 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

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