1. 4 th Edition Copyright 2004 - Prentice Hall12-1 Abnormal Psychology Anxiety & Mood Disorders Unit 5

2. Copyright 2004 - Prentice Hall12-2 Criteria of Abnormal Behavior statistical rarity-- behavior is infrequent in population. Dysfunctional-- behavior interferes with daily functioning.

3. Copyright 2004 - Prentice Hall12-3 Abnormal Behavior personal distress – behavior is upsetting/confusing to patient Deviates from social norms = abnormal (deviant) behavior social norms can change over time and vary across cultures.

4. Copyright 2004 - Prentice Hall12-4 Abnormal Behavior Insanity - a legal ruling that an accused individual is not responsible for a crime. Criteria: unable to tell right from wrong when crime was committed Insanity pleas are infrequently used and rarely successful.

5. Copyright 2004 - Prentice Hall12-5 Abnormal Behavior Models medical model: abnormal behaviors are illnesses - prescribe medical treatments. psychodynamic model: unconscious conflicts from childhood.

6. Copyright 2004 - Prentice Hall12-6 Abnormal Behavior Models behavioral model: abnormal behaviors are learned (cond., modeling) cognitive model: our interpretation of events/ our beliefs influence our behavior.

7. Copyright 2004 - Prentice Hall12-7 Abnormal Behavior Models sociocultural model social /cultural factors considered Biopsychosocial— combination approach

8. Copyright 2004 - Prentice Hall12-8 Classifying and Counting Psychological Disorders The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) provides rules for diagnosing psychological disorders that have increased reliability.

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11. Copyright 2004 - Prentice Hall12-11 Rorschach Test (Projective Tests)

12. Copyright 2004 - Prentice Hall12-12 Thematic Apperception Test

13. Copyright 2004 - Prentice Hall12-13 Classifying and Counting Psychological Disorders Rosenhan's pseudopatient study questions our ability to distinguish normal and abnormal behaviors and how labels affect perception of behavior.

14. Copyright 2004 - Prentice Hall12-14 Classifying and Counting Psychological Disorders Epidemiologists study prevalence & incidence of accidents, diseases, and psychological disorders.

15. Copyright 2004 - Prentice Hall12-15 Classifying and Counting Psychological Disorders Phobias, substance abuse/dependence, and MDD are among most common d/o.

16. Copyright 2004 - Prentice Hall12-16 Classifying and Counting Psychological Disorders Many suffer from more than one psychological disorder (co-morbidity).

17. Copyright 2004 - Prentice Hall12-17 Anxiety, Somatoform, and Dissociative Disorders Anxiety involves behavioral, cognitive, and physiological elements. Biopsychosocial model most effective.

18. Copyright 2004 - Prentice Hall12-18 Anxiety, Somatoform, and Dissociative Disorders a chronically high level of anxiety = generalized anxiety disorder (GAD) Worry about 2 or more areas of life.

19. Copyright 2004 - Prentice Hall12-19 Anxiety, Somatoform, and Dissociative Disorders Phobias are excessive, irrational fears of activities, objects, or situations. most frequently diagnosed phobia is agoraphobia (“fear of the marketplace”) No escape!

20. Copyright 2004 - Prentice Hall12-20 Anxiety, Somatoform, and Dissociative Disorders The DSM-V: agoraphobia and specific phobia. conditioning and modeling may explain phobias.

21. Copyright 2004 - Prentice Hall12-21 Phobias

22. Copyright 2004 - Prentice Hall12-22 Psychologically Based Therapies Systematic desensitization relaxation techniques asked to imagine or approach feared situations gradually (Counter- conditioning)

23. Copyright 2004 - Prentice Hall12-23 Anxiety D/Os Fear of being in situations that may subject one to scrutiny DSM-V: Social Anxiety D/O

24. Copyright 2004 - Prentice Hall12-24 Anxiety, Somatoform, and Dissociative Disorders Frequent panic attacks (which resemble heart attacks) main symptom of panic disorder. Biological and cognitive explanations for this disorder have been proposed.

25. Copyright 2004 - Prentice Hall12-25 OCD Obsessions are thoughts, images, or impulses that occur repeatedly; compulsions are irresistible, repetitive acts (behaviors) trying to decrease thoughts.

26. Hoarding Disorder Persistent difficulty parting with possessions, regardless of their value Living areas become cluttered Parting causes extreme distress New classification

29. Animal Hoarding

30. Copyright 2004 - Prentice Hall12-30 Anorexia/ Bulimia Nervosa Stress-related eating disorders Anorexia Nervosa – self-starving (<85% of normal body weight) Bulimia Nervosa – binge and purge eating Type A Personality? Control? Identity issues?

31. Anorexia Nervosa Hungry, but don’t eat for fear of being fat Distorted image of their body No sign of other disease Weight less than minimally normal Some starve themselves to death (20% die total)

32. Why anorexia? Neurotransmitter imbalance Brain images-no pleasure from food Societal pressures Low self esteem levels Stress and anxiety

35. Bulimia Nervosa Binge eating with loss of control, followed by vomiting, laxatives, exercise maintain normal weight, distorted image @ least once a week for 3 months

36. Binge Eating Disorder 3 or more of the following: Very rapid eating uncomfortably full Large amounts of food, but not hungry Eating alone b/c embarrassment Disgust, guilt, depression afterwards @ least once/week for 3 months

37. Post Traumatic Stress Disorder PTSD exposure to actual or threatened death, serious injury or sexual violation Doesn’t have to happen to you! clinically significant distress/ dysfunction: impairment in social interactions, capacity to work or other important areas of functioning

38. Copyright 2004 - Prentice Hall12-38 PTSD Trauma (violence, war, crime, disaster, etc.) 1 st month after Trauma occurs = acute stress d/o Acute or Chronic PTSD after 1 mo. sleep disturbances, nightmares, flashbacks, irritability

39. TREATMENT early intervention!!! -cognitive behavioral therapy: learn about own symptoms and disorder=control “reliving the events” -anti-anxiety/anti-depressant meds -virtual reality/exposure therapy

40. Copyright 2004 - Prentice Hall12-40 Biomedical Therapies antianxiety drugs: benzodiazepines (Valium, Xanax) (GABA agonists) Anti-depressants: SSRIs (Zoloft, Paxil, Prozac, Lexapro) may reduce symptoms (seratonin agonists) SNRIs (Cymbalta, Effexor, Pristiq)

41. Copyright 2004 - Prentice Hall12-41 Anxiety, Somatoform, and Dissociative Disorders Somatic symptom disorder Many physical symptoms w/ no known medical causes – (headaches, pain, digestive, etc.) psychological factors (depression and/or anxiety) are involved.

42. Copyright 2004 - Prentice Hall12-42 Conversion Disorder Somatic disorder with loss of sensory or motor function without medical explanation. (blindness, deafness, paralysis)

43. Copyright 2004 - Prentice Hall12-43 Illness Anxiety D/O Somatoform disorder with belief of a specific, serious disease despite repeated medical findings to the contrary (DSM IV: hyponchondriac)

44. Copyright 2004 - Prentice Hall12-44 Dissociative Disorders Dissociative disorders involve disruptions in some function of awareness in the mind. Depersonalization D/O: “The Flash”- Existential moments dissociative amnesia: memories cannot be recalled dissociative fugue: memory loss accompanied by travel.

45. Copyright 2004 - Prentice Hall12-45 Anxiety, Somatoform, and Dissociative Disorders Dissociative identity disorder (multiple personality) - presence of two or more personalities in one individual. The 3 Faces of Eve Sybil

46. Copyright 2004 - Prentice Hall12-46 Mood Disorders lifetime prevalence of depression is twice as high in women as men; prevalence rates around the world are increasing.

47. Copyright 2004 - Prentice Hall12-47 Mood Disorders symptoms of depression include sadness, reduced pleasure and energy levels, feelings of guilt, sleep and appetite changes (more than 2 weeks) and suicidal thinking.

48. Copyright 2004 - Prentice Hall12-48 Mood Disorders Suicide, often associated with depression, is a leading cause of death in US.

49. Copyright 2004 - Prentice Hall12-49 Suicide Rates

50. Copyright 2004 - Prentice Hall12-50 Mood Disorders Medical: low levels of norepinephrine or serotonin. Behavioral: learned helplessness Cognitive: people believe they cannot control outcomes

51. Copyright 2004 - Prentice Hall12-51 Mood Disorders Mood disorders tend to run in families (genetic)

52. Copyright 2004 - Prentice Hall12-52 Mood Disorders Mood disorder concordance rates in twins: 65% identical vs 14% fraternal. Depression comorbid with other disorders.

53. Copyright 2004 - Prentice Hall12-53 Depression Disorders Dysthymic - chronic low mood Unipolar-Major Depression Double Depression – Dysthymic disorder w/ major depressive episode SAD- melatonin/ phototherapy Postpartum depression-hormones

54. Copyright 2004 - Prentice Hall12-54 Models on Mood Disorders Biological/ Medical – Concordance; SSRIs & Lithium (seratonin & norepinepherine) Psychodynamic – attachment issues Cognitive—Explanatory styles (t/p, s/u, e/i) optimist/ hardy, hopelessness (arbitrary inference: conc w/o supporting evidence) Behavioral—Learned helplessness/ reinforcers Biopsychosocial – interacting factors

55. Copyright 2004 - Prentice Hall12-55 Mood Disorders Bipolar disorder involves swings between depression and mania. symptoms of mania include euphoria, increased energy, poor judgment, decreased sleep, and elevated self-esteem