Abnormal Psychology
A.K.A. Psychological Disorders
A “harmful dysfunction” in which behavior is judged to be
atypical, disturbing, maladaptive and unjustifiable.
Hmmmm……
How To Vote via Texting
1. Standard texting rates only (worst case US $0.20)
TIPS 2. We have no access to your phone number
Investigating abnormal
behavior – our first
questions:
• To identify the criteria for judging whether
behavior is psychologically disordered.
• Describe the medical model of psychological
disorders, and discuss the bio-psycho-social
perspective offered by critics of this model.
Activity 1.1
 Write down three criteria you believe could
be used to define abnormal behavior
 Use the prompt: “Behavior might be
considered psychologically disordered if it is
…”
 Brainstorm and reach consensus
Let’s take a look - Scene 1
 Denise ignored the reports to buy bottled
water, canned food, plastic sheeting and duct
tape after hearing that there was an
increased threat of terrorism in the Us,
despite the fact that she had time and money
to purchase these.
Scene 2
 Steve is passionate in his belief that animals
should not be used in research. He has
devoted his life to the cause. Last week, he
bombed the administrative office of a
pharmaceutical company that is known to
perform animal research. Four people were
injured in the explosion and one died.
Scene 3
 Joanna’s mother died suddenly three weeks
ago. She was numb for about a week, but
now is overwhelmed by sadness. She has not
gone back to work yet because she cannot
get herself out of bed in the morning. She
eats very little and feels scared that she will
not be able to cope with future challenges.
Psychological behaviors run a continuum from
very mild to extreme. Everyone has these
behaviors to one degree or another. It is not until a
behavior or feeling interferes with your quality of
life that they become a disorder.
Psychologically disordered behavior involves that
behavior which is atypical, disturbing to
oneself and/or others, maladaptive and not
justifiable to oneself or to others.
Abnormal Behavior: Three Criteria
 Behavior that deviates from the norm or that
is atypical.


Hearing voices.
Men who wear women’s clothing for sexual arousal.
 Behavior that is maladaptive, disrupting job
or family.
 Alcoholism.
 Drug addiction.
 Behavior that causes personal distress or
pain.
 Depression.
 Anxiety.
Psychological Disorder
 A “harmful dysfunction” in which behavior is
judged to be atypical, disturbing, maladaptive
and unjustifiable.
What is abnormal, disturbing maladaptive
and unjustifiable depends on:
•Culture
•Time Period
•Environmental Conditions
•Individual Person
What is “well-being”
 Defining Psychological Well-Being

 Carol Ryff – must define well-being in the positive –
following are six core dimensions of well-being:

  Self – acceptance: Positive attitude toward the
self but acknowledges and accepts multiple aspects
of the self
  Positive relations with other people – capable of
empathy, affection, and intimacy, and are concerned
about the welfare of others
  Autonomy – independent, self-determining, and
self-controlled
  Environmental mastery – sense of mastery and
competence in managing the environment – able to
choose or create contexts that are supportive of their
personal needs or values
  Purpose in life – has both goals and a sense of
directedness – feels that there is meaning to present
and past life and holds beliefs that give life purpose
 Personal Growth – see themselves as growing and
expanding – open to new experiences – have a sense
of realizing their potential
Early Theories
Afflicted
people were
possessed by
evil spirits.
Early Theories
 Music or singing was
often used to chase
away spirits.
•In some cases
trephening was
used:
Cutting a hole in
the head of the
afflicted to let out
the evil spirit.
Trephening
Early Theories
 Another theory was to make the body
extremely uncomfortable.
History of Mental Disorders
In the 1800’s,
disturbed people
were no longer
thought of as
madmen, but as
mentally ill.
They were first put in hospitals.
Did this mean better treatment?
Early Mental Hospitals
 They were nothing more than barbaric
prisons.
•The patients were chained
and locked away.
•Some hospitals even charged admission
for the public to see the “crazies”, just like
a zoo.
Philippe Pinel
French doctor who
was the first to take
the chains off and
declare that these
people are sick and
“a cure must be
found!!!”
Somatogenic
 At this time- it was believed that mental
illness had a bodily cause- Somatogenic.
But Somatogenic could not explain
disorders such as hysteria (now
called conversion disorder).
Many disorders are psychogenic: the
origin is psychological, not physical.
Current Perspectives
 Biological Perspective: psychological
disorders are sicknesses and can be
diagnosed, treated and cured.
Current Perspectives
 Bio-Psycho-Social Perspective: assumes
biological, psychological and sociocultural
factors combine to interact causing
psychological disorders.
Used to be called Diathesis-Stress Model:
diathesis meaning predisposition and stress
meaning environment.
Classifying Psychological
Disorders
DSM-IV: Diagnostic
Statistical Manual of
Mental Disorders:
the big book of
disorders.
Two Major Classifications:
Preview
Basic Issues of Mental Disorders
• Sex/culture differences in diagnosis
• Diagnostic issues
Perspectives to study mental
disorders
The idea of multiple causation
Basic Issues of Mental
Disorders
 Culturally and Gender specific
Behavior is culturally
dependent
 Hissing is a polite way to show respect for superiors in
Japan
 Face-to-face conflict is avoided in Thailand – better to
say “Why don’t you go see your house?”
 Thailand – polite way to say “no” is to giggle
 New Guinea – a man is considered “abnormal” if he
has not engaged in homosexual behavior before
marriage
 In societies where hunger is endemic, fat
women are viewed as much more attractive
than slender ones.
 India – by leaving some food on the plate, a
guest indicates the generosity of the host
who has so much food out it can’t be finished
 Thailand – public displays of affection
between men and women are unacceptable –
interestingly, men holding hands is
considered a sign of friendship.
 Latin cultures – children, especially girls, are
socialized to value conformity to social
norms – rebelliousness and delinquency are
rare
 Mexican adolescents will be reluctant to
engage in any activity that might bring shame
to their family.
Behavior is gender dependent
Men more likely to hiccup
More boys than girls sleepwalk
A man’s hands are usually warmer –
women’s blood vessels are more
expandable – body can accept 40%
more blood during pregnancy with no
blood pressure increase
A woman’s forehead is more liekly to
feel warm – however, at ovulation her
temp increases about 1 degree and
remains there for 12-14 days prior to
menstuation
Woman’s armpits are smellier
Men perspire most heavily on upper
chest
Women smell, taste, and hear better –
increases as estrogen increases,
peaking at ovulation
Men more likely to wake at night with
a stomach- ache – 2 to 1
 Men – more sleep apnea
 Men – more sneezing
 Who’s heart will still be beating when it’s 78
years old? Women – life expectancy is 79.5 vs
74.1
Perspectives on Mental
Disorders
Sociocultural Perspective
larger culture important to
development of mental disorders
supporting evidence from culturebound syndromes
Anorexia and Bulimia in North America
and Western Europe
Sociocultural: culture-bound
syndromes
 Susto
 
Found mostly in Latin America
 
Marked by severe anxiety, restlessness,
depression, loss of weight, weakness, rapid heartbeat
and a fear of black magic
 
Most likely to occur in infants and young children
 
Claim that it is caused by contact with
supernatural beings or with frightening strangers, or
even by bad air from cemeteries
 Treatment involves rubbing certain plants and animals
against the skin
Sociocultural: culture-bound
syndromes
Latah

Occurs among uneducated middle-aged or
elderly women in Malaya
Unusual circumstances (such as hearing
someone say “snake” or even being tickled)
produce a fear response that is characterized
by repeating the words and actions of other
people, uttering obscenities, and acting the
opposite of what other people ask
Sociocultural: culture-bound
syndromes
 Koro
 
Pattern of anxiety found in Southeast Asian men
 
Involves the intense fear that one’s penis will
withdraw into one’s abdomen, causing death
 
Caused by an imbalance of ‘yin’ and ‘yang’
 
Treatment involves keeping a firm hold on his
penis (often with the assistance of family members)
until the fear subsides
 Another treatment involves clamping the penis to a
wooden box
Sociocultural: culture-bound
syndromes
Amok
 
Found in the Philippines, Java, and certain parts of
Africa occurring more often in men than in women
 
Those suffering the affliction jump around
violently, yell loudly, and attack objects and other
people
 
Symptoms preceded by social withdrawal and a
loss of contact with reality
 
The outburst is often followed by depression, then
amnesia
 Thought that stress, shortage of sleep, alcohol
consumption, and extreme heat are the primary
causes
Sociocultural: culture-bound
syndromes
 Winigo

Intense fear of being turned into a
cannibal by a supernatural monster

Once common among Algonqauin Indian
hunters

Characterized by depression, lack of
appetite, nausea, and sleeplessness

Could be brought on by coming back from
a hunting expedition empty-handed
 Some afflicted hunters did kill and eat
,members of their own households
Perspectives
School or Perspective
Cause of Disorder
Psychoanalytic/Psychody
namic
Internal, unconscious conflicts
Behavioral
Reinforcement history/ the environment
Biomedical
Organic problems, biochemical imbalances, genetic predispositions
Cognitive
Irrational, dysfunctional thoughts or ways of thinking
Humanistic
Failure to strive towards one's potential or being out of touch with
one's feelings
Sociocultural
Dysfunctional society
Case Study - Anne
 Read your case study
 Discuss with a partner
 Share with class
Mental Disorders, Basic
Concepts
 “Mental Disorder” controversy
 Symptom vs. Syndrome
symptom: individual characteristic of thought,
feelings, behaviors
syndrome: constellation of symptoms an individual
shows
 Syndrome
clinically significant detriment
internal source of distress
involuntary manifestation
Issues with Diagnosis
reliability: individual diagnosticians
reach the same conclusions using the
same system
DSM-IV: observable characteristics to
maximize reliability
validity: the extent to which the
system’s categories are clinically
meaningful
Labeling people
The Legal Notion of
Insanity:
 Insanity is a legal term with three meanings:
 (1) Insanity as a criminal defense.
 Cannot control behavior or understand its
meaning.
 Alternative: Guilty but Mentally Ill.
 (2) Insanity as incompetence to stand trial.
 Not able to participate in own defense.
 (3) Insanity as a condition of involuntary
commitment.
 A danger to oneself or others.
Perspectives on Mental
Disorders
Biopsychological Perspective
mental disorders as physical diseases –
focus on symptoms
The perspective has gained credibility
from recent discoveries that genetically
influenced abnormalities in brain structure
and biochemistry contribute to a wide
range of disorders, including
schizophrenia, depression, and anxiety
disorders.
chemical imbalances – impacted by
medicene
birth difficulties
heritability
Perspectives on Mental
Disorders
Psychodynamic Perspective
Sigmund Freud
Unconscious conflicts and drives
over aggressive or sexual impulses
Early childhood trauma
therapy helps person become aware
of underlying conflicts
Currently practiced to a lesser
extent
Perspectives on Mental
Disorders
Cognitive Perspective
conscious thoughts
learned maladaptive thought
patterns cause mental disorder
Behavioral Perspective
learned maladaptive patterns of
behavior cause mental disorder
Multiple Causation
Predisposing causes
High
Amount of stress
in place before onset
make person
susceptible
inherited
characteristics
learned beliefs
sociocultural beliefs
Disorder
manifested
Disorder
not
manifested
Low
Low
High
Predisposition for the disorder
Multiple Causation
 Precipitating causes
High
Amount of stress
immediate events
that bring on the
disorder (stress)
loss (e.g., loved
one, job)
perceived threat
when
predisposition high,
precipitating event
may be small
Disorder
manifested
Disorder
not
manifested
Low
Low
High
Predisposition for the disorder
Multiple Causation
Maintaining causes
consequences of the disorder
keep disorder going once it begins
sometimes positive consequences
(e.g., extra attention)
often negative consequences (e.g.,
lack of friends)
Sex Differences in
Prevalence
Large sex differences in prevalence
Differences in Reporting
men report less psychological distress
than women
don’t admit distress?
Physiological vs. psychological distress
tradeoff?
Men use more alcohol and drugs
men seem to express anger more than distress
Issues with Diagnosis
reliability: individual diagnosticians
reach the same conclusions using the
same system
DSM-IV: observable characteristics to
maximize reliability
validity: the extent to which the
system’s categories are clinically
meaningful
Labeling people
DSM IV
 A. Published by the American Psychiatric Association,
the DSM-IV, as it is known, is a widely used diagnostic
classification system. It provides a set of criteria which
allows diagnosticians to make assessments.
 B. The diagnostic system is based on five axes which
are used by clinicians to provide a complete diagnosis.
1. Axis l includes 16 major categories of adult psychological
disorders, such as mood disorders and schizophrenic
disorders.
2. Axis 2 includes the personality disorders and
developmental disorders.
3. Axis 3 includes medical conditions that might affect or
interact with the client’s psychological disorder, such as
hypothyroidism or headaches.
4. Axis 4 is a rating of recent social and environmental
sources of stress, such as a death in the family or chronic
unemployment.
5. Axis 5 is a Global Assessment of Functioning (GAF)
made on a scale that ranges from 1 to 100, where 100
represents unimpaired function and 1 represents severe
dysfunction
6. An example of how a therapist might make a complete
DSM multiaxial diagnosis is:
a) Axis 1: alcohol dependence
b) Axis 2: dependent personality disorder
c) Axis 3: diabetes
d) Axis 4: death of spouse; unemployment
e) GAF = 60 (moderate symptoms, e.g., occasional panic
attacks or moderate difficulty in social, occupational, or
school functioning)
Criticism of DSM IV
 1. The system relies heavily on the medical perspective.
 2. Reliability in diagnosis remains a problem;
psychological disorders have "fuzzy borders." Different
disorders share certain characteristics, for example, and
a person might exhibit some, but not all, characteristics
of a particular disorder.
Bias in Diagnosis
Diagnosed as
histrionic
personality
Diagnosed as
antisocial
personality
 diagnose men with “male” disorders and women
with “female” disorders
 Ford & Widiger (1989)
 antisocial = “male” disorder
 histrionic = “female” disorder
Differences in Experiences
Men & women have different social
experiences
Women
abuse from spouses
abuse in childhood
traditional roles
As employment for genders becomes
more similar, gender gap in some
disorders decreases
End
Dissociative and
Personality Disorders
 Dissociative amnesia (psychogenic)
Lose memory for distant and recent
Lose personal identity – general
knowledge remains intact
No anterograde amnesia
Often reverses itself abruptly
Dissociation
 Incapacity to integrate one’s thoughts,
feelings or experiences into one’s present
consciousness
The Curious Experiences Survey – measures self
reported Dissociative experiences.
 Total your score
 Range from 17 – 85 – higher means more
experience with dissociation
 Three factors in dissociation:
 Depersonalization
 Self-absorption
 Amnesia
Dissociative Disorder
Interview Schedule
 Have you ever walked in your sleep?
 Did you have imaginary playmates as a child?
 Were you physically abused as a child or
adolescent?
 Were you sexually abused as a child or
adolescent?
 Have you ever noticed that things are
missing from your personal possessions or
where you live?
 Have you ever noticed that things appear
where you live, but you don’t know where
they cam from or how they got there?
 Do people ever talk to you as if they know
you but you don’t know them, or only know
them faintly?
 Do you ever speak about yourself as “we” or
“us”?
 Do you ever feel that there is another person
or persons inside you?
 If there is another person inside you, does he
or she ever come out and take control of your
body?
Personality Disorders
 Important: Strictly for research, not clinical
diagnosis.
 Score one for every true
 Used in a study of risk taking:
8.33 for residents in long-term drug rehap
6.06 for skilled rock climbers
5.15 for Police officers/fire fighters
commended for bravery
Major Depressive Disorder
 Reverse responses to 2, 5, 6, 11, 12, 14, 16,
17, 18, and 20.
(1=4, 2=3, 3=2, 4=1)
 Add all numbers
 Range from 20 – 80
 50-59 – suggest mild to moderate depression
 60 – 69 indicate moderate to severe
depression
 >70 – severe depression
College  Especially prone to depression – experience
all the stress transitions simultaneously
Lose family
Lose friends
Lose familiar surroundings
Equally able students
Suicide
 Unendurable psychological pain
 Frustrated psychological needs
 The search for a solution
 An attempt to end consciousness
 Helplessness and Hopelessness
 Constriction of options
 Ambivalence
 Communication of intent
 Departure
 Lifelong coping patterns
• It is estimated that depression increases the risk
of a first suicide attempt by at least 14-fold.
• Over half of all kids who suffer from depression
will eventually attempt suicide at least once, and
more that seven percent will die as a result.
• Four times as many men commit suicide than
women, but young women attempt suicide three
times more frequently than young men.
• Fifty-three percent of young people who commit
suicide abuse substances.
• Firearms are used in a little more than half of all
youth suicides.
Close-up Extension: Self
Mutilation
 Reverse 2, 3, 5, 7, 9, 11, 13, 17, 22
 Add all numbers
 Range from 24 – 120
 Higher – more positive emotional investment
in one’s body
 Higher scale report higher self-esteem as
well as having experienced greater maternal
care – more likely to indicate a capacity to
enjoy sensual and bodily pleasures
Body Image Feelings and Attitudes
# 5, 10, 13, 16, 17, and 21
Comfort in Physical Contact with
Oters
#2, 6, 9, 11, 20, and 23
Concern for Body Care
#1, 4, 8, 12, 14, and 19
Investment in body Protection
#3, 7, 15, 18, 22, and 24
Self Mutilation
 2 million self-mutilators – vast majority
women
 Typically begin as teenagers
 Princess Diana brought attention to the
disorder
 Some suicidal, most do it to cope with
stresses
 Many sexually abused as children learning to
shield themselves by dissociating
 Almost all – grew up with poor
communication between parent and child
Schizophrenia
 Schizophrenia
 literal translation “split mind”
 a group of severe disorders
characterized by:
 disorganized and delusional thinking
 disturbed perceptions
 inappropriate emotions and actions
Schizophrenia
 Delusions
 false beliefs, often of persecution or
grandeur, that may accompany
psychotic disorders
 Hallucinations
 sensory experiences without
sensory stimulation
Psychosis refers to a general lack of
contact with reality
Schizophrenia
form of psychosis involving
disorders of
perception
language
thought
emotion
behavior
Schizophrenia Symptoms
Perceptual Symptoms
Sensory filtering & perception impaired
Hallucinations - perceptions without
sensations
Language and Thought Disturbance
Word salad: jumbled speech
Delusions - mistaken beliefs maintained despite
contrary evidence
Paranoid
Persecution
Schizophrenia Symptoms
Emotional Disturbance
Behavioral Disturbance
Unusual actions that have
meaning to the person
Catalepsy immobile stance
(like a statue)
Waxy Flexibility
Refusal to communicate with
others
Classification of Schizophrenia
1.
Positive symptoms involve distorted or excessive
mental activity
 Delusions, hallucinations,altered emotions,
erratic behaviors
 Positive symptoms occur during acute
episodes
2. Negative symptoms involve behavioral and
mental deficits
 Flattened emotions, social withdrawal
 Negative symptoms are chronic
3. Disorganization of behavior
Biological Views of Schizophrenia
Genetics: 43 to 83%
concordance (identical
twins)
Neurotransmitters:
Dopamine activity excessive
in the schizophrenic brain
Brain damage: enlarged
ventricles are evident in
schizophrenia
A common finding in
the brains of people
with schizophrenia is
larger than normal
lateral ventricles.
Heritability of Schizophrenia
Biological Views of Schizophrenia
 Genetics: 43 to 83%
concordance (identical twins)
 Neurotransmitters: Dopamine
activity excessive in the
schizophrenic brain
 Brain damage: enlarged
ventricles are evident in
schizophrenia
 Decreased frontal and temporal
lobe activity
 Other potential causes…
A common finding in
the brains of people
with schizophrenia is
larger than normal
lateral ventricles.
Psychosocial Theories of
Schizophrenia
Stress –
Diathesis-stress model
Genetic predisposition +
overwhelming stress
Family communication
Schizophrenia
Schizophrenia
Understanding Schizophrenia
 Triggering experiences, genes predispose but
some react to traumatic triggers by
developing schizophrenia.
 Biochemical: 6 times the normal amount of
dopamine receptors that increase brain
activity to manic levels. Thus dopamine
blockers reduce symptoms.
 Dopamine-blocking drugs have little impact
on persistent negative symptoms
 It is also thought to perhaps be triggered or
caused by the introduction of a prenatal virus
that affects brain development, possibly in
the thalamus. People conceived in Winter
months are more apt to develop
schizophrenia in Northern hemisphere, while
the reverse is true in the Southern.
 Abnormal brain activity – low in frontal lobes
 Studies have found enlarged, fluid-filled areas
Genetic Factors
 Definite genetic link: the closer you are
genetically to someone with Schizophrenia,
the more likely you are to get it.
 1 in 100 people get it.
 1 in 10 of siblings
 1 in 2 identical twins, even if raised apart
Psychological Factors
Genetically predisposed physiological
abnormalities do not, by themselves,
cause schizophrenia, neither do
prenatal and psychological factors
alone
MAYBE, in conjunction, there are
psychologial triggers
As the bio-psycho-social perspective
emphasizes, the traffic runs both
ways.
Download

Mental Disorders, Basic Concepts