PSYCHOLOGICAL DISORDERS No really, what is “Normal” besides a town that is home to Illinois State University? ABNORMAL BEHAVIOR • WHAT IS ABNORMAL BEHAVIOR? • Psychologists tend to agree on certain criteria for a workable definition for psychological disorders. Although there will always be a continuum between normal and abnormal, mental health and mental illness, three criteria are often used to judge severity of problem behaviors. ABNORMAL BEHAVIOR ABNORMAL BEHAVIOR • All societies have their standards for acceptable behavior. When one deviates from typical behavior, a given society or culture may label the person different or abnormal. ATYPICAL BEHAVIOR or unusual behavior that is also disturbing to the values or beliefs of others is likely to be considered deviant. ABNORMAL BEHAVIOR ABNORMAL BEHAVIOR • An unusual behavior is more likely to be seen as disordered when it is judged as HARMFUL OR MALADAPTIVE. If one is unable to adjust to society and function effectively behavior may be considered abnormal. Often it is a matter of degree. Drinking alcohol becomes a problem when the person is no longer able to function well at home or one the job although the person may deny he has a problem at all. MALADAPTIVE ABNORMAL BEHAVIOR • PERSONAL DISTRESS is the third common criteria. When one feels psychological pain such as in depression or debilitating anxiety as in a phobia the level of distress becomes an important criterion. PERSONAL DISTRESS ABNORMAL BEHAVIOR • Although these three criteria of level of deviance, maladaption and personal distress are accepted criteria, one must remember that diagnoses of psychological disorders all involve VALUE JUDGEMENTS and CULTURAL NORMS about what is normal or abnormal. Both are fallible and change with social trends. MODELS OF ABNORMAL BEHAVIOR • • • • • • STATISTICAL APPROACH PSYCHODYNAMIC MODEL BEHAVIORAL MODEL HUMANISTIC MODEL COGNITIVE APPROACH SOCIOCULTURAL MODEL OF ABNORMALITY MODELS OF ABNORMAL BEHAVIOR • The STATISTICAL APPROACH defines normal behavior by describing what the average person does and abnormality as deviance from this norm. Often a criterion is used of plus or minus two standard deviations from the mean on any behavior or standardized test. Problems with this definition are that it equates "normality" with conformity. Often deviation from the mean such as a high intelligence quotient may actually be desirable. Normal Person Normal Mayor, Chris Koos MODELS OF ABNORMAL BEHAVIOR • The PSYCHODYNAMIC MODEL views abnormal behavior as the result of unresolved psychological conflicts from early childhood and from intrapsychic conflict between instinctual selfish desires of the id and the demands of the society and personal conscience present in the superego. Unresolved Psychological Conflicts From Early Childhood MODELS OF ABNORMAL BEHAVIOR • The BEHAVIORAL MODEL proposes that disorders are caused by poor LEARNING ENVIRONMENTS that reinforce problematic behaviors. To a behaviorist there is "no such thing as an abnormal person, only a normal person in an abnormal environment." SOCIAL LEARNING theorists emphasize that society often provides deviant maladaptive models that children imitate. The key to modifying problem behaviors lies in providing positive learning experiences, healthy models to imitate and in rewarding positive behaviors. Deviant Maladaptive Models That Children Imitate MODELS OF ABNORMAL BEHAVIOR • The HUMANISTIC MODEL proposes that we are self-actualizing our potential. If our natural growth toward self-fulfillment is blocked by negative criticism and conditions of worth we may develop a negative self-concept that obstructs our growth and distorts our view of the world. We may begin to withdraw emotionally and lose touch with our inner self that longs to self-actualize. Through unconditional positive regard, empathy, acceptance and respect we can rediscover our inner beauty and seek our self-fulfillment. Withdraw Emotionally And Lose Touch With Our Inner Self MODELS OF ABNORMAL BEHAVIOR • The COGNITIVE APPROACH views abnormal behavior as a result of distorted or irrational thinking. The cognitive model asserts the psychological disorder is the result of faulty thinking that leads to inappropriate and self-defeating behavior. For example, Beck, a wellrespected cognitive therapist, believes depression is the result of thinking negative and depressing thoughts about life’s experiences and challenges patient’s ideas about their illness, helping them to think more positively. These thoughts become "automatic thoughts" and are difficult to break. Negative Thinking And Depressing Thoughts MODELS OF ABNORMAL BEHAVIOR • The SOCIOCULTURAL MODEL OF ABNORMALITY argues that abnormal behavior is an attempt to adjust to an unjust mad world. To sociocultural theorists it is society, not the person, that is sick. They contend that we who "adjust" to this "insane world" do so at the heavy price of "conformity" to the madness around us and a loss of our individuality. R.D. LAING argues that it is we who conform to this age of anxiety who are mad and it is the mentally ill who are able to express their individuality. Non-Conformists Clarification of “Abnormal” • Although not a prominent theory, the sociocultural theory gives us pause. Perhaps "normality" is but a "half-crazed adjustment to a crazy world." Perhaps the violence, materialism, focus on superficial qualities, social ills, the drug-craze are signs of social madness that we would be wise to alienate ourselves from rather than try to conform and fit into a "normal" box. Certainly the sociocultural theory calls to question current psychiatric practices of institutionalization and chemotherapy as the proper "therapy" for those who do not choose to conform to "normality". Many of our best-known artists, writers and geniuses have been labeled "abnormal" Abnormal Clarification of “Abnormal” • The LEGAL MODEL defines INSANITY as a person who is not responsible for their actions because they cannot understand the difference between right and wrong. To be declared "not guilty by reason of insanity" the person must have a mental illness that causes them to engage in the criminal act. INSANITY Clarification of “Abnormal” • The PSYCHOPHYSIOLOGICAL APPROACH views abnormal behavior as due to underlying physiological abnormalities in the nervous system and particularly the brain. Recent research with brain-imaging machines gives credence to the approach as the brains for instance of schizophrenics differ from normal brain scans. Brain-Imaging Clarification of “Abnormal” • The MEDICAL MODEL assumes that the behavior disorder is caused by an underlying illness. Just as when one has a physical illness he goes to the doctor explains his symptoms, the physician makes a diagnosis and generally prescribes medication. The medical model also uses symptoms, diagnosis and chemotherapy as the main steps in mental illness treatment of mental illness. MEDICAL MODEL Clarification of “Abnormal” • The American Psychiatric Association has adopted a DIAGNOSTIC AND STATISTICAL MANUAL (4th edition) {DSM IV} to assist in the diagnosis of mental illness. It lists the symptoms for each "mental disorder" as well as the statistics of occurrence in a population. DSM IV CHILDHOOD DISORDERS • 37 diagnoses including mental retardation, eating disorders, conduct disorder, autistic disorder attention deficit/hyperactivity disorder, speech problems, enuresis and highly aggressive behavior. HYPERACTIVITY Guinness The Crazy Maine Coon COGNITIVE DISORDERS • DELIRIUM, DEMENTIA, AMNESTIC AND OTHER COGNITIVE DISORDERS of the brain caused by drugs, toxins, aging or diseases. Examples include Delirium (extreme mental confusion), dementia (marked deterioration of intellect) and Alzheimer's disease as well as damage caused by ingestion of toxic substances (lead, drugs). Psychological symptoms are directly related to injury to the brain or its biochemical environment. DELIRIUM PSYCHOACTIVE SUBSTANCE USE DISORDERS • PSYCHOACTIVE SUBSTANCE USE DISORDERS include excessive use and dependence on psychoactive drugs including cocaine, amphetamines, barbiturates, alcohol, heroin and other drugs that alter perception, emotions and/or behavior. Although controversial, tobacco and marijuana are also included. SUBSTANCE USE DISORDERS SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS • Schizophrenia is characterized by three common symptoms. • Disorders of Thought - include disturbed content including delusions and disorganization including word salad and loose associations. • Disorders of Perception – include hallucinations or false or distorted perceptions • Disorders of Emotion - inappropriate or odd emotional responses, flat affect or inappropriate tears, laughter or anger and sometimes bizarre motor behavior (waxy flexibility) Delusions Disorders of Perception SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS • "Schizo", Latin for "split" and "phrenic", "mind" describes the split from reality experienced by the schizophrenic mind. The personality loses it unity and wholeness as a result of unorganized, incoherent thinking, shifting emotional moods and strange perceptions INCOHERENT THINKING Shifting Emotional Moods Strange Perceptions SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS • Persons suffering from DISORGANIZED SCHIZOPHRENIA have HALLUCINATIONS, sensory experiences such as auditory hallucinations, hearing voices or feeling bugs crawling on them that are not there. They often have DELUSIONS, false beliefs such as delusions of persecution, believing someone is trying to hurt or kill them or other deluded thoughts. With such unorganized and incoherent thoughts, disorganized schizophrenics have difficulty communicating and are confused. They often withdraw and regress to silly, childlike behavior. SCHIZOPHRENIA SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS • A less common form of schizophrenia is CATATONIC SCHIZOPHRENIA. The catatonic person may become completely immobile, maintaining the same position for long periods of time. In this condition known as a CATATONIC STUPOR the person is robot-like but completely conscious of what is happening. They may also exhibit other bizarre motor behavior such as WAXY FLEXIBILITY taking a bizarre posture or waving the hands in front of the face in a repetitive series of odd circles. SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS • The PARANOID SCHIZOPHRENIC has elaborate systematized delusions about the world. Three main types of delusions are delusions of grandeur in which one is a famous person such as Christ, delusions of reference in which chance events such as thunderstorms carry important messages and delusions of persecution that cause the schizophrenic to feel others are plotting against him.