Are you Crazy?
Normal or Not?
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Story: A man living in the Ozark
Mountains has a vision in which God
speaks to him. He begins preaching to
his relatives and neighbors, and soon has
the entire town in a state of religious
panic. People begin to say that he has a
“calling.” His reputation as a prophet and
a healer spreads, and in time he is
drawing large audiences wherever he
goes.
However, when he ventures in St. Louis
ad attempts to hold a prayer meeting,
blocking traffic on main street at rush
hour, he Is arrested. He tells the
policemen about his conversations with
God, and they hurry him off to the nearest
mental hospital.
Normal or not?
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Who is right…The man who
believes he is a prophet, or the
police officers?
It Is often difficult to draw a line
between normal and abnormal
behavior.
Behavior that some consider to be
normal seems abnormal to others.
Many people believe that having
visions and hearing voices are
important parts of a religious
experience.
Other people believe that these are
symptoms of a psychological
disorder.
Normal or Not?
The man in the example on the
previous slide was interviewed
by psychiatrists, diagnosed as
paranoid schizophrenic, and
hospitalized.
 Had he stayed at home, people
would have continued to see
him as perfectly normal – even
popular…
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Defining and Identifying Psychological Disorders
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In the previous example, the
man was classified as mentally
troubled because his behavior
was so different from what
others felt was normal under
the circumstances.
Yet, the fact that a person is
different does not necessarily
mean that he or she is suffering
from a mental illness.
Deviation from Normality
One approach to
defining abnormality
is to say that
whatever most people
do is normal.
 Abnormality, then,
would be any
deviation from the
average or from the
majority.
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Deviation from Normality
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The deviance approach,
however, as commonly used
as it is, has serious
limitations.
For example: If most people
cheat on their income-tax
returns, does that mean that
the people who do not cheat
are abnormal?
Because the majority is not
always right or best, the
deviance approach to
defining abnormality is not by
itself a useful standard.
Adjustment
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Another way to distinguish
normal from abnormal
people is to say that normal
people are able to get along
in the world – physically,
emotionally, and socially.
Basically, people who live
by the rules of society.
By this definition, abnormal
people would be the ones
who fail to adjust to society.
What do you think?
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So what is right?
Who is to say what
issues constitute a
psychological
disorder, and what
issues are merely
minor variations from
what is considered to
be normal behavior?
Back in the day…
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Used to be that
people thought one
was possessed by
demons if they
acted abnormally
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As time progressed
and the scientific
revolution took
hold, they took the
chains off people
who were
abnormal.
So, what does it mean to have a
psychological disorder?
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Psychological Disorder-a harmful dysfunction
in which behaviors are maladaptive, unjustifiable,
disturbing, and atypical…M.U.D.A.
M-maladaptive
 U-unjustifiable
 D-disturbing
 A-atypical
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Maladaptive Behavior
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Refers to types of behaviors that inhibit a
person’s ability to adjust to particular
situations and are destructive.
People cannot adapt to what life gives them.
 They exhibit behavior that is destructive to
oneself or others.
 Got any examples?
 Here is one
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Unjustifiable
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Without a rational basis
Disturbing Behavior
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Troublesome to other people
Atypical
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So different that it violates a norm
Can you think of anything?
 How about this?
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Read these one and try to
diagnose…
A man walks up to a window, by or
through which no one can see him,
carrying a chair. He puts down the
chair, opens the window, takes off his
clothes, and seats himself on the
chair. Why? He says he feels the
need to take an “air bath.”
Every morning, a woman who lives in a
Boston suburb asks her husband to bring in
the morning newspaper, which the carrier
throws just inside their fence. She does
this because she is terribly afraid of
encountering a poisonous snake. Her
husband, concerned about her behavior,
repeatedly tells her that there are no
poisonous snakes living in their town.
Nevertheless, she is afraid to leave the
house.
A teenage boy packs a blanket and
a bottle of water. Ignoring nearfreezing temperatures, he climbs a
nearby mountain, spreads the
blanket on the ground, sits crosslegged on it, closes his eyes, and
remains there throughout the night.
In the morning, he runs home and
tells his father he has seen a vision.
A teenage girl misses school for 3
days. She periodically breaks
into tears. She finds it nearly
impossible to get out of bed in the
morning, although she cannot
sleep for more than an hour or
two at a time. She has no
appetite and becomes nauseated
if people urge her to eat.
Last one…
Anne is a sixteen-year-old girl living in a medium-sized city in the Midwest. Her
family includes a mother, father, fourteen-year-old brother, and a great-aunt,
who has lived with the family since Anne was four. Anne is a junior at City
High School and is taking a college-preparatory program. Her appearance is
strikingly different from the other girls in her class.
She wears blouses which she has made out of various scraps of material. The
blouses are accompanied by the same pair of overalls everyday, two
mismatched shoes, and a hat with a blue feather. She is a talented artist,
producing sketches of her fellow classmates that are remarkably accurate.
She draws constantly, even when told that to do so will lower her grade in
classes where she is expected to take lecture notes. She has no friends at
school, but seems undisturbed by the fact that she eats lunch by herself and
walks alone around the campus. Her grades are erratic; if she likes a class
she often receives an A or B, but will do no work at all in those she dislikes.
Anne can occasionally be heard talking to herself; she is interested in poetry,
and says she is "composing" if asked about her poetry. She refuses to watch
television, calling it a "wasteland." This belief is carried into the classroom,
where she refuses to watch videotapes, saying they are poor excuses for
teaching. Her parents say they don’t understand her; she isn’t like anyone in
their family. She and her brother have very little in common. He is
embarrassed by Anne’s behavior, and doesn’t understand her either. Anne
seems blithely unaware of her apparent isolation, except for occasional
outbursts about the meaninglessness of most people’s activities.
How do we explain disorders?
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Medical Model of explanation
Caused primarily by biological reasons
 We treat these causes through medicine,
surgery, and ECT (shock therapy)
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Bio-Psycho-Social Model of explanation
Caused by a combination of reasons (mostly
psychological trauma)
 We treat with psychotherapy
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A Few Different Types of
Disorders
Anxiety
 Mood
 Somatoform
 Dissociative
 Schizophrenic
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Anxiety Disorders
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Anxiety: is a general state of
dread or uneasiness that a
person feels in response to a
real or imagined danger.
People suffering from anxiety
disorders feel anxiety, but not
just normal anxiety.
They suffer from anxiety that is
out of proportion to the situation
that is provoking it.
This intense anxiety may
interfere with the normal
functioning of everyday life.
Anxiety disorders are the most
common mental disorders in the
United States.
Anxiety Disorders
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These disorders share certain
characteristics, including feelings of
anxiety and personal inadequacy and
an avoidance of dealing with
problems.
People with anxiety disorders often
have unrealistic images of
themselves.
Their emotional problems may be
expressed with constant worrying,
sudden mood swings, or a variety of
physical symptoms (headaches,
sweating, muscle tightness,
weakness, and fatigue.)
These people often have difficulty
forming and sustaining long term
relationships.
Why do you think this is?
Anxiety Disorders
Phobias
 Panic Attacks
 PTSD
 OCD
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Phobia Disorder
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Phobia: An intense or irrational fear
of an object or situation.
Phobias range in intensity from mild
to extremely severe.
Most people deal with phobias by
simply avoiding what frightens
them.
Thus, phobias are learned and
maintained by reinforcing the
effects of avoidance, which reduces
anxiety but not the phobia.
Example: If you are afraid of
spiders, you do your best to avoid
them at all costs.
Panic Disorder
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Panic Disorder: An extreme anxiety
that manifests itself in the form of
panic attacks.
During a panic attack, a victim
experiences sudden and
unexplainable attacks of intense
anxiety, leading the individual to feel
a sense of inevitable doom or even
the fear that he or she is about to die.
Many symptoms of panic disorder
include; an extreme sense of
smothering, choking, difficulty
breathing, fainting, dizziness, nausea,
and chest pains.
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Here is a
classic
example
Panic Disorder
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Although panic attacks
sometimes last for an
hour or more, most
attacks last only a few
minutes and come on
without warning.
Panic disorder may be
inherited.
However, the panic victim
usually experiences their
first attacks shortly after a
stressful event.
Post Traumatic Stress Disorder
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Post-Traumatic Stress Disorder: A
disorder in which victims of traumatic
events experience the original event in
the form of dreams or flashbacks.
This disorder is common among
veterans of military combat and
survivors of acts of terrorism, natural
disasters such as floods or tornadoes,
other catastrophes such as a plane
crash, and human aggression such as
rape or assault.
The event that triggers the disorder
overwhelms a person’s sense of reality
and ability to cope.
This disorder may begin shortly after a
traumatic experience or it may develop
much later.
Post-Traumatic Stress Disorder
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Typical symptoms include involuntary
flashbacks and recurring nightmares
during which the victim reexperiences the ordeal, often
followed by insomnia or feelings of
guilt.
Post-Traumatic Stress Disorder can
be extremely long lasting.
Survivors of the holocaust, veterans
of the Vietnam war, and survivors of
the attacks on Pearl Harbor may still
display symptoms of this disorder.
Not everyone though, who
experiences a traumatic event will
develop this disorder.
Somatoform Disorder
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Somatoform Disorder:
Physical symptoms for
which there is no
apparent physical cause.
Somatoform is also
commonly known as
Hysteria.
The term hysteria was
more commonly used in
Sigmund Freud’s time.
It was used to refer to
unexplainable fainting,
paralysis, or deafness.
Somatoforms Disorder
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There are 2 major types of Somatoform
Disorder…Conversion Disorder and
Hypochondriasis.
Conversion Disorder: Changing emotional
difficulties into a loss of a specific voluntary body
function.
While the loss of functioning is completely real, no
physical damage is present.
Many people occasionally experience mild
conversion disorders, such as when a person is
frightened and cannot move, but true conversion
disorder is not simply a brief loss of functioning
due to fright…It persists.
Conversion Disorder
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A conversion disorder results in a
real and prolonged handicap; the
person literally cannot feel his left
hand, move his legs, or exercise
some other normal physical function.
For example; a man might wake up in
the morning and not be able to feel
anything from the waist down, finding
himself paralyzed.
The normal reaction to this would be
one of panic. However, he may
simply accept this, showing that it is
more of a psychological problem than
a physical one.
Hypochondriasis
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Hypochondriasis: A disorder in
which a person who is in good
health becomes preoccupied with
imaginary ailments.
The hypochondriac spends a lot of
time looking for signs of serious
illness and often misinterprets minor
aches, pains, bruises, or bumps as
signs of a fatal illness.
Despite negative results in medical
tests and physical evaluations, the
hypochondriac typically continues
to believe that a disease or
malfunction exists.
Dissociative Disorders
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Dissociative Disorder: A disorder in
which a person experiences
alterations in memory, identity, or
consciousness.
There are many different types of this
disorder.
1. Dissociative Amnesia: The
inability to recall important personal
events or information; is usually
associated with stressful events.
Amnesiacs remember how to speak
and usually retain some general
knowledge, but may forget who they
are, where they live and work, or who
their family is.
Dissociative Disorders
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2. Dissociative Fugue: A dissociative disorder
in which a person suddenly and unexpectedly
travels away from home or work and is unable to
recall the past.
Example; a women may suddenly disappear
and wake up three days later in a restaurant 200
miles from home.
If she is not treated, she may actually establish a
new identity – assume a new name, marry, take
a job, and so on – in a new place.
She may repress all knowledge of a previous
life.
Dissociative Disorders
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A fugue state may last for a
few days or even decades.
However long it lasts, the
individual, when she comes
out of it, will have no memory
of what happened during this
period of time.
Fugue, then, is a sort of
traveling amnesia, and it
probably serves the same
psychological function as
dissociative amnesia…The
escape from an unbearable
conflict or anxiety.
Dissociative Disorders
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3. Dissociative Identity Disorder:
A person exhibits two or more
personality states, each with its
own patterns of thinking and
behaving.
Previously known as multiple
personality disorder.
These different personality states
may take control at different
times.
Some psychologists believed that
this division of a personality is an
effort to escape a part of the self
that he or she fears.
The secret self then emerges in
the form of a separate
personality.
This is the rarest of the
Dissociative Disorders.
Schizophrenia and Mood Disorders
A Story…
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A woman was delighted to receive a
letter from her son abroad, but
distraught when she read it;
“Dear Mother…I am writing on
paper. The pen I am using is from a
factory called Perry and Co. The
factory is in England. The city of
London is in England. I know this
from my school days. Then I always
liked geography. My last teacher in
that subject was professor Wilikers.
He was a man with black eyes.
There are also blue and grey eyes
and other sorts too. I have heard it
said that snakes have green eyes.
All people have eyes. There are
some, too, who are blind.”
Schizophrenia
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The man who wrote this letter
was later diagnosed with
schizophrenia.
Sufferers of schizophrenia often
have difficulty using language to
communicate.
They seem to go from one phrase
to another by random
association.
This confused language may
result because schizophrenia
affects the working memory,
which is used to form sentences.
A person with schizophrenia will
not remember the beginning of a
sentence and thus finishes it with
an unrelated thought.
Schizophrenia
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While the disorders
discussed so far are
primarily problems of
emotion, schizophrenia is
a problem of cognition,
but it also involves
emotion, perception, and
motor functions.
Schizophrenia affects 1 in
100 people worldwide, but
the odds increase to 1 in
10 if someone in your
family already has it.
…Or am I?
Schizophrenia
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Schizophrenia: A group of disorders
characterized by confused and disconnected
thoughts, emotions, and perceptions.
With schizophrenia, a person’s thought
processes are somewhat disturbed, and the
person has lost contact with reality to a
considerable extent.
Schizophrenia is not a single problem; it has no
single cause or cure.
Rather, it is a collection of symptoms that
indicates an individual has serious difficulties
trying to meet the demands of life.
Schizophrenia
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Many people with schizophrenia
experience delusions and
hallucinations.
Delusions: False beliefs that a
person maintains in the face of
contrary evidence.
Hallucinations: Perceptions that
have no direct external cause.
For example; a person with
schizophrenia may perceive
hearing a voice, when, in fact, there
is no sound present.
Types of Schizophrenia
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Psychologists classify schizophrenia
into many different types:
Paranoid: Involves hallucinations and
delusions or grandeur; “I am the
savior of my people,” or persecution;
“someone is always watching me…”
Catatonic: These people may remain
motionless for long periods, exhibiting
a waxy flexibility in which limbs in
unusual positions may take a long
time to return to a resting, relaxing
position. Much like the melting of a
wax statue.
Types of Schizophrenia
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Disorganized: These people use incoherent
language, inappropriate emotions, giggling for no
apparent reason, generally disorganized motor
skills, and delusions.
Remission: This label is used for anyone whose
symptoms seem to be completely gone but still exist
deep in the psyche. The expectation is that
eventually these issues will return.
Types of Schizophrenia
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Undifferentiated: Encompasses the basic
symptoms of schizophrenia, such as the
deterioration of daily functioning,
hallucinations, delusions, and confusion.
Causes of Schizophrenia
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It is not fully known what exactly causes this
disorder.
It is known that schizophrenia seems to have a
biological basis and can be inherited.
The proper workings of the brain depend on the
correct amount of chemicals and oxygen. It is
thought that schizophrenia might be caused by a
lack of one or both of these items.
Mood Disorders
We all have mood swings.
 Sometimes we are happy or
elated, while other times we feel dejected,sad, or
depressed.
 Yet, even when we are discouraged, most of us
feel that we can control our emotions and that
these feelings will pass.
 But what happens if they do not?
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According to the National Institute of Health, 20% of the U.S. adult population
will suffer from a mood disorder during their lifetime
Mood Disorders
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Major Depressive Disorder: Severe form of
lowered mood in which a person experiences
feelings of worthlessness and diminished
pleasure or interest in many activities.
This depression can range from mild sensations
to intensely suicidal.
This disorder is marked by; problems eating,
lack of physical activity, problems sleeping,
walking, and talking…as well as feelings of guilt,
worthlessness, and suicide.
Mood Disorders
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Bipolar Disorder: Disorder in
which an individual alternates
between feelings of mania
(euphoria) and depression.
In the manic phase, a person
experiences elation, extreme
confusion, distractability, and
racing thoughts. Often this
person is irresponsible, has
exaggerated self esteem, and
exhibits irrational behavior.
Example
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On admission, she slapped the nurse,
addressed the house physician as God,
made the sign of the cross, and laughed
loudly when asked to put on a hospital
gown. This she promptly tore to
shreds…She sang at the top of her voice,
screamed through the window, and leered
at the patients walking in the yard.
(Karnash, 1945)
Bipolar Disorder
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In the depressive phase, the individual is
overcome by feelings of failure, sinfulness,
worthlessness, and despair.
Example:
“The patient lay in bed, immobile, with a dull,
depressed expression on his face. His eyes
were sunken and down. Even when spoken to,
he would not look at the eyes of the speaker.
Usually he would not respond at all to questions,
but sometimes, after apparently great effort, he
would mumble something about the “scourge of
God.” (Morris and Maisto, 2000)
Bipolar Disorder
In some cases, a patient will frantically
alternate between these feelings of
Euphoria and depression.
 These people rapidly make statements
that do not seem coherent or logical.
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