Unit 12:
Abnormal Psychology
Perspectives on Psychological
Disorders
Questions…
• How should we define psychological
disorders?
• How should we understand disorders?
• How should we classify psychological
disorders?
Diagnosing & Treatment
Psychological
Perspectives
Defining Psychological Disorders
• Psychological disorders
– Deviant (different) behavior (from one’s culture)
– Distressful behavior
– Harmful dysfunctional behavior (impair your life)
• Definition varies by context/culture
– wartime
– talking to dead
– homosexuality
• Attention deficit hyperactivity disorder (ADHD)
Understanding Psychological Disorders
The Medical Model Demon
…led topossession
harsh and
• Philippe Pinel (1745-1826)
– reform inhumane conditions of mentally ill patients
as
ineffective
cause for
mental
remedial
illness
treatment
• Medical model
psychopathology
– Idea that mental illness has physical causes that
can be diagnosed based on symptoms &
sometimes cured through therapy in a hospital.
Understanding Psychological Disorders
The Biopsychosocial Approach
• Interaction of nature & nurture
• Influence of culture on disorders
self-focused
rumination
rejection from
others
low serotonin
levels
Why would it
be difficult to
explain
anorexia
nervosa
occurring
mostly in
Western
cultures in
terms of the
medical
model?
The Biopsychosocial Approach to
Psychological Disorders
Classifying Psychological Disorders
• Diagnostic & Statistical Manual of
Mental Disorders (DSM)
–DSM-IV-TR
–DSM-5 (last year)
• International Classification of
Diseases (ICD-10)
Why is the DSM good?
Advantages of the medical model & diagnostic labels:
– reliability of diagnoses by different psychologists
(83%)
– Focuses treatment
– Help mental health professionals communicate about
patient
60 disorder categories in 1950s vs. 400 today
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
1._______describes
Axis III
physical disorders, such as high blood pressure, that may
accompany a psychological disorder.
V to estimate the extent to which a person's quality of life has
2. The purpose of Axis
______is
been compromised by a psychological disorder.
Axis II
3. Personality disorders are described by ____
IV
4. Axis
____contains
information relating to the severity of stress that a person experiences
while suffering from a psychological disorder.
5. The major clinical syndromes from which a person might be suffering are described by
Axis
____ I
V describes person's overall level of psychological, social, and occupational
6. Axis
_____
functioning.
Axis. I
7. Eating and sleep disorders are described by ____
8. AxisIV
______ relates to the source, severity, and duration of stress that may accompany a
psychological disorder.
9. Axis
____ II would be particularly relevant in assessing an individual who suffers from
persistent lying and stealing, lack of empathy for others, lack of guilt for committing
misdeeds, and poor self-control.
10. That a person who is being assessed for a psychological disorder also suffers from
Axis III
dizziness and ringing in the ears would be noted using ____.
Labeling Psychological Disorders
• Rosenhan’s study
Reported
hospital were
complaining
hearing
voices;
In the
19 days to
thea“patients”
admitted,of
they
exhibited
no further
symptoms
but clinicians
causes
disorder
otherwise
acted
normal.“discovered”
Misdiagnosed
w/ofdisorder.
• Power of labels
– preconception can stigmatize
• Stereotypes of the mentally ill
– Mental illness seldom leads to violence
• Self-fulfilling prophecy
– gifted, extroverted, nasty
Anxiety Disorders
Anxiety Disorders
• Anxiety disorders – distressing
persistent anxiety / maladaptive
behaviors that reduce anxiety
–Generalized anxiety disorder
–Panic disorder
–Phobia
–Obsessive-compulsive disorder
–Post-traumatic stress disorder
Generalized Anxiety Disorder
• Generalized anxiety disorder
– No physical problem but can
manifest itself physically or lead to
physical problem
–2/3 women
–Continual worry
–Cannot identify cause
• Free floating anxiety
– Often accompanied by
depression
Panic Disorder
• Panic disorder
–Panic attacks
• Strikes suddenly, minutes long, intense dread
• Heart palpitations, shortness of breath, choking
sensations, trembling or dizzy
• Phobias
Phobias
– Irrational fear causes person to avoid some
object, activity or situation
–Specific phobia
• Focus on animals, insects, heights,
small spaces – specific trigger
–Social phobia
–Agoraphobia
Go to lengths to
avoid situation
• Fear of situations where escape may
be impossible or where panic attack
happened before
Phobias
Phobias
Obsessive-Compulsive Disorder
• Obsessive-compulsive disorder
–Consistently interfere with everyday
–An obsession vs a compulsion
– Hoarders
– Checkers
– Counters
– Cleaners
http://www.youtube.com/watch?v=dSZNnz
9SM4g
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
http://www.youtube.com/watch?v=dSZNnz9SM4g
Post-Traumatic Stress Disorder
• PTSD
• Numbed social withdrawal,
anxiety, insomnia
• “shellshock” or “battle fatigue”
–
–
–
–
–
Not just due to a war situation
10%-32%
Greater one’s stress during event
Sensitive limbic system (stress hormones)
“benefit
1/10 women & 1/20 men
finding”
• Post-traumatic growth
http://www.youtube.com/watch?v=swsX8Q51Fj4
Wartorn (HBO) Part1/5
Understanding Anxiety Disorders
The
Learning
Perspective
Two ways to understand anxiety
disorders:
• Fear conditioning
– Anxious people are hyperactive to
possible threats
Learning
Perspective
–Stimulus generalization
–Reinforcement
Biological Perspective
• Observational learning
– Parents communicate fear to
children
Understanding Anxiety Disorders
The Biological Perspective
• Natural selection
– Phobias focus on fears faced by our
ancestors/compulsive acts exaggerate behaviors
that helped survival
• Genes
– Runs in families / identical twins
– anxiety gene
– Glutamate & Serotonin
• The Brain
– Overarousal in brain areas – impulse control &
habitual behaviors
– Anterior cingulate cortex (frontal lobe) / (amygdala)
Anxiety Disorders Case Studies
Answers
1. GAD
2. Panic Attacks w/
Agoraphobia
3. Specific Phobia
4. OCD
5. PTSD
6. Specific Phobia
7. OCD
8. Agoraphobia
9. GAD
10. Social Phobia
11. PTSD
12. GAD
13. PTSD
Somatoform Disorders
http://www.youtube.com/watch?v=LRzytAhu0hg
Conversion Disorder (2:03)
http://www.youtube.com/watch?v=T9R
Ps_ysYgE
Conversion Disorder
Today Show
Somatoform disorder
–Disorder takes a bodily form w/o
apparent physical cause
–Conversion disorder
• Anxiety converted into physical symptoms
–Hypochondriasis
• Interpret normal physical sensation as disease
–move from dr. to dr. (reinforcing)
–Munchasuen (Munchasuen by Proxy)
factitious disorders
Dissociative Disorders
http://www.youtube.com/w
atch?v=0tITzDjPf4g
Intro to DID – Inside (5:05)
• Dissociative disorders
– Conscious awareness becomes dissociated (separate)
from previous memories, thoughts, feelings
–Fugue state
• couple hours – days; travel; new identity
–Dissociative Amnesia
• Unable to remember information about
oneself
• No organic cause
–Dissociative Identity Disorder
• 2 or more separate identities rule behavior
Understanding Dissociative Identity Disorder
 Genuine disorder or not?
 losing oneself in a role?
 hypnotizable
 DID rates
 1930s-60s = 2 per decade
 1980s = 20,000
 Therapist’s creation?
 Handedness & Shifting visual acuity
 Brain activity is different
 Result of trauma (PTSD/Freud) or reinforcing b/c
reduces anxiety?
Mood Disorders
http://www.youtube.com/watch?v=2rxeFgK
IS9s
Brain Imaging
http://www.youtube.com/watch?v=InNhDfD
fl5c
Synapse Review
• Mood disorders – emotional extremes
–Major depressive disorder
• 2+ weeks of depressed mood,
worthlessness, diminished
interest
– Phobias more common / depression #1
reason to seek help
–13% US adults / women 2xs as
likely
–Bipolar disorder (formerly manicdepressive)
• Alternate between hopelessness & lethargy
of depression & overexcited mania
Major Depressive Disorder
• Major depressive disorder
–Lethargy
–Feelings of
worthlessness
–Loss of interest in
family and friends
–Loss of interest in
activities
At least 5
symptoms
present for
2 weeks
not caused
by drugs or
medical
condition
Dysthymic Disorder – depressive state lasting more than 2 yrs.
Major Depressive Disorder
Major Depressive Disorder
Major Depressive Disorder
Women more likely to
attempt, men more
likely to succeed
Bipolar Disorder
• Bipolar Disorder
Diagnosis of young boys
has skyrocketed
–Mania (manic)
Afflicts men & women
equally in adults.
• Overtalkative, overactive, elated, little
need for sleep, etc.
–Bipolar disorder and creativity
Objective 10: Understanding Mood Disorders
• Many behavioral and cognitive changes accompany depression
– Trapped in unmotivated, negative mood
• Depression is widespread
– Maybe causes are common too, then
• Compared with men, women are nearly twice as vulnerable to major
depression
– Women more vulnerable to disorders involving internal states
– Women get sadder / Men get madder
• Most major depressive episodes self-terminate
– 50% relapse in 2 yrs
• Stressful events related to work, marriage and close relationships often
precede depression
– Less than 1% risk if no stressful life event
• With each new generation, depression is striking earlier and affecting more
people
– Authentic but today’s young people more willing to seek help
Understanding Mood Disorders
The Biological Perspective
• Genetic Influences
– Mood disorders run in families
• Heritability (35-40%)
• Linkage analysis – chromosome
neighborhood
• The depressed brain
– Less activity in left frontal lobe (more active while manic)
– Hippocampus (memory) vulnerable to stress
• Biochemical influences
– Norepinephrine and serotonin
– SSRI
Increases arousal & boosts mood
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Biological Perspective
Understanding Mood Disorders
The Social-Cognitive Perspective
• Negative Thoughts and Moods Interact
–Self-defeating beliefs
• Learned helplessness
• Overthinking (women) - ruminate
–Explanatory style –who do you blame failures on
• Stable, global, internal explanations
–Cause versus indictor of depression?
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
Understanding Mood Disorders
Explanatory Style
DEPRESSION
Successful
Coping
Understanding Mood Disorders
The Social-Cognitive Perspective
• Depression’s Vicious Cycle
–Stressful experience
–Negative explanatory style
–Depressed mood
–Cognitive and behavioral changes
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Understanding Mood Disorders
The Vicious Cycle of Depression
Biopsychosocial Approach to
Depression
Biopsychosocial Approach to
Depression
Biopsychosocial Approach to
Depression
Biopsychosocial Approach to
Depression
Mood Disorders: Soc-Cog Causes
Practice MC Questions
1.
2.
3.
4.
5.
B
B
B
C
D
Stable / Global / Internal = Depression
Temporary / Specific / External = Successful Coping
Schizophrenia
http://www.youtube
.com/watch?v=nL_O
TM7I3C0
Childhood
Schizophrenia (4:59)
Symptoms of Schizophrenia
• Schizophrenia (split mind)
– Group of disorders characterized by disorganized &
delusional thinking, disturbed perceptions, &
1 in 100
inappropriate emotions & actions
– Not multiple personalities
24 million world
wide
David Berkowitz
John Hinkley
Mark David Chapman
Symptoms of Schizophrenia
• Disorganized thinking • The sheep languished
–Delusions
• Delusions of
persecution
• Delusions of
grandeur
• Paranoid
• “Word Salad”
– Breakdown in
selective attention
•
•
•
•
blue trains suffer
Run desk making dinner
sunglasses menu
Dogs sleep chicken
pencil trees
Garbage pink
composition solely bags
speak deodorant
Horse paper handbags
skipping forests play
together
Symptoms of Schizophrenia
• Disturbed perceptions
–Hallucinations
• Sensory experience w/o sensory
stimulation
–hearing voices
http://www.youtube.com/watch?v=4LScZZOkeIs
Virtual Reality Hallucination (3:40 – start at :34
Symptoms of Schizophrenia
• Inappropriate Emotions
–Flat affect
• Emotionless state
• Inappropriate Actions
–Catatonia
• Motionless for hours / agitated
–Senseless compulsive acts
–Disruptive social behavior
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Types of Schizophrenia
Onset and Development
• Positive vs. negative symptoms
• 1 in 100
+ symptoms that are in ADDITION to
• No cultural
normal behavior (delusions,
hallucinations, erratic emotions)
boundaries
• Male & females
equally (men=severe • Chronic (process) schizophrenia
• Acute (reactive) schizophrenia
& earlier)
• Onset:
– 18 (men) early 20’s
(women)
– Some suddenly
appear
– Some gradual
Understanding Schizophrenia
Brain Abnormalities
1. Dopamine Overactivity
–Dopamine – D4 dopamine
receptor
–Dopamine blocking drugs
• Glutamate
– Excitatory
– Not enough glutamate =
negative sypmtoms
Understanding Schizophrenia
Brain Abnormalities
2. Abnormal Brain
Activity & Anatomy
– Frontal lobe & core
brain activity
• less activity
– Active during
hallucinations
– Fluid filled areas of the
brain
• Surrounding cerebral tissue
is smaller (thalamus)
Understanding Schizophrenia
Brain Abnormalities
3. Maternal Virus During Pregnancy
–Influence of the flu during pregnancy
• Winter & Spring births higher risk
• Flu during 2nd trimester
– Fetal virus plays a contributing role to development
of schizophrenia
– 98% of women who get flu during 2nd trimester DO
NOT have offspring w/ schizophrenia
Understanding Schizophrenia
4. Genetic predisposition
• 1 in 100 odds – 1 in 10 w/sibling or parent w/ disorder
• 1 in 2 if identical twin has schiz. (even when reared
apart)
• Adopted children don’t “catch” the disorder
• Gene may get “turned-on” or not depending on
environment
Odds of any 4 people picked at
random all beirng diagnosed w/
schiz. Is 1 in 100 million.
Genetically identical Genanin
sisters all have the disease
Understanding Schizophrenia
Psychological Factors
• Possible warning signs
– Mother severely schizophrenic
– Birth complications (low weight/oxygen
deprivation)
– Separation from parents
– Short attention span
– Poor muscle coordination
– Disruptive or withdrawn behavior
– Emotional unpredictability
– Poor peer relations and solo play
Personality Disorders
http://www.youtube.co
m/watch?v=clw_97mqpM
Charles Manson
http://www.youtube.co
m/watch?v=ErB0R4wl
B64
Jeffery Dahmer
http://www.youtube.com/watch?v=PuB_ng5
uVaI
Personality Disorders
• Personality disorders
– psychological disorders characterized by inflexible
and enduring behavior patterns that impair social
functioning.
– Anxiety cluster
• avoidant personality – fearful of rejection
– Eccentric cluster
• emotionless disengagement – schizoid per.
– Dramatic/impulsive cluster
• histrionic pers. - attention getting
– Self-focused /Self-inflating cluster
• narcissistic
Antisocial Personality Disorder
• Antisocial personality disorder
–Sociopath or psychopath
–
–
–
–
–
Typically male
Before 15
Lower reaction to stress
Unconcerned w/ social rewards
drugs& alcohol
frontal lobe
http://www.yo
utube.com/w
atch?v=0qyC
R9tPDgM
Rates of Disorder
Rates of Disorder
• Mental health
statistics
• Influence of poverty
• Other factors
01. OCD
02. Conversion Disorder
03. Phobia
04. Dissociative Fugue
05. OCD
06. Panic Disorder
07. Phobia
08. Dissociative Amnesia
09. Obsessive-Compulsive Disorder
10. Conversion Disorder
11. Obsessive-Compulsive Disorder
12. Generalized Anxiety Disorder
13. Obsessive-Compulsive Disorder
14. Dissociative Amnesia
15. Conversion Disorder
16. Obsessive-Compulsive Disorder
1.
2.
3.
4.
5.
6.
7.
8.
Major Depression
Paranoid Schiz.
Disorganized Schiz.
Bipolar
Paranoid Schiz.
Catatonic Schiz.
Paranoid Schiz.
Paranoid Schiz.
The End
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Definition
Slides
Psychological Disorder
= deviant, distressful, and dysfunctional
patterns of thoughts, feelings, or
behaviors.
Attention-deficit Hyperactivity
Disorder (ADHD)
= a psychological disorder marked by the
appearance by age 7 of one or more of
three key symptoms; extreme inattention,
hyperactivity, and impulsivity.
Medical Model
= the concept that diseases, in this case
psychological disorders, have physical
causes that can be diagnosed, treated,
and, in most cases, cured often through
treatment in a hospital.
DSM-IV-TR
= the American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, updated
as of 2000 “text revision”; a widely used
system for classifying psychological
disorders.
Anxiety Disorders
= psychological disorders characterized by
distressing, persistent anxiety or
maladaptive behaviors that reduce anxiety.
Generalized Anxiety Disorder
= an anxiety disorder in which a person is
continually tense, apprehensive, and in a
state of autonomic nervous system
arousal.
Panic Disorder
= an anxiety disorder marked by
unpredictable minutes-long episodes of
intense dread in which a person
experiences terror and accompanying
chest pain, choking, or other frightening
sensations.
Phobia
= an anxiety disorder marked by a
persistent, irrational fear and avoidance of
a specific object, activity, or situation.
Obsessive-compulsive Disorder
(OCD)
= an anxiety disorder characterized by
unwanted repetitive thoughts (obsessions)
and/or actions (compulsions).
Post-traumatic Stress Disorder
(PTSD)
= an anxiety disorder characterized by
haunting memories, nightmares, social
withdrawal, jumpy anxiety, and/or
insomnia that lingers for four weeks or
more after a traumatic experience.
Post-traumatic Growth
= positive psychological changes as a result
of struggling with extremely challenging
circumstances and life crises.
Somatoform Disorder
= psychological disorder in which the
symptoms take a somatic (bodily) form
without apparent physical cause.
Conversion Disorder
= a rare somatoform disorder in which a
person experiences very specific genuine
physical symptoms for which no
psychological basis can be found.
Hypochondriasis
= a somatoform disorder in which a person
interprets normal physical sensations as
symptoms of the disease.
Dissociative Disorders
= disorders in which conscious awareness
becomes separated (dissociated) from
previous memories, thoughts, and
feelings.
Dissociative Identity Disorder
(DID)
= a rare dissociative disorder in which a
person exhibits two or more distinct and
alternating personalities. Formerly called
multiple personality disorder.
Mood Disorders
= psychological disorders characterized by
emotional extremes.
Major Depressive Disorder
= a mood disorder in which a person
experiences, in the absence of drugs or a
medical condition, two or more weeks of
significantly depressed moods, feelings of
worthlessness, and diminished interest or
pleasure in most activities.
Mania
= a mood disorder marked by a hyperactive,
wildly optimistic state.
Bipolar Disorder
= a mood disorder in which the person
alternates between the hopelessness and
lethargy of depression and the overexcited
state of mania. (formerly called manicdepressive disorder.)
Schizophrenia
= a group of severe disorders characterized
by disorganized and delusional thinking,
disturbed perceptions, and inappropriate
emotions and actions.
Delusions
= false beliefs, often of persecution or
grandeur, that may accompany psychotic
disorders.
Personality Disorders
= psychological disorders characterized by
inflexible and enduring behavior patterns
that impair social functioning.
Antisocial Personality Disorder
= a personality disorder in which the person
(usually a man) exhibits a lack of
conscience for wrongdoing, even toward
friends and family members. May be
aggressive and ruthless or a clever con
artist.