Abnormal Psychology and
Therapy
By: Spencer Bumpus, Jamie Schick, Kristina Depaola,
Sarah Clay
Abnormal Behavior
● Abnormal behavior is behavior that is deviant,
maladaptive, or personally distressful over a long period
of time
○ An example of deviant behavior is a woman who washes her hands 5
times in one hour and takes 7 showers a day because her behavior is
abnormal
○ An example of maladaptive behavior is a man who thinks he can harm
people by breathing, he may try to hold his breath for long periods of
time
○ An example of a behavior causing personal distress is a woman who
makes herself vomit after each meal
Abnormal Behavior
● Biological Approach
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This approach focuses on the brain, genetics, and the
neurotransmitter functioning as a source of
abnormality
The biological approach is evident to the medical
model that says that psychological disorders have a
background of biological factors
Abnormal Behavior
● Sociocultural Approach
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The social contexts that a person lives in are highly
emphasized with this approach
■ gender, ethnicity, social status, family relationships, and culture
● This perspective stresses the ways that
cultures influence the understanding and
treatments of psychological disorders
Abnormal Behavior
● Bio Psychosocial Approach
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Biological factors such as genes, psychological
factors such as childhood experiences, and
sociocultural factors such as gender, can act alone
but they can also operate together
Biological, psychological, and sociocultural all play a
factor in normal and abnormal behavior
Abnormal Behavior
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Classifying Abnormal Behavior
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Psychologists have a system to classify symptoms
into specific disorders
Having a classification system helps doctors be on
the same page about identifying disorders
Abnormal Behavior
● DSM-IV
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○ The Diagnostic and Statistical Manual of Mental
Disorders
■ It includes 374 disorders
It is split up into five parts
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Axis I: All diagnostic categories except personality disorders and mental retardation
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Axis II: Personality disorders and mental retardation
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Axis III: General medical conditions
Abnormal Behavior
● Critiques of DSM-IV
○ the manual classifies individuals based on their symptoms, using
medical terminology in the psychiatric tradition of thinking about
mental disorders in terms of disease
○ It focuses strictly on pathology and problems, critics say that they
should also focus on positive things
○ Another criticism is the labels it gives people
Anxiety Disorders
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GAD
Panic Disorder
Phobic Disorder
OCD
PTSD
Generalized Anxiety Disorder (GAD)
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experience anxiety for at least 6 months but
are unable to specify the reasons for the
anxiety.
people are nervous most of the time
worry about work, relationships, or health
suffer from fatigue, muscle tension, stomach
problems, and difficulty sleeping.
Causes of GAD
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genetic predisposition
deficiency in GABA
sympathetic nervous system activity
respiratory system abnormalities
GAD Video
http://www.youtube.com/watch?v=KbY4HG4
Uod4
Panic Disorder
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person experiences recurrent, sudden onsets
of intense apprehension or terror, often
without warning and with no specific cause.
produce severe palpitations, extreme
shortness of breath, chest pains, trembling,
sweating, dizziness, and feeling helplessness.
Causes of Panic Disorder
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may have a genetic predisposition
may have an autonomic nervous system that
is predisposed to be overly active.
may stem from problems involving one or
both of norepinephrine and GABA
women are twice as likely to have panic
disorder as opposed to men.
Panic Disorder Case Study
I remember my first panic attack like it was yesterday. I guess I’d always been an anxious type, but this was like nothing I’d ever
experienced. I was at a football game about six years ago, big crowd, St Kilda getting hammered by the Pies. I think I was a bit edgy – I’ve
never liked being hemmed in, stuck somewhere I couldn’t get out of easily. Then suddenly this thing just took me over. I got these pains in
my chest and I couldn’t breathe. I was sure I was having a heart attack and was going to die. I was thinking about my daughter – she was
two at the time – and thinking it can’t end like this, I’ve got to see her again. I was sweating, heart racing, trembling….I had to get out of
there. I managed to push my way through the crowd and I saw a St John’s ambo. What a relief. He helped me to the ambulance and they
took me straight to hospital, wired me up to all sorts of machines and then…..they told me there was nothing wrong, that it was all in my
head. All in my head? Those pains were real, I can tell you. All they said was that I’d had a panic attack, and I was so happy to be alive, I
didn’t ask them more about it. I just wanted to get home. But since then, my life has changed. I only went back to sea once (my skills are
needed more on shore than at sea, thank God) but that was terrifying. I spent the whole time worrying about whether I’d have an attack
while we were far from land and I avoided being below decks whenever I could. Since the first time, I’ve had about a dozen attacks and
each one was terrifying. I’ve stopped going anywhere that I can’t get out of easily in case I have another one. No shopping centres. No
cinemas. No football games. No public transport. No crowded places. I left the navy because I couldn’t face going to sea again.
Phobic Disorders
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characterized by an irrational,
overwhelming, persistent fear of a particular
object or situation.
CAN pinpoint the cause of their feelings
fear becomes a phobia when the person goes
to almost any length to avoid it
social phobia: fear of being humiliated or
Causes of Phobic Disorders
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could be a neural circuit for social phobia
that involves the thalamus, amygdala, and
cerebral cortex.
serotonin may also be involved
some theorists consider phobias to be
learned fears
Phobic Disorder Case Study
Sarah Bromley, 35, is a make up artist from Sheffield. She developed her phobia while living in the Middle East as a child.
Aged seven, a cockroach became entangled in her hair, Sarah screamed for help, but her parents had great difficulty
removing it, and as a result of this traumatic experience she began to develop an extreme phobic reaction to them.
For the next 28 years Sarah's phobia increasingly impacted on her life. She refused to go on a trekking holiday with her
husband, music producer Roo, for fear of coming face-to-face with cockroaches and has also had to turn down work
abroad because of her phobia.
After years, Sarah bravely volunteered to enter The Panic Room. Over the course of three days she underwent a course
of treatment with Dr Felix Economakis.
Using a combination of clinical hypnosis, systematic desensitisation and graded exposure, she gradually became more
comfortable in the presence of cockroaches, but how would she cope with a giant Madagascan cockroach awaiting her
in the final Panic Room?
A few weeks after her treatment Sarah has for the first time been able to visit her parents in Spain without fear of
breaking into cold sweat and panic should she see a cockroach, and is overjoyed at the change she's experienced "It's a huge relief, that black cloud's completely gone."
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Obsessive-Compulsive Disorder (OCD)
anxiety provoking thoughts that will not go
away and/or urges to perform repetitive,
ritualistic behaviors to prevent or produce some
future situation.
obsession (recurrent thought) -> compulsion
(recurrent behavior)
checking, cleansing, and counting are common
compulsions.
Causes for OCD
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brain imaging studies show neurological
links for OCD
basal ganglia are so active in OCD that
numerous impulses reach the thalamus
which causes obsessive thoughts or
compulsive behaviors.
OCD Video
http://www.youtube.com/watch?v=Rn1OYlYzgm8
Post-Traumatic Stress Disorder
(PTSD)
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develops through exposure to a traumatic event
that has overwhelmed the persons abilities to
cope.
flashbacks, avoidance, reduced abilities to feel
emotions, excessive arousal, difficulties with
memory and concentration, feelings of
apprehension, and impulsive outbursts of
behavior.
Causes of PTSD
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can immediately follow a traumatic event or
come months after.
most individuals exposed to a traumatic
event will experience some type of PTSD but
the level of the disorder varies.
PTSD Case Study
Joe saw a good deal of active combat during his time in the military. Some incidents in particular had never left his mind
– like the horrifying sight of Gary, a close comrade and friend, being blown-up by a land-mine. Even when he returned
to civilian life, these images haunted him. Scenes from battle would run repeatedly through his mind and disrupt his
focus on work. Filing up at the gas station, for example, the smell of diesel immediately rekindled certain horrific
memories. At other times, he had difficulty remembering the past — as if some events were too painful to allow back
in his mind. He found himself avoiding socializing with old military buddies, as this would inevitably trigger a new round
of memories. His girlfriend complained that he was always pent-up and irritable – as if he were on guard, and Joe
noticed that at night he had difficulty relaxing and falling asleep. When he heard loud noises, such as a truck backfiring he literally jumped, as if he were readying himself for combat. He began to drink heavily.
Personality Disorders
Personality disorders are a class of mental disorders
characterized by enduring maladaptive patterns of
behavior, cognition and inner experience exhibited across
many contexts and deviating markedly from those accepted
by the individual's culture.
Antisocial Personality
Disorder
A psychological disorder characterized by guiltiness, law breaking,
exploitation of others, irresponsibility, and deceit. These individuals don't
play by the rules and they often live a life full of crime and violence. This
disorder is far more common in men than in women and is related to
criminal behavior, vandalism, substance abuse, and alcoholism.
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Disregard for right and wrong
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Persistent lying or deceit to exploit others
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Using charm or wit to manipulate others for personal gain or for
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agitation, impulsiveness, aggression or
violence
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Intense egocentrism, sense of superiority and exhibitionism
Lack of empathy for others and lack of
remorse about harming others
sheer personal pleasure
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Hostility, significant irritability,
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Unnecessary risk-taking or dangerous
behaviors
Recurring difficulties with the law
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Poor or abusive relationships
Antisocial Personality
Disorder
Those with antisocial personality disorder rarely seek out treatment on their own. Individuals
generally receive treatment only after some type of altercation with the legal system. Results
usually occur after long term treatment.
Case Study
Ted Bundy was born in Vermont on November 24, 1946. He grew up with his mother, never knowing who his father
was. Bundy spent the first three years of his life in Philadelphia. At age 4 Bundy and his mother moved to
Washington. It was at this time that his mother met Johnnie Bundy. Ted was very jealous of his mother’s
relationship with Johnnie. In 1953 Ted’s mother and Johnnie were married. They later had four children.
At the age of 7, Ted’s second grade teacher broke a ruler over his hand for punching one of his classmates in the
face. This is when he first noticed his feelings of “disturbing uneasiness” as he called it.
Although Ted seemed to have some behavioral problems in school, his grades were above average. He attributes
his success to his mother’s diligent efforts to help him with his homework. His mother did not however discuss any
personal matters with Ted. She did not socialize or gossip with others and never discussed her childhood.
Ted also kept to himself and from early on chose to be alone. Ted found it difficult to socialize and did not participate
in organized activities. Ted tried out for the baseball and basketball teams, but didn’t make it. This was very
traumatic for him. Because of this Ted decided to try skiing. He used to make fake ski tickets so he could ski for
free. He was never caught.
When Ted was asked about his childhood, he described it as lonely and empty. He felt that he was overlooked by his
parents. He did make some friends in junior high , but still lacked in his social skills. In high school he had only one
date because he felt “inept with girls”.
In January of 1974 in Seattle, Ted Bundy’s first murder was documented. His had smashed a rod over Sharon
Clarke’s head while she was sleeping. Sharon was a stranger to Bundy and no reason for the attack was ever
given. A few weeks later, a college student living a couple of blocks from Sharon disappeared. From March until
June four more female college students disappeared.
Bundy used his good looks and charm to persuade young women to help him. In July of 1974 Bundy approached several young women
with his arm in a sling and asked them to help him put a sailboat on top of his car. One young women agreed to help him and was never
seen again. The same day another women disappeared from the washroom at the same lake. The remains of these two women and
several others were found in a forest near the lake. All of his victims tended to be college-age, white, attractive women. Bundy continued
this killing spree until October of 1974.
In November Bundy tried to catch another victim, but she escaped, however he did kill another woman that same day. Then in January of
1975 Bundy began killing again, this time in Colorado. Several woman were reported missing from different places.
Finally on August 16, 1975 Bundy was arrested for driving suspiciously slowly down the street and refusing to stop when ordered by a
police officer. The officer found a hair that matched one of the victim’s in Bundy’s car, and a witness said they saw Bundy the night
another victim disappeared. Bundy was tried for murder in Aspen, Colorado.
Bundy insisted on defending himself and was provided law books as he requested. He was also allowed to wander the Aspen law library
where he jumped out the window and escaped. Eight days later he was recaptured and this time kept under heavy watch.
Because of Bundy’s legal skills, he was able to delay the case by filing many motions. During this time period he lost weight and carved a
hole in his prison cell, which he was able to squeeze through and escape a second time. He traveled to many places and ended up in
Tallahassee, Florida near the FSU sorority houses.
On January 15,1978 five young women from a sorority house were severely beaten. Two of them died and at least two of them were
raped. One month later a 12 year old was found raped and strangled to death. On February 15, 1978 Bundy was again arrested for
failing to stop when ordered by a police officer. It didn’t take long for them to discover Bundy was wanted for murder in Colorado.
Bundy admitted to 23 murders and was sentenced to death. He died in the electric chair on January 24, 1989, in Florida.
Bundy was classified as high Factor 1 psychopath. This means he is very intelligent and had few indications of psychopathy early in life.
The components of a factor 1 psychopath include a grandiose sense of self, pathological lying, conning-manipulative behaviors, lack of
remorse, lack of empathy, and failure to accept responsibility.
Psychopathy is the label name for antisocial personality disorder. Individuals with antisocial personality disorder are often charming,
spontaneous, and likable at first, but are actually deceitful and manipulative. Many people suffering from ASPD live only in the present
and have no consideration for the past or future (Carson, Butcher, & Mineka, p.312). People with ASPD behave as if social regulations
do not apply to them. They do as they please and feel no remorse for their wrong-doing. They persistently disregard and violate the
rights of others.
Only people 18 years or older are diagnosed with ASPD. According to the DSM, this diagnosis is made only when these three criteria are met.
(1)There have been at least three behavioral problems occurring after age 15. (2) There were at least three instances of deviant behavior
before age 15. (3) The antisocial behavior is not a symptom of another mental disorder such as schizophrenia or a manic episode.
Bundy is a classic example of an antisocial behavior. He was charming and likable while at the same time extremely manipulative. He showed
no feelings of remorse for any of his victims. He was also very intelligent and used this to his advantage.
The problem with ASPD, especially factor 1 psychopathy, is that it is very difficult to treat. Treatment has shown to be effective in the average
criminal, however not with psychopaths, such as Bundy. There is actually a chance that psychopaths who are high factor 1 may get worse with
treatment because instead of learning about themselves, they learn more about others and use that information.
As with treating any personality disorder, getting the person into therapy and keeping them involved is very difficult. Most individuals, including
Bundy, have no interest in changing their behavior. It is also difficult because high factor 1s are so deceitful and manipulative it is hard to
believe anything they say.
Cognitive-behavioral therapy is a technique often used for the treatment of ASPD. According to our book, cognitive-behavioral interventions
include: increasing self-control, self-critical thinking, and social perspective-taking; victim awareness; anger management; changing antisocial
attitudes; curing any drug addictions; and reducing contacts with antisocial peers and improving interactions with nonantisocial peers.
It is very unlikely that cognitive therapy will be effective, especially with someone like Ted Bundy. The most effective tool possible is prevention.
It is very important to prevent children misbehaving and intervene any behavioral problems at an early age.
Borderline Personality Disorder
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A psychological disorder characterized by a pervasive pattern of instability in
interpersonal relationships, self-image, and images, and of marked
impulsivity beginning by early adulthood and present in a variety of
contexts.
Impulsive and risky behavior, such as risky
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Inappropriate anger and antagonistic
driving, unsafe sex, gambling sprees or illegal drug
behavior, sometimes escalating into
use
physical fights
Awareness of destructive behavior, including self-
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injury, but sometimes feeling unable to change it
Difficulty controlling emotions or
impulses
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Wide mood swings
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Suicidal behavior
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Short but intense episodes of anxiety or
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Feeling misunderstood, neglected, alone,
depression
empty or hopeless
Borderline Personality Disorder
Therapy is often effective in many patients. The goal of the therapist is to help
the client learn to be more aware of other peoples perspectives. Psychiatric
drugs such as antidepressants are often effective, both alone and in
combination with psychology. Antipsychotic medications are sometimes used in
cases involving distorted thinking patterns.
Video
http://bpdvideo.com/videos/1understanding-borderline-personalitydisorder/
http://bpdvideo.com/videos/2-causes-ofborderline-personality-disorder/
Psychological Disorder & Health & Wellness
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A psychological disorder, also known as a mental disorder, is
a pattern of behavioral or psychological symptoms that
impact multiple life areas and/or create distress for the
person experiencing these symptoms.
Over 26 percent of Americans aged 18 and older suffer from a
diagnosable psychological disorder in any given year.
Often comes along with judgement and a negative stigma
Consequences of Stigma
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Stigma: a mark of disgrace associated with a particular
circumstance, quality, or person
For many individuals who are diagnosed with one or more
such disorders, a significant obstacle in the pursuit of normal
life is the fear of stigma, stereotypes, prejudice, and
discrimination
Fear of Stigma can prevent individuals from seeking
treatment and from talking about their problems to friends
and family
Consequences of Stigma
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Having a disorder and experiencing the stigma associated
with it can negatively affect the physical health of a person
and also worsen the condition of their mental state
The stigma attached to psychological disorders can provoke
prejudice and discrimination toward individuals who are
struggling with these problems.
Prejudice and
Discrimination
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Labels of Psychological disorders can lead to negative stereotypes;
stereotypes: a generalization about a group’s characteristics that
does not carry any variations from one individual to another
Often vivid cases of a violence etc. from people with a mental
disorder paint the stereotype for the rest of people with disorders.
o An Oxford University researcher found that only about 18% of
homicides are committed by people with a psychological
disorder while many people believe the number would be much
higher
One of the most feared aspects of a mental disorder is
discrimination; discrimination is acting prejudicially toward a
person who is a member of a stigmatized group.
Overcoming Stigma
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The Americans with Disabilities Act (ADA) prohibits discrimination
against people with disabilities in employment, transportation,
public accommodation, and telecommunications
Fair Housing Act – This law makes it illegal to deny housing to a
renter or buyer because of a disability.
The Individuals with Disabilities Education Act – This law requires
that a free public education be made available to children and youth
with disabilities. It also requires that the education be designed to
meet their unique educational needs.
The Rehabilitation Act – The purpose of this law is to help people
with disabilities become employed and independent.
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Overcoming Stigma
Vital to recognize the strengths in people with mental
disorders- both in confronting the disorder and in carrying
on despite their problems- and their achievements
Many people who have accomplished great things in life have
been diagnosed with some sort of psychological disorder:
o Abraham Lincoln- Bipolar Disorder and Anxiety
o Jim Carrey- Manic Depression
o Demi Lovato- Bipolar Disorder
o Halle Berry
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Therapy
Biological therapies are treatments that reduce or eliminate
the symptoms of psychological disorders by altering aspects
of body functioning.
Drug therapy is the most common form of biomedical
therapies
Psychotherapeutic drugs are mainly used in three diagnostic
categories: anxiety disorders, mood disorders, and
schizophrenia
antianxiety drugs, antidepressant drugs, antipsychotic drugs
Anti-anxiety Drug Therapy
● Antianxiety drugs are commonly known as tranquilizers
● Reduce anxiety by making the individual calmer and less
excitable and also reduce brain activity
● Benzodiazepines are potentially addictive but offer the most
relief for the symptoms of anxiety disorders
● Xanax, Valium, and Librium are the most commonly
prescribed; fast acting medications taking effect within hours
● Come with side effects including drowsiness, loss of
coordination, fatigue, and mental slowing
Anti-anxiety Drug Therapy
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Non-benzodiazepines are often used to treat generalized
anxiety disorder
o must be taken daily for two to three weeks before the
patient notices a difference
Benzodiazepines and non-benzodiazepines are not generally
prescribed for long periods of time due to the risk of
addiction and increasing tolerance.
Antidepressant Drug
Therapy
● Antidepressant drugs regulate mood
● Four main classes of antidepressant drug: tricyclics,
tetracyclics, monoamine oxidase (MAO) inhibitors, and
selective serotonin reuptake inhibitors
○ help alleviate the depressed mood though their effects on
the neurotransmitters in the brain.
● All antidepressant drugs allow the person’s brain to increase
or maintain its levels of neurotransmitters, especially
serotonin and norepinephrine
Antidepressant Drug
Therapy
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Tricyclics are believed to work by increasing the level of
certain neurotransmitters, especially norepinephrine and
serotonin
o reduce the symptoms in about 60 to 70 percent of cases
o Take 2-4 weeks to improve mood
Tetracyclic antidepressants also called noradrenergic and
specific serotonergic antidepressants, enhance brain levels of
neurotransmitters and are often related to tricyclics
o Are now more often used due to the short list of side
effects.
Antidepressant Drug
Therapy
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MAO inhibitors are thought to work because they block the enzyme
monoamine oxidase; this breaks down norepinephrine and serotonin in
the brain.
o Scientists believe that by blocking MAO inhibitors the
neurotransmitters are able to stick in the brain’s synapses and help
regulate mood
o May be dangerous due to the risk of stroke and high blood pressure if
mixed with certain foods or different drugs
SRRIs target serotonin and work mainly by interfering only with the
reabsorption of serotonin in the brain
o Prozac, Paxil, and Zolof are the main SRRIs prescribed due to the low
risk of side effects compared to other antidepressants.
o Do have some side effects such as insomnia, anxiety, and headaches
Antidepressant Drug
Therapy
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The number of Americans who had been prescribed
antidepressants doubled between 1996 and 2005, with 10%
of Americans taking antidepressants at some point of their
life
Also effective in some cases of anxiety disorders
Lithium: a widely used treatment for bipolar disorder;
thought to stabilize moods by influencing norepinephrine
and serotonin, but the exact mechanism is unknown
Antipsychotic
Drug
Therapy
• Antipsychotic drugs are powerful drugs that diminish
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agitated behavior, reduce tension, decrease hallucinations,
improve social behavior, and produce better sleep patterns in
individuals who have severe psychological disorders
Neuroleptics are the most extensively class of antipsychotic
drugs
o explanations for the effectiveness of neuroleptics stem
from their ability to block dopamine's action in the brain
o Tardive dyskinesia: a neurological disorder characterized
by involuntary random movements of the facial muscles,
tongue, and mouth as well as overall twitching
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Antipsychotic Drug Therapy
Often need to increase dosages by administering small
increases of the amount a person takes everyday instead of
just an initial large dose
Although the drugs help regulate moods, symptoms, and
some behaviors often times people with a serious mental
illness need training in vocational, family, and social skills.
Generally just give people the ability to return to the
community but many people still struggle with everyday life
Electroconvulsive Therapy
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Hippocrates noted that head traumas, seizures, and
convulsions would sometimes lead to cures of disorders.
Electroconvulsive therapy, commonly called shock therapy,
sets of a seizure in the brain much like what happens when
someone has epilepsy; it was and still is believed that a
seizure could cure a psychological disorder.
ETC used to be used to punish patients in mental hospitals
Both Ernest Hemingway and Sylvia Plath underwent the
procedure and later committed suicide.
Electroconvulsive Therapy
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Today ETC is given to individuals who have not responded to drug
therapy and its administration involves anesthesia and muscle
relaxers to allow one to sleep through the procedure
Relapse rate for people who undergo ETC is relatively high but does
provide rapid relief of symptoms
Memory loss and cognitive impairments have been known to come
along with ETC
Due to the controversy that comes along with ETC, doctors have
been inducing seizures in people with psych disorders through deep
brain stimulation: implantation of electrodes in the brain that emit
signals to alter the brain’s electrical circuitry
Increased Risk of Suicide in
Children
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Parents show concern for their children taking antidepressant drugs
A study done by the FDA involving 4,300 children gave one group
antidepressants and the other a placebo; none of the children in this study
committed suicide.
o Although this indicates antidepressants do not have an effect on suicide
rates, studies involving the drugs are not done with people already at risk
of suicide so therefore the drugs may not prevent suicide either
“Black box” warning required that antidepressants warn people taking the drug
of the potential risk and thoughts of suicide that come along with the drug itself
Since the black box warning FDA studies have shown no relation to suicide in
adults or children
As many as 17% of adolescents think about suicide in a year but most of them
are not taking antidepressant medication
Drug Chart
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Psychosurgery
Psychosurgery is a biological intervention that involves the removal
or destruction of brain tissue
In the 1930s Antonio Egas Moniz developed a surgical procedure to
treat psychological disorder
o In his procedure a device was inserted into the brain and
destroyed fibers that connect the frontal lobe which are a key
role in emotion
American Walter Freeman developed prefrontal lobotomies
o few minute long procedure with an icepick like tool which also
destroyed parts of the frontal lobe
Due to developing drugs the harsh procedures stopped
Works Cited
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http://www.ox.ac.uk/media/news_stories/2006/news_item_1190.html
http://apt.rcpsych.org/content/16/1/53.full
http://www.womenshealth.gov/mental-health/your-rights/americansdisability-act.html
http://connect.mcgrawhill.com/connect/hmEBook.do?setTab=sectionTabs
http://bpdvideo.com/