Abnormal Psychology Psychological Disorders How common are they? 1994: Michigan Institute for Social Research Nearly ½ of people age 15-54 have experienced at least one bout with psych disorder Psych disorders peak between ages 25 and 34 Only 1 out of 4 ever receive help Many are mild, thus recover without help Most common disorders Major depressive episode, alcohol dependence, social phobia, simple phobia Psych Disorders in the U.S. …. Psych disorders are often culturally based… Examples p. 8 Michigan study… ¼ of Americans met criteria for mental illness within prior year ¼ of those had serious disorder U.S. posed to rank #1 in mental illness… So what is a mental illness and what criteria qualify somehow as mentally ill…? What is Abnormal Psych?? Abnormal Psychology Study of people who suffer from psychological disorders Behavior and or thoughts From depression, substance abuse, learning difficulties to schizophrenia and bipolar disorder What constitutes Abnormal? 4 Criteria to characterize as abnormal Unjustifiable (irrational) : can’t justify / doesn’t make sense Maladaptive: Harmful / disturbing to the individual Atypical (unusual): not shared by members of population Disturbing (irrational): Disturbing to others All or most not required to be diagnosed OR….. “Deviant, Distressful, Dysfunctional” DSM-IV Diagnostic and Statistical Manual of Mental Disorders Resource to diagnose patients (only) Symptoms of everything considered to be psychological disorder 16 clinical syndromes Weakness: assumption / labeling of mental illness based on symptoms… Rosenhan Study Dangers of labeling patients with disorders 8 participants who faked symptoms All acted completely normal except for testifying to hearing voices (3 words) All diagnosed with Schizophrenia and discharged as “Schizophrenia in remission” Average stay in institutions- 18 days Perspectives on Causes… Psychoanalytic theorists Behaviorists Maladaptive ways of thinking Humanistic theorists History of reinforcement Cognitive theorists Unconscious conflicts (traumatic events during psychosexual stages) A person’s feelings, self-esteem, self-concept Biomedical theorists Hormonal / neurotransmitter imbalances, brain structure, genetic abnormalities An Eclectic Approach Specific fields are not exclusive to their theories Consider any/ all theories as potential influence to a specific illness 6 Major Types of Disorders… Anxiety Disorders Somatoform disorders (psych issue causes physiological problem) Dissociative disorders (disruption in conscious processes) Mood / affective disorders (extreme / inappropriate emotions) Schizophrenic disorders: (Disordered, distorted thinking) Personality Disorders: (Maladaptive behavior that affects functioning) Don’t Get Paranoid… Intern’s Syndrome Tendency to see in oneself the characteristics of a disorder one is studying. Anxiety Disorders When do we classify it as a disorder? Distressing, persistent anxiety or maladaptive behaviors to reduce anxiety Think of one of one of the most stressful moments or events in your lifetime. Choose three adjectives to describe how you felt and three physical characteristics that you experienced. Heart palpitations, sweaty palms, dizziness, ringing in ears, muscular tension, sleeplessness.... Types of Anxiety Disorders Generalized Anxiety Disorder (GAD) Constant low-level anxiety (nervousness) 2/3 are women Patient can’t identify its cause and thus can’t deal with or avoid it. Often accompanied by depression Tense, jittery, muscular tension, agitation, sleeplessness, difficulty concentrating (fidgeting, twitching, trembling) Panic Disorders Acute episodes of intense anxiety without provocation (panic attack) Tend to increase in frequency (minutes long) 1 in 75 (smokers 2-4 x more likely) Heart palpitations, shortness of breath, choking sensations, trembling, dizziness… “feels like a heart attack” Charles Darwin (age 28) Phobias Focuses anxiety on a specific object, activity or situation. Irrational fear that disrupts behavior Identify these phobias: Agoraphobia Social phobia Androphobia Coulrophobia Cynophobia Didaskaleinophobia Obsessive-Compulsive Disorder OCD Persistent obsessive (uncontrollable) thoughts lead to compulsive (uncontrollable) actions Obsession creates anxiety / reduced by compulsive behavior Cleanliness, security, symmetry, organization Often late teens, early twenties (2-3%) Howard Hughes Post-Traumatic Stress Disorder PTSD Cause: experiencing / witnessing a traumatic event (fear, helplessness, horror) Nightmares, flashbacks, social withdrawal, insomnia Combat veterans, disaster or accident survivors, sexual assault victims, 2/3 of prostitutes Basic trust erodes, sense of hopelessness 15% of Vietnam vets (45% for heavy combat) 1 in 6 Iraqi combat infantry veterans Theories Explaining Anxiety Disorders Brainstorm with a partner. How would the Psychoanalytic theorist explain the cause of anxiety disorders? Create an example. Unconscious conflict Conflict of id, ego, superego Anxiety disorder is the outward manifestation of an internal, unconscious conflict Theories Explaining Anxiety Disorders How would the behavioral theorist explain the cause of anxiety disorders? Learned response: Classical, or Operant learning Provide an example for each. (Pick a specific anxiety disorder for the example.) Chronically anxious, ulcer-prone rats by unpredictable electric shock Theories Explaining Anxiety Disorders How would the cognitive theorist explain the cause of anxiety disorders? Dysfunctional , maladaptive ways of thinking Example: GAD the result of unreasonably high standards set for oneself: thus constant anxiety from impossibility of meeting goals Theories Explaining Anxiety Disorders Biological Perspective Natural Selection Genes Fear of spiders, snakes, storms, heights etc. increase survival (genetic) Twin studies (together and apart) The Brain OCD: Anterior cingulate cortex: monitors actions, checks for errors (hyperactive regionlike a hiccup…) Theories Explaining Anxiety Disorders Two biggest perspectives today: Behavioral (learning) and biological Mood Disorders Experiencing extreme or inappropriate emotions. Two major forms: Major depression (unipolar depression) Bipolar Disorder (manic depression) Major Depressive Disorder “common cold” of psychological disorders Biggest cause of therapy (mental health services) 2 weeks or more (with absence of clear reason) Fatigue, loss of appetite, feelings of worthlessness, hopelessness, disinterestedness, changed sleeping patterns SAD: Seasonal-Affective Disorder Facts about Major Depressive Disorder Women are nearly 2 x more likely to have it Leading cause of disability worldwide (5.8 % of men, 10.5% of women) Most major depressive episodes selfterminate Stressful events often precede depression Rate is increasing with each new generation Bipolar Disorder Depressed and manic episodes (alternate) Depression- typical characteristics (1% of pop. , equal between genders, yrs. 20-30) Manic- high energy (and often highly illogical) Overly active, elated, outspoken, less sexual inhibition Often reckless, poor judgment Mild cases can produce creative genius “Famous Folks with Disorders” Depression Abraham Lincoln Winston Churchill Meriwether Lewis Emily Dickenson Isaac Newton Mozart Woody Allen Buzz Aldrin Drew Carey Harrison Ford Beyonce Knowles Bipolar Walt Whitman Ernest Hemingway Virginia Wolf Mark Twain Edgar Allen Poe Kurt Cobain Mel Gibson Ozzy Osbourne Robert Downey Jr. Explaining Mood Disorders Biological Perspective Whole-body disorder Genetic predispositions (runs in families), biochemical imbalances Neurotransmission Norepinephrine (increases arousal, mood) Too little = depression Too much = mania Serotonin Too little = depression (Prozac, Zoloft, Paxil) / Exercise! Explaining Mood Disorders Social-Cognitive Perspective Aaron Beck: Cognitive Triad Depression stems from unreasonably negative ideas about oneself, one’s setting and one’s future (Thus depression is mostly cognition based, not mood based) Martin Seligman (Cognitive-Behavioral) Learned Helplessness (prior events convince a person of the inability to control future) = passivity and depression More prevalent in Western societies Epidemic hopelessness due to individualism and decline of commitment to family and religion Explanatory Styles and Depression The Social-Cognitive Dilemma Chicken and Egg Argument Does learned hopelessness, self-defeating beliefs and negative explanatory styles cause depression, or does depression cause them…??? Multiple Factors… Depression’s Vicious Cycle Characteristics, factors of depression tend to promote each other in a wicked cycle… helplessness, lethargy, sorrow, isolation, dismissal, failure Somatoform Disorders “soma” = body Psychological problem manifested in a physiological symptom (IOW: physical problem without a physical cause) Common among those claiming disability Two major disorders: hypochondriasis: imagined or exaggerated illnesses (no medical cause) Conversion disorder: involves motor or sensory problems with no biological explanation / cause Conversion blindness, conversion paralysis Explaining Somatoform Psychoanalytic Outward manifestations of unconscious conflict Behaviorists Reinforcement for behavior (can’t work or sympathy / attention) Clinical Distinction… Somatoform patient: unconscious of psychological causes (does not seek to maintain role of patient) factitious patient: Consciously creating the symptoms, …prolonging role of patient Malingering patient: consciously creating symptoms,…end goal (often financial) Dissociative Disorders Disruption in conscious processes (lose identity) Usually from traumatic event Famous films: Sybil, Three Faces of Eve, Dr. Jekyll and Mr. Hyde Types of Dissociative Disorders Psychogenic Amnesia: Amnesia with no physiological basis biologically induced amnesia = organic amnesia) Fugue = Psychogenic Amnesia + unfamiliar environment (fugue = flight / loss of identity and flee) Types of Dissociative Disorders Dissociative Identity Disorder (DID) AKA Multiple Personality Disorder Usually from traumatic event / overwhelming stress (high % report child abuse) often at young age (3-5 years) Self-protection / coping mechanism Distinctive identities for different events (toddler to adult) Norm- 3-6 identities (2 to qualify) Almost entirely confined to N. America Very controversial as medical diagnosis Explaining Dissociative Disorders Psychoanalytic theorist: Extremely traumatic event so repressed that causes split in consciousness Behaviorist putting event out of mind is reinforcing (to feel better) Schizophrenia Schizophrenia Disordered / distorted thinking Breakdown in selective attention (Can’t filter out information) ► Disturbed perceptions Delusions: beliefs that have no basis in reality ►Delusions of persecution = paranoia ►Delusions of grandeur = greatness Hallucinations: Perceptions in the absence of sensory stimulation ► Inappropriate actions / emotions Things to consider… ► Most severe of psych disorders ► Usually starts in late teens / early twenties ► 1 out of every 100 people have Schizophrenia Types of Schizophrenia Disorganized Schizophrenia Paranoid Schizophrenia Catatonic Schizophrenia Undifferentiated Schizophrenia Acute vs. Chronic Schizophrenia What’s the difference? Acute: Abrupt display of symptoms- can be short duration and never return or become longterm issue Chronic: Long-term struggle with Schizophrenia Disorganized Schizophrenia ► Odd use of language (Word Salad = fragmented speech Neologisms: made up words Clang associations: string together nonsense words that rhyme ► Inappropriate effect: Laugh in sorrowful setting Flat effect: no emotional response at all Paranoid Schizophrenia ► Delusions of persecution ► “out to get me” Catatonic Schizophrenia ► Engage in odd movements ► Remain motionless for hours (odd positions / poses / Waxy flexibility ► parrot-like repeating of speech, movement Undifferentiated Schizophrenia ► Disordered thinking, but no symptoms of other types of Schizophrenia Schizophrenic Symptoms: 2 Types Positive Symptoms ► Excesses in behavior, thought, mood Negative Symptoms ► Deficits, such as flat effect, or catatonia. (Absence of normal behavior) Explaining Schizophrenia ► Biological Dopamine hypothesis ►Excessive levels) levels = Schizophrenia (average 6x normal Enlarged brain ventricles Genetic predispositions Abnormality of 5th chromosome ► Social-Cognitive Double binds: contradictory messages = distorted ways of thinking Personality Disorders (Notes = Dark Green) Enduring, maladaptive behavior that negatively affects one’s ability to function. Usually less serious than other disorders. Nurture based Personality Disorder Antisocial disorder (most serious) No regard for others’ feelings / world as hostile / look out for oneself / absence of conscience No fear, no shame serial criminals, serial killers (worst case) Electric shock: no increased anxiety in anticipation Causes: Both Biological and Psychological • Nurture influential: hero or villain… More Personality Disorders Borderline Personality Dependant personality disorder Self-love, grandiose self-importance, entitlement, failed relationships, “”narcissistic paradox” Histrionic Disorder: (center of attention) Feel persecuted, very distrustful Narcissistic Disorder Overly dependant on attention, help from others Paranoid Personality Disorder Disorder of emotions (intense instability) self-mutilation Severe anxiety, depression Overly dramatic behavior Obsessive-Compulsive Disorder Overly concerned with thoughts and behaviors Other Personality Disorders Paraphilia: sexual attraction to things not normally seen as sexual (object, person, activity) Examples below: Pedophilia / children Zoophilia / animals Fetish (objects, shoes, feet etc.) Voyeur: watching others sexual activity Masochist / having pain inflicted on oneself Sadist: inflicting pain on others More common in men (exception is masochism) Other Personality Disorders Eating Personality Disorders Anorexia Nervosa, Bulimia Substance Abuse Drugs, alcohol Developmental Disorder (Addictions) Disorders Autism, Attention deficit / hyperactivity disorder (ADHD) Remember… Personality disorders are more minor than other disorders ( in thought and behavior) Example Paranoid personality disorder • Suspicion of persecution, but not the delusions, hallucinations of the Paranoid Schizophrenic Mental Disorders by Nation