ABNORMAL PSYCHOLOGY
HISTORY OF UNDERSTANDING
PSYCHOLOGICAL DISORDERS
In Ancient times, disorders were thought to
have been caused by movements of the sun
and moon (lunacy is full moon) or by evil
spirits.
 Treatments for people with mental illness were
very inhumane even up until the mid 1900’s.
Patients were often chained like animals,
beaten, burned, castrated, etc.

CONDITIONS FOR PSYCHOLOGICALLY DISABLED

Ancient Greek Trephines
European Trephines
“released evil spirits.”
CONDITIONS FOR PSYCHOLOGICALLY DISABLED
MEDICAL MODEL IMPROVES CONDITIONS
Eventually the medical model came to
dominate understandings of mental illness.
 The medical model assumes that diseases
have physical causes that can be diagnosed
based on their symptoms and be treated and in
most cases cured.
 Assumption of medical model drastically
improves conditions in mental hospitals.
 BUT, the medical model often times promotes
the myth that disorders are brought on by single
causes.

HISTORICAL TREND OF
DEINSTITUTIONALIZATION
Starting in the 1950s and 1960s more and more
drugs began being used to “cure”
psychological disorders.
 Because of this there was a policy of
deinstitutionalization instituted where patients
were removed from mental institutions to live in
family based or community based
environments.

PSYCHOLOGICAL DISORDERS
PSYCHOLOGICAL BEHAVIORS RUN A CONTINUUM
FROM VERY MILD TO EXTREME. EVERYONE HAS
THESE BEHAVIORS TO ONE DEGREE OR ANOTHER. IT
IS NOT UNTIL A BEHAVIOR OR FEELING INTERFERES
WITH YOUR QUALITY OF LIFE THAT THEY BECOME A
DISORDER.
PSYCHOLOGICAL DISORDERS ARE:
Atypical (deviant)
Disturbing (distressing)
Maladaptive (dysfunctional)
Unjustifiable
What is “insane”?
Insanity is a legal definition, not a psychological one. The term of
insanity is applied to someone who is incapable of determining if an
act is wrong and cannot control their behavior.
The insanity defense is rarely used – just 0.9% of the time (9 times in
1000). The success rate is less than 20% of the time it is used.
People who are declared not guilty by reason of insanity generally
spend more time institutionalized than they would have been
imprisoned.
Being declared insane is not the same as being declared not
competent to stand trial – this simply means you are unable to
understand the charges against you and the proceedings of the
court (could apply to very young children, for example).
Defining Disorders
DSM IV-Diagnostic and statistical manual vol. 4.: attempts to
describe psychological disorders, without explaining the causes,
predicts the future course, and suggests treatments. It focuses on
observable behaviors to make diagnoses.
Categorizes 400+ disorders, in 17 categories.
Axis I: refers to clinical disorders which need clinical attention. Includes
most mental disorders
Ex: Depression, Schizophrenia, Phobia, etc.
Axis II: Includes personality disorders and mental retardation.
Ex: Antisocial, Narcissistic, Avoidant, etc.
Axis III: relates to physical conditions which may contribute to mental
illness. Ex: brain injury, cancer, HIV, etc.
Axis IV: relates to psycho-social events in a persons life which may
contribute to mental illness.
Ex: death of a loved one, divorce, new job, etc.
Axis V: relates to a rating clinician gives patient on how well they are
functioning in life presently and within the last year.
Advantages of Diagnosis and the DSM-IV




Diagnosis can facilitate communication
Diagnosis can provide etiology (study of causation) clues
Diagnosis provides prognosis (likely outcome)
Diagnosis can give direction for treatment plans
Disadvantages of Diagnosis and the DSM-IV




Diagnosis is not theoretically neutral
No clear line between normal and abnormal in many
cases
Reliability is still a problem (if 5 psychologists examine a
patient will they all come up with the same diagnosis?)
Diagnostic labels may take on a life of their own and are
hard to remove – LABELING THEORY – Rosenhan –
this can lead to self-fulfilling prophecy.
DAVID ROSENHAN TESTS POWER OF
LABELING AND ITS RELIABILITY
Description of Rosenhan’s study:
He had colleagues attempt to fake symptoms to get into
mental hospitals. Each pseudopatient told the hospitals they
had been hearing voices. Apart from that they told no lies
other than fake names, addresses, etc.
After being admitted, the fake patients acted completely
normal. Hospital staff failed to identify the fakers and
interpreted all of their normal behavior in terms of mental
illness. Ex: guy taking notes was said to have “writing
behavior” which seemed pathological.
What does this say about the impact of labeling?
Psychological Disorders: Causes
Are not usually caused by a single factor. The biopsycho-social school argues that most disorders
are caused by a biological predisposition,
physiological state, psychological dynamics, and
social circumstances.
Biological / genetic
predisposition
+
Stress
(environment)
= DISORDER
The diathesis-stress model
The model looks at the diathesis or genetic/biologic vulnerability to
a disorder/disease and the stress(or)s that may trigger it.
The diathesis-stress model uses the analogy of a "walking time
bomb" to help explain why, for example, not 100% of identical twins
both get schizophrenia. It also helps to explain why a large percent
of people in traumatic situations (post 9/11, rape, etc.) never
develop PTSD.
The model further talks about a balance -- the greater the diathesis
or predisposition, the less the stress required for the disorder to
"appear" and visa versa.
MOST MENTAL HEALTH PROFESSIONALS
ASSUME DISORDERS HAVE INTERLOCKING
CAUSES
Bio-Psycho-Social
Perspective:
assume biological,
psychological, and
socio-cultural
factors interact to
produce disorders.
Biological
(Evolution,
individual
genes, brain
structures
and chemistry)
Sociocultural
(Roles, expectations,
definition of normality
and disorder)
Psychological
(Stress, trauma,
learned helplessness,
mood-related perception
and memories)
WHAT ARE THE CATEGORIES
DISORDERS FIT INTO?
Categories of Disorder:
1. Anxiety
2. Mood
3. Dissociative
4. Schizophrenia (No Need in IB)
5. Personality
6. Somatoform (Not in Book)
7. Facticious (Not in Book)
ANXIETY DISORDERS
Anxiety Disorders in general refer to disorders
that involve persistent and distressing
nervousness and apprehension OR
maladaptive behaviors which reduce anxiety
(defenses against anxiety).
General Characteristics of Anxiety:
 Constant worrying, fear, or uncertainty
 Feels inadequate
 Oversensitive
 Difficulty concentrating
 May suffer insomnia
ANXIETY DISORDERS
General Anxiety Disorder: person is tense,
apprehensive, and in a state of autonomic
nervous system arousal (Sympathetic N.S.).
Persistent symptoms: sweating, heart racing,
dizziness, shaking accompanied by persistent
negative feelings and fear…not triggered by
specific events.
ANXIETY DISORDERS
Panic Disorder: unpredictable,
minutes long intense anxiety
attack, as if you're going to be
killed any second, but no
specific, real threat is
apparent. “Panic Attacks.”
Usually accompanied by chest
pain or other frightening
sensations.
ANXIETY DISORDERS
Obsessive-Compulsive Disorder (OCD):
Obsessions: intrusive thoughts or fears.
Compulsions: repetitive behaviors that
soothe the fears
example of OCD ritual behavior
“As Good As It Gets”
Anxiety Disorders
Phobias:
i. Specific: persistent, irrational fear of a specific
object of situation. Very common. Spiders,
snakes, heights, water, enclosed spaces are all
very common phobias.
ii. Social: Fear of being embarrassed in public.
Example: public speaking
iii. Agoraphobia: Fear of public spaces
Copycat – Sigourney Weaver
Anxiety Disorders
Phobias:
SPECIFIC PHOBIAS
 Triskaidekaphobia
PHOBIAS
 Santa
Claustrophobia
PHOBIA
 Trichophobia
ANXIETY DISORDERS
Post Traumatic Stress Disorder (PTSD):
caused by prolonged or intensely stressful
situations, like war or rape.
Symptoms: difficulty sleeping, nightmares;
anxiety attacks or Generalized Anxiety
Disorder (GAD); intrusive memories; Guilt
associated with event;
US Military awareness campaign- PTSD
& mTBI (mild traumatic brain injury)
ANXIETY DISORDER (NOT IN BOOK)
Tourette’s Syndrome: involves
involuntary twitching and the
making of unusual sounds.
dopamine which helps control
movement and norepinephrine,
which helps body respond to
stress seems to be involved in
Tourette’s Syndrome.
Marc Elliott – Tourette’s Tolerance
CAUSES OF ANXIETY DISORDERS FROM
LEARNING PERSPECTIVE (BEHAVIORAL)
1. Fear Conditioning : ex: rape victim may develop
fear of being alone in apartment.
2. Stimulus Generalization: ex: fear of heights leads
to fear of flying even without flying.
3. Reinforcement (ENCOURAGES behavior):
avoiding places you have phobia about rewards you
by lessening your anxiety.
4. Observational Learning/Modeling
ex: monkeys with snakes.
CAUSES OF ANXIETY DISORDERS FROM
BIOLOGICAL PERSPECTIVE
1. Evolution: certain fears help
us survive.
2. Genes: correlations with
identical twins and phobias.
3. Physiology: brain chemistry.
Often see increased brain
activities in brain areas
involving impulse control. Ex:
picture overactive frontal lobe
activity involved in directing
attention.
CAUSES OF ANXIETY DISORDERS FROM
COGNITIVE PERSPECTIVE

An individual interprets (or misinterprets) a
harmless situation as a dangerous or threatening
situation.
Somatoform Disorders:
Various disorders that have no medical cause
They must happen before age 30 – rules out aches and pains
of aging.
Examples:
Conversion Disorder:
A person develops symptoms such as paralysis, numbness or
blindness. Yet, there is no medical reason for the symptoms.
Hypochondriasis:
Preoccupation or worry about having a serious illness
ex. My headache is a sign I have a brain tumor.
Somatization Disorder:
Repeated complaints about vague and unverifiable medical
conditions: dizziness, nausea, conscious awareness of an
irregular heartbeat (too fast, too slow, etc).
CAUSES OF SOMATOFORM DISORDERS
FROM THE PSYCHOANALYTIC
PERSPECTIVE

The disorders are repressed emotions that
get transformed into physical symptoms
CAUSES OF SOMATOFORM DISORDERS
FROM THE BEHAVIORAL PERSPECTIVE

Operant conditioning is responsible because
the patient gets rewarded for his/her
complaints (medicine, attention)
CAUSES OF SOMATOFORM DISORDERS
FROM THE SOCIAL COGNITIVE
PERSPECTIVE

Patients pay too much attention to their
health which results in sensations that are
more easily perceived (patients notice every
little ache or spot on their skin, etc.)
Dissociative Disorders
Dissociation is the feeling that you are outside
of yourself, looking at yourself. That your mind
is separate from your body. A person’s
memories and emotions are somehow
separated from his/her conscious awareness.
This is a controversial disorder. Many experts
do not believe it is real.
Dissociative Amnesia
Selective memory loss of a specific traumatic event
(not a brain injury). The amnesia vanishes as abruptly
as it begins and rarely reoccurs. Ex. A woman who
gives birth to a stillborn baby might not remember that
she was even pregnant.
Dissociative Disorders
Fugue-state
This type of dissociation involves a person who just
leaves one’s home and starts on new life, with no
memory of one’s past life. The memory may reoccur
and the person may return home, only to leave again.
Dissociative Identity Disorder:
This is a disorder wherein your mind partitions itself
into two or more distinct personalities that may or may
not know about each other. One “personality”
emerges to handle stressful situations that the whole
psyche or other parts cannot handle.
Caused by traumatic event or events where the mind
represses parts of itself that can’t handle the pain.
Repressed from a psychoanalytical point of view.
The Debate Over Multiple Personalities (DID)
CAUSES OF DISSOCIATIVE DISORDERS
FROM THE PSYCHOANALYTIC
PERSPECTIVE

Repression of a traumatic event
MOOD DISORDERS
In any given 1-year period, 9.5% of the population, or about
18.8 million American adults, suffer from a depressive illness.
DEPRESSION
A
depressive disorder is an illness that involves the body, mood and thoughts.
It
affects the way a person eats and sleeps, the way one feels about oneself,
and the way one thinks about things.
Nearly
everyone will experience at least some type of mild depression in their
life often due to some external sad event.
A
depressive disorder is not the same as a passing blue mood. It is not a sign
of personal weakness or a condition that can be willed or wished away.
People
with a depressive illness cannot merely "pull themselves together" and
get better. Without treatment, symptoms can last for weeks, months, or years.
Appropriate treatment, however, can help most people who suffer from
depression.
SYMPTOMS OF DEPRESSION
 Persistent sad, anxious, or "empty" mood
 Feelings of hopelessness, pessimism
 Feelings of guilt, worthlessness, helplessness
 Loss of interest in hobbies and activities that were once enjoyed
 Decreased energy, fatigue, being "slowed down”
 Difficulty concentrating, remembering, making decisions
 Insomnia, early-morning awakening, or oversleeping
 Changes in appetite and weight loss or weight gain
 Thoughts of death or suicide; suicide attempts
 Restlessness, irritability
 Persistent physical symptoms that do not respond to treatment, such as
headaches, digestive disorders, and chronic pain
TYPES OF MOOD DISORDERS
Major Depressive Disorder
Combination of symptoms that interfere with the
ability to work, study, sleep, eat, and enjoy
once pleasurable activities.
Such a disabling episode of depression may
occur only once but more commonly occurs
several times in a lifetime.
5 (or more) of the symptoms have been
present during the same 2-week period
Dysthmia
A less severe
type of
Depressed
mood
fordepression,
most of thedysthymia,
day, for
involves
long-term,
symptoms
more days
than not,chronic
as indicated
eitherthat
by do
not disable,account
but keeporone
from functioning
well
subjective
observation
by others,
or
feeling
good. Less
Manysevere
people than
with major
forfrom
at least
2 years.
dysthymia also
experience major depressive
depressive
disorder.
episodes at some time in their lives.
GENDER DIFFERENCES IN RATES OF DEPRESSION

Women experience depression about twice as often as men.

Although men are less likely to suffer from depression than
women, 3 to 4 million men in the United States are affected by the
illness. Men are less likely to admit to depression, and doctors are
less likely to suspect it.

The rate of suicide in men is four times that of women, though
more women attempt it. In fact, after age 70, the rate of men's
suicide rises, reaching a peak after age 85.
GENDER AND DEPRESSION
25
Around the world
women are more
susceptible to
depression
20
Percentage 20
of population
aged 18-84
experiencing 15
major 15
depression
at some 10
point In life
10
5
5
0
0
USA Edmonton Puerto
Rico
Males
Paris
Females
West Florence Beirut
Germany
Taiwan
Korea
New
Zealand
GENDER AND DEPRESSION
10%
Percentage 8
depressed
Females
6
4
2
0
Males
12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+
Age in Years
EXPLAINING DEPRESSION
Psychoanalytic
Social-cognitive
Negative events that occur in adulthood
evoke memories of childhood traumas
OR unresolved anger or sadness in your
unconscious from your childhood are
turned inward.
“attributional theory”
Biological
Norepinephrine
Serotonin
(people suffering from depression tend
to have low levels of both of these
neurotransmitters)
•Genetics
•(if an identical twin suffers from major
depressive disorder or bipolar disorder
the chances that the other twin will
experience symptoms is higher than
those with a fraternal twin who is
suffering)
the depressed person tends to think:
internal
("it's my fault"),
stable
("things can't change")
global
("this affects everything")
Behavioral
Learned helplessness
SYMPTOMS OF BIPOLAR DISORDER
Cycling mood changes: severe highs (mania) and lows (depression)
Mania often affects thinking, judgment, and social behavior in ways that
cause serious problems and embarrassment. Mania, left untreated, may
worsen to a psychotic state.
Symptoms of Mania:
Abnormal or excessive elation
Overactive / overtalkative
Unusual irritability
Decreased need for sleep
Grandiose notions
Increased talking
Racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
SEASONAL AFFECTIVE DISORDER
• regularly occurring symptoms of depression (excessive eating and
sleeping, weight gain) during the fall or winter months
• full remission from depression occur in the spring and summer
months
•
• symptoms have occurred in the past two years, with no nonseasonal
depression episodes
• seasonal episodes substantially outnumber nonseasonal depression
episodes.
• a craving for sugary and/or starchy foods
CAUSE OF SAD?
Melatonin is normally released by the pineal gland in the evening as sunlight is
diminishing. Melatonin causes us to feel tired and withdraw. This helps us to sleep,
but if we have to be awake when melatonin is in our system, we become lethargic,
disoriented, irritable and moody. Almost everyone with a mood disorder suffers
worse in the winter because of excess melatonin in his or her system.
PERSONALITY AND FACTICIOUS DISORDERS
PERSONALITY DISORDERS ARE A DIAGNOSTIC
CATEGORY WHICH DESCRIBES INFLEXIBLE BEHAVIOR
PATTERNS THAT IMPAIR SOCIAL RELATIONSHIPS AND
FUNCTIONING.
Types of Personality Disorders:
Paranoid Personality Disorder
Histrionic Personality Disorder
Borderline Personality Disorder
Narcissistic Personality Disorder
Antisocial Personality Disorder
TYPES OF PERSONALITY DISORDERS:
Paranoid Personality Disorder:
constant and longstanding
mistrust of others; believe
others are out to get you.
(more common in males)
Types of Personality Disorders:
Histrionic Personality
Disorder
characterized by excess and
extreme emotions and
attention seeking behavior.
Always need to be center of
attention, overly dramatic,
and often inappropriately
sexually provocative.
TYPES OF PERSONALITY DISORDERS:
Borderline Personality:
characterized by instability in
relationships and moods.
Tend to have poor self-image
and are very impulsive and
unpredictable. Black and
white thinking.
TYPES OF PERSONALITY DISORDERS:
Narcissistic Personality:
characterized by an exaggerated
sense of self-importance. Often
believes they are overly
“special,” and that they are
entitled to special treatment.
“Don’t you know who I am?”
Very self-absorbed.
5 signs that should alert you to a potential Facebook
narcissist:
Don't worry if this sounds a little bit like you. A
small amount of narcissism is a healthy thing. It
shows you have self-esteem, protects you
against others, and allows you to take care of
yourself.
It's only when the scales tip too far the other
way, when you no longer care about other
people or what they need, that could indicate
that you may have stepped into the narcissist
trap.
5 signs that should alert you to a potential Facebook
narcissist:
1.
They have an astoundingly high number of Facebook friends and wallposts. Just like in
real life narcissists focus on quantity of friends over quality and have many superficial
friendships.
2.
Their profile photo is posed, glamorous and otherwise artificial. A narcissist will use a
glamorous, posed and otherwise artificial picture of themselves while people with a
more healthy sense of self are content with an honest snapshot of what they really
look like.
3.
They have opened profiles on more than one self-promotion site like Facebook,
YouTube and MySpace. A narcissist never gets tired of speaking or writing about
themselves.
4.
They were born after the 1980's. Since the 1980's there has been a wave of overly
empathic parenting. "Instead of teaching children and teens to figure things out,
accept consequences for their actions, and feel any real pain, parents rush in to
rescue, solve and eliminate all struggle for their kids.“
5.
They tend to use their site to put other people down.
TYPES OF PERSONALITY DISORDERS:
Narcissistic Personality Inventory:
Want to check you rate on seven component
traits of narcissism? Go to the following website:
http://psychcentral.com/cgibin/narcissisticquiz.cgi
ANTISOCIAL PERSONALITY DOES NOT MEAN
SHYNESS/NOT GOOD WITH PEOPLE
Anti-Social Personality Disorder:
characterized by a lack of conscience
for wrong-doing toward anyone. Fail to
conform to social norms and laws. Very
deceitful, irresponsible, and dangerous.
Often aggressive or con artists and
fearless. No remorse for wrongdoing.
Murderers like Charles Manson.
BIOLOGICAL LINK TO ANTI-SOCIAL BEHAVIOR?
 PET
scans illustrate reduced activation in a
murderer’s frontal cortex
Normal
Murderer
FACTICIOUS DISORDERS
Facticious Disorders: are conditions in which a
person acts as if he or she has an illness by
deliberately producing, feigning, or exaggerating
symptoms.
Ex. Münchausen syndrome: psychiatric disorder where
one fakes physical or psychological illnesses or diseases
to gain sympathy for themselves. Münchausen syndrome
by proxy: involves inflicting physical symptoms on others
usually a child to gain sympathy.
MISCELLANEOUS DISORDER
Phenylketonuria (PKU): a genetic disorder that
makes metabolizing certain foods (most proteins
for example) impossible.
If undetected or untreated, it can cause mental retardation,
seizures and / or brain damage.
Treatment usually consists of a special diet that a person
must be on for life.
Percentage of Americans Who Have Ever Experienced Psychological Disorders
Ethnicity
Disorder
White
Black
Alcohol abuse
or dependence
13.6%
13.8%
Generalized anxiety
3.4
6.1
Phobia
9.7
Obsessive-compulsive
disorder
Gender
Hispanic
16.7%
Men
Women
Totals
23.8%
4.6%
13.8%
3.7
2.4
5.0
3.8
23.4
12.2
10.4
17.7
14.3
2.6
2.3
1.8
2.0
3.0
2.6
Mood disorder
8.0
6.3
7.8
5.2
10.2
7.8
Schizophrenic
disorder
1.4
2.1
0.8
1.2
1.7
1.5
Antisocial personality
disorder
2.6
2.3
3.4
4.5
0.8
2.6