Abnormal
Psychology
Psychological Disorders
Before we begin…
•
Be careful about joking about
psychological disorders…
 You are not OCD just because you
like your hands clean.
•
People-centered language
 Please be compassionate!
•
Sophomore syndrome (or WebMD
syndrome)
 You are not a psychologist—you
can’t diagnose yourself or others!
What if we
treated other
medical
disorders like
we treat mental
illness?
More Helpful
Advice
What makes a behavior a
disorder?
•
Psychological disorder: persistently harmful thoughts, feelings,
and actions
•
3 D’s: deviant, distressful, dysfunctional
•
Deviant: must depart from “normal” behavior
•
Distressful: must be a problem for the victim/subject and/or those
around him or her
•
Dysfunctional: must interfere with normal life function
 Agoraphobia
 OCD
 Schizophrenia
Understanding psychological
disorders
•
Medical model
 What role does biology play?
 Brain formation, parts of the brain, neurotransmitters
 Mental health: a mental illness needs to be diagnosed on the basis of its
symptoms and cured through therapy, which may include treatment in a
psychiatric hospital
•
Biopsychosocial approach
 Today’s psychologists: all behavior, normal or disordered, arises from the
interaction of nature and nurture
 Takes into account more than brain biology
 Ex: anorexia nervosa and bulimia, susto, Taijin-kyofusho (same underlying
cause, different manifestations)
Classifying psychological
disorders
•
Diagnostic and Statistical Manual
of Mental Disorders, currently in
its 5th printing
•
Axis 1: Clinical Syndrome?
•
Axis 2: Personality Disorder or
Mental Retardation?
•
Axis 3: General Medical
Condition?
•
Axis 4: Psychosocial or
Environmental Problems?
•
Axis 5: Global Assessment
Labeling psychological disorders
•
Caution is needed; we see what we
want to see!
•
Dangers of “labeling”
•
Bias can change our perceptions
and our treatment
Anxiety Disorders
•
Generalized Anxiety Disorder
•
Panic Disorder
•
Phobias
•
Obsessive-Compulsive Disorder
•
Post-Traumatic Stress Disorder
Generalized Anxiety Disorder
•
Pervasive, dysfunctional, near-constant worry which is most often
more intense than the situation warrants
•
Sufferers can’t relax, startle easily, and have trouble concentrating
•
Accompanied by fatigue, headaches, muscle tension, muscle aches,
difficulty swallowing, trembling, twitching, irritability, sweating,
nausea, lightheadedness, having to go to the bathroom frequently,
feeling out of breath, and hot flashes
•
Affects 3.1% of the population; average onset at 31 years old; affects
twice as many women as men; genetic component (runs in families)
Panic Disorder
•
Characterized by sudden, frequent panic attacks with no definable
cause
•
Panic attack: difficulty breathing, pounding heart or chest pain,
intense feeling of dread, sensation of choking or smothering,
dizziness or feeling faint, trembling or shaking, sweating, nausea or
stomachache, tingling or numbness in the fingers and toes, chills or
hot flashes, a fear that you are losing control
•
Can be caused by family history, abnormalities in the brain,
substance abuse or major life stress
Obsessive-Compulsive Disorder
•
A disorder characterized by obsessions (thoughts that can’t be
controlled) and compulsions (behaviors that can’t be controlled).
Both must be present in order for it to be obsessive-compulsive
disorder.
•
Caused by both biology and environment
•
Family history and stressful life events are both risk factors
Post-Traumatic Stress Disorder
•
A mental health condition
triggered by a terrifying event,
whether experiencing it or
witnessing it
•
Many people who go through
trauma have difficulty adjusting
and coping for a while, but
eventually get better. If
symptoms get worse or last for
months or years, you may have
PTSD.
•
Symptoms: Intrusive memories,
avoidance, negative changes in
thinking, changes in emotional
reactions
•
Coping techniques:







Differential focus on the good
Survival for some purpose
Psychological distancing
Mastery
Will to live
Hope
Social support
Phobias
•
Top 10 Fears:










Fear of snakes
Fear of being buried alive
Fear of heights
Fear of being bound or tied up
Fear of drowning
Fear of public speaking
Fear of hell
Fear of cancer
Fear of tornadoes and hurricanes
Fear of fire
•
Over 700 specific fears listed;
likely thousands more
Mood Disorders
•
Major Depressive Disorder (lethargy, feelings of worthlessness, loss
of interest in family, friends, or activities for more than two weeks)
 Dysthymic disorder (a down-in-the-dumps mood that fills most of the day,
nearly every day, for two years or more)
•
Bipolar Disorder (alternation between mania and depression)
Facts about depression
•
Widespread--Called “the common cold” of abnormal psychology, but
that doesn’t mean it’s not devastating.
•
Behavioral and cognitive changes accompany depression, including
self-sabotage, sensitivity, lack of motivation, anxiety, substance
abuse.
•
Women are twice as likely to suffer (or are they…?).
•
Most major depressive episodes self-terminate.
•
Stressful events often precede an episode.
•
With each generation, the rate of depression is increasing, and the
disorder is striking earlier.
Depression: Cognitive Errors
•
Sadder-but-wiser effect
 Also known as “depressive realism”
 Study by Alloy and Abrahamson
 Being realistic isn’t the same as
being adaptive
•
Cognitive Errors
 Cognitive triad: interpreting facts
in a negative way, focus on the
negative aspects of any situation,
and has pessimistic expectations of
the future
•
College student effect
 College students are at a much
higher risk for depression due to
drastic life changes; those who go in
with both realistic expectations and
optimism succeed most
Why?
 Biological perspective
 Depressed brain
 Lack of norepinephrine and
serotonin
 Less good Omega-3 fatty acids in
diet
 Left frontal lobe (positive
emotions) inactive
 Hippocampus vulnerable to stressrelated damage
 Genetic influences
 Twin studies
 Gene studies now under way
•
Social-Cognitive Perspective
 Negative thoughts and negative
moods interact
 Learned helplessness
 Vicious Cycle
Statistics about Suicide
•
Suicide takes the lives of nearly 40,000 Americans every year.
Many who attempt suicide never seek professional care.
There are twice as many deaths due to suicide than HIV/AIDS.
Between 1952 and 1995, suicide in young adults nearly tripled.
Over half of all suicides occur in adult men, ages 25-65.
In the month prior to their suicide, 75% of elderly persons had visited a physician.
Suicide rates in the United States are highest in the spring.
Over half of all suicides are completed with a firearm.
For young people 15-24 years old, suicide is the second leading cause of death.
Suicide rates among the elderly are highest for those who are divorced or widowed.
80% of people that seek treatment for depression are treated successfully.
15% of those who are clinically depressed die by suicide.
There are an estimated 8 to 25 attempted suicides to 1 completion.
Statistics about Suicide
•
The highest suicide rate is among men over 85 years old: 65 per 100,000 persons.
1 in 65,000 children ages 10 to 14 die by suicide each year.
Substance abuse is a risk factor for suicide.
The strongest risk factor for suicide is depression.
In 2011, 39,518 people died by suicide. (CDC)
Suicide is the 10th leading cause of death in the U.S. (homicide is 16th). (CDC)
It is estimated that there are at least 4.5 million survivors in this country. (AAS)
An average of one person dies by suicide every 13.3 minutes. (CDC, AAS)
There are four male suicides for every female suicide. (CDC, AAS)
Research has shown medications and therapy to be effective suicide prevention.
Suicide can be prevented through education and public awareness.
Bipolar Disorder
•
Symptoms: regular cycling
episodes of depression and mania
•
Mania: Mood is euphoric,
expansive, and elevated, often
accompanied by irritability and
frustration; Grandiose cognition;
Motivational symptoms, including
tendency towards gambling,
reckless driving, or poor
investments; Physical symptoms
like lessened need for sleep
•
“When I start going into a high, I
no longer feel like an ordinary
housewife. Instead, I feel
organized and accomplished, and I
begin to feel my most creative self.
I can write poetry easily. I can
compose melodies without effort.
I can paint…I feel pleasure, a
sense of euphoria or elation. I
want it to last forever. I don’t
seem to need much sleep. I’ve lost
weight and I feel healthy, and I
like myself. I’ve just bought six
new dresses, in fact, and they look
quite good on me. I feel sexy and
men stare at me. Maybe I’ll have
an affair or perhaps several.”
Somatoform Disorders
•
Somatization Disorder or Conversion Disorder (long history of
medical problems, usually unexplained, that start before age 30; can
include pain, neurologic problems, gastrointestinal complaints,
sexual symptoms)
•
Hypochondriasis (preoccupied with concern that they have a serious
disease)
•
Body dysmorphic disorder (obsessed with and exaggerate a physical
flaw, or a preoccupation with changing the body through weight loss
or gain, tattoos, piercings, or surgery)
•
Factitious Disorder (Munchausen syndrome)
Dissociative Disorders
•
Schizophrenia (means “split mind”)
•
Dissociative Identity Disorder (multiple personality)
Schizophrenia
•
Positive symptoms: means that symptoms are ADDED to person’s
“normal” behavior—hallucinations (auditory, visual), disturbed
perceptions, motor behaviors, etc.
•
Negative symptoms: means that normal behaviors may be
ABSENT or REMOVED—lack of emotion (flat affect), inappropriate
emotions, catatonia, social isolation, etc.
5 Truths About Schizophrenia
•
It’s NOT Multiple Personality Disorder
•
Voices don’t make you do terrible things
•
You can’t necessarily tell who has it
•
The medication is an illness of its own (nervous tics, manic energy,
sensitivity to the sun, agonizing muscle cramps…)
•
Symptoms vary widely, and what people believe about schizophrenia
impacts you more than the disorder
Types of Schizophrenia
•
Paranoid (preoccupation with
delusions or hallucinations, often
with themes of persecution or
grandiosity)
•
Disorganized (disorganized speech
or behavior, or flat or inappropriate
emotion)
•
Catatonic (immobility or excessive,
purposeless movement)
•
Undifferentiated (many, varied
symptoms)
•
Residual (withdrawal after
hallucinations and delusions have
disappeared)
•
“This morning, when I was at
Hillside Hospital, I was making a
movie. I was surrounded by movie
stars…I’m Mary Poppins. Is this
room painted blue to get me
upset? My grandmother died four
weeks after my eighteenth
birthday.”
Why?
Biological
•
Brain abnormalities
 Low brain activity in frontal lobes
 Fluid-filled areas, shrinkage of cerebral
tissue
•
Dopamine overactivity
•
Maternal virus during midpregnancy
•
Genetic factors (1-in-100 odds become
1-in-10 if parent or sibling has
schizophrenia)
Psychological
•
Risk factors:
 A mother whose schizophrenia is severe
and long-lasting
 Birth complications, often involving
oxygen deprivation and low birth weight
 Separation from parents
 Short attention span and poor muscle
coordination
 Disruptive or withdrawn behavior
 Emotional unpredictability
 Poor peer relations and social play
Dissociative Identity Disorder
•
The presence of two or more distinct or split identities that
continually have power over person’s behavior
•
Thought to stem from trauma
•
Some debate among mental health professionals that it even exists
Symptoms
•
Depression
•
Mood swings
•
Suicidal tendencies
•
Sleep disorders
•
Anxiety, panic attacks, phobias
•
Alcohol and drug use
•
Compulsions and rituals
•
Psychotic-like symptoms (hallucinations
•
Eating disorders
Personality Disorders
•
Antisocial Personality Disorder (also called sociopathy; complete lack
of regard for others’ feelings or for social rules)
•
Narcissistic Personality Disorder (obsessed with self and others’
impressions; desperate insecurity)
•
Borderline Personality Disorder (“I hate you, don’t leave me.”;
unstable sense of self, unstable relationships, inappropriate anger
and emotions)
•
Histrionic Personality Disorder (attention-seeking behaviors and
extreme emotionality)
Therapy
Psychotherapy
 Treatment used by therapists to help troubled people
overcome their problems



Verbal interaction between therapist and client
Development of a supportive and trusting relationship
Analysis by the therapist of the client’s problems
 Help people understand and take ownership in solving
problems
 Can take on many forms
Therapy
Group Therapy
Cognitive-Behavioral Therapy
 Patients work together with
 Substituting healthy
the aid of a leader
 Helps patients see how
other people are struggling
with similar problems
 One therapist can help a
large number at a reduced
cost
thoughts for negative ones
 Changing disruptive
behaviors for healthy ones