Abnormal Psychology A.K.A. Psychological Disorders A “harmful dysfunction” in which behavior is judged to be atypical, disturbing, maladaptive and unjustifiable.

Early Theories Abnormal behavior was evil spirits trying to get out. Trephining was often used.

Conditions for Psychologically Disabled Dorothea Dix CIVIL WAR

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. Mental Disorders have Biological causes They can be treated with Medicine 1955: First antipsychotic drug – culorpromaziva Drop in institutionalization

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.

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) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Sociocultural (Roles, expectations, definition of normality and disorder) LSD  Schizophrenia

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 Distressful for others Distressful For Self Gets in the way of functioning Without reason

DSM IV-V Diagnostic Statistical Manual of Mental Disorders: the big book of disorders. DSM will classify disorders and describe the symptoms. DSM will NOT explain the causes or possible cures. Different perspectives give different reasons

Perspectives and Disorders Psychological School/PerspectiveCause of the Disorder Psychoanalytic/PsychodynamicInternal, unconscious drives HumanisticFailure to strive to one’s potential or being out of touch with one’s feelings BehavioralReinforcement history, the environment CognitiveIrrational, dysfunctional thoughts or ways of thinking, observation SocioculturalDysfunctional Society Biomedical/Neuroscience/ Behavioral Neuroscience Organic problems, biochemical imbalances, genetic predispositions BiopsychosocialProblems stem from an interaction between biology, your environment, & your thinking/unconscious

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.

Two Major Classifications in the DSM Neurotic Disorders Distressing but one can still function in society and act rationally. Anxiety, Depressions, OCD Psychotic Disorders Person loses contact with reality, experiences distorted perceptions Schizophrenia, Bipolar, Multiple Personality Disorder John Wayne Gacy

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 Describe Rosenhan’s study: Faked symptoms of having voices in their head, admitted and acted 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? Self-fulfilling Prophecy  Top-down Processing, Expectations, Perceptual Set When someone is diagnosed with a mental illness, we tend to view their behavior as a product of mental illness

Become Psychotic Activity Discussion Multiple Causation (biopsychosocial) Interaction of factors

KNOW WHAT CATEGORY ANY DISORDER FITS INTO Categories of Disorder: 1.Anxiety & OCD 2. Somatoform 5.Dissociative 6.Mood Disorders 7.Personality 8. Schizophrenia 9.Facticious (Not in Book)

1. Anxiety Disorders a group of conditions where the primary symptoms are anxiety or defenses against anxiety. the patient fears something awful will happen to them. They are in a state of intense apprehension, uneasiness, uncertainty, or fear.

Phobias (Specific & Social) A person experiences sudden episodes of intense dread. Must be an irrational fear. Phobia List Specific (heights, snakes) Social (Public speaking, eating in public)

Anxiety Disorders Phobias:

Panic Disorder An anxiety disorder marked by a minutes- long episode of intense dread in which a person experiences terror and accompanying chest pain, choking and other frightening sensations.

Agoraphobia An intense fear of public places, being due to their vastness or crowdedness Generally involves the fear of having a panic attack and not being able to escape Fear of having a panic attack in public & not being able to get away

Generalized Anxiety Disorder An anxiety disorder in which a person is continuously tense, apprehensive and in a state of autonomic nervous system arousal. The patient is constantly worried, feels inadequate, is oversensitive, can’t concentrate and suffers from insomnia. No particular cause (Sympathetic activation)

Obsessive-Compulsive Disorder Persistent unwanted thoughts (obsessions) cause someone to feel the need (compulsion) to engage in a particular action. Obsession about dirt and germs may lead to compulsive hand washing. How would Skinner explain OCD? Behavior relieves the anxiety caused by the thought (obsession) B.F. Skinner thinks  Negative Reinforcement

Post-Traumatic Stress Disorder a.k.a. PTSD (Trauma-related disorder) Flashbacks or nightmares following a person’s involvement in or observation of an extremely stressful event. Memories of the event cause anxiety.

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; compulsions are negatively reinforced because they REMOVE the anxiety of the obsession 4. Observational Learning/Modeling ex: monkeys with snakes; possibly me with frogs

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 & OCD from Cognitive Perspective An individual interprets (or misinterprets) a harmless situation as a dangerous or threatening situation.

Motor Disorders (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.