Abnormal Psychology PSY 120 Prof. South 11/21/08
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Transcript of Abnormal Psychology PSY 120 Prof. South 11/21/08
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Abnormal Psychology
PSY 120Prof. South
11/21/08
1. What is abnormal?
2. Categories and Causes
3. Mood Disorders
4. Anxiety Disorders
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Social Cognitive Theory
Approach to personality that suggests it is human human experiencesexperiences
and interpretationsinterpretations of these experiences, that determine growth and development of personality
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Social-Cognitive Perspective
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Culture
Kind of culture you Kind of culture you are from will greatly are from will greatly affect your affect your personalitypersonality
different cultures value different things
If you have what the culture values, life will be less stressful
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Defining Abnormal Behavior
A clinically significant behavioral or psychological syndrome with:
1. Present distress
2. Disability
3. An increased risk of suffering pain, death, disability, or loss of freedom
DSM-IV-TR200+ diagnostic categories18 primary headings
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Not included
1. Expected & culturally sanctioned response
2. Deviant behavior
3. Conflicts between individual & society
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Difficulties in Diagnosis
• Is this person’s behavior abnormal?
– Example: A woman does not like to throw away plastic bags and religiously cleans them and stores them away. She has hundreds of plastic bags but rarely uses them. She gets very angry if anyone suggests she should get rid of them.
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Difficulties in Diagnosis
• If a relative or friend:
– No.
• If a stranger:
– Yes.
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“Uncle George’s Pancakes Fallacy” (Meehl, 1973)
• People tend to compare the patient’s behavior to that of a friend or relative (e.g., good ole Uncle George)
– The assumption is: your friend or relative is not mentally ill (because you couldn’t have any crazy friends or relatives…)
– Proper conclusion is that your friend or relative also evidences abnormal behaviors
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The Five DSM-IV Axes
Axis I Most major disorders
Axis II Stable, enduring problems; personality disorders
Axis III Medical conditions
Axis IV Psychosocial problems/stressors
Axis V Global clinician rating of adaptive functioning
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Axis I• Mood Disorders• Anxiety Disorders• Substance-Related Disorders• Schizophrenia and Other Psychotic Disorders• Eating Disorders• Somatoform Disorders• Dissociative Disorders• Sexual and Gender Identity Disorders• Sleep Disorders• Impulsive-Control Disorders• Adjustment Disorders• Factitious Disorders• Delirium, Dementia, and Amnestic and other Cognitive Disorders
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Axis II
• Disorders usually first diagnosed in infancy, childhood, or adolescence
• Personality Disorders
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Current System of Classification• Disorders grouped together under broader categories
– E.g. Mood Disorders• Depressive Disorders
– Depressive Disorder– Dysthymic Disorder– Depressive Disorder NOS
• Bipolar Disorders– Bipolar I– Bipolar II– Cyclothymic Disorder– Bipolar Disorder NOs
• To qualify for a diagnosis, meet certain number of criteria for each disorder• Thus, a “categorical” system of diagnosis• Is this the best way?
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Major Depression1 or more Major
Depressive Episodes
SymptomsBehavior
Affective
Cognitive
Physiological
Anhedonia
Episodic Course
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Major Depressive Episode(5 or more for 2 weeks)
#1. depressed mood most of day (sad, empty)
#2 loss of interest or pleasure
#3 weight
#4 sleep
#5 body
#6 fatigue
#7 worthless/ guilt
#8 thinking
#9 recurrent thoughts of death, suicide
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Bipolar I Disorder
Bipolar II• Alternates between depressive episodes
and hypomanic episodes
• Alternates between full manic episodes and depressive episodes
• Average age of onset is 18 years, but can begin in childhood
• Tends to be chronic
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Elevated, expansive, or irritable mood (>1 Elevated, expansive, or irritable mood (>1 week), plus 3 or more of:week), plus 3 or more of:
Grandiosity/inflated self-esteemGrandiosity/inflated self-esteem
Decreased need for sleepDecreased need for sleep
Pressured speech Pressured speech
Flight of ideasFlight of ideas
Easily distracted to irrelevant stimuliEasily distracted to irrelevant stimuli
Increase in goal-directed activityIncrease in goal-directed activity
Excessive involvement in activities with potential Excessive involvement in activities with potential for harmful consequencefor harmful consequence
Manic EpisodeManic Episode
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Mood Disorders Among Twins
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Causes of Mood Disorders
Biological
Stress
Learned Helplessness
Social and Cultural
Cognitive Theory
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Beck’s Cognitive Triad for Depression
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An Integrative Model of Mood Disorders
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Anxiety Disorders
• Panic Disorder
• Agoraphobia
• Specific Phobia
• Social Phobia
• Obsessive-Compulsive Disorder
• Post-traumatic Stress Disorder
• Acute Stress Disorder
• Generalized Anxiety Disorder
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Difference between “Normal & Abnormal” Anxiety
Normal
–Everyone experiences anxiety from time to time
–Often important to have low to moderate levels of anxiety for optimal performance
–A little anxiety motivates you to “go the extra mile
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Abnormal– intense
anxiety where there is no danger
–Overwhelmed with anxiety is not adaptive
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Generalized Anxiety Disorder
Defining Features– Excessive uncontrollable worry about life events– Strong, persistent anxiety – Somatic symptoms – Persists for 6 months or more
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Panic DisordersEpisode in which intense anxiety &
physiological symptoms are suddenly experienced… recurrent, unpredictable
Panic attack symptoms include:
–Shortness of breath–Chest pain & discomfort– heart palpitations–Feeling of choking–Numbness or tingling–Chills or hot flushes–Sweating –Shaking
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PanicMisappraisal of what’s happening
–Catastrophic conclusion
•I feel flush, fast heart beat.. I must be having a heart attack vs. I am a little over excited today
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Defining Features– Extreme and irrational fear of specific
object/situation– Interferes with one's ability to function– Recognize fears are unreasonable, but avoids
phobic objects
Specific Phobias
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Social Phobia
Defining Features
– Fear of being scrutinized by others
– Interferes with functioning
– Avoids social situations
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Obsessive-Compulsive Disorder• Recurrent obsessions and/or compulsions that are
severe enough to be time consuming or cause marked distress and/or significant impairment.
• At some point, person has recognized that the obsessions or compulsions are excessive or unreasonable.
• Common: cleaning or checking rituals
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Obsessions
#1 Violence is MOST common theme
#2 Contamination, 2nd common theme
– shaking hands – touching a public door
knob– or toilet
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Compulsions
• Most common manifestations:
• Hand washing (cleaning)• Checking behavior
• Counters & Perfectionists
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Post Traumatic Stress Disorder• WW II military gave greater recognition to the
condition they termed "shell shock“ (PTSD)• PTSD follows a
traumatic event• Symptoms:
Re-experiencing
Avoidance
Arousal
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Summary of Anxiety Disorders
One of the largest domains of psychopathology
From normal to disordered – Multiple factors– Fear & anxiety persist to non-
dangerous cues– Significant distress
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Addictive Disorders: one of country’s major mental and
health problem
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Substance Use Disorders
• Abuse– Interference with ability to fulfill major role
obligations and/or legal difficulties associated with use
• Dependence– Pattern of use that results in tolerance,
withdrawal, and compulsive drug-taking behavior
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Types of psychoactive substances
• Alcohol• Amphetamines• Caffeine• Marijuana/hashish• Cocaine• Hallucinogens• Inhalants• Nicotine• Opiates• Phencyclidine• Sedatives, hypnotics, anxiolytics
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midbrain: nucleus accumbens
All drugs which All drugs which people become people become dependent upon act dependent upon act on theon the
“ “pleasure pathways”pleasure pathways”
internal reward internal reward centers, made up of centers, made up of dopamine-sensitive dopamine-sensitive neuronsneurons
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Ethnic DifferencesRates of alcoholism among Rates of alcoholism among Asian populations are lower Asian populations are lower than among European than among European peoplepeople
This fact may be related to a This fact may be related to a mutant enzyme that leads to mutant enzyme that leads to hypersensitive reactions to hypersensitive reactions to alcohol in Asiansalcohol in Asians
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Mental health resources
• Center for Counseling and Psychological Services (CAPS) – 494-6995. Offices at PUSH and in Psychological Sciences Building.
• Urgent care after hours at PUSH 494-1724.• Crisis Center 742-0244• Mental Health American of Tippecanoe County 742-1800,
http://www.mhalafayette.org/• NAMI West Central Indiana 423-6939, http://www.nami-wci.org/