ABNORMAL PSYCHOLOGY

Studying disorders of the brain that disrupt feelings, thinking, mood, ability to relate to others and behavior

Bio psychosocial Model

Judgments of abnormality are relative, but psychological disorders clearly exist and need to be classified, explained and treated….

• Diagnostic and Statistical Manuel of Mental Disorders (DSM-5)

• Insanity= legal term • Controversial!!!!• Changes made reflect current syndromes (Internet addiction) and “roads” to medical insurance

There is a difference between a statistical abnormality and something considered abnormal ….

• Think: An IQ of 145 is statistically abnormal but isn’t considered “abnormal” or undesirable.

• Social nonconformity (failure to conform to social norms) is considered abnormal only if unhealthy

The “other” criteria…• The behavior is disturbing to others• The behavior violates cultural standards• The behavior is disturbing to the individual• The behavior is irrational or indefensible• The behavior is maladaptive (with underlying

psychological or biological dysfunction that makes it difficult to adapt to the environment)

BE CAUTIOUS WITH LABELS….LABELS HURT PEOPLE

Do these “labels” cause more harm then good?

David Rosenhan study.

Anxiety• Anxiety is the body’s reaction to stress• Anxiety is universal=partly genetic (60% of children born to parents suffering panic disorder will also have panic)

• Flight-Fight-Fear-Faint• Each person responds to anxiety differently• All ages • Symptoms: Some we feel, some we cannot feel, some are chronic

• Multiple treatments available- Cultural differences in symptoms and treatments

Phobia= Intense, irrational fear that interferes with everyday activities.• Fear can be of objects or events• Can have fear of fear (panic)• Most common phobia= Social Phobia (13% in lifetime, 8% within past year)

• Early childhood fears frequently disappear without treatment. (study of 482 children; 40% have 7+ fears)

• Phobias in children that continue until adulthood rarely disappear without treatment

Agoraphobia= Fear of open spacesGreek translation= fear of the marketplace

Cause is unknownTypically begins after a

stressful experience or change

Begins with panic attack that is not associated with the earlier stressful event

Increases in panicLose freedom to move

around- some become isolated

Phobia

CausesGenesClassical conditioning

Overactive Limbic system

Misinterpretation of body signals

TreatmentDesensitization Therapy/Counter conditioning

Anxiety medication

Over exposure

Panic=Intense anxiety NOT activated by an even or object

• Attack comes on suddenly• Attack reaches peak within minutes (lingering effects can

last several hours)• Unpredictable (some exceptions) • Symptoms: racing heart, chest pain, sweating, dizzy, feeling

of unreality, fear of loosing control, tingling, feeling of dying, feel they are loosing mind, oxygen drowning)

• Onset: 25% of population will experience at least one panic attack. Typical onset is mid-late teens, early 20’s.

• Effects more women than men (2x)• 3% of US population has panic diagnosis. (1.2% severe)• Approximately 20% of people with panic will experience

depression during lifetime.

Panic

Causes• Genetic Influence

(increases with immediate family member)

• Learned-Cognitive & Behavioral

Treatment

Chemical• benzodiazepine (short vs.

long term)• SSRI

Cognitive/Behavior • Talk therapy(change

thinking) with desensitization techniques. (high success rate)

• Acceptance based therapy

Obsessive-Compulsive Disorder/OCD= Unwanted, repetitive thoughts, ideas, images (obsessions) that cannot be prevented without engaging in specific behaviors (compulsions)

Compulsions= in the beginning they reduce anxiety- stop working

Common Behaviors Need to touch, tap, rub,

count, check, clean Mental rituals Superstitious behavior Excessive list making Trichotillomania Hoarding/collecting

Obsessions= Come from what you care about- cause anxiety

Common Thoughts Germs Dirt Something undone Violence Religion Health May not know where the

anxious thoughts come from

Who has OCD?Many/most have some symptoms of OCD (1-3% lifetime)

2-3% (1 in 50) are diagnosed with OCDRatio boys/girls about the sameTypically begins in adolescent/young adultsTypically begins after a very stressful eventY-BOCS Checklist (over 16) used for diagnosis

OCD

Causes

• Brain dysfunction: cingulate gyrus, basil ganglia, thalamus (create trouble regulating impulse control)

• Reduced serotonin • PANDAS (age 3-puberty)• Classical Conditioning• Genes (none identified-

strong family relationship)

Treatment

Treatment

•SSRI (anti-depressant/anxiety)•Cognitive Behavior Therapy•Psycho Surgery

Post Traumatic Stress Disorder (PTSD) Persistent re-experience of a traumatic event(s) in thoughts/dreams- Natural or unnatural events

Difficulty sleepingOutburst of angerIrritabilityDifficulty concentratingDepressionRecurring nightmaresIntrusive thoughtsAlcohol/drug abuse

Not all persons that experience trauma develop PTSD- Why?

Social Support (Vietnam vs Sept. 11th)Coping strategiesSome personality characteristics increase likelihood- such as passive, sensitive

Treatment

•SSRI (anti-depressant/anti anxiety)•Cognitive-Behavior Therapy (based on the idea that anxiety comes from a misinterpretation of bodily sensations AND the person has not found healthy ways of coping to stresses in life)

•Eye Movement Desensitization Therapy

Dissociative Disorders...Controversial/Rare

Dissociative Identify Disorder (formerly multiple personality disorder)

Dissociative Amnesia

Dissociative fugue

Disorders of identify or sense of self. Involve memory loss and trauma

Somatoform Disorders

Conversion disorder

Hypochondriasis

Physical symptoms without apparent physical cause