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Abnormal Psychology


Abnormal Psychology Body dysmorphic disorder BDD is thought to be a subtype of obsessive-compulsive disorder. It is not a variant of anorexia nervosa or bulimia ... – PowerPoint PPT presentation

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Title: Abnormal Psychology

Abnormal Psychology
  • Major criteria for diagnosing psychological
  • - 1. Deviance-behavior that is not considered
    to be in the norm
  • - 2. Maladaptive behavior-behavior that
    interferes with a persons social or occupational
  • - 3. Personal distress-how much distress it
    causes the individual

  • 4. Irrational that is, does it make sense
    under the circumstances taking place?
  • 5. Disturbing troublesome to others should
    be troublesome to more than just one or two
  • Brigitte and Flava Flav

Mental Disorders
  • Alcohol abuse and dependence is the most widely
    reported disorder with men at 23.8 and women
    at 4.6
  • Mood Disorders are next men at 5.2 and women
    at 10.2
  • Schizophrenia men 1.2 and women 1.7

  • Youth and Mental Illness
  • - U.S. adolescents appear to be at high risk for
    mental illness
  • - Schizophrenia tends to manifest itself in
    adolescence or early adulthood
  • - U.S. adolescents are the only group in which
    there continues to be an increase in the death
    rate, from accidents, suicide and homicide

Warning Signs of trouble
  • - marked drop in school performance or
    increase in absenteeism
  • - excessive use of alcohol and/or drugs
  • - marked changes in sleeping and/or eating
  • - many physical complaints (headaches, stomach
  • - aggressive or non-aggressive violations of the
    rights of others

  • - withdrawal from friends, family and regular
  • - depression demonstrated by continued,
    prolonged negative mood and often accompanied by
  • - appetite and/or difficulty sleeping
  • - frequent outbursts of anger or rage
  • - low energy level, poor concentration,
    complaints of boredom
  • - loss of enjoyment in what used to be favorite
  • - unusual neglect of personal appearance

Abnormal behavior
  • Diagnostic and Statistical Manual
  • Guide for diagnosing disorders

5 Axes to DSM-IV-TR
  • Axis I Clinical Syndromes
  • Axis II Developmental Disorders and Personality
  • Axis III Medical Conditions Physical
  • Axis IV Psychosocial Stressors
  • Axis V GAF Score (Global Assessment of

Anxiety Disorders
  • Generalized Anxiety Disorder
  • - marked by a chronic, high level of anxiety
    that is not due to anything specific. Age of
    onset may be between 10 and 14 years of age.
  • - Causes-No specific threat, symptoms must be
    present for at least 6 months
  • - Symptoms-Restlessness or feelings of being
    keyed up or on edge, being easily fatigued,
    difficulty concentrating, irritability, muscle
    tension, sleep disturbance
  • - Treatments-Benzodiazepines (Valium and
    Ativan), Antidepressants, Psychotherapy

Phobic Disorder
  • marked by a persistent and irrational fear of
    things that dont really pose a threat. Age of
    onset often between 7 and 9 years of age
  • - Causes-may run in families and be present in
    females more often, usually a classically
    conditioned response

Phobias contd
  • Symptoms-marked and persistent fear that is
    excessive or unreasonable, intentional avoidance
    of object or situation
  • - Treatment-Antianxiety drugs (e.g., Valium),
    Antidepressants, Behavior therapy (systematic
    desensitization or flooding)

Obsessive-Compulsive Disorder
  • An unusual disorder of ritual and doubt.
  • Obsessions are persistent and intrusive thoughts,
    images, ideas or impulses.
  • Compulsions are repetitive, purposeful behaviors
    that are performed in response to an obsession.
  • They understand that their actions are
    unreasonable, but cannot stop themselves. Age of
    onset is usually between 9 and 12 years of age.

  • - Symptoms-
  • Obsessions recurrent and persistent thoughts,
    excessive worry about real-life problems,
    impulses which may be deemed inappropriate.
  • Compulsions repetitive behaviors or mental
    acts that a person feels driven to perform as a
    result of the obsession, behaviors done to reduce
    distress. Marked distress, time consuming or
    significantly interferes with a persons normal

  • Causes-
  • may be genetic
  • may be due to neurotransmitter activity
  • some have the onset of this disorder after having
    strep throat (which may alter the functioning of
    the basil ganglia)

  • - Treatments-
  • Behavior therapy (systematic des., flooding,
    thought stopping)
  • Antidepressants (today, Luvox is commonly used,
    also may use Prozac or Zoloft)

Panic Disorder
  • characterized by sudden and unexpected attacks
    of anxiety. Age of onset usually between 15 and
  • - Causes-defects in the brain (specifically the
    brain stem, limbic system and frontal cortex)
  • - Symptoms-heart palpitations, sweating,
    trembling, feeling of choking, shortness of
    breath, fear of dying, chest pain or discomfort,
    feeling dizzy.
  • - Treatments-
  • Antidepressants
  • Antianxiety drugs (e.g., Xanax, Ativan)
  • Cognitive-Behavioral treatments

Post-Traumatic Stress Disorder (PTSD)
  • - display of persistent anxiety following an
    overwhelming traumatic event
  • - Causes-traumatic event that is not a usual
    event in the normal human experience
  • - Symptoms-traumatic event is persistently
    reexperienced, may have images or thoughts of the
    event, recurrent distressing dreams of the event,
    reliving the event, insomnia, exaggerated startle
  • - Treatments-Behavior therapy (systematic des.,
    flooding), Cognitive-Behavioral therapy

Somatoform Disorders
  • Disorders in which the person may feel physical
    pain or problems but there is no physiological
    basis for them, they are psychological in nature.

Types of Somatoform Disorders
  • Somatization Disorder When the person
    experiences a wide variety of physical problems
    that are due to psychological problems.
  • Conversion Disorder When the person experiences
    a loss of physical functioning in a body part
    with no physical reason for this to happen. May
    effect, vision, hearing, use of limbs.
  • Hypochondriasis When the person is excessively
    worried about their health, worry about
    developing illnesses and often manufacture the
    symptoms of various illnesses in their head.

Causes and Treatments
  • Causes of these disorders May be due to
    increased sensitivity of autonomic nervous
    system, while others feel it is a personality or
    cognitive defect. People who are histrionic,
    that is, self-centered, suggestible, excitable,
    and highly emotional may be more susceptible.
  • Treatment Psychoanalysis or cognitive therapy
    may be helpful.

Dissociative Disorders
  • When a person experiences bouts of memory
    loss, due to loss of consciousness and have
    disruptions in their sense of identity.
  • Dissociative Amnesia A sudden loss of memory
    for important personal information that is too
    severe to be considered normal. May occur for
    one traumatic event or period of time.
  • Dissociative Fugue When a person loses their
    memory for their entire life along with who they
    are and what their identity is. May forget name,
    family, where they live, etc.

  • Dissociative Identity Disorder When there is
    the existence of two or more personalities
    coexisting in the same body (used to be called
    Multiple Personality Disorder). The host
    personality is supposedly unaware of any other
    personalities, however, some have reported that
    one or more of the other personalities may be
    aware of what is happening.
  • Causes It is thought that the cause of
    Dissociative Identity Disorder is some type of
    repeated, chronic psychological trauma during
    childhood. Dissociative amnesia or fugue may be
    brought on by excessive stress.
  • Treatment Psychoanalysis is usually a treatment

Personality Disorders
  • 1. Shizoid Personality Disorder
  • odd eccentric behavior, tend to be loners, may
    be perceived to be cold and unfeeling, trouble
    keeping jobs and maintaining relationships, show
    very little emotion

  • 2. Paranoid Personality Disorder
  • - suspicious and mistrustful of others, refuse
    to accept criticism or blame, may be cautious,
    scheming, devious, or argumentative
  • 3. Schizotypal Personality Disorder
  • - suspicious, shows signs of paranoia, aloof and
    impersonal, shows signs of magical thinking,
    unusual perceptual thinking

4. Antisocial personality disorders
  • failure to conform to social norms with respect
    to lawful behaviors deceitfulness, as indicated
    by repeated lying
  • impulsivity
  • irritability and aggressiveness
  • reckless disregard for safety of self or others
  • consistent irresponsibility
  • lack of remorse

5. Borderline personality disorder
  • frantic efforts to avoid real or imagined
  • a pattern of unstable and intense interpersonal
  • identity disturbance markedly and persistently
    unstable self-image impulsivity in at least two
    areas (e.g., spending, sex, substance abuse,
    reckless driving, binge eating)
  • recurrent suicidal behavior
  • chronic feelings of emptiness
  • inappropriate, intense anger or difficulty
    controlling anger

6. Histrionic personality disorder
  • is uncomfortable in situations in which he or she
    is not the center of attention
  • interaction with others is often characterized by
    inappropriate sexually seductive or provocative
  • consistently uses physical appearance to draw
    attention to self
  • shows self-dramatization
  • is suggestible, i.e., easily influenced by others
    or circumstances
  • considers relationships to be more intimate than
    they actually are

7. Narcissistic personality disorder
  • has a grandiose sense of self-importance
  • is preoccupied with fantasies of unlimited
    success, power, brilliance, beauty, or ideal love
  • believes that he or she is "special" and unique
    and can only be understood by, or should
    associate with, other special or high-status
    people (or institutions)
  • requires excessive admiration
  • has a sense of entitlement
  • is interpersonally exploitative, i.e., takes
    advantage of others to achieve his or her own
  • lacks empathy is unwilling to recognize or
    identify with the feelings and needs of others
  • is often envious of others or believes that
    others are envious of him or her
  • shows arrogant, haughty behaviors or attitudes

Avoidant personality disorder
  • avoids occupational activities that involve
    significant interpersonal contact, because of
    fears of criticism, disapproval, or rejection
  • is unwilling to get involved with people unless
    certain of being liked
  • shows restraint within intimate relationships
    because of the fear of being shamed or ridiculed
  • is preoccupied with being criticized or rejected
    in social situations
  • is inhibited in new interpersonal situations
    because of feelings of inadequacy
  • views self as socially inept, personally
    unappealing, or inferior to others
  • is unusually reluctant to take personal risks or
    to engage in any new activities because they may
    prove embarrassing

Dependent personality disorder
  • has difficulty making everyday decisions without
    an excessive amount of advice and reassurance
    from others
  • needs others to assume responsibility for most
    major areas of his or her life
  • has difficulty expressing disagreement with
    others because of fear of loss of support or
  • has difficulty initiating projects or doing
    things on his or her own (because of a lack of
    self-confidence in judgment or abilities rather
    than a lack of motivation or energy)
  • goes to excessive lengths to obtain nurturance
    and support from others, to the point of
    volunteering to do things that are unpleasant
  • feels uncomfortable or helpless when alone
    because of exaggerated fears of being unable to
    care for himself or herself

Obsessive-compulsive personality disorder
  • is preoccupied with details, rules, lists, order,
    organization, or schedules to the extent that the
    major point of the activity is lost
  • shows perfectionism that interferes with task
    completion (e.g., is unable to complete a project
    because his or her own overly strict standards
    are not met)
  • is excessively devoted to work and productivity
    to the exclusion of leisure activities and
    friendships (not accounted for by obvious
    economic necessity)
  • is overconscientious, scrupulous, and inflexible
    about matters of morality, ethics, or values (not
    accounted for by cultural or religious
  • is unable to discard worn-out or worthless
    objects even when they have no sentimental value
  • is reluctant to delegate tasks or to work with
    others unless they submit to exactly his or her
    way of doing things
  • adopts a miserly spending style toward both self
    and others money is viewed as something to be
    hoarded for future catastrophes
  • shows rigidity and stubbornness

Mood Disorders
  • 1) Major Depression A whole body illness
    involving body, mood and thoughts. Affects the
    way the person eats, sleeps and how they feel
    about themselves. Symptoms can last for weeks,
    months or years. Usually lasts around 9 months,
    but if it goes longer, it will usually dissipate
    within 2 years.

  • Causes 1) Some types run in families, 2) low
    levels of serotonin, 3) low self-esteem, 4) those
    who are pessimistic, 5) those overwhelmed by
    stress, 6) serious loss, 7) chronic illness, 8)
    difficult relationships, 9) financial problems
  • Symptoms 1) persistent sad, anxious, empty
    mood, 2) feelings of hopelessness, 3) feelings of
    guilt, worthlessness, helplessness, 4) loss of
    interest in pleasures or hobbies, 5) insomnia or
    oversleeping, 6) weight loss or weight gain, 7)
    decreased energy/fatigue, 8) thoughts of suicide
    or death

Depression continued
  • Treatments 1) Antidepressants (Tricyclics,
    MAOIs, SSRIs), 2) Psychotherapy (talking
    therapies, gaining insight), 3) ECT (for severe
    depression), Lithium (for recurrent major
    depression), 4) behavior therapy (gaining
    self-reinforcements for positive behavior)

Teen Depression
  • Approximately 1 in 33 children and 1 in 8
    adolescents are affected by depression at any
    given time
  • Suicide is the 3rd leading cause of death for
    15-24 year olds and the 6th leading cause for
    5-14 year olds
  • 70 of those diagnosed do not get any treatment

  • High risk loss, attention disorders, conduct or
    anxiety disorders
  • High risk Teenage girls, minorities
  • Treatment is most effective when there is early
    intervention, yet most people do not know the
    symptoms of depression

  • Often, a teen with depression may be seen as a
    normal teen angst as they may appear angry,
    belligerent, irritable and hostile
  • When this extends beyond 6 months, however, this
    is considered to be a problem

Bipolar Disorder
  • Bipolar Disorder A disorder that is
    characterized by episodes of depression and
  • Causes 1) runs in families, 2) many different
    genes may be working together
  • Symptoms
  • Depression See major depression
  • Mania 1) inappropriate elation, 2)
    inappropriate irritability, 3) severe insomnia,
    4) increased talking, 5) disconnected and racing
    thoughts, 6) inappropriate social behavior, 7)
    feelings of grandiosity, 8) racing thoughts, 9)
    abuse of drugs and alcohol

  • Bipolar is a continuous range.
  • At one end is severe depression, above which is
    moderate depression and then mild low mood, which
    many people call "the blues" when it is
    short-lived but is termed "dysthymia" when it is

Descriptions by Bipolars
  • Depression I doubt completely my ability to do
    anything well. It seems as though my mind has
    slowed down and burned out to the point of being
    virtually useless. I am haunted with the
    total, the desperate hopelessness of it all.
    Others say, "It's only temporary, it will pass,
    you will get over it," but of course they haven't
    any idea of how I feel, although they are certain
    they do. If I can't feel, move, think or care,
    then what on earth is the point?

  • Hypomania At first when I'm high, it's
    tremendous ideas are fast like shooting stars
    you follow until brighter ones appear. All
    shyness disappears, the right words and gestures
    are suddenly there uninteresting people, things
    become intensely interesting. Sensuality is
    pervasive, the desire to seduce and be seduced is
    irresistible. Your marrow is infused with
    unbelievable feelings of ease, power, well-being,
    omnipotence, euphoria you can do anything but,
    somewhere this changes.

  • Mania The fast ideas become too fast and there
    are far too many overwhelming confusion replaces
    clarity you stop keeping up with itmemory goes.
    Infectious humor ceases to amuse. Your friends
    become frightened. everything is now against the
    grain you are irritable, angry, frightened,
    uncontrollable, and trapped.

  • Treatments
  • 1) Lithium
  • 2) Antipsychotic drugs
  • 3) Psychosocial treatment
  • 4) Psychoeducation
  • 5) Family Therapy
  • 6) Psychotherapy (individual and group therapy)

  • Seasonal Affective Disorder Disorder in which
    there is some form of depression associated with
    the time of year (usually found in fall and
  • Causes Thought that the pineal gland monitors
    the amount and quality of light that our eyes
    receive. The Pineal body secretes chemicals,
    which controls sleep and may switch the body into
    a hibernating mode for the winter months.
  • Symptoms 1) depression occurs during certain
    seasons in the year, 2) weight gain, 3) excessive
    sleeping, 4) loss of interest in pleasures or
  • Treatments Light therapy (phototherapy)

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Schizophrenic Disorders
  • Class of disorders that may be characterized by
    delusions, hallucinations, disorganized speech
    and maladaptive behavior. People are often on
    medications for life.
  • 4 types
  • 1. Paranoid type marked by delusions of
    persecution and delusions of grandeur.
  • 2. Catatonic type marked by either long
    periods of motionlessness and unaware of
    environment or periods of hyperactive movement
    and incoherent speech.

  • 3. Disorganized type marked by emotional
    indifference, incoherent speech, random babbling
    and silliness
  • 4. Undifferentiated type demonstrates
    behaviors from the other three categories.
  • Causes May be the only disorder that people
    agree has a genetic component. May be related to
    neurotransmitter activity, especially an excess
    of dopamine. May have structural abnormalities of
    the brain.
  • Treatments Medications are usually effective.
    Clozapine and Haldol

Attention Deficit Hyperactivity Disorder
  • (ADHD)-disorder in which the individual may
    experience periods of inattentiveness,
    hyperactivity, impulsivity, and difficulty
    concentrating. Age of onset may be earlier than
    6 or 7, but not clearly diagnosed until this
  • - Causes-implications regarding various areas of
    the brain

  • Symptoms-Inattentive type
  • inattention that has persisted for at least 6
    months which becomes maladaptive, may lack
    attention to detail, make careless mistakes,
    difficulty maintaining attention for in tasks or
    play, difficulty following directions, often
    loses things, often forgetful in their daily

  • Hyperactivity-impulsive type-fidgeting with hands
    or feet, squirms in seat, leaves seat in
    classroom, runs about or climbs excessively when
    inappropriate, has difficulty playing or engaging
    in leisure activities, often talks excessively.
  • Combined type symptoms of the above two.

  • Symptoms were present before the age of 7 and
    some impairment must be present in two or more
  • -Treatments-behavioral therapy, pharmacological
    (usually Ritalin)
  • See a nutritionist

Why does someone develop an eating disorder?
  • Dieting
  • Sports
  • Control issues
  • Emotional instability

  • Very often, the female (or male) will also engage
    in the use of laxative, diuretics and /or diet
  • May also engage in overexercising
  • May be an addictive behavior

Anorexia nervosa the relentless pursuit of
  • Person refuses to maintain normal body weight for
    age and height.
  • Weighs 85 or less than what is expected for age
    and height.
  • In women, menstrual periods stop. In men levels
    of sex hormones fall.
  • Young girls do not begin to menstruate at the
    appropriate age

  • Person denies the dangers of low weight.
  • Is terrified of becoming fat.
  •  Is terrified of gaining weight even though s/he
    is markedly underweight.
  • Reports feeling fat even when very thin.
  • often includes depression, irritability,
    withdrawal, and peculiar behaviors such as
    compulsive rituals, strange eating habits, and
    division of foods into "good/safe" and
    "bad/dangerous" categories.
  • May be overly engaged with or dependent on
    parents or family. Dieting may represent
    avoidance of, or ineffective attempts to cope
    with, the demands of a new life stage such as

  • Research suggests that about one percent (1) of
    female adolescents have anorexia.
  • That means that about one out of every one
    hundred young women between ten and twenty are
    starving themselves, sometimes to death.

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Bulimia nervosa the diet-binge-purge disorder
  • Person binge eats.
  • Feels out of control while eating.
  • Vomits, misuses laxatives, exercises, or fasts to
    get rid of the calories.
  • Diets when not bingeing. Becomes hungry and
    binges again.
  • Believes self-worth requires being thin. (It does

  • May shoplift, be promiscuous, and abuse alcohol,
    drugs, and credit cards.
  • Weight may be normal or near normal unless
    anorexia is also present.
  • Like anorexia, bulimia can kill.
  • Bulimics are often depressed, lonely, ashamed,
    and empty inside. Friends may describe them as
    competent and fun to be with, but underneath,
    where they hide their guilty secrets, they are

  • Research suggests that about four percent (4),
    or four out of one hundred, college-aged women
    have bulimia.
  • About 50 of people who have been anorexic
    develop bulimia or bulimic patterns. Because
    people with bulimia are secretive, it is
    difficult to know how many older people are

Binge eating disorder
  • The person binge eats frequently and repeatedly.
  • Feels out of control and unable to stop eating
    during binges.
  • May eat rapidly and secretly, or may snack and
    nibble all day long.
  • Feels guilty and ashamed of binge eating.
  • Has a history of diet failures

  • Tends to be depressed and obese.
  • People who have binge eating disorder do not
    regularly vomit, overexercise, or abuse laxatives
    like bulimics do.
  • They may be genetically predisposed to weigh more
    than the cultural ideal (which at present is
    exceedingly unrealistic), so they diet, make
    themselves hungry, and then binge in response to
    that hunger.
  • Or they may eat for emotional reasons to comfort
    themselves, avoid threatening situations, and
    numb emotional pain. Regardless of the reason,
    diet programs are not the answer. In fact, diets
    almost always make matters worse.

Anorexia athletica (compulsive exercising)
  • Not a formal diagnosis. The behaviors are usually
    a part of anorexia nervosa, bulimia, or
    obsessive-compulsive disorder.
  • The person repeatedly exercises beyond the
    requirements for good health.
  • May be a fanatic about weight and diet.
  • Steals time to exercise from work, school, and
  • Focuses on challenge. Forgets that physical
    activity can be fun.
  • Defines self-worth in terms of performance

  • Is rarely or never satisfied with athletic
  • Justifies excessive behavior by defining self as
    a "special" elite athlete.
  • Compulsive exercising is not an official
    diagnosis as are anorexia, bulimia, and binge
    eating disorder.
  • The real issues are not weight and performance
    excellence but rather control and self-respect.

Body dysmorphic disorder
  • BDD is thought to be a subtype of
    obsessive-compulsive disorder. It is not a
    variant of anorexia nervosa or bulimia nervosa.
  • The person with an eating disorder says, "I am so
    fat." The person with BDD says, "I am so ugly."
  • BDD often includes social phobias. Sufferers are
    shy and withdrawn in new situations and with
    unfamiliar people.
  • BDD affects about two percent of the people in
    the United States. It strikes males and females
    equally. Seventy percent of cases appear before
    age eighteen.
  • Sufferers are excessively concerned about
    appearance, in particular perceived flaws of
    face, hair, and skin. They are convinced these
    flaws exist in spite of reassurances from friends
    and family members who usually can see nothing to
    justify such intense worry and anxiety.

  • BDD sufferers are at elevated risk for despair
    and suicide. In some cases they undergo multiple,
    unnecessary plastic surgeries.
  • BDD is treatable and begins with an evaluation by
    a physician and mental health care provider.
  • Treatments that have been found to be effective
    include medication (especially meds that adjust
    serotonin levels in the brain) and cognitions

Orthorexia nervosa
  • Not an official eating disorder diagnosis. A
    pathological fixation on eating "proper" or
    "pure" or "superior" food.
  • People with orthorexia nervosa feel superior to
    others who eat "improper" food, which might
    include non-organic or junk foods
  • Orthorexics obsess over what to eat, how much to
    eat, how to prepare food "properly," and where to
    obtain "pure" and "proper" foods.
  • Eating the "right" food becomes an important ,or
    even the primary, focus of life. One's worth or
    goodness is seen in terms of what one does or
    does not eat. Personal values, relationships,
    career goals, and friendships become less
    important than the quality and timing of what is
  • Perhaps related to, or a type of,
    obsessive-compulsive disorder

What are the health risks?
  • Nausea, irritability, fatigue, dizzy
  • Body lacks essential nutrients
  • Irregular or cessation (amenorrhea) of menstrual
  • Bones may become brittle and susceptible to
    breakage osteoporosis due to low estrogen

  • Bones tend to age prematurely
  • Skin may become dry and cold
  • Fine hair develops on arms, face, back and legs
  • Depressed functioning of the brain

  • Risk increased of heart failure
  • Restlessness
  • Kidney problems

  • Changes in body metabolism associated with weight
    loss leads to a lowering of
  • Heart rate
  • Blood pressure
  • Breathing rate
  • Body temperature (which may result in feeling

  • Self-induced vomiting and laxative abuse are
    associated with physical complications such as
  • Swollen salivary glands (evident by swelling on
    the sides of the face)
  • Erosion of tooth enamel, increase in dental
  • Fatigue
  • Body fluid loss
  • Bloating, swelling of the feet and ankles

  • Soreness or tears in the lining of the mouth or
  • Constipation, stomach cramps
  • Numbness and tingling in the limbs
  • Dizziness, weakness, fainting

  • Anorexia nervosa can lead to serious symptoms,
    such as heart problems, seizures, and kidney
    damage. Death may even occur as a result.

  • Psychotherapy
  • Likely to seek therapy are insured,
    divorced/separated, single, over 16 years of age,
  • Psychologists may earn a Ph.D., Psy.D., or Ed.D.
    They have 5 to 7 years of training beyond
    bachelors degree. Also there is a requirement
    of 1 to 2 years in a clinical setting.
  • Psychiatrists earn an M.D. degree. Graduate
    training requires 4 years of coursework in
    medical school. There is also a requirement of a
    4 year apprenticeship in a residency at a

Insight Therapies
  • 1) Psychoanalysis-deals with unconscious
    conflicts, motives, and defenses through
    techniques such as free association and
    transference. (Freud)
  • a) free association where the client
    spontaneously express their thought and feelings
    exactly as they occur, with very little
  • b) dream analysis when therapist interprets
    symbolic meanings of clients dreams

  • c) talking therapies in which the client talks,
    trying to reach catharsis (release of emotions)
  • Possible negative problems during therapy
  • a) resistance a mostly unconscious defense
    mechanism that may hinder the progress of therapy
  • b) transference when the client transfers
    feelings for their critical relationships onto
    the therapist
  • c) countertransference when the therapist
    transfers feelings they have for others onto the

  • 2) Client-centered therapy-therapy in which the
    client plays a major role in determining the pace
    and direction of therapy. The client is thought
    to be their own best therapist. Therapist
    serves as a facilitator, they provide
    clarification. Carl Rogers, founder of this
    method of therapy, states

  • It is the client who knows what hurts, what
    directions to go, what problems are crucial, what
    experiences have been deeply buried. It began to
    occur to me that unless I had a need to
    demonstrate my own cleverness and learning, I
    would do better to rely upon the client for the
    direction of movement in the process

  • Rogers believed that the therapist should be
  • genuine
  • empathetic (feeling for the client)
  • have unconditional positive regard (be
    nonjudgmental towards the client regardless of
    what they tell the therapist)

  • 3) Cognitive therapy helps the client to
    recognize and overcome negative thoughts about
    themselves. (Aaron Beck and Albert Ellis).
    Client is trained to detect their automatic
    thought processes. Often utilized with
    behavioral therapy today.
  • 4) Group therapy when several clients are
    treated at the same time. Participants often act
    as the therapist while the therapist serves as
    a facilitator.
  • Advantages
  • 1) saves time and money
  • 2) clients realize that their misery
    is not unique
  • 3) participants can work on social

  • Behavior Therapies-based on the principles of
    classical, operant and observational learning.
  • 1. Aversion therapy-an aversive stimulus is
    paired with a stimulus that brings on an
    undesirable response.
  • 2. Systematic desensitization-clients slowly
    faces phobic stimulus in a step-by-step process
    in which they relieve themselves of anxiety at
    each step
  • 3. Flooding-clients are quickly exposed to
    phobic stimulus not allowing for time to relieve

  • 4. Token economies giving tokens for correct
    behavior that can be later exchanged for desired
  • 5. Social skills training-designed to improve
    interpersonal skills that emphasizes modeling,
    behavioral rehearsal and shaping (reinforcing
    each step towards desired goal behavior)
  • 6. Biofeedback-a bodily function (such as heart
    or blood pressure) is monitored, and information
    about the bodily function is given back to the
    client. Helps control physiological processes.

Biomedical Therapies
  • 1. Psychopharmacotherapy-treatment of mental
    disorders with medication
  • a) Antianxiety drugs relieve tension,
    apprehension and nervousness. Effects are seen
    rather immediately and can last for several
    hours. Most popular are Xanax and Valium.

  • b) Antipsychotic drugs
  • primarily used to treat Schizophrenia, but
    may be given to those with severe mood disorders
    who become delusional.
  • appear to decrease the levels of dopamine in
    a persons system.
  • Most popular are Thorazine, Mellaril and
  • Antipsychotics may have a negative side
    effect called tardive dyskinesia, which has
    symptoms similar to Parkinsons disease
    (involuntary writing and ticklike movements of
    the mouth, tongue, face, hands and feet).

  • c) Antidepressant drugs drugs that gradually
    elevate mood and help bring people out of a
    depression. Takes several weeks to see
    improvement. There are three types
  • 1. Tricyclics the first group of
    antidepressant drugs. Have a tendency to have
    more side effects than SSRIs. (Elavil)
  • 2. MAOIs (monoamine oxidase
    inhibitors)-Second group of antidepressant meds.
    One has to be very careful about certain foods
    and meds taken with these drugs as they could
    have potentially fatal results. (Nardil)
  • 3. SSRIs (selective serotonin reuptake
    inhibitors)-Newest class of antidepressant drugs.
    Include meds such as Prozac, Paxil, and Zoloft.

  • d) Lithium-chemical used to control mood swings
    in patients with bipolar disorder. Lithium
    levels in the blood must be monitored carefully
    because high levels could be toxic or even fatal.

  • 1. Electroconvulsive Therapy (ECT)-treatment in
    which electric shock is used to produce a
    cortical seizure accompanied by convulsions.
    Primarily used on those with severe depression.
    May lead to gaps in memory or short-term memory
    loss. Seems to rewire the brains circuitry.ECT
  • 2. Lobotomy-Procedure in which cells in the
    forebrain are lesioned. Has been used to treat
    severe schizophrenics. Lobotomy Lobtomy 2
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