Unit 12: Abnormal Psych

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Unit 12 Abnormal Psych

• A.P. Psych

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Essential Question

• What is a psychological disorder, what are the
  causes and symptoms of various psychological
  disorders, and how do psychologists use the
  DSM-IV to diagnose them?

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Unit 12 (A)

• Day 1

• Perspectives on Psychological Disorders

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Do Now (Discussion)

• What does it mean to be normal?
• What separates normal from abnormal?
• Should we use these labels?

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Perspectives on Psychological Disorders

• Psychologists define disorder as deviant,
  distressful, and dysfunctional behavior.
• The definitions of these words vary over time as
  well as across cultures.

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Perspectives on Psychological Disorders

• Psychologists use The Medical Model to understand
  and diagnose psychological disorders.
• The Medical Model The concept that psychological
  diseases/disorders have physical causes. Also,
  they can be diagnosed based on physical symptoms
  and treated through therapy and medication.

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Perspectives on Psychological Disorders

• Biopsychosocial Approach
• Modern approach stating that disorders are caused
  by a combination of genetic predisposition,
  psychological traits, and cultural experiences.

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Classifying Psychological Disorders

• How?
• Psychologists use the fifth edition of the
  American Psychiatric Associations Diagnostic and
  Statistical Manual of Mental Disorders (DSM-5) to
  diagnose disorders based on observable symptoms.

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Classifying Psychological Disorders

• Why?
• The DSM gives psychologists and insurance
  companies a common language to use when
  organizing treatment and insurance plans. Many
  insurance companies require a DSM diagnosis when
  considering how much financial assistance to give
  a patient for their treatment.

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Labeling Psychological Disorders

• There is a lot of controversy surrounding the use
  of the DSM because it puts labels on people.
  Labels lead to preconceptions and bias that often
  create ethical and moral dilemmas such as
  insanity pleas in serious crime cases.

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3 Ds of Psychological Disorders

• Deviance
• Distress
• Dysfunction

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Classification

• 5 Axes of DSM-IV
• Axis 1 Clinical Disorders
• Axis 2 Personality Disorders/Mental Retardation
• Axis 3 Medical Disorders
• Axis 4 Psychosocial Stressors
• Axis 5 Global Assessment of Functioning (GAF)
  (1-100)

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Code Global Assessment of Functioning (GAF) Scale Description of Functioning
91 - 100 Person has no problems OR has superior functioning in several areas OR is admired and sought after by others due to positive qualities
81 - 90 Person has few or no symptoms. Good functioning in several areas. No more than "everyday" problems or concerns.
71 - 80 Person has symptoms/problems, but they are temporary, expectable reactions to stressors. There is no more than slight impairment in any area of psychological functioning.
61 - 70 Mild symptoms in one area OR difficulty in one of the following social, occupational, or school functioning. BUT, the person is generally functioning pretty well and has some meaningful interpersonal relationships.
51 - 60 Moderate symptoms OR moderate difficulty in one of the following social, occupational, or school functioning.
41 - 50 Serious symptoms OR serious impairment in one of the following social, occupational, or school functioning.
31 - 40 Some impairment in reality testing OR impairment in speech and communication OR serious impairment in several of the following occupational or school functioning, interpersonal relationships, judgment, thinking, or mood.
21 - 30 Presence of hallucinations or delusions which influence behavior OR serious impairment in ability to communicate with others OR serious impairment in judgment OR inability to function in almost all areas.
11 - 20 There is some danger of harm to self or others OR occasional failure to maintain personal hygiene OR the person is virtually unable to communicate with others due to being incoherent or mute.
1 - 10 Persistent danger of harming self or others OR persistent inability to maintain personal hygiene OR person has made a serious attempt at suicide.
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Unit 12 (B)

• Day 2

• Anxiety Disorders

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Do Now (Discussion)

• What is anxiety?
• How is it different from worry or fear?

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Anxiety Disorders

• Anxiety disorders are psychological disorders
  characterized by distressing, persistent anxiety
  or maladaptive behaviors meant to reduce anxiety.
• People with anxiety disorders feel persistently
  and uncontrollably tense and apprehensive, with
  no apparent cause.

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Anxiety Disorders

• Generalized Anxiety Disorder - unexplainable and
  continuous tenseness and uneasiness.
• Panic Disorder - unexplainable sudden episodes of
  intense dread.
• Phobias - irrational and intense fear of a
  specific object or situation.

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Anxiety Disorder

• Obsessive Compulsive Disorder (OCD) -
  unexplainable repetitive thoughts or actions.
• Post-Traumatic Stress Disorder (PTSD) - lingering
  memories, nightmares, and other symptoms after a
  severely threatening, uncontrollable event.

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Anxiety Disorders

• What causes them?
• Freud
• manifestation of mental energy associated with
  the discharge of repressed impulses
• Learning Perspective
• product of fear conditioning, stimulus
  generalization, reinforcement of fearful
  behaviors, and observational learning of others
  fear.

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Anxiety Disorders

• Biological Perspective
• consider the roles that life-threatening animals,
  objects, or situations played in natural
  selection and evolution genetic inheritance of a
  high level of emotional reactivity and abnormal
  responses in the brains fear circuits.

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• Anxiety Disorders
• http//www.youtube.com/watch?v_Cr7IomSy8s
• OCD
• http//www.youtube.com/watch?vtPFQMRx2l3Y
• Dogs and PTSD
• http//content.time.com/time/video/player/0,32068,
  671301612001_2030797,00.html
• Top 10 Phobias
• http//www.youtube.com/watch?vhsr8JsUr6kU

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Unit 12 (C)
Day 3

• Somatoform Disorders

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Somatoform Disorders
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Do Now (Discussion)

• Have you ever felt ill or as though you had a
  serious medical issue only to find that nothing
  was wrong with you?

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Somatoform Disorders

• Psychological disorder in which the symptoms take
  a somatic (bodily) form without apparent physical
  cause, or medically unexplained illnesses.
• Somatoform disorders are one of the most common
  problems that result in doctors visits.

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What causes them?

• Stress is a probable trigger for somatoform
  disorders. Stress can manifest itself in a
  somantic (or bodily) form without there being
  physical causes.
• People under stress are also more likely to be
  more bothered by normal bodily sensations, such
  as a slight headache.

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Somatoform Disorders and Culture

• Culture plays a large role in peoples physical
  complaints. In China, for example, psychological
  explanations for anxiety and depression are less
  socially acceptable than physical symptoms of
  distress.

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According to a cross national survey that
screened 90,000 people for major depressive
episodes using a standard set of questions 19.2
of Americans have experienced a depressive
episode, while only 6.5 of people in China have.
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Conversion Disorder

• A rare somatoform disorder in which a person
  experiences very specific genuine physical
  symptoms for which no physiological basis can be
  found.
• Anxiety is presumably converted into a physical
  symptom.

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Conversion Disorders

• Conversion disorders, while mystifying, are no
  less real than physiological disorders.
• People with conversion disorders who claim to
  have lost sensation in certain areas have been
  known to be unaffected by pins being stuck into
  them.

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Hypochondriasis

• A somatoform disorder in which a person
  interprets normal physical sensations as symptoms
  of a disease.

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Unit 12 (D)

• Day 4

• Dissociative Disorders

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Dissociative Disorders
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Dissociative Disorders

• Disorders in which conscious awareness becomes
  separated or dissociated from previous memories,
  thoughts, and feelings.

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What is dissociation?

• Dissociation occurs when a persons consciousness
  is separated from painful memories, feelings, and
  thoughts.
• It tends to be caused by extremely stressful
  situations or in a response to some sort of
  trauma.

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Dissociative Identity Disorder (D.I.D.)

• Dissociative identity disorder is often referred
  to as multiple personality disorder.
• A person with D.I.D. will have two or more
  distinct identities with different personalities.
  Often the original personality claims to be
  unaware of the others.

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What causes D.I.D.?

• 98-99 percent of individuals with D.I.D. have
  recognized personal histories of recurring,
  overpowering, and often life-threatening
  disturbances at a sensitive developmental stage
  of childhood, usually before the age of 9.

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• http//www.youtube.com/watch?vweLvkZGr9Tw
• http//www.youtube.com/watch?v11oD_8jYy0c

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Is it legitimate?

• Is D.I.D. a genuine disorder or is it an
  extension of our normal capacity for personality
  shifts?

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Maybe Not

• Nicholas Spanos asked college students to pretend
  they were accused murderers being examined by a
  psychiatrist. When hypnotized, most students
  expressed a second personality.

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Maybe Not

• Nicholas Spanos
• Are dissociative identities more extreme versions
  of selves we present?
• Are people with D.I.D. simply prone to fantasy
  and convincing themselves they have other
  personalities?
• Most people with D.I.D. are highly
  hypnotizablewhat does this relationship mean?

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Maybe Not

• D.I.D. is strangely localized by time and space.
  After DID was first entered in the DSM,the amount
  of cases in America skyrocketed.
• D.I.D. is more rare in Britain than it is in
  America, and in Japan and India, it is
  essentially nonexistent.
• Could it be a cultural phenomenon?

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Maybe

• Handedness sometimes switches with personalities
• Ophthalmologists have detected shifting visual
  acuity and eye muscle balance with personalities
• People with D.I.D. have heightened activity in
  brain areas associated with control and the
  inhibition or traumatic memories.

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Unit 12 (E)
Day 5

• Mood Disorders

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Do Now

• 1. I do things slowly.
• 2. My future seems hopeless.
• 3. It is hard for me to concentrate on reading.
• 4. The pleasure and joy has gone out of my life.
• 5. I have difficulty making decisions.
• 6. I have lost interest in aspects of life that
  used to be important to me.
• 7. I feel sad, blue, and unhappy.
• 8. I am agitated and keep moving around.
• 9. I feel fatigued.
• 10. It takes great effort for me to do simple
  things.

• 11. I feel that I am a guilty person who deserves
  to be punished.
• 12. I feel like a failure.
• 13. I feel lifeless -- more dead than alive.
• 14. My sleep has been disturbed -- too little,
  too much, or broken sleep.
• 15. I spend time thinking about HOW I might kill
  myself.
• 16. I feel trapped or caught.
• 17. I feel depressed even when good things happen
  to me.
• 18. Without trying to diet, I have lost, or
  gained, weight.

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Mood Disorders
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What are mood disorders?

• Mood disorders are characterized by emotional
  extremes.

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Mood disorders come in two principal forms

• Major depressive disorder- prolonged hopelessness
  and lethargy

• Bipolar disorder- altering between depression and
  mania (an overexcited, hyperactive state.)

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Major Depressive Disorder

• Major depressive disorder is a mood disorder in
  which a person experiences, in absence of drugs
  or a medical condition, two or more weeks of
  significantly depressed moods, feelings of
  worthlessness, and diminished interest or
  pleasure in most activities.

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How common is it?

• It is the number one reason people seek mental
  health services
• 13 of U.S. adults have been plagued by
  depression at some point
• In any given year depressive episodes effect 5.8
  percent of men and 9.5 percent of women
  worldwide.

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What are some main causes?

• Response to past and current loss. (25 of people
  diagnosed with depression are struggling with the
  emotional impact of loss.)
• Other life events
• A persons biology/brain chemistry

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Bipolar Disorder

• A mood disorder in which the person alternates
  between the lethargy of depression and the
  overexcited state of mania.

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• Depressive phase- fatigue and decreased energy,
  difficulty concentrating, feeling hopeless or
  irritable, feeling sad or empty, loss of
  appetite, loss of interest in daily activities.

• Manic phase- racing thoughts, elation, little
  need for sleep, fewer sexual inhibitions. Speech
  is often loud, flighty, and hard to interrupt.
  May need protection from poor judgement, but
  creativity is often fueled.

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True of false?

• 1. Few behavioral and cognitive changes accompany
  depression.
• 2. Depression is widespread
• 3. Compared with women, men are nearly twice as
  vulnerable to major depression.
• 4. Most major depressive episodes so not end
  without assistance.
• 5. Stressful events often precede depression
• 6. With each new generation, depression is
  striking earlier and affecting more people.

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Genetic Influences of Mood Disorders

• Mood disorders are often genetic
• The heritability of major depression is about
  35-40
• Risk goes up if one has a parent or sibling with
  a mood disorder.
• Risk goes up even higher if one has an identical
  twin with a mood disorder

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The Depressed Brain

• Less activity in the brain
• The left frontal lobe is likely to be inactive
• Frontal lobes tend to be smaller
• The hippocampus is vulnerable to stress related
  damage
• Norepinephrine, which increases arousal and
  boosts mood, is scarce.
• Serotonin, which also boosts mood, is scarce as
  well.

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The Social-Cognitive Perspective

• Learned helplessness result in self-defeating
  beliefs, and can ultimately result in depression.
  
• Women are more susceptible to learned
  helplessness, which factors into their higher
  risk for depression.

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Depressions Vicious Cycle

• When people feel down they are more likely to
  remember bad experiences and think negatively

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Abnormal Psychology

• Schizophrenia

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Venture into the mind of a Schizophrenia
sufferer. This is made to raise awareness about
mental illness. This is how they see and hear the
world. Don't turn your back on them just because
they're different. Put yourself in their shoes
and experience what they experience
everyday. Alone but never alone
Starring Alicia Gall Music By Alexander
Kokic-Schmidt
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HOW MUCH DO YOU KNOW ABOUT SCHIZOPHRENIA?

• 1. Schizophrenia is caused by poor parenting.
• True False Dont know
• 2. Schizophrenia is caused by street drugs.
• True False Dont know
• 3. People who have schizophrenia are usually
  violent and dangerous.
• True False Dont know
• 4. People with schizophrenia have multiple or
  split personalities.
• True False Dont know
• 5. Schizophrenia can be successfully treated.
• True False Dont know

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TRUE FALSE ANSWERS

• 4 People with schizophrenia have multiple or
  split
• personalities-False.
• People with schizophrenia are split from reality,
  rather than having a multiple or split
  personality.
• 5. Schizophrenia can be successfully
  treated-True.
• Schizophrenia cannot be cured, but the symptoms
  can be treated.

• 1. Schizophrenia is caused by poor
  parenting-False.
• The cause of schizophrenia is not known. However,
  it is definitely an organic (physical,
  biological) disease and is the fault of no one.
• 2. Schizophrenia is caused by street drugs-False.
• Schizophrenia is not caused by street drugs. Some
  researchers believe, however, that street drugs
  can precipitate schizophrenia in an individual
  who has a predisposition to develop the disease.
• 3. People who have schizophrenia are usually
  violent and dangerous-False.
• People who have schizophrenia tend to be
  vulnerable, fragile people. If violent, the
  violence is most often directed towards
  themselves suicide.

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Schizophrenia Split Mind

• Schizophrenia Serious mental disorder
  (psychosis) characterized by thought
  disturbances, hallucinations, anxiety, emotional
  withdrawal, and delusions.
• Psychosis Disorder that is characterized with a
  break from reality.

• delusions False beliefs of being persecuted
  (being plotted against), grandiose, or being
  controlled by others.
• hallucinations False sensory perception such as
  hearing voices or seeing images that are not
  there.

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Positive Symptoms
Negative Symptoms

• Absence of appropriate behaviors
• Flattened affect
• Anhedonia Patients may fail to experience or
  express pleasure in things that they once found
  enjoyable.
• Reduced speech.
• Lack of initiative Also called avolition.

• Presence of inappropriate behaviors
• Delusions
• Hallucinations
• Disorganized speech
• Disorganised or catatonic behavior

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Subtypes of Schizophrenia

• Categorized by
• Disorganized and delusional
• thinking.
• Disturbed perceptions.
• Inappropriate emotions and actions.

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Theories About the Cause of Schizophrenic
Disorders

• The dopamine hypothesis, which is an older
  theory, is believed to be a biological cause of
  schizophrenia where high levels of dopamine are
  found. It is also the most popular theory.
• Some of the antipsychotic drugs used to treat the
  disorder often result in lower levels of
  dopamine. They often cause negative side effects
  for the patients such as muscle tremors or
  stiffness (tardive dyskinesia)
• Schizophrenia is believed to be genetically
  influenced
• people who are related to someone with
  schizophrenia tend to have a higher risk of
  getting it the closer the genetic relationship.
  (identical twins have 1 in 2 chance, yet the
  general population is 1 in 100)

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Environmental

• Environmental factors may increase chances of
  developing schizophrenia in people that already
  have genetic predisposition.
• Double binds is when a person is given
  contradictory messages so they can not make their
  own rational decisions.
• Diathesis-stress model is another influence. It
  can be applied to schizophrenia and other
  psychological disorders.
• Environmental stressors trigger the biological
  predisposition for the mental illness to release
  itself. This can explain why some twins both
  don't have schizophrenia.
• Schizophrenia affects young people as they mature
  into adults. It affects men and women equally,
  but men tend to suffer from it more severely than
  women.

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Lesson Activities Divided Minds
The likelihood of an individual suffering from
schizophrenia is 50 if their identical twin has
the disease.

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Review

• Do you think schizophrenia is affected by nature
  or nurture? Why or why not? Give specific
  examples.

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Abnormal Psychology

• Personality Disorders

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Do Now
Personality Disorder Video
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Defining Personality Disorders
Personality Disorders are maladaptive patterns of
behavior that impair social functioning including

1. Distorted thinking patterns
2. Problematic emotional responses
3. Over or under regulated impulse control
4. Interpersonal difficulties

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Cluster A- Odd Behavior
All share some of the common symptoms seen in
schizophrenia

• Paranoid Personality Disorder
• Irrational suspicions and mistrust of others
• Schizoid Personality Disorder
• Lack of interest in social relationships
• Schizotypal Personality Disorder
• odd behavior or thinking

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Cluster B- Dramatic

• Histrionic Personality Disorder
• Shallow or exaggerated emotions with attention
  seeking behavior even it is damaging.
• Narcissistic Personality Disorder
• Grandiosity, need for admiration and lack of
  empathy
• Borderline Personality Disorder (video)
• Unstable relationships, self image, identity, and
  behavior

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Symptoms of Antisocial Personality Disorder
Cluster B- Dramatic

• Antisocial Personality Disorder, sociopath,
  psychopath
• 70 more prevalent in men
• Failure to conform to social norms with respect
  to lawful behaviors as indicated by repeatedly
  performing acts that are grounds for arrest
• Deceitfulness, as indicated by repeated lying,
  use of aliases, or conning others for personal
  profit or pleasure
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness, as indicated by
  repeated physical fights or assaults
• Reckless disregard for safety of self or others
• Consistent irresponsibility, as indicated by
  repeated failure to sustain consistent work
  behavior or honor financial obligations
• Lack of remorse, as indicated by being
  indifferent to or rationalizing having hurt,
  mistreated, or stolen from another
• Children with Conduct Disorder probably won't
  develop antisocial personality disorder, but many
  people with antisocial personality disorder had
  Conduct Disorder as a child (emotional and
  behavioral problems)

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Cluster B- Dramatic Cause of Antisocial
Personality Disorder

• The main cause of antisocial personality disorder
  is unknown.
• Genetic and environmental factors like abuse and
  abandonment, are believed to contribute to the
  disorder.
• Children with Conduct Disorder probably won't
  develop antisocial personality disorder, but many
  people with antisocial personality disorder had
  Conduct Disorder as a child (emotional and
  behavioral problems)

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Cluster C- Anxious

• Avoidant Personality Disorder
• social inhibition, feeling inadequate
• Dependent Personality Disorder
• general psychological dependence on others
• Obsessive Compulsive Personality Disorder
• preoccupation with orderliness, perfectionism,
  and mental and interpersonal control, at the
  expense of flexibility, openness, and efficiency

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Review

• http//www.funtrivia.com/playquiz/quiz3009062272eb
  8.html
• http//psychcentral.com/blog/archives/2010/11/30/p
  ersonality-disorders-shakeup-in-dsm-5/

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Abnormal Psychology

• Rates

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Rates of Psychological Disorders
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Crime Rates
The prevalence of mental health disorders among
females in the juvenile justice system is higher
than males. What do you think about this?
14.2
29.6
14..9
6.4
11.9
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Students Silenced by Mental Health Stigma
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Discussion