Griggs Chapter 10: Abnormal Psychology

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General Psychology (PY110)

• Chapter 10
• Abnormal Psychology

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Abnormal Psychology

• The scientific study of mental disorders and
  their treatment

Ab
Normal
Meaning Away From
Societal and cultural attitudes make normal can
be a moving target
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What is Abnormal?

• Abnormality can be defined using
• Statistical methods Is the behavior uncommon?
• Maladaptive Is the behavior unrewarding or
  damaging?
• Cultural Doe the behavior violate cultural
  norms?

Abnormal
Abnormal
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Perspectives

• Abnormal behavior and thinking can be linked to
  the four major perspectives
• Biological Brain/body, chemical imbalance
• Behavioral Actions/reactions that include
  signs of disorder
• Cognitive The effect of thinking OCD,
  paranoia
• Sociocultural What is acceptable in one culture
  may not be in another
• No single perspective explains even one disorder
• The biopsychosocial approach is used to
  explaining abnormality
• This includes biological, behavioral, cognitive,
  and social/cultural factors

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Nature or Nurture

• As with other areas of human development,
  abnormality is linked to both genetic and
  environmental causes
• Certain genetic types are more susceptible to
  depression, but environment is also important
• There is a 70 chance that if one twin has
  schizophrenia, the other will as well
  suggesting a genetic (or biological) link
• Current research is trying to identify the
  specific genes that make a person vulnerable to
  this disorder

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How is Abnormality Decided?

• What makes one person abnormal and another normal?

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Diagnostic and Statistical Manual

• The DSM-IV was published in 1994 by the American
  Psychiatric Association
• First edition released in 1952 described only
  about 60 disorders
• There are more than 300 known disorders listed
• Health insurance companies require a DSM-IV
  classification before they will pay for therapy

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Three Major Categories of Clinical Disorders
Category Specific Disorders within Category
Anxiety disorders Specific phobia, social phobia, agoraphobia, panic disorder with and without agoraphobia, generalized anxiety disorder, obsessive-compulsive disorder
Mood disorders Major depressive disorder, bipolar disorder
Schizophrenic disorders Schizophrenia (paranoid, disorganized, catatonic, undifferentiated, and residual subtypes)
Mildest
Most Severe
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Anxiety Disorders

• Disorders in which excessive anxiety leads to
  personal distress and atypical, maladaptive and
  irrational behavior

Specific Phobia
Social Phobia Agoraphobia
Panic Disorder
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
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Specific Phobia

• Fear of something specific
• Snakes, spiders, tests,
• Marked by an excessive / unreasonable reaction
• Phobias are learnt by classical conditioning
• we acquire them by experience

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Social Phobia

• A fear of one or more social situations in which
  there is exposure to unfamiliar people or
  scrutiny by others
• May include eating in public, resulting in the
  sufferer rejecting all lunch and dinner
  invitations

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Agoraphobia

• Agoraphobia is the fear of places or situations
  from which escape might be difficult or
  embarrassing
• Includes crowds, standing in line or even being
  in a car in heavy traffic
• Sufferers avoid leaving the security of their
  homes

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Panic Disorder

• A condition in which a person experiences
  recurrent panic attacks (sudden onsets of intense
  fear like they are in mortal danger)
• Some a reaction to something he dreads, such as
  giving a speech, but other attacks occur without
  any apparent reason
• Can occur with or without agoraphobia
• One explanation for panic disorder is a
  fear-of-fear hypothesis

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Generalized Anxiety Disorder

• A disorder in which the person has excessive,
  global anxiety and worry that they cannot
  control, for a period of at least 6 months
• The anxiety is not tied to any specific object
  or situation
• May be related to a biochemical dysfunction in
  the brain, which involves GABA, a major
  inhibitory neurotransmitter

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Obsessive-Compulsive Disorder

• A person experiences recurrent obsessions or
  compulsions that are excessive or unreasonable
• Obsession - a persistent intrusive thought, idea,
  or impulse
• Compulsion - a repetitive behavior that a person
  feels compelled to perform
• Thought to be caused by neurotransmitter
  imbalance involving serotonin
• Sufferers may be helped by using serotonin
  boosting anti-depressant drugs

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Mood Disorders

• Involve dramatic changes in a persons emotional
  mood that are excessive and unwarranted

Major Depressive Disorder
Bipolar Disorder
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Major Depressive Disorder

• Major depression is characterized by symptoms
  such as
• Feelings of intense hopelessness, low
  self-esteem, worthlessness, and extreme fatigue
• Dramatic changes in eating and sleeping behavior
• Inability to concentrate
• Greatly diminished interest in family, friends,
  and activities for a period of two weeks or more
• Thoughts of suicide
• Women suffer from major depressive disorder
  twice as often as men
• Does not include normal grief and extreme
  sadness
• Its normal to grieve the death of a close
  friend or relative

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Bipolar Disorder

• Mood swings between depression and mania
• Symptoms of mania include
• Abnormally elevated mood
• Inflated self-esteem with grandiose delusions
• Decreased need for sleep
• Constant talking, distractibility, restlessness,
  and poor judgment
• In bipolar I disorder, the person has both major
  manic and depressive episodes
• In bipolar II disorder, the person has full-blown
  depressive episodes, but milder manic episodes

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Schizophrenic Disorders

• Schizophrenia means split mind, as mental
  functions split from each other
• Characterized by loss of contact with reality
• More likely to require hospitalization than
  sufferers of any other mental disorder (40 of
  all hospitalized)
• About 1 of the population suffers from
  schizophrenia
• The onset tends to be in late adolescence or
  early adulthood
• Symptoms classified as positivenegative, or
  disorganized

Normal Person
Schizophrenic
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Positive Symptoms of Schizophrenia

• Positive symptoms are the more active symptoms
  that reflect an excess or distortion of normal
  thinking or behavior, including hallucinations
  and delusions
• Hallucinations tend to be auditory, such as
  hearing voices that are not real
• There are different forms of delusions
• Delusions of persecutions involve thoughts of
  conspiracy against you
• Delusions of grandeur involve believing that you
  are a person of great importance, such as Jesus
  Christ
• Hallucinations and delusions are positive
  symptoms because they refer to things that have
  been added

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Negative and Disorganized Symptoms of
Schizophrenia

• Negative symptoms refer to things that have been
  removed or do not work normally
• deficits or losses in emotion, speech, energy
  level, social activity, and even basic drives
  such as hunger
• Disorganized symptoms include disorganized
  speech, disorganized behavior, and inappropriate
  emotions
• Disorganized speech is like a word salad, with
  unconnected words incoherently spoken together

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Five Subtypes of Schizophrenic Disorder
Subtype Symptoms
Disorganized Disorganized speech, disorganized behavior, or inappropriate emotion
Catatonic Extreme movement symptoms ranging from excessive motor activity to posturing (immobility for long periods)
Paranoid Organized cognition and emotion, but with hallucinations and delusions that are usually concerned with persecution
Undifferentiated Mixed-bag categorysymptoms fit the criteria of more than one of the above three types or none of them
Residual There has been a past schizophrenic episode, but presently only some negative symptoms and no positive symptoms (hallucinations and delusions)
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Two Major Types of Therapy
Psychotherapy Involves the use of psychological
interventions
Biomedical Therapy Involves the use of
biological interventions, such as drugs
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Biomedical Therapies
DrugTherapy
Electro-convulsiveTherapy
Psycho-surgery
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Electro-convulsive Therapy

• Used to treat major depression when
  anti-depressant drugs are no longer effective
• Patient is anaesthetized with a muscle relaxant
  and a 30-45 second electrical shock is
  administered to the head
• Effective but often results in memory loss

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Drug Therapy
Lithium
AntianxietyDrugs
Antidepressants
AntipsychoticDrugs
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Drug Therapies

• Effective in treating symptoms of abnormality for
  1/3 of sufferers
• Work partially or intermittently for 1/3, and
  Ineffective for1/3
• Lithium used to control mania associated with
  bi-polar disorder
• Anti-depressants (includingSSRIs) used to
  correct neurotransmitter imbalancesconnected
  with depression
• Should be used in conjunction with psychotherapy
  not a replacement for it

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Psychotherapies

• Four major types

Psychoanalysis
Behavioral
Humanistic
Cognitive
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Psychotherapies

• Psychoanalysis and humanistic therapies are
  referred to as insight therapies
• They stress that a person achieve understanding
  of the causes of their behavior and thinking
• Behavioral and cognitive therapies are usually
  referred to as actions therapies
• They stress that the actions of the person must
  change for therapy to be effective

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Psychoanalysis

• Uses Free Association - patient spontaneously
  describes thoughts, feelings, and mental images
• Brings conflict to a conscious level - provides
  clues to the unconscious conflicts leading to a
  persons problems
• Other tools used include hypnosis and dream
  analysis
• Resistance is a patients unwillingness to
  discuss a particular topics
• When a resistance is hit, it may provide clues
  into unconscious conflicts

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Problems with Psychoanalysis

• Transference can occur when the patient acts
  toward the therapist as they did toward
  important figures in their life, such as their
  parents
• Psychoanalysis requires a lot of time and is
  expensive
• Critics question the validity of psychoanalysis
  main construct, unconscious conflicts and their
  impact on behavior and thinking

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Humanistic Therapy

• Most influential humanistic therapy is Carl
  Rogerss client-centered therapy
• The therapist uses unconditional positive regard,
  genuineness, and empathy to help the person to
  gain insight into their true self-concept (Real
  Ideal)
• Is often conducted in groups reducing costs
• To achieve this goal, the therapist is
  non-directive and involves
• Genuineness - honestly sharing his own thoughts
  and feelings with the client
• Active Listening - to achieve empathetic
  understanding of the clients feelings
• Mirroring - to echo these feelings back to the
  client, so they can gain a clearer image of their
  true feelings

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Behavioral Therapy

• Psychotherapy which uses the principles of
  classical and operant conditioning to change a
  persons behavior from maladaptive to adaptive
• Maladaptive behaviors are learned and therefore
  can be unlearned
• In counterconditioning, a maladaptive response
  is replaced by an incompatible adaptive response
• Systematic desensitization is counterconditioning
  where a fear response to an object or situation
  is replaced with a relaxation response in a
  series of progressively increasing fear-arousing
  steps
• Pioneered by Joseph Wolpe

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Cognitive Therapy

• Psychotherapy in which the therapist changes the
  persons thinking from maladaptive to adaptive
• This is achieved by Elliss ABC model
• A refers to the Activating event (e.g., failure
  to be perfect)
• B refers to the persons Belief about the event
  (e.g., feeling like a failure for normal levels
  of imperfection)
• C is the resulting emotional Consequence (e.g.,
  depression)
• According to Ellis
• A does not cause C rather, B causes C