4 th edition copyright 2004 - prentice hall12-1 abnormal psychology anxiety & mood disorders...
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4th Edition
Copyright 2004 - Prentice Hall 12-1
Abnormal Psychology
Anxiety & Mood Disorders
Unit 5
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Copyright 2004 - Prentice Hall 12-2
Criteria of Abnormal Behavior
• statistical rarity-- behavior is infrequent in population.
• Dysfunctional-- behavior interferes with daily functioning.
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Abnormal Behavior
• personal distress – behavior is upsetting/confusing to patient
• Deviates from social norms = abnormal (deviant) behavior
• social norms can change over time and vary across cultures.
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Abnormal Behavior
• Insanity - a legal ruling that an accused individual is not responsible for a crime.
• Criteria: unable to tell right from wrong when crime was committed
• Insanity pleas are infrequently used and rarely successful.
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Abnormal Behavior Models
• medical model: abnormal behaviors are illnesses - prescribe medical treatments.
• psychodynamic model: unconscious conflicts from childhood.
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Abnormal Behavior Models
• behavioral model: abnormal behaviors are learned (cond., modeling)
• cognitive model: our interpretation of events/ our beliefs influence our behavior.
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Abnormal Behavior Models
• sociocultural model social /cultural factors considered
• Biopsychosocial—combination approach
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Classifying and Counting Psychological Disorders
• The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) provides rules for diagnosing psychological disorders that have increased reliability.
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Rorschach Test (Projective Tests)
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Thematic Apperception Test
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Classifying and Counting Psychological Disorders
• Rosenhan's pseudopatient study questions our ability to distinguish normal and abnormal behaviors and how labels affect perception of behavior.
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Classifying and Counting Psychological Disorders
• Epidemiologists study prevalence & incidence of accidents, diseases, and psychological disorders.
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Classifying and Counting Psychological Disorders
• Phobias, substance abuse/dependence, and MDD are among most common d/o.
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Classifying and Counting Psychological Disorders
• Many suffer from more than one psychological disorder (co-morbidity).
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Anxiety, Somatoform, and Dissociative Disorders
• Anxiety involves behavioral, cognitive, and physiological elements.
• Biopsychosocial model most effective.
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Anxiety, Somatoform, and Dissociative Disorders
• a chronically high level of anxiety = generalized anxiety disorder (GAD)
• Worry about 2 or more areas of life.
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Anxiety, Somatoform, and Dissociative Disorders
• Phobias are excessive, irrational fears of activities, objects, or situations.
• most frequently diagnosed phobia is agoraphobia (“fear of the marketplace”) No escape!
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Anxiety, Somatoform, and Dissociative Disorders
• The DSM-V: agoraphobia and specific phobia.
• conditioning and modeling may explain phobias.
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Phobias
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Psychologically Based Therapies
• Systematic desensitization
• relaxation techniques • asked to imagine or
approach feared situations gradually
• (Counter-conditioning)
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Anxiety D/Os
Fear of being in situations that may subject one to scrutiny
•DSM-V: Social Anxiety D/O
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Anxiety, Somatoform, and Dissociative Disorders
• Frequent panic attacks (which resemble heart attacks) main symptom of panic disorder.
• Biological and cognitive explanations for this disorder have been proposed.
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OCD
• Obsessions are thoughts, images, or impulses that occur repeatedly;
• compulsions are irresistible, repetitive acts (behaviors) trying to decrease thoughts.
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Hoarding Disorder• Persistent difficulty parting
with possessions, regardless of their value
• Living areas become cluttered• Parting causes extreme
distress• New classification
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Animal Hoarding
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Anorexia/ Bulimia Nervosa
• Stress-related eating disorders• Anorexia Nervosa – self-starving (<85% of
normal body weight)• Bulimia Nervosa – binge and purge eating
• Type A Personality?• Control?• Identity issues?
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Anorexia Nervosa• Hungry, but don’t eat for fear
of being fat• Distorted image of their body• No sign of other disease• Weight less than minimally
normal• Some starve themselves to
death (20% die total)
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Why anorexia?• Neurotransmitter imbalance
• Brain images-no pleasure from food
• Societal pressures
• Low self esteem levels
• Stress and anxiety
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Bulimia Nervosa• Binge eating with loss of control,
followed by vomiting, laxatives, exercise
• maintain normal weight, distorted image
• @ least once a week for 3 months
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Binge Eating Disorder
• 3 or more of the following:• Very rapid eating • uncomfortably full• Large amounts of food, but not
hungry• Eating alone b/c embarrassment• Disgust, guilt, depression
afterwards• @ least once/week for 3 months
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Post Traumatic Stress Disorder
• PTSD• exposure to actual or threatened death,
serious injury or sexual violation
• Doesn’t have to happen to you!
• clinically significant distress/ dysfunction: impairment in social interactions, capacity to work or other important areas of functioning
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PTSD
• Trauma (violence, war, crime, disaster, etc.)
• 1st month after Trauma occurs = acute stress d/o
• Acute or Chronic PTSD after 1 mo.
• sleep disturbances, nightmares, flashbacks, irritability
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TREATMENT• early intervention!!!
• -cognitive behavioral therapy: learn about own symptoms and disorder=control “reliving the events”
• -anti-anxiety/anti-depressant meds
• -virtual reality/exposure therapy
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Biomedical Therapies
• antianxiety drugs:
• benzodiazepines (Valium, Xanax) (GABA agonists)
• Anti-depressants:
• SSRIs (Zoloft, Paxil, Prozac, Lexapro) may reduce symptoms (seratonin agonists)
• SNRIs (Cymbalta, Effexor, Pristiq)
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Anxiety, Somatoform, and Dissociative Disorders
• Somatic symptom disorder
• Many physical symptoms w/ no known medical causes – (headaches, pain, digestive, etc.) psychological factors (depression and/or anxiety) are involved.
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Conversion Disorder
• Somatic disorder with loss of sensory or motor function without medical explanation.
• (blindness, deafness, paralysis)
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Illness Anxiety D/O
• Somatoform disorder with belief of a specific, serious disease despite repeated medical findings to the contrary (DSM IV: hyponchondriac)
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Dissociative Disorders
• Dissociative disorders involve disruptions in some function of awareness in the mind.
• Depersonalization D/O: “The Flash”- Existential moments• dissociative amnesia: memories
cannot be recalled• dissociative fugue: memory loss
accompanied by travel.
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Anxiety, Somatoform, and Dissociative Disorders
• Dissociative identity disorder (multiple personality) - presence of two or more personalities in one individual.
• The 3 Faces of Eve
• Sybil
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Mood Disorders• lifetime prevalence of depression is twice
as high in women as men; prevalence rates around the world are increasing.
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Mood Disorders
• symptoms of depression include sadness, reduced pleasure and energy levels, feelings of guilt, sleep and appetite changes (more than 2 weeks) and suicidal thinking.
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Mood Disorders
• Suicide, often associated with depression, is a leading cause of death in US.
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Suicide Rates
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Mood Disorders
• Medical: low levels of norepinephrine or serotonin.
• Behavioral: learned helplessness
• Cognitive: people believe they cannot control outcomes
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Mood Disorders
• Mood disorders tend to run in families (genetic)
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Mood Disorders
• Mood disorder concordance rates in twins: 65% identical vs 14% fraternal.
• Depression comorbid with other disorders.
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Depression Disorders
Dysthymic - chronic low mood
Unipolar-Major Depression
Double Depression – Dysthymic disorder w/ major depressive episode
SAD- melatonin/ phototherapy
Postpartum depression-hormones
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Models on Mood Disorders
• Biological/ Medical – Concordance; SSRIs & Lithium (seratonin & norepinepherine)
• Psychodynamic – attachment issues • Cognitive—Explanatory styles (t/p, s/u, e/i) optimist/ hardy, hopelessness (arbitrary
inference: conc w/o supporting evidence)• Behavioral—Learned helplessness/
reinforcers• Biopsychosocial – interacting factors
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Mood Disorders
• Bipolar disorder involves swings between depression and mania.
• symptoms of mania include euphoria, increased energy, poor judgment, decreased sleep, and elevated self-esteem