abnormal psych

Abnormal Psych

Chapter 16

Psychological Disorders


1. Define abnormal vs. normal

2. Distinguish b/w methods of deciding normality

3. Recognize and use the bell-shaped curve showing normal

4. Develop and analyze surveys to determine normal personality qualities and behaviors


1. Normal/ Abnormal: Who decides?

2. Group Survey Creation

3. Individual survey Completion

4. Results tabulation and presentation of results


1. Quiz 16-1/ Developmental Review Sheets on Desk/ EC on Desk

2. Calendar Review3. Developmental Test Review4. Abnormal ProjectHW: 16-2, Review U1 (Prologue & Ch 1)EC Due


16-1 619-626Perspectives on Psychological Disorders: Medical Model, Pinel, Bio-

Psycho-Social Perspective, DSM-IV, Diagnostic Labeling, Rosenhan 1. Identify the criteria for judging whether behavior is psychologically

disordered. 2. Describe the medical model of psychological disorders, and

discuss the bio-psycho-social perspective offered by critics of this model.

3. Describe the aims of DSM-IV and discuss the potential dangers associated with the use of diagnostic labels.


Psychological Disorder a “harmful dysfunction” in which behavior is judged to be:

atypical--not enough in itself disturbing--varies with time and culture maladaptive--harmful unjustifiable--sometimes there’s a good reason


5 Axes of the DSM-IV Axis I- addresses clinical syndromes & major disorders: schizo, anxiety dis, dis

diag in infancy, childhood, adolesc, somatoform dis, sexual dis, delirium, amnesia, dementia

<<all disorders other than Personality & MR>> Axis II- personality disorders; MR Axis III – Gen Med Conditions relevant to understanding/ managing the disorder

(Hypothyrodism-Depression) Axis IV-Psychosocial & Environmental Problems that may affect diagnosis,

treatment, prognosis of mental disorders (housing, economic, family) Axis V-rep global assessment of person’s level of functioning. (90 indicates

minimal symptoms & 1 maximal –ie. viol subj likely to harm others)

Historical Perspective Perceived Causes

movements of sun or moon lunacy--full moon

evil spirits Ancient Treatments

exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood, bloodletting


Phillipe Pinel –France early 1800s – said madness was sickness of mind, not demon posession, unchained patients and talked to them

Led to Medical Model in 1800s (hospitals replaced asylums) Medical Model

concept that diseases have physical causes can be diagnosed, treated, and in most cases, cured assumes that these “mental” illnesses can be diagnosed on the

basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital

Psychological Disorders Cross-Cultural Analysis

Environmental effects evident from cross-cultural analysis: Dep and Schizo present worldwide Anorexia & Bulimia – Western Susto- Latin America; severe anxiety, restlessness, fear of black

magic Taijin-kyofusho-Japan; social anxiety of appearance, blushing & fear

of eye contact


Today, mental health workers agree that disorders influenced by:

genes physiological states inner psychological dynamics social-cultural circumstances Bio-Psycho-Social Perspective

assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders

Bio-Psycho-Social Perspective

Psychological Disorders--Etiology

DSM-IV American Psychiatric Association’s Diagnostic

and Statistical Manual of Mental Disorders (Fourth Edition)

a widely used system for classifying psychological disorders

presently distributed as DSM-IV-TR (text revision)

17 categories of mental disorders & neurotic disorders & psychotic disorders

Most Health insurance companies require diagnosis w DSM-IV to pay for therapy

Anxiety Disorders Anxiety Disorders

distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Generalized Anxiety Disorder person is tense, apprehensive, and in a state of autonomic

nervous system arousal

Anxiety Disorders

Panic Disorder marked by a minutes-long episode

of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation

Anxiety Disorders

Phobia persistent, irrational fear of a specific

object or situation Obsessive-Compulsive Disorder

unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

Anxiety Disorders Common and uncommon fears

Anxiety Disorders

Anxiety Disorders

PET Scan of brain of person with Obsessive/ Compulsive disorder

High metabolic activity (red) in frontal lobe areas involved with directing attention

Mood Disorders

Mood Disorders characterized by emotional extremes

Major Depressive Disorder a mood disorder in which a person, for no apparent reason,

experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

Dysthymic Disorder- less extreme than MJD, but longer lasting (“the blues”)

Mood Disorders

Manic Episode a mood disorder marked by a

hyperactive, wildly optimistic state Bipolar Disorder

a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania

formerly called manic-depressive disorder

Mood Disorders-Depression


Canadian depression rates

Mood Disorders- Suicide

Mood Disorders-Bipolar

PET scans show that brain energy consumption rises and falls with emotional switches

Depressed state Manic state Depressed state


Altering any one component of the chemistry-cognition-mood circuit can alter the others


The vicious cycle of depression can be broken at any point

Schizophrenia & Personality Disorders

1. 16-4 Quiz

2. Projects

3. HW: 17-1, Review Ch 5&6 Sensation & Perception

Schizophrenia & Personality Disorders

16-4 646-657Schizophrenia: Symptoms, Subtypes, Biological and Psychological Factors;

Personality Disorders; Prevalence of Psych Disorders

1. Explain the development of mood disorders, paying special attention to the

biological and social-cognitive perspectives.2. Describe the various symptoms and types of schizophrenia, and discuss research

on its causes.3. Describe the nature of personality disorders, focusing on the characteristics of the

antisocial personality disorder.4. Describe the characteristics and possible causes of dissociative identity disorder.5. Describe the prevalence of various disorders and the timing of their onset.

Dissociative Disorders

Dissociative Disorders conscious awareness becomes separated

(dissociated) from previous memories, thoughts, and feelings

Dissociative Identity Disorder rare dissociative disorder in which a

person exhibits two or more distinct and alternating personalities

formerly called multiple personality disorder

Schizophrenia

Schizophrenia literal translation “split mind” a group of severe disorders

characterized by: disorganized and delusional thinking disturbed perceptions inappropriate emotions and actions

Schizophrenia

Delusions false beliefs, often of persecution

or grandeur, that may accompany psychotic disorders

Hallucinations sensory experiences without

sensory stimulation

Schizophrenia

Personality Disorders

Personality Disorders disorders characterized by

inflexible and enduring behavior patterns that impair social functioning

usually without anxiety, depression, or delusions


Antisocial Personality Disorder disorder in which the person

(usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members

may be aggressive and ruthless or a clever con artist


Boys who were later convicted of a crime showed relatively low arousal

Personality Disorders PET scans illustrate reduced activation in a

murderer’s frontal cortexNormal Murderer

Rates of Psychological Disorders

Chapter 17

Therapy

17-1 659-664Psychological Therapies: Dix, Psychoanalysis - Methods, Psychodynamic Therapy; Freud,

Humanistic-Client Centered Therapy, Active Listening, UPR, Maslow, Rogers

1. Discuss the aims and methods of psychoanalysis, and explain the critics’ concerns with this form of therapy, noting how psychodynamic therapists have tried to answer the criticisms.

2. Identify basic characteristics of the humanistic therapies and the specific goals and techniques of client-centered therapy.

17-2 664-673 Behavior Therapies: Classical Conditioning Therapies-Counterconditioning (Exposure

Therapies--Systematic Desensitization, Vrtual Reality Exposure Therapy; Aversive Conditioning), Operant Conditioning Therapy-Token Economy, Cognitive Therapy, CBT, Group & Family Therapy

3. Identify the basic assumptions of behavior therapy, and discuss the classical conditioning

techniques of systematic desensitization and aversive conditioning. 4. Describe therapeutic applications of operant conditioning principles, and explain the critics’

concerns with this behavior modification process. 5. Describe the assumptions and goals of the cognitive therapies and their application to the

treatment of depression. 6. Describe the rationale and benefits of group therapy, including family therapy.

1. States of Consciousness Q/A2. States of Consciousness Review Quiz3. Review Test Essay4. Project Presentations5. HW: 17-4, Practice Essays – Bring on Disk or

Flash Drive

1. States of Consciousness Q/A2. States of Consciousness Review Quiz3. IB Exam Prep4. Review Test Essay5. HW: 17-4, Practice Essays – Bring on Disk or

Flash Drive

17-3 674-684 Evaluating Psychotherapy: Effectiveness of Psychotherapy,

Meta-Analysis, Alternative Therapies: Therapeutic Touch, EMDR, Light Exposure Therapy, Commonalities of Therapies, Types of Therapists

7. Discuss the findings regarding the effectiveness of the psychotherapies, and explain why ineffective therapies are often mistakenly perceived to be of value.

8. Describe the commonalities among the psychotherapies, and discuss the role of values and cultural differences in the psychotherapeutic process.

1. 17-4 Quiz2. Project Presentations3. Essay Review4. Review Confusing Pairs/ Fond Remb/ People Packet5. HW: Disorders & Therapies- Take Home Tests on Web 2 Sheets of PaperTake Both, Check Answers, then create test review sheet and

create notes for missed questions (if you missed 10 items, you should have 10 annotations for notes)

1. 17-4 Quiz2. Project Presentations3. Review M.C.4. Review Confusing Pairs/ Fond Remb/ People Packet5. HW: OnlineDisorders & Therapies- Take Home Tests on Web, can work w/

partner Review Essay Rubrics

**FRI Review Session in S-7, 2:15-3:15 (Con’t be Late)….EC???

Deinstitutionalization – 50s, sparked by ThorazineDissociative Disorders Dissociative Amnesia – forget after trauma Dissociative Fugue- flee and forget after trauma Dissociative Identity Disorder-multiple personality disorderConversion Disorder-convert psychological distress into medical problemSomatoform Disorders- Hypochondriasis – misinterpret normal bodily changes/ functions as abnormal Conversion Disorder-convert psychological distress into medical problem

Extra Items Notes:Hans Selye

17-4 685-693 Biomedical Therapies: Drug Therapies-Anitpsychotics,

Antianxietys, Antidepressants, Mood Stabilizers-lithium, ECT, Psychosurgery-lobotomy

9. Identify the common forms of drug therapy. 10. Describe the use of electroconvulsive therapy and

psychosurgery in the treatment of psychological disorders.

History of Treatment

Therapy

Psychotherapy an emotionally charged, confiding

interaction between a trained therapist and someone who suffers from psychological difficulties

Eclectic Approach an approach to psychotherapy that,

depending on the client’s problems, uses techniques from various forms of therapy

Therapy- Psychoanalysis

Psychoanalysis Freud believed the patient’s free

associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight

use has rapidly decreased in recent years Resistance

blocking from consciousness of anxiety-laden material

Therapy- Psychoanalysis

Interpretation the analyst’s noting supposed dream

meanings, resistances, and other significant behaviors in order to promote insight

Transference the patient’s transfer to the analyst of

emotions linked with other relationships e.g. love or hatred for a parent

Humanistic Therapy

Client-Centered Therapy humanistic therapy developed by

Carl Rogers therapist uses techniques such as

active listening within a genuine, accepting, empathic environment to facilitate clients’ growth

Humanistic Therapy Active Listening-empathic listening in

which the listener echoes, restates, and clarifies

Behavior Therapy

Behavior Therapy therapy that applies learning principles to

the elimination of unwanted behaviors Counterconditioning

procedure that conditions new responses to stimuli that trigger unwanted behaviors

based on classical conditioning includes systematic desensitization and

aversive conditioning

Behavior Therapy Exposure Therapy

treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid

Behavior Therapy Systematic Desensitization

type of counterconditioning associates a pleasant, relaxed state with

gradually increasing anxiety-triggering stimuli

commonly used to treat phobias Aversive Conditioning

type of counterconditioning that associates an unpleasant state with an unwanted behavior

nausea ---> alcohol (eg. Antabuse)

Behavior Therapy Systematic Desensitization

Behavior Therapy

Aversion therapy for alcoholics

(eg. Antabuse)

Behavior Therapy

Token Economyan operant conditioning procedure that rewards desired behavior

patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats

Cognitive Therapy

Cognitive Therapy teaches people new, more adaptive ways of thinking and acting

based on the assumption that thoughts intervene between events and our emotional reactions

Cognitive Therapy

The Cognitive Revolution

Cognitive Therapy

A cognitive perspective on psychological disorders

Cognitive Therapy

Cognitive therapy for depression

Cognitive Therapy

Cognitive-Behavioral Therapya popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

Group and Family Therapies

Family Therapy treats the family as a system views an individual’s unwanted

behaviors as influenced by or directed at other family members

attempts to guide family members toward positive relationships and improved communication

Evaluating Psychotherapies

To whom do people turn for help for psychological difficulties?


Regression toward the mean tendency for extremes of unusual

scores to fall back (regress) toward their average

Meta-analysis procedure for statistically

combining the results of many different research studies


Poor outcome Good outcome

Averageuntreated

person

Averagepsychotherapy

client

Number ofpersons

80% of untreated people have pooreroutcomes than average treated person

Therapists and their Training

Clinical psychologists Most are psychologists with a Ph.D.

and expertise in research, assessment, and therapy, supplemented by a supervised internship

About half work in agencies and institutions, half in private practice


Clinical or Psychiatric Social Worker A two-year Master of Social Work

graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems

About half have earned the National Association of Social Workers’ designation of clinical social worker


Counselors Marriage and family counselors

specialize in problems arising from family relations

Pastoral counselors provide counseling to countless people

Abuse counselors work with substance abusers and with spouse and child abusers and their victims


Psychiatrists Physicians who specialize in the

treatment of psychological disorders Not all psychiatrists have had

extensive training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems

Many have a private practice

Biomedical Therapies

Psychopharmacology study of the effects of drugs on

mind and behavior Lithium

chemical that provides an effective drug therapy for the mood swings of bipolar (manic-depressive) disorders

Biomedical Therapies The emptying of U.S. mental hospitals

Biomedical Therapies

Biomedical Therapies Electroconvulsive Therapy (ECT)

therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

Psychosurgery surgery that removes or destroys brain

tissue in an effort to change behavior lobotomy

now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients

Electroconvulsive Therapy

Mind-Body Interaction

abnormal psych

Documents

psychological disorderstoday

personality disorders

social perspectiveassumes

mental illnesses

animals blood

abnormal psychchapter

aims of dsm

mental health workers