abnormal psychology
TRANSCRIPT
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Abnormal
Psychology
Dr. Irene Karayianni
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Abnormal Behavior
• Actions, thoughts and feelings that are distressing or harmful
• Not able to function in everyday life
• Not only strange and unusual
• 20% of USA population
– It is not a single symptom, but a syndrome (pattern of symptoms that appear
together)
– continuity hypothesis: abnormal behavior is more severe form of normal Ψ
problems
– discontinuity hypothesis: abnormal behavior is entirely different from normal Ψ
problems
• BUT – A bit subjective
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Historical views
Supernatural theories
• Possessed by evil spirits
• Severe consequences
• Treatment: prayer, fasting, purgatives (help the person vomit out the
evil spirit), destroy their bodies to drive out Satan
Image source: http://mentalillness.umwblogs.org/stone-age/
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Historical views
Biological theories
• Hippocrates: biological disorders of the body cause abnormal behavior
• The body contains 4 important fluids (humors)
– Blood
– Phlegm
– Black bile
– Yellow bile
• Imbalance in fluids illness and abnormal behavior
• He set the foundation for natural causes (rather than supernatural)
• Creation of Psychiatry
Image source: http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html
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Historical views
Psychological theories
• Pythagoras said that abnormal behavior is caused by Psychological
factors such as stress
• He placed individuals in temples to receive rest, exercise, good
diet, someone to talk to, practical advice
Image source: http://www.cntraveler.com/hot-list/2012/spas/caudalia-vinotherapie-spa-alentejo-portugal
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Contemporary views
• Abnormal behavior is due to
– Biological causes: genetic predispositions, abnormal functioning of nervous
system
– Psychological causes: stress, abnormal social learning
– Social causes: inadequate social support
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Diagnostic and Statistical Manual of Mental Disorders (DSM)
• Provides common set of definitions of mental disorders
• Diagnostic criteria
• Multi axial system (give more than one diagnosis). Five axes:
I. clinical disorders: most mental disorders
II. personality disorders and mental retardation
III. general medical conditions
IV. psychosocial and environmental problems: adverse living conditions,
stressful circumstances
V. global assessment of functioning: how well the person is functioning in
life
DSM-I (1952)
DSM-II (1968)
DSM-III (1980)
DSM-III-R (1987)
DSM-IV (1994)
DSM-IV-TR (2000)
DSM-5 (2013)
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How harmful are abnormal psychological problems?
• 9 in top 10 leading causes of disability are either psychological disorders
(e.g. depression) or strongly associated with them (e.g. alcohol)
• 50% of all disability experience is related to abnormal psychological
problems
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Stigma
• We have negative perceptions of people with abnormal psychological
problems
• They make us uncomfortable
• We might be afraid of them
• Consequences:
– Stigma makes mental health problems worse, lose social support
– Prevent patients to seek health
• Fight stigma
– It is easier to think of mental problems through the continuity hypothesis;
emotions can get out of hand vs. mentally ill, losing your mind
– Education
Image source: http://www.imagebase.net/Concept/Test-012-copy
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Insanity
• It is not psychological term
• A legal definition concerning a person’s inability to
– tell right from wrong they cannot be found guilty in trial
– understand trial proceedings they can’t stand trial, unable to help their
defense
– understand whether the person is a direct danger to self or others they
can be put in mental institution without their will
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Anxiety disorders Phobias
Generalized and Panic Anxiety disorders
Post traumatic stress disorder
Obsessive Compulsive disorders
Image source: http://www.dailywt.com/10-sings-you-may-have-an-anxiety-disorder/
High level of negative emotions
Nervous, worried, tense, scared,
anxious
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Phobias
• Intense, irrational fear for a specific situation /
object that that the individual will often go to
great pains to avoid.
• Specific phobia: scared of a specific thing
• Social phobia: scared of social interactions,
especially with strangers or situations they may
be evaluated negatively
• Agoraphobia: fear of open spaces; leaving your
home or other familiar places
Image source: http://www.thewellnessdirectory.co.nz/ailment/agoraphobia
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Examples of specific phobias
• Acrophobia - Fear of Heights
• Claustrophobia - Fear of Enclosed Spaces
• Nyctophobia - Fear of the Dark
• Ophidiophobia - Fear of Snakes
• Herpetophobia - fear of reptiles
• Arachnophobia - Fear of Spiders
• Astraphobia - Fear of Thunder and Lightning
• Nosophobia - Fear of Having a Disease
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Generalized anxiety disorders
• Generalized anxiety disorders: Vague, uneasy sense of general tension
and worry for no apparent reason that makes the individual very
uncomfortable because of its long duration
• Panic anxiety disorder: Panic attacks; pattern of anxiety in which long
periods of calm are broken by very uncomfortable attack of anxiety
that are not tied to a specific situation.
– Increase in breathing
– Rapid heartbeats, like having a heart attack
– 5% of population
Image source: http://www.nativeremedies.com/ailment/symptoms-of-panic-attacks.html
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Post-traumatic stress disorder
• Severe anxiety and distress that persists long after traumatic event
• Many recover, but for others it is chronic
• Can lead to serious problems (alcohol, suicide)
• It involves:
– memories of event that intrude into consciousness and dreams
– intense emotional and autonomic reactions to reminding stimuli
– avoidance of stimuli associated with event
– feeling numbed to the ordinary emotions and pleasures of life
– difficulty sleeping, hyperarousal, irritability and difficulty concentrating
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Stressors that cause Post-traumatic stress disorder
• war, combat-related stress
• physical assault
• rape and sexual molestation
• automobile accident
• witnessing violence and disasters
• terrorism
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Who develops Post-traumatic stress disorder
• Not everyone who experiences a traumatic event <10%
• MORE likely…
– Those who experienced a more severe stressful event
– Lower intelligence
– More mental health problems prior to event
– Exposed to previous trauma
– Genetic predisposition
– People with less social support after event
– Females that were raped
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Obsessive-Compulsive Disorders
• Obsession = anxiety provoking thoughts that don’t go away
• Compulsion: irresistible urge to engage in specific irrational behaviors,
such as washing your hands, repeatedly touching a spot in your
shoulder, checking the locks on doors, etc.
• 2% of population
http://www.youtube.com/watch?v=dSZNnz9SM4g
Image source: http://www.patient.co.uk/blogs/sarah-says/obsessive-compulsive-disorder
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Somatoform disorders Somatization disorders
Hypochondriasis
Conversion disorders
Somatoform pain disorders
Image source: http://www.minddisorders.com/Py-Z/Somatization-and-somatoform-disorders.html
Experiencing symptoms of physical
health problems that have
psychological causes
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Somatization disorders
• Chronic and recurrent aches, pains, tiredness and other symptoms of
body illness in the absence of a known medical cause.
• Usually experience other psychological difficulties (anxiety, depression)
• Dangerous because they go to extremes to alleviate symptoms (too
many medicines, alcohol, etc)
Image source: http://mighty-pen.hubpages.com/hub/Somatoform-Disorders
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Hypochondriasis
• Milder form of somatization disorder
• Preoccupation with health
• Overreact to minor coughs and pains
• Going to unreasonable lengths to avoid germs and cancer-causing agents
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Conversion disorders
• Rare
• Anxiety is “converted” into serious body symptoms
• Individuals experience serious body symptoms such as functional
blindness, deafness, inability to speak and paralysis without apparent
physical cause
• Individuals are ineffective and depend on others
• They show a beautiful indifference (they don’t seem to care so much,
little emotional response for their condition)
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Somatoform pain disorders
• Primary symptom is pain with no physical cause
• The pain does not follow nerve pathways
• Occurs at time of high stress
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Dissociative disorders Depersonalization
Dissociative amnesia
Dissociative fugue states
Dissociative identity disorder (multiple personality)
Image source: http://www.flickr.com/photos/theojunior/12146506273/
Sudden changes in cognition
Change in memory, perception, identity
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Depersonalization
• Perceptual experience of one’s body or surroundings becoming distorted
or unreal
• E.g. enlarged hands, leaving one’s body and looking at it from the
ceiling
Image source: https://www.healthtap.com/user_questions/481914-what-is-the-definition-or-description-of-depersonalization
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Dissociative amnesia
• Memory loss that is psychologically caused
• Loss of memory for all or part of the event
• Occurs after a period of intense stress
• Memories are recovered in time
Image source: http://psych.answers.com/abnormal/avoidant-personality-disorder-the-dos-and-donts-of-managing-your-symptoms
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Dissociative fugue states
• Reversible amnesia for personal identity, including the memories,
personality, and other identifying characteristics of individuality
• usually involves unplanned travel or wandering
• Is sometimes accompanied by the establishment of a new identity.
• After recovery, previous memories usually return intact, but there is
typically amnesia for the fugue episode.
Image source: http://www.comediva.com/how-to-throw-ultimate-breaking-bad-marathon-party/
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Dissociative identity disorder (multiple personality)
• Shift abruptly and repeatedly from one personality to another
• Two or more personalities, different from one another
• The original personality is often conventional, unhappy, moralistic
• At least one alternative personality is sensual and rebellious
• The original personality is not aware of the alternatives
• The alternatives are aware of the original personality
• Effort to cope with painful memories from abuse during childhood?
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Mood disorders Major depression
Bipolar disorder
Schizophrenia
Image source: http://anxietyreliefzone.com/generalized-anxiety-disorder/anxiety-disorders-in-teens-when-should-they-get-help/
Involving depression and/or abnormal joy
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Major depression
• Episodic disorder – symptoms come and go
• 1/3 experience it only once
• Half usually recover after 12 weeks
– Deep unhappiness, loss of interest in life
– Believe that the future is miserable
– Negative opinion of self and others
– No reason to live
– Increased / decreased sleep
– Increased / decreased appetite
– Loss of interest in sex
– Loss of energy
– Difficulty concentrating
– Loss of productivity
• Causes: high stress, loss of loved one, firing, personal humiliation,
genetic reasons, negative opinion of self
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Bipolar disorder (manic-depressive psychosis)
• Experiencing periods of mania that alternate irregularly with periods of
depression
• Some shift frequently, some infrequently. Avg: 3-4 / year
• 1% of population
• Manic episode:
– intense pleasure, “high”, euphoria, high self esteem, unrealistic optimism,
little sleep is needed; also shopping sprees, quitting job, getting divorce,
sexual promiscuity
– If someone tries to control them, they get angry
• Causes: genetic predisposition
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Schizophrenia
• Involves
– disturbance in the way of thinking (delusions – strange false beliefs,
hallucinations – bizarre false perceptual experiences) out of touch with
reality
– Disorganized, illogical emotions, thinking, behavior difficult to have
conversations with them
– reduced enjoyment and interests less pleasure
• 1% of population
• Males are 30% more likely than women
• Some people recover completely, more than half experience repeated
episodes
http://www.youtube.com/watch?v=rWsYIoLZHYI
Movie: a beautiful mind
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Schizophrenia causes
• genetic factors
• environmental factors
– pregnancy complications that cause abnormal brain development
– childhood head injuries
– viral infections of the brain
– living in stressful urban environments
– living in families with high levels of disharmony
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Schizophrenia types
• It is a broad class of psychotic disorders, broken down into 3 subtypes
– Paranoid schizophrenia: false beliefs or delusions that seriously distort
reality. Exceptional importance of self (e.g. being Jesus Christ) and hence
others are out to get them. Hallucinations (see, hear or feel things that are
not there).
– Disorganized schizophrenia: delusions and hallucinations have little
recognizable meaning because the speech and thoughts are so disorganized.
Withdrawal from human contact, silliness of emotion, childlike.
– Catatonic schizophrenia: abnormalities in social interaction, posture and
body movement. Long periods of catatonic blankness, like statues, no
talking, not seem to be listening. Frequently, periods of agitation and anger.
Image source: http://thebestpictureproject.wordpress.com/2011/04/30/awakenings/
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Attention-Deficit/Hyperactivity Disorder (ADHD)
Begins in childhood, but does not always end there
Inattention symptoms:
• Can’t sustain attention
• No attention to details
• Careless mistakes
• Distracted easily
• Not complete tasks
• Disorganized
• Loses pencils, pen, assignments
• Not listen when being spoken to
• Avoids tasks that require sustained
attention
• Forgetful
Hyperactivity – impulsivity symptoms
• Twists and turns when seated
• Runs or climbs excessively
• Restlessness
• Difficulty in sitting quietly and
playing
• Talks excessively
• Answers before the questions is
completed
• Has difficulty waiting his/her turn
• Interrupts others
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Attention-Deficit/Hyperactivity Disorder (ADHD)
• Associated with difficulties at school
• Difficulties in relationships
• Accidental injuries
• Diagnosis when the individual exhibits 6+ of either group of symptoms
that cause problem in at least 2 areas of life
• Difficult to diagnose:
– Symptoms are variation of normal behavior
– Other mental problems are characterized by restlessness and attention
problems
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Personality disorders Schizoid
Antisocial
Schizotypal
Paranoid
Histrionic
etc
Psychological disorders that result from personalities that developed improperly during childhood
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Schizoid personality disorder
• Were very shy as children
• Emotional coldness, apathy
• Distant
• Lack of interest in social relationships
• Little or no desire to have friends
• Withdrawal in solitude, loners
• Later in life: lose interest in personal appearance, hygiene and polite
social conventions
• Often they do not work / homeless
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Antisocial personality disorder
• Smooth social skills, sweet talking
• Lack of guilt about violating social rules and laws
• Unemotional
• Taking advantage of others
• Difficulty in maintaining relationship with others
• They enter easily intimate relationships but break up quickly
• Impulsive
• Abnormal need for stimulation, novelty (they may become addicts)
• Lose their temper quickly
• Lie easily and skillfully
• As children: bullies who fight, lie, cheat, steal, blame others, not learn
from mistakes
https://www.youtube.com/watch?v=wTuzVm8xtjM
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Schizotypal personality disorder
• Few friends
• Suspicious
• Misinterpret situations as being strange
• Strange ideas (e.g. their mind can be read by others, or messages can
be received in strange ways)
• paranormal and superstitious beliefs
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Paranoid personality disorder
• Very suspicious of others
• No trust to others
• Extreme irritability and sensitivity
• Coldness
• Lack of tender feelings
Image source: http://anxietyreliefzone.com/generalized-anxiety-disorder/anxiety-disorders-in-teens-when-should-they-get-help/
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Histrionic personality disorder
• Self-centered
• Wants to be the center of attention
• Manipulating others through exaggerated expression on emotions
• Superficially charming and seductive
• Lacks genuine concern for others
• Frequent angry outbursts
Image source: http://learnhowtorock.alloyentertainment.com/perfs-back-to-school-style/#1 http://www.alexiscolby.com/2011/11/in-every-way-lady.html h
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Narcissistic personality disorder
• Too self absorbed
• Egocentric
• Vanity
• Unrealistic sense of self importance
• Feels entitled to special consideration
• Fantasies of future success
• Requires constant attention and compliment
• Reacts negatively / indifferent to criticism
• Exploits others
• Lack of genuine concern for others
Image source: http://setfreefromtheic.wordpress.com/2011/08/20/why-narcissists-make-bad-church-leaders/
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Borderline personality disorder
• Emotionally unstable
• Impulsive
• Unpredictable
• Unstable personal relationships
• Angry
• Almost constantly needs to be with others
• Lack of clear identity
• Feelings of emptiness
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Avoidant personality disorder
• Extreme shyness
• Social withdrawal
• Although they desire friends
• Extremely sensitive to rejection
• Very low self-esteem
Image source: http://lostemerald.wordpress.com/2011/02/09/i-am-shocked-histrionic-and-avoidant-personality-disorders/
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Dependent personality disorder
• Passive dependence on others for support and decisions
• Low self esteem
• Puts needs of others before self
Image source: http://blog.turbotax.intuit.com/2011/03/29/who-can-i-claim-as-a-dependent-for-this-tax-year/
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Obsessive compulsive personality disorder
• Perfectionist
• Dominating
• Poor ability to express affection
• Excessive devotion to work
• Indecisive when faced with major decisions
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Sexual and Gender
identity disorders
Sexual practice that differs considerably from the norm
Image source: http://hqworld.net/gallery/details.php?image_id=13553&sessionid=07448aa8acc039bb553b33356fbe23a7
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Transvestism
• Almost always males
• Dressing in clothes of the other sex
– They find this sexually stimulating
– They free themselves from limiting sexual stereotypes
• With relatively well-adjusted sex lives
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Gender identity disorder
• Aka transsexualism
• The individual feels trapped in the body of the wrong sex
• May dress in the clothes of the other sex
• May undergo hormone injections and plastic surgery
• Possible sex-change operation
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Fetishism
• Obtaining sexual arousal primarily or exclusively from specific objects
or types of material (e.g. leather, lace)
• Is considered abnormal if it interferes with sexual adjustment of the
person or the partner
Image source: http://www.papermag.com/2011/05/a_hush-hush_louboutin_sale_lit.php
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Sexual sadism and masochism
• S&M
• Sexual Sadism: receiving sexual pleasure from causing pain on others
• Sexual Masochism: receiving pain is sexually exciting
• Sometimes verbal abuse or degradation, instead of physical pain
• Many individuals who practice S&M, do so with a consenting partner,
and do not cause pain that is medically dangerous
• In some cases, it involves intense pain or death
Image source: http://lordsofthedrinks.com/2014/01/09/men-in-saudi-arabia-get-whip-lashes-and-jail-time-for-party-with-alcohol-and-girls/
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Voyeurism
• Obtaining sexual pleasure by watching others undressing or engaging in
sexual activities
• Usually when the other is not aware of their presence
• Element of danger involved
• Usually heterosexual males who find it difficult to establish a normal
sexual relationship
• Few commit rape
Image source: http://yatin.chawathe.com/photos/2002-07-Turkey/istanbul/html/peeping-tom.html
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Exhibitionism
• Obtain sexual pleasure from exposing their genitals to others
• They want to shock their victims
• Rarely dangerous in other ways
• Almost all are heterosexual males
• Typically married
• Shy and with inhibited sex lives
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Forced sexual behavior
• Rape: forcing sexual activity on an unwilling person
– Usually males
– Aggressive impulses, need to feel powerful and dominating rather than
sexual desire
– 18 mil women have been raped in the USA
– Usually by someone they already know