Are you Crazy?

Normal or Not? Story: A man living in the Ozark

Mountains has a vision in which God speaks to him. He begins preaching to his relatives and neighbors, and soon has the entire town in a state of religious panic. People begin to say that he has a “calling.” His reputation as a prophet and a healer spreads, and in time he is drawing large audiences wherever he goes.

However, when he ventures in St. Louis ad attempts to hold a prayer meeting, blocking traffic on main street at rush hour, he Is arrested. He tells the policemen about his conversations with God, and they hurry him off to the nearest mental hospital.

Normal or not? Who is right…The man who

believes he is a prophet, or the police officers?

It Is often difficult to draw a line between normal and abnormal behavior.

Behavior that some consider to be normal seems abnormal to others.

Many people believe that having visions and hearing voices are important parts of a religious experience.

Other people believe that these are symptoms of a psychological disorder.

Normal or Not?The man in the example on the

previous slide was interviewed by psychiatrists, diagnosed as paranoid schizophrenic, and hospitalized.

Had he stayed at home, people would have continued to see him as perfectly normal – even popular…

Defining and Identifying Psychological Disorders

In the previous example, the man was classified as mentally troubled because his behavior was so different from what others felt was normal under the circumstances.

Yet, the fact that a person is different does not necessarily mean that he or she is suffering from a mental illness.

Deviation from NormalityOne approach to

defining abnormality is to say that whatever most people do is normal.

Abnormality, then, would be any deviation from the average or from the majority.

Deviation from Normality The deviance approach,

however, as commonly used as it is, has serious limitations.

For example: If most people cheat on their income-tax returns, does that mean that the people who do not cheat are abnormal?

Because the majority is not always right or best, the deviance approach to defining abnormality is not by itself a useful standard.

Adjustment Another way to distinguish

normal from abnormal people is to say that normal people are able to get along in the world – physically, emotionally, and socially.

Basically, people who live by the rules of society.

By this definition, abnormal people would be the ones who fail to adjust to society.

What do you think? So what is right? Who is to say what

issues constitute a psychological disorder, and what issues are merely minor variations from what is considered to be normal behavior?

Back in the day…Used to be that

people thought one was possessed by demons if they acted abnormally

As time progressed and the scientific revolution took hold, they took the chains off people who were abnormal.

So, what does it mean to have a psychological disorder?

Psychological Disorder-a harmful dysfunction in which behaviors are maladaptive, unjustifiable, disturbing, and atypical…M.U.D.A.M-maladaptiveU-unjustifiableD-disturbingA-atypical

Maladaptive BehaviorRefers to types of behaviors that inhibit a

person’s ability to adjust to particular situations and are destructive.People cannot adapt to what life gives them.They exhibit behavior that is destructive to

oneself or others.Got any examples?Here is one

UnjustifiableWithout a rational basis

Disturbing BehaviorTroublesome to other people

AtypicalSo different that it violates a norm

Can you think of anything?How about this?

Read these one and try to diagnose…

A man walks up to a window, by or through which no one can see him, carrying a chair. He puts down the chair, opens the window, takes off his clothes, and seats himself on the chair. Why? He says he feels the need to take an “air bath.”

Every morning, a woman who lives in a Boston suburb asks her husband to bring in the morning newspaper, which the carrier throws just inside their fence. She does this because she is terribly afraid of encountering a poisonous snake. Her husband, concerned about her behavior, repeatedly tells her that there are no poisonous snakes living in their town. Nevertheless, she is afraid to leave the house.

A teenage boy packs a blanket and a bottle of water. Ignoring near-freezing temperatures, he climbs a nearby mountain, spreads the blanket on the ground, sits cross-legged on it, closes his eyes, and remains there throughout the night. In the morning, he runs home and tells his father he has seen a vision.

A teenage girl misses school for 3 days. She periodically breaks into tears. She finds it nearly impossible to get out of bed in the morning, although she cannot sleep for more than an hour or two at a time. She has no appetite and becomes nauseated if people urge her to eat.

Last one…

Anne is a sixteen-year-old girl living in a medium-sized city in the Midwest. Her family includes a mother, father, fourteen-year-old brother, and a great-aunt, who has lived with the family since Anne was four. Anne is a junior at City High School and is taking a college-preparatory program. Her appearance is strikingly different from the other girls in her class.

She wears blouses which she has made out of various scraps of material. The blouses are accompanied by the same pair of overalls everyday, two mismatched shoes, and a hat with a blue feather. She is a talented artist, producing sketches of her fellow classmates that are remarkably accurate. She draws constantly, even when told that to do so will lower her grade in classes where she is expected to take lecture notes. She has no friends at school, but seems undisturbed by the fact that she eats lunch by herself and walks alone around the campus. Her grades are erratic; if she likes a class she often receives an A or B, but will do no work at all in those she dislikes. Anne can occasionally be heard talking to herself; she is interested in poetry, and says she is "composing" if asked about her poetry. She refuses to watch television, calling it a "wasteland." This belief is carried into the classroom, where she refuses to watch videotapes, saying they are poor excuses for teaching. Her parents say they don’t understand her; she isn’t like anyone in their family. She and her brother have very little in common. He is embarrassed by Anne’s behavior, and doesn’t understand her either. Anne seems blithely unaware of her apparent isolation, except for occasional outbursts about the meaninglessness of most people’s activities.

How do we explain disorders?Medical Model of explanation

Caused primarily by biological reasonsWe treat these causes through medicine,

surgery, and ECT (shock therapy)Bio-Psycho-Social Model of explanation

Caused by a combination of reasons (mostly psychological trauma)

We treat with psychotherapy

A Few Different Types of Disorders

AnxietyMoodSomatoformDissociativeSchizophrenic

Anxiety Disorders Anxiety: is a general state of

dread or uneasiness that a person feels in response to a real or imagined danger.

People suffering from anxiety disorders feel anxiety, but not just normal anxiety.

They suffer from anxiety that is out of proportion to the situation that is provoking it.

This intense anxiety may interfere with the normal functioning of everyday life.

Anxiety disorders are the most common mental disorders in the United States.

Anxiety Disorders These disorders share certain

characteristics, including feelings of anxiety and personal inadequacy and an avoidance of dealing with problems.

People with anxiety disorders often have unrealistic images of themselves.

Their emotional problems may be expressed with constant worrying, sudden mood swings, or a variety of physical symptoms (headaches, sweating, muscle tightness, weakness, and fatigue.)

These people often have difficulty forming and sustaining long term relationships.

Why do you think this is?

Anxiety DisordersPhobiasPanic AttacksPTSDOCD

Phobia Disorder Phobia: An intense or irrational fear

of an object or situation. Phobias range in intensity from mild

to extremely severe. Most people deal with phobias by

simply avoiding what frightens them.

Thus, phobias are learned and maintained by reinforcing the effects of avoidance, which reduces anxiety but not the phobia.

Example: If you are afraid of spiders, you do your best to avoid them at all costs.

Panic Disorder Panic Disorder: An extreme anxiety

that manifests itself in the form of panic attacks.

During a panic attack, a victim experiences sudden and unexplainable attacks of intense anxiety, leading the individual to feel a sense of inevitable doom or even the fear that he or she is about to die.

Many symptoms of panic disorder include; an extreme sense of smothering, choking, difficulty breathing, fainting, dizziness, nausea, and chest pains.

Here is a classic example

Panic Disorder Although panic attacks

sometimes last for an hour or more, most attacks last only a few minutes and come on without warning.

Panic disorder may be inherited.

However, the panic victim usually experiences their first attacks shortly after a stressful event.

Post Traumatic Stress Disorder Post-Traumatic Stress Disorder: A

disorder in which victims of traumatic events experience the original event in the form of dreams or flashbacks.

This disorder is common among veterans of military combat and survivors of acts of terrorism, natural disasters such as floods or tornadoes, other catastrophes such as a plane crash, and human aggression such as rape or assault.

The event that triggers the disorder overwhelms a person’s sense of reality and ability to cope.

This disorder may begin shortly after a traumatic experience or it may develop much later.

Post-Traumatic Stress Disorder Typical symptoms include involuntary

flashbacks and recurring nightmares during which the victim re-experiences the ordeal, often followed by insomnia or feelings of guilt.

Post-Traumatic Stress Disorder can be extremely long lasting.

Survivors of the holocaust, veterans of the Vietnam war, and survivors of the attacks on Pearl Harbor may still display symptoms of this disorder.

Not everyone though, who experiences a traumatic event will develop this disorder.

Somatoform Disorder Somatoform Disorder:

Physical symptoms for which there is no apparent physical cause.

Somatoform is also commonly known as Hysteria.

The term hysteria was more commonly used in Sigmund Freud’s time.

It was used to refer to unexplainable fainting, paralysis, or deafness.

Somatoforms Disorder There are 2 major types of Somatoform

Disorder…Conversion Disorder and Hypochondriasis.

Conversion Disorder: Changing emotional difficulties into a loss of a specific voluntary body function.

While the loss of functioning is completely real, no physical damage is present.

Many people occasionally experience mild conversion disorders, such as when a person is frightened and cannot move, but true conversion disorder is not simply a brief loss of functioning due to fright…It persists.

This doesn’t refer to “Psychosomatic”..that is a real disorder caused by psychological factors such as an ulcer or high blood pressure

Conversion Disorder A conversion disorder results in a real

and prolonged handicap; the person literally cannot feel his left hand, move his legs, or exercise some other normal physical function.

For example; a man might wake up in the morning and not be able to feel anything from the waist down, finding himself paralyzed.

The normal reaction to this would be one of panic. However, he may simply accept this, showing that it is more of a psychological problem than a physical one.

Hypochondriasis Hypochondriasis: A disorder in

which a person who is in good health becomes preoccupied with imaginary ailments.

The hypochondriac spends a lot of time looking for signs of serious illness and often misinterprets minor aches, pains, bruises, or bumps as signs of a fatal illness.

Despite negative results in medical tests and physical evaluations, the hypochondriac typically continues to believe that a disease or malfunction exists.

Dissociative Disorders Dissociative Disorder: A disorder in

which a person experiences alterations in memory, identity, or consciousness.

There are many different types of this disorder.

1. Dissociative Amnesia: The inability to recall important personal events or information; is usually associated with stressful events.

Amnesiacs remember how to speak and usually retain some general knowledge, but may forget who they are, where they live and work, or who their family is.

Dissociative Disorders 2. Dissociative Fugue: A dissociative disorder

in which a person suddenly and unexpectedly travels away from home or work and is unable to recall the past.

Example; a women may suddenly disappear and wake up three days later in a restaurant 200 miles from home.

If she is not treated, she may actually establish a new identity – assume a new name, marry, take a job, and so on – in a new place.

She may repress all knowledge of a previous life.

Dissociative Disorders A fugue state may last for a

few days or even decades. However long it lasts, the

individual, when she comes out of it, will have no memory of what happened during this period of time.

Fugue, then, is a sort of traveling amnesia, and it probably serves the same psychological function as dissociative amnesia…The escape from an unbearable conflict or anxiety.

Dissociative Disorders 3. Dissociative Identity Disorder:

A person exhibits two or more personality states, each with its own patterns of thinking and behaving.

Previously known as multiple personality disorder.

These different personality states may take control at different times.

Some psychologists believed that this division of a personality is an effort to escape a part of the self that he or she fears.

The secret self then emerges in the form of a separate personality.

This is the rarest of the Dissociative Disorders.

Schizophrenia and Mood Disorders

A Story… A woman was delighted to receive a

letter from her son abroad, but distraught when she read it;

“Dear Mother…I am writing on paper. The pen I am using is from a factory called Perry and Co. The factory is in England. The city of London is in England. I know this from my school days. Then I always liked geography. My last teacher in that subject was professor Wilikers. He was a man with black eyes. There are also blue and grey eyes and other sorts too. I have heard it said that snakes have green eyes. All people have eyes. There are some, too, who are blind.”

Schizophrenia The man who wrote this letter

was later diagnosed with schizophrenia.

Sufferers of schizophrenia often have difficulty using language to communicate.

They seem to go from one phrase to another by random association.

This confused language may result because schizophrenia affects the working memory, which is used to form sentences.

A person with schizophrenia will not remember the beginning of a sentence and thus finishes it with an unrelated thought.

Schizophrenia While the disorders

discussed so far are primarily problems of emotion, schizophrenia is a problem of cognition, but it also involves emotion, perception, and motor functions.

Schizophrenia affects 1 in 100 people worldwide, but the odds increase to 1 in 10 if someone in your family already has it.

…Or am I?

Schizophrenia Schizophrenia: A group of disorders

characterized by confused and disconnected thoughts, emotions, and perceptions.

With schizophrenia, a person’s thought processes are somewhat disturbed, and the person has lost contact with reality to a considerable extent.

Schizophrenia is not a single problem; it has no single cause or cure.

Rather, it is a collection of symptoms that indicates an individual has serious difficulties trying to meet the demands of life.

Schizophrenia Many people with schizophrenia

experience delusions and hallucinations.

Delusions: False beliefs that a person maintains in the face of contrary evidence.

Hallucinations: Perceptions that have no direct external cause.

For example; a person with schizophrenia may perceive hearing a voice, when, in fact, there is no sound present.

Types of Schizophrenia Psychologists classify schizophrenia

into many different types: Paranoid: Involves hallucinations and

delusions or grandeur; “I am the savior of my people,” or persecution; “someone is always watching me…”

Catatonic: These people may remain motionless for long periods, exhibiting a waxy flexibility in which limbs in unusual positions may take a long time to return to a resting, relaxing position. Much like the melting of a wax statue.

Types of Schizophrenia Disorganized: These people use incoherent

language, inappropriate emotions, giggling for no apparent reason, generally disorganized motor skills, and delusions.

Remission: This label is used for anyone whose symptoms seem to be completely gone but still exist deep in the psyche. The expectation is that eventually these issues will return.

Types of SchizophreniaUndifferentiated: Encompasses the basic

symptoms of schizophrenia, such as the deterioration of daily functioning, hallucinations, delusions, and confusion.

Causes of Schizophrenia It is not fully known what exactly causes this

disorder. It is known that schizophrenia seems to have a

biological basis and can be inherited. The proper workings of the brain depend on the

correct amount of chemicals and oxygen. It is thought that schizophrenia might be caused by a lack of one or both of these items.

Mood Disorders

We all have mood swings. Sometimes we are happy or elated, while other times we feel dejected,sad, or

depressed. Yet, even when we are discouraged, most of us

feel that we can control our emotions and that these feelings will pass.

But what happens if they do not?

According to the National Institute of Health, 20% of the U.S. adult population will suffer from a mood disorder during their lifetime

Mood Disorders Major Depressive Disorder: Severe form of

lowered mood in which a person experiences feelings of worthlessness and diminished pleasure or interest in many activities.

This depression can range from mild sensations to intensely suicidal.

This disorder is marked by; problems eating, lack of physical activity, problems sleeping, walking, and talking…as well as feelings of guilt, worthlessness, and suicide.

Mood Disorders Bipolar Disorder: Disorder in

which an individual alternates between feelings of mania (euphoria) and depression.

In the manic phase, a person experiences elation, extreme confusion, distractability, and racing thoughts. Often this person is irresponsible, has exaggerated self esteem, and exhibits irrational behavior.

ExampleOn admission, she slapped the nurse,

addressed the house physician as God, made the sign of the cross, and laughed loudly when asked to put on a hospital gown. This she promptly tore to shreds…She sang at the top of her voice, screamed through the window, and leered at the patients walking in the yard. (Karnash, 1945)

Bipolar Disorder In the depressive phase, the individual is

overcome by feelings of failure, sinfulness, worthlessness, and despair.

Example: “The patient lay in bed, immobile, with a dull,

depressed expression on his face. His eyes were sunken and down. Even when spoken to, he would not look at the eyes of the speaker. Usually he would not respond at all to questions, but sometimes, after apparently great effort, he would mumble something about the “scourge of God.” (Morris and Maisto, 2000)

Bipolar Disorder In some cases, a patient will frantically

alternate between these feelings of Euphoria and depression.

These people rapidly make statements that do not seem coherent or logical.