Chapter 14 & 15

Abnormal Psychology & Treatment

4 Components of Abnormality Unusual – against majority Maladaptive – interferes with ability to

function Labeled as abnormal by society it occurs in Perceptual or cognitive dysfunction

Abnormal

Psychoanalytic

Result: Freud problems between Id, Ego, Super Ego lead to abnormalities

Unconscious drive Humanistic

Result: Too sensitive to criticisms/judgments of others Cognitive

Result: Faulty illogical thoughts Behavioral

Result: All behavior is learned Biological

Result: Brain function due to structural/chemical abnormalities Sociocultural

Result: Society/culture decide what is acceptable behavior

Theories of Psychopathology

Axis I: clinical disorders, including major

mental disorders, as well as developmental and learning disorders

Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, phobias, and schizophrenia.

DSM-IV-TR

Axis II: underlying pervasive or personality

conditions, as well as mental retardation Common Axis II disorders include personality

disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.

DSM-IV-TR

Axis III: Acute medical conditions and physical

disorders. Common Axis III disorders include brain

injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.

DSM-IV-TR

Axis IV: psychosocial and environmental

factors contributing to the disorder. Negative life events, an environmental

difficulty, family or interpersonal stress.

DSM-IV-TR

Axis V: Global Assessment of Functioning or

Children’s Global Assessment Scale for children under the age of 18. (on a scale from 100 to 1)

100- superior functioning in a wide range of activities.

50-serious symptoms or difficulty in social, occupational, or school functioning.

20-some danger of hurting self or others, occasional failure to maintain minimal personal hygiene, or gross impairment in communication.

DSM-IV-TR

Dangers of labeling – labels behavior as

disorders and because labeling is not an exact science it can have adverse effects on how a person is judged.

Rosenhan along with seven others reported hearing voices however responded to question showed no evidence of pathology . . . Still diagnosed mentally ill

David Rosenhan (1973)

Anxiety – tension/nervousness/panic attacks

overwhelming sense of panic, fear and desire to escape Panic Disorder General Anxiety Disorder (GAD) Obsessive-Compulsive Disorder (OCD) Post-Traumatic Stress Disorder Phobias

Anxiety Based Disorders

Somatoform – disorder characterized by

physical symptoms without any actual physical cause Conversion Disorder – Paralysis or blindness (no

physical cause) Freud Hysteria

Hypochondriasis Factitious Disorders – person inflects injury to

self to produce symptoms

Somatoform Disorders

Mood Disorders – extreme disturbance of

emotional balance Unipolar (major depression)

2 or more weeks Bipolar Disorder

Primarily Depressive Primarily Manic – rear Normal – Manic – Depressive

Seasonal Affective Disorder Sunlight not weather!

Mood Disorders

Schizophrenia – disordered thoughts/behaviors which

include delusions/hallucinations/inappropriate response Disorganized – incoherent speech, inappropriate emotion Catatonic – stupor, rigid boy postures fixed position Paranoid – auditory hallucinations, secret codded messages

hidden for them Undifferentiated – Multiple symptoms not easily categorized Residual – Some schizoid tendencies/traits but not profoundly

schizophrenic Dopamine hypothesis - excess dopamine receptors in brain

Schizophrenia

Organic Disorders – caused by damage to

brain tissue Mostly result of disease or chemicals:

Dementia, Alzheimer’s disease, and some drug/alcohol dependence

Organic Disorders

Personality Disorders – extreme abnormal

personality that conflicts with social functioning Paranoid – extreme distrust, suspicion of others Antisocial – disregard for the rights/interests of

others Narcissistic – Self-preoccupation and focus on

self Dependent – need to be cared for Histrionic – excessive emotional reactions and

excitability, need for attention

Personality Disorders

Dissociative Disorders – dysfunction of

memory or altered sense of identity Amnesia – sudden memory loss caused by

trauma Anterograde amnesia – loss of memories

occurring after traumatic event Retrograde amnesia – loss of memory prior to

event Fugue – sudden complete loss of identity,

caused by stress, create new identity Dissociative Identity Disorder (DID) – Multiple

personality disorder

Dissociative Disorders

Attention Deficit Hyperactivity Disorder

(ADHD) – inattentiveness, difficulty paying attention, organization, forgetfulness, distractible Need for attention

Conduct disorder Oppositional Defiance Disorder

Attention Deficit & Disruptive Behavior Disorder

Chapter 15

Treatment

Free association

Patient reports any and all conscious thoughts Hypnosis – unconsious

Manifest Content – subject of dream Latent Content – symbols Transference – patient shifts thoughts/feelings

about people/events onto therapist Countertransference – therapist transfers their

feelings onto their patient

Psychoanalysis

Client-Centered Therapy

Carl Rogers (invented) Understand client through their own reality Nondirectional approach – focus on clients perception

and how that effects them Goal of therapy: self-actualization (full potential)

Genuineness – active listener and relate to client Unconditional Positive Regard – show complete

acceptance of client no matter what Accurate empathic understanding – therapist ability

to view world from clients eyes (empathy)

Humanistic

Fritz Perls

Combines both physical/mental therapies Client maybe asked to act out conflict in order

to make them aware of their interactions between body and mind

Gestalt Therapy

Behavioral Therapy – short-term process, no

deep underlying cause of problem, abnormal behavior is the problem and symptom

Insight Insight into the cause is the processes of

getting better Psychoanalysis

Behavioral Therapy v. Insight Therapy

Conterconditioning – response to a given

stimulus is replaced by a different response Alcoholic – replace good feelings while drinking,

with feelings concerning alcohol Aversion Therapy – Administer punishment

while stimulus Drink alcohol get slapped!

Systematic Desensitization – replace anxiety with relaxation

Behavioral TherapyCounterconditioning

Extinction Procedures – weaken maladaptive

responses Flooding – expose client to stimulus that

causes undesirable response Fear spiders, here’s a Camel spider have fun!

Implosion – client imagines stimulus rather than confront it

Behavioral Psychology

Operant Conditioning

Behavior-control technique Behavioral contracting

Patient and client draw up a contract both agree to follow. Follow behavior, rewarded if do the right thing

Modeling Bandura’s social learning theory Vicarious learning – watch and learn

Behavioral Psychology

Rational-emotive behavior therapy (REBT) also called

Rational-emotive therapy (RET) Albert Ellis – when confronted with situations, people recite

statements to themselves that express maladaptive thoughts Change thoughts by facing it

Aaron Beck – focus on maladaptive schemas Negative triad – negative view of self, world, future Maladaptive inference – person draws conclusions without

evidence Dichotomous thinking – all-or-none conceptions of situations

“If I don’t get this job, I’ll be a complete failure.”

Cognitive Therapy

Electroconvulsive Therapy (ECT)

High voltage electricity pass through head Causes temp amnesia, possible seizures Success with depression (last option) Possible memory loss

Psychosurgery Prefrontal lobotomy – patient left catatonic state

Biological Therapies

Psychopharmacology - treatment of psychological and

behavioral maladaptations with drugs Psychotropic (psychologically active drugs)

4 classes of psychotropic/psychologically active drugs: Antipsychotics Antidepressants Anxiolytics Lithium salts

Antipsychotics – Clozapine, Thorazine, Haldol Reduce schizophrenia symptoms blocking neural

receptors for dopamine Tardive dyskinesia – shaking (side effect)

Biological Therapies

Antidepressants – Monoamine oxidase (MAO)

inhibitors, tricyclics, selective reuptake inhibitors MAO – like Eutron increase amount of serotonin,

norepinephrine in synaptic cleft Tricyclics – like Norpramin, amitriptyline, impiramine

Increase amount of serotonin/norepinephrine Selective reuptake inhibitors (selective serotonin

reuptake inhibitors or SSRIs) – block reuptake mechanism of cell that released the neurotranmitters. Prozac (fluoxetine) Fewer side effects

Biological Therapies

Anxiolytics – depress CNS and reduce anxiety,

increase feelings of well-being, and reduce insomnia Common anti-anxiety is Xanax, also include

barbiturates (rarely used) Benzodiazepines – Valium (diazepam) and Librium

(chlordiazepoxide) cause muscle relaxation Lithium Carbonate

A salt effective in treatment of bipolar disorder

Biological Therapies

Group therapy

12 Step programs Couples therapy Family therapy

Modes of Therapy