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Abnormal psychology

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Abnormal psychology

  1. 1. Abnormal Psychology Dr. Irene Karayianni
  2. 2. 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
  3. 3. 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/
  4. 4. 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
  5. 5. 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
  6. 6. 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
  7. 7. 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)
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. 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
  15. 15. 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
  16. 16. Stressors that cause Post-traumatic stress disorder • war, combat-related stress • physical assault • rape and sexual molestation • automobile accident • witnessing violence and disasters • terrorism
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. 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
  21. 21. 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
  22. 22. 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)
  23. 23. Somatoform pain disorders • Primary symptom is pain with no physical cause • The pain does not follow nerve pathways • Occurs at time of high stress
  24. 24. 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
  25. 25. 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
  26. 26. 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
  27. 27. 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/
  28. 28. 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?
  29. 29. 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
  30. 30. 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
  31. 31. 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
  32. 32. 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
  33. 33. 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
  34. 34. 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/
  35. 35. 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
  36. 36. 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
  37. 37. Personality disorders Schizoid Antisocial Schizotypal Paranoid Histrionic etc Psychological disorders that result from personalities that developed improperly during childhood
  38. 38. 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
  39. 39. 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
  40. 40. 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
  41. 41. 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/
  42. 42. 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
  43. 43. 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/
  44. 44. 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
  45. 45. 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/
  46. 46. 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/
  47. 47. Obsessive compulsive personality disorder • Perfectionist • Dominating • Poor ability to express affection • Excessive devotion to work • Indecisive when faced with major decisions
  48. 48. 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
  49. 49. 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
  50. 50. 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
  51. 51. 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
  52. 52. 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/
  53. 53. 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
  54. 54. 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
  55. 55. 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