Abnormal Psychology: Disorders and Treatments

I. Abnormal Behavior
a. No clear definition
b. Factors
i. Place
ii. Time
iii. Mental state
iv. Actions
v. Must be self-recognized
c. Cultural-specific disorders
i. Demonic possession
ii. Brain fag syndrome
iii. Running amok
iv. Dissociative identity disorder/Multiple personality disorder
1) Split personality syndrome; alternates between 2 or more personalities (own name, behavior, etc.)

d. Biopsychosocial model – used to understand mental illnesses by the predominant view in Western culture
i. Biological roots – genetic factors, injury, disease processes that result in abnormal brain development, damage, imbalances of neurotransmitters and hormones, which result in abnormal behavior
ii. Psychological roots – life history and experiences contribute to ability to cope and degree of vulnerability to stress
iii. Social and cultural context – people greatly influenced by how other people act toward them and expectations of society

e. Classifying Psychological Disorders
i. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) – establishes uniform definitions and standards for diagnosis (labels)
1) Lists symptoms, criteria, and distinctions
2) Axis I – Lists of Clinical Disorders
a) Involves deterioration of functioning
b) Most common disorders
c) Major categories:
i) Substance-related
ii) Disorders evident in childhood
iii) Schizophrenia
iv) Delusional (paranoid)
v) Mood
vi) Anxiety
vii) Somatoform
viii) Dissociative
ix) Sexual
x) Eating
xi) Sleep
xii) Impulse control
3) Axis II – lists of personality disorders and mental retardation
a) Persist throughout life
b) Personality disorder – a maladaptive, inflexible way of dealing with situations and people
c) Major categories:
i) Mental retardation
ii) Personality

f. Treatments of Mental Disorders
i. Psychotherapy – treatment of psychological disorders by methods involving an ongoing relationship between a trained therapist and client

2) 5 types
a) Psychoanalysis
b) Cognitive therapy
c) Humanistic therapy
d) Family systems therapy
e) Behavioral therapy

a) Psychoanalysis – Uses free association and transference to bring unconscious material to consciousness, producing catharsis
i) Free association – saying whatever’s on mind
ii) Transference – the transferring of associated feelings to the therapist

b) Cognitive therapy – improves functioning by changing people’s thoughts and beliefs about situations
i) Caused by irrational beliefs and unrealistic goals

c) Humanistic therapy – believe people naturally strive to achieve full potential
1) Person-centered (nondirective/client-centered) therapy – most common type
2) Caused by rejection of society

d) Family systems therapy – treats person in context of the family; believes problems arise in family setting
1) Caused by distorted communication and confused roles within a society

e) Behavioral therapy – learned inappropriate maladaptive behaviors

ii. Rational-emotive therapy (RET) – assumes thoughts precede emotions, and unpleasant feelings result from irrational thoughts

iii. Cognitive-behavior therapy – sets clear goals for changing behavior

iv. Eclectic therapists – combined approaches

v. Brief therapy models – therapist and client agree to a certain length, number of meetings, expectations and goals for treatment

vi. Group therapy – treatment of many clients on ongoing basis; allows others to relate, practice social skills, and receive feedback

vii. Self-help groups – no therapist involved

g. Deinstitutionalization – trend over the second part of the 20th century of removing patients from mental hospitals

h. Insanity defense
i. Legal term

i. Preventing Mental Illness
i. Prevention – before illness begins
ii. Intervention – early stages
iii. Maintenance – taking steps to prevent illness from becoming serious

II. Anxiety Disorders – certain amount of fear and caution in the face of potential hazards
a. Pathological if interferes with daily functioning
b. Major symptoms
i. Fear
ii. Avoidance behavior
iii. Fearful thoughts
c. Types
i. Panic disorder (PD)
ii. Generalized anxiety disorder
iii. Phobia
iv. Somatoform disorder
v. Dissociative identity disorder
vi. Obsessive-Compulsive Disorders

i. Panic disorder (PD) – frequent periods of anxiety and occasional attacks of panic
1) Treatments: psychotherapy, anti-depressant drugs

iii. Phobia – strong and persistent fear of a specific object or situation and interferes with daily living
1) Social phobia – severe avoidance of other people and fear of doing anything in public
2) Agoraphobia – an intense fear of open or public places
3) Acrophobia – Heights
4) Public speaking
5) Being alone

vi. Obsessive-Compulsive Disorders – persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress
1) Obsessions – repetitive, unwelcome streams of thought
2) Compulsions – repetitive, almost irresistible actions

III. Substance-Related Disorders
a. Substance-Dependence/Addiction – the dependence on a dangerous habit making it impossible or difficult for the person to quit
b. Addiction is a function of the person along the drug
c. Symptoms
i. Tolerance – decreased effect of a given dose
ii. Withdrawal – unpleasant sensations when the drug is not used (or too little is used)
d. Nucleus accumbens – small area in the brain critical for the motivating effects of many experiences
i. Nearly all drugs simulate activity of the neurotransmitter dopamine in the area
ii. The activating of the synapses cause an increase in attention, accompanied with great pleasure and addiction
e. Alcoholism

e. Alcoholism
i. Type I/A – develops gradually over the lifespan and less severe in its health consequences
ii. Type II/B – early onset and more severe and prevalent in men
iii. Most widespread treatment is offered by the Alcoholic Anonymous (AA) (self-help group)
iv. Controlled drinking – the reducing of the consumption of alcohol from abusive to moderate

IV. Mood Disorders
a. Bipolar Disorder

Depression
Schizophrenia
Autism

a. Bipolar Disorder
i. Bipolar I – at least one mania
ii. Bipolar II – alternation between major depression and hypomania
iii. Drug therapies
1) Lithium – naturally occurring chemical used to treat mania
2) Valproate and anticonvulsant drug

b. Depression
i. Women more likely to experience from adolescence and onward
ii. Possible influential factors:
1) Negative events
2) Lack of social support
3) Genetic predisposition
iii. Sex difference in depression: hormones
1) Women experience more rapid hormonal changes
iv. Sex difference in depression: coping
1) Men tend to distract while women tend to dwell
v. Treatments
1) Cognitive therapy – develop positive beliefs
2) Antidepressant medications
3) Electroconvulsive shock therapy (ECT) – induces convulsion similar to an epileptic seizure

c. Schizophrenia – disconnection of intellectual from emotional aspects of mind
1) Hallucinations
2) Delusions
a) 3 types
i) Persecutions
ii) Grandeur – belief of own importance
iii) Ideas of reference
3) Incoherent speech
4) Grossly disorganized behavior
5) Loss of normal emotional responses and social behaviors
i. Positive symptoms – presence of inappropriate behaviors
ii. Negative symptoms – absence of appropriate behaviors
iii. Drug Therapies – helps relieve symptoms
1) Antipsychotic
2) Neuroleptic
iv. 4 types
1) Undifferentiated
a) Deterioration of daily functioning, hallucinations, delusions, inappropriate disorders
2) Catatonic – prominent movement disorder
a) Rigid inactivity, excessive activity, awareness of surroundings
3) Disorganized
a) Incoherent speech, extreme isolation, odd behavior
4) Paranoid
a) Elaborate hallucinations and delusions, delusions with themes of persecution and grandeur, other thought problems are less pronounced

d. Autism
i. Early onset (before 2 years)
ii. Symptoms
1) Impaired social relationships
2) Impaired communications
3) Stereotyped behaviors
4) Severe language and cognitive delays likely without intervention
iii. Asperger’s disorder – milder form
1) Learn to function effectively in social situations and are less likely to be cognitively limited