Abnormal Behavior ­ patterns of emotion, thought, and action considered pathological

(diseased or disordered)

  • Identifying Abnormal Behavior
  • o Statistical Infrequency ­how rare/unusual something is
    • Cannot be only defining characteristic
  • o Disability/dysfunction ­ does the maladaptive behavior (not good for you) cause a dysfunction for the person or other people
    • Not good for you or other people­ alcoholism, drugs
    • Practical and flexible
    • 2 aspects

maladaptive to ones’ self ­ inability to reach goals, adapt to life demands

maladaptive to society ­ interferes, disrupts social group functioning

o Personal distress­  some people have the idea that if you are okay with it and it does not cause distress, then you don’t have a mental disorder (wrong)

o Social norm violation

  • EX­ clothes in public o Deviation from an ideal ­ humanism and existentialsim
  • If you are not self­actualized, you are mentally ill
  • Not used by therapists o Medical disorder ­ Alzheimer’s disease

o Insanity ­ legal term applied when people cannot be held responsible for their actions or allowed to manage their own affairs because of mental illness

 Avoided by psychologists because it confuses legal and mental health issues

 Historical Views of Psychological Disorders

  • Supernatural View ­ mysterious actions were attributed to supernatural powers and possession

o Trephining ­ boring holes in skull to let out evil spirits

  • Naturalistic View ­ ancient Greece

o Hippocrates ­ believed that madness was like any other sickness­a natural event arising from natural causes; a physical illness

Imbalances in 4 humors ­ trying to link mental to physical

Blood ­ air

  • Hot and moist
  • Sanguine­amorous, happy, generous

Yellow bile ­ fire

  • Hot and dry
  • Choleric­ violent, vengeful

Phlegm ­ water

  • Cold and moist
  • Phlegmatic­ dull, pale, cowardly

Black Bile ­ earth

  • Cold and dry
  • Melancholic­gluttonous, lazy, sentimental
  • Middle Ages­ Europeans reverted to supernatural iew of abnormal behavior o Naturalistic views still held in Arab cultures o If you were mentally ill, you were bad and being punished o Exorcisms and horrifying tortures
  • Late Middle Ages­ public and private asylums where emotionally disturbed people could be confined were being established o In worst cases, inmates were chained down and deprived of food, light, or air to “cure” them
  • Turning point­ 1793­ Phillpe Pinel became director of Bicetre Hospital in Paris o Medical Model of Mental Illness­ perspective that assumes diseases have physical causes that can be diagnosed, treated, and possibly cured

o Dorothea Dix­ schoolteacher from Boston

  • Led a nationwide campaign for humane treatment of mentally ill people.
  • Conditions did not change all that much o Deinstitutionalization­ movement of mental patients out of large hospitals
  • Major goal of mental health care in last half of 20th century
  • Psychiatry­ branch of medicine dealing with the diagnosis, treatment, prevention of mental disorders o Thomas Szasz­ critic of medical model
    • The myth of Mental Illness­ used to suppress behaviors we do not accept in society, by the state to control people for expressing unpopular views
    • Separation of Psychiarty and the state o David Rosenhan’s Study on being sane in insane places
    • 8 sane persons gained “secret admission” to 12 different mental hospitals around US, complaining of hearing hallucinatory voices saying “dull” and “thud”
    • Most diagnosed with Schizophrenia, released in remission, meaning they were no longer showing symptoms
    • Conclusion­ psychiatry cannot distinguish same from insane

 Anxiety Disorders ­ type of abnormal behavior characterized by unrealistic, irrational fear; normal reactions to stress

  • GAD­ chronic, uncontrollable, an excessive worry not focused on any particular object or situation o ~ 4 million US, 2xs as many women as men
    • Women more likely to express and report symptoms o Diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems
    • Interference with rest of life
    • Usually realize they are too worried
  • Panic disorder­ sudden and inexplicable attacks of intense fear o Symptoms­ difficulty breathing, heart palpitations, dizziness, trembling, terror, feelings of impending doom
    • Can occur at any time­ peak within 10 minutes o ~ 2.4 million US, 2Xs as common in women
    • Comorbidity­ more than one illness at the same time

 Depression, self medication, alcohol, drugs o May restrict normal activities

  • OCD­ characterized by recurrent, unwanted thoughts (obsession) and/or repetitive behaviors

(compulsions) o Do not gain pleasure from compulsive behavior­ just the relief from anxiety of not performing behavior

o ~ 3.3 million US­ effects men and women equally

 Children are often unaware OCD is abnormal

  • Phobia­ intense, irrational fear and avoidance of a specific object or situation o 3 main categories
    • Fear of public places (agoraphobia)­ avoid crowds

 Usually develops after multiple panic attacks

  • Simple phobias­ caused by a specific thing
  • Social Phobia­ combination of excessive self­consciousness, a fear of pubic scrutiny or humiliation in common social situations, and a fear of negative evaluation by others

 Mood Disorders ­ characterized by extreme disturbances in emotional states

  • Depression
    • Symptoms­ sad mood, loss of interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, recurrent thoughts of death or suicide o Unipolar disorders:
      • Major Depressive disorder­ 5 or more symptoms and impairment in usual functioning nearly every day during the same 2 week period
      • Dysthymic disorder­ depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression o Bipolar disorder/Manic depressive illness­ brain disorder that causes unusual shifts in a person mod, energy, and ability to function
      • Develops in late adolescent ot early adulthood
      • Symptoms of Mania: Increased energy, activity, restlessness, excessively high, overly good, euphoric mood, extreme irritability, racing thoughts and talking very fast, jumping from one idea to another, distractibility, can’t concentrate well, little sleep needed, unrealistic beliefs in one’s abilities and powers, poor judgment, spending sprees, a lasting period of behavior that is different from usual, increased sexual drive, abuse of drugs, particularly cocaine, alcohol, and sleeping medications; provocative, intrusive, or aggressive behavior; denial that anything is wrong
      • Manic episode is diagnosed if elevated mood occurs with 3 or more of the other symptoms most of the day, nearly every day, for 1 week or longer

 If mood is irritable, 4 additional symptoms must be present  Hypomania­ mild to moderate level of mania

 Severe episodes of mania/depression include symptoms of psychosis­ lose touch with reality

  • Various mood states in bipolar disorder are a continuum
  • Schizophrenia­ group of psychotic disorders involving major disturbances in perception, language, thought, emotion, and behavior.
    • Individual withdraws from people and reality­ fantasy life of delusions and hallucinations
    • Most chronic/disabling of severe mental illnesses o ~ 1% of population worldwide­ men and women equally
      • Earlier in men­ late teens to early twenties
      • Women generally affected in twenties to early thirties o Symptoms:
      • Perceptual­ senses may be either enhanced or blunted

Hallucinations­ sensory perceptions that occur without external stimulus

  • Auditory is most common in US
  • Very rarely may hurt others because of symptoms­ most are not violent and withdraw and prefer to be left alone

Language and thought­ words lose their usual meanings, logic is impaired, thoughts may be disorganized and bizarre

Word salad­ jumble of extremely incoherent speech

Neogolisms­ made up words

Delusions­ mistaken beliefs maintained in spite of strong evidence to contrary and are not explained by a person’s usual cultural concepts

  • Paranoia­ false, irrational beliefs maintained in spite of strong evidence to contrary
  • Delusions of grandeur­ believe they are famous or important person
  • Delusions of Reference­ unrelated events gain a special significance
  • Emotional Disturbances­ range from exaggerated emotions to Blunted or Flat affect­ severe reduction in emotional expressiveness
  • Behavioral disturbances­ unusual actions that may have special meaning

Tardive dyskinesia­ repetitive, involuntary, purposeless movements,

  • Due to medications­irreversible o May include grimacing, tongue protrusion, lip smacking, puckering and pursing, rapid eye blinking

Cataleptic­ assuming uncomfortable stances for a long period of time

Waxy flexibility­ describes how a person’s arms will remain frozen in a particular position if they are moved by someone else

o Causes­ not one single cause

  • Inherited

 Close relatives are more likely to develop it than people who have no relatives with the illness

  • Chemical defect in brain

 NT­ especially dopamine (reward system) and glutamate (remember new information)

  • Physical Abnormality in Brain

 Structure­ larger ventricles­ cause/effect

 Function­ increased/decreased activity in several regions

 Dissociative disorders ­ resulting from avoidance of painful memories or situations

  • Child may resort to “going away” during traumatic effect­ due to extreme, repeated physical, sexual, or emotional abuse
  • Dissociative Fugue­ involves a sudden loss of memory and assumption of a new ID in a new locale o Unclear if there is a back story
  • Dissociative amnesia­ sudden loss of memory
  • Dissociative identity disorder­ presence of 2 or more distinct personality systems in same individual at different times

Personality Disorders­ inflexible, maladaptive personality traits that cause significant impairment of social and occupational functioning

  • Antisocial Personality disorder­ lack of conscience o Symptoms: use other people to get what they want; breaks the law repeatedly; lies, steals, fights often; disregards the safety of self and others; demonstrates a lack of guilt; had a childhood diagnosis of conduct disorder

o Cause in unknown, but a combination of genetic factors and child abuse are believed to contribute to development

Diathesis stress model­ genetics predisposed but encouraged by environmental factors

  • Borderline personality disorder­ mood instability and poor self image

Symptoms: difficulty maintaining relationships­serial monogamy; codependency for sense of happiness; self injurious­ cut, burn; high rates of alcohol, drug use­ self medicate