Abnormal Psychology
Chapter
One
Chapter Fifteen
Chapter Eight
Chapter Twelve
Chapter Thirteen
Chapter Fourteen
Chapter Sixteen
-Abnormal Behavior
-Anxiety Disorders
-Somatoform Disorders
-Dissociative Disorders
-Mood Disorders
-Schizophrenia
-Personality Disorders
-Sexual Disorders
Chapter Thirteen
-Abnormal Behavior
Definition &
Incidence of Psychological Abnormality 
Defining Psychological
Abnormality:
Deviance -
Social Norm Violation Distress -
Personal Discomfort Dysfunction
- Impairment in Adaptive Behavior
Inicidence of Psychological Abnormality
Perspectives on Mental Disorder:
Biogenic:
Inherited or acquired brain disorders involving imbalance in neurotransmitters
or damage to brain structures.
Psychodynamic:
Unconscious conflicts over impulses such as sex and aggression originating
in childhood.
Behavioral:
Reinforcement of inappropriate behaviors and punishment or extinction
of appropriate behaviors.
Cognitive-Behavioral:
Irrational or maladaptive thinking about one's self, life events and the
world in general.
Sociocultural
perspective: Social ills such as poverty, minority and gender discrimination
and lack of respected role for elders creates social stress.
The Concept of
Insanity
Legal Term: Was
the person unable to tell the difference between
right & wrong at the time of the crime?
Is it a legal
loophole?
Use of the Insanity Defense |
||
Public Belief |
Reality |
|
% of felony indictments involving the insanity
plea |
37% |
0.9% |
% of pleas resulting in acquittal |
44% |
26% |
Classification
of Psychological Disorders
DSM IV
Spells out the number, severity & duration of symptoms that define
a diagnostic category.
Mental Disorders
- Symptoms
& Treatment
-Anxiety Disorders
Phobias: Anxiety disorders characterized by an intense irrational fear
and heightened physiological arousal that is out of all proportion to
the danger elicited by the object. The intense fear makes the person go
to great lengths to avoid the feared object or endure it with intense
anxiety if it cannot be avoided.
agoraphobia:
An anxiety about being in places or situations from which escape might
be difficult or embarrassing if a panic attack or panic-like symptoms
(sudden dizziness or onset of diarrhea) were to occur.
social phobias:
Irrational, marked, and continuous fear of performing in social
situations. Affected indiviudals fear that they will humiliate or embarrass
themselves.
specific
phobias: Unreasonable, marked, and persistent fears triggered by
anticipation of, or exposure to, a specific object or situation (flying,
heights, spiders, seeng blood): formerly called simple phobias.
Etiology of Phobias
Behavioral
"All of us are born with a set of instinctive fears--of falling,
of the dark, of lobsters, of falling
on lobsters in the dark, or speaking before a Rotary Club, and of the
words "Some Assembly
Required." ~ Dave Barry ~
-Somatoform Disorders
Somatoform Disorders:
A pattern of recurring, multiple and significant bodily(somatic) complaints
that extend over several years. The physical symptoms (pain, vomiting,
paralysis, blindness) are not under voluntary control, have no known physical
causes, and are believed to be caused by psychological factors.
Hypochondriasis:
A condition in which a person believes that they have a serious disease
despite repeated medical findings to the contrary.
Somatization
Disorder: A somatoform disorder that begins before age 30. lasts
several years and is characterized by multiple symptoms -- including pain,
gastrointestinal, sexual, and neurological symptoms -- that have no physical
causes but aretriggered by psychological problems or distress.
Conversion
Disorder: A type of somatoform disorder characterized by unexplained
and significant physical symptoms or deficits that affect voluntary motor
or sensory functions and that suggest a real neurological or medical problem.
Etiology of Somatoform
Disorders
Psychodynamic:
Intrapsychic conflict is converted to symptoms that disrupt physical functioning
Behavioral: Somatoform
symptoms are learned & maintained by modeling and positive reinforcement
-Dissociative Disorders
Dissociative Disorders
Characterized by a disruption, split, or breakdown in a person's normal
integrated and functioning consciousness, memory, identity or perception.
Dissociative
Amnesia: Is characterized by inability to recall important personal
information or events and is usually associated with stressful or traumatic
events. The importance or extent of the information forgotten is too great
to be explained by normal forgetfulness.
Dissociative
Fugue: Is a disturbance marked by suddenly and unexpectedly traveling
away from home or place of work and being unable to recall one's past.
The person may not remember his or her identity or may be confused about
his or her new, assumed identity.
Dissociative
Identity Disorder (formerly multiple personality disorder): Is the
presence of two or more distinct identities or personality states, each
with its own pattern of perceiving, thinking about and relating to the
world. Different personality states may take control of the individual's
thoughts and behaviors at different times.
Etiology of dissociative
disorders
Psychodynamic
Iatrogenic
Putnam et.al.
in 1986 reported that more cases of MPD had been reported in the previous
5 years than in the previous 2 centuries.
Before 1973
the average number of personalities was 3. After 1973 (Sybil was published
in 1973) the average number of personalities was 12.
A survey
of all psychiatrists in Switzerland found that 90% of them had never seen
a case of MPD. The data indicated that 6 psychiatrists (out of 655 surveyed)
accounted for 2/3 of the MPD diagnoses in Switzerland.
Faking:
| Excerpt from interview between psychologist working for defence of Ken Bianchi. Watkins: I've talked a bit to Ken, but I think that perhaps there might be another part of Ken that I haven't talked to, another part that maybe feels somewhat differently from the part that I've talked to. And I would like to communicate with that other part. And I would like that other part to come to talk to me....Part, would you please come to commmunicate with me?...Would you please come, Part, so I can talk to you? Another part, it is not just the same as the part of Ken I've been talking to...All right, Part, I would like for you and I to talk together, we don't even have to-we don't have to talk to Ken unless you and Ken want to.... Bianchi: Yes. Watkins: Part, are you the same thing as Ken, or are you different in any way?... Bianchi: I'm not him. Watkins: You're not him. Who are you? Do you have a name? Bianchi: I'm not Ken. Watkins: You're not Ken. OK. Who are
you? Tell me about yourself. Watkins: Do you have a name I can call you by? Bianchi: Steve. Watkins: Huh? Bianchi: You can call me Steve. |
-Mood Disorders
Unipolar Depression
Symptoms
1st
Person Accounts
Etiology of Depression:
Biogenic
Psychodynamic
Behavioral
Cognitive-Behavioral
Bipolar Disorder
Symptoms
1st Person Account
Bipolar Disorder
- 1st Person Account:
"When I start going into a high, I no longer feel like an ordinary housewife. Instead, I feel organized and accomplished and I begin to feel I am my most creative self. I can write poetry easily. I can compose melodies without effort. I can paint. My mind feels facile and absorbs everything. I have countless ideas about improving the conditions of mentally retarded children of how a hospital for these children should be run, what they should have around them to keep them happy and calm and unafraid. I see myself as being able to accomplish a great deal for the good of people. I have countless ideas about how the environment problem could inspire a crusade for the health and betterment of everyone. I feel able to accomplish a great deal for the good of my family and others. I feel pleasure, a sense of euphoria or elation. I want it to last forever. I don't seem to need much sleep. I've lost weight and feel healthy and I like myself. I've just bought six dresses, in fact, and they look quite good on me. I feel sexy and men stare at me. Maybe I'll have an affair, or perhaps several. I feel capable of speaking and doing good in politics. I would like to help people with problems similar to mine so they won't feel helpless. It's wonderful when you feel like this....The feeling of exhilaration-- the high mood -- make me feel light and full of the joy of living. However, when I go beyond this stage, I become manic, and the creativeness becomes so magnified I begin to see things in my mind that aren't real. For instance., one night I created an entire movie, complete with cast, that I still think would be terrific. I saw the people as clearly as if watching them in real life. I also experienced complete terror, as if it were actually happening, when I knew an assassination was about to take place. I cowered under the covers and become a complete shaking wreck. As you know, I went into a manic psychosis at that point. My screams awakened my husband, who tried to reassure me that we were in our bedroom and everything was the same. There was nothing to be afraid of. Nevertheless, I was admitted to the hospital the next day." |
Etiology of Bipolar Disorder
Biogenic
-Schizophrenia
Symptoms - Positive
Delusions
Arthur, who had been insecure and shy for as long
as he could remember, took a job in a large office. Unsure of his
clerical abilities, he worked long and hard at his job, rejecting
invitations to have lunch or coffee with his colleagues. Gradually,
they stopped inviting him, going off merrily by themselves, and
returning full of laughter and cheer. Six weeks after his error had been discovered, he began to "sense" that people had been through his drawers, both at home and in the office. Moreover, certain papers that were necessary for his work were missing, leading him to believe that others were now actively plotting his vocational downfall. Their failure to invite him to lunch was taken as further evidence of the plot. He became very fearful and disorganized. Continually preoccupied with his troubles, he found it difficult to sleep, eat, or concentrate. His work deteriorated both in quality and in output. When his supervisor finally asked him what was wrong, he blurted out, "You know what's wrong. You and they have made it wrong ever since I came here." He then ran out of the office, never to return. Within the year, Arthur's behavior had so deteriorated that he was hospitalized with the diagnosis of paranoid schizophrenia. |
Hallucinations:
| A thirty-two-year-old housewife complained of a man's voice speaking in an intense whisper from a point about two feet above her head. The voice would repeat almost all the patient's goal-directing thinking -- even the most banal thoughts. The patient would think, "I must put the kettle on." and after a pause of not more than one second, the voice would say, "I must put the kettle on." It would often say the opposite, "Don't put the kettle on." |
| A forty-one-year-old housewife heard a voice coming from a house across the road. The voice went on incessantly in a flat monotone describing everything she was doing with an admixture of critical comments. "She is peeling potatoes, got hold of the peeler, she does not want that potato, she is putting it back, because she thinks it has a knobble like a penis, she has a dirty mind, she is peeling potatoes, now she is peeling potatoes, now she is washing them...." |
"If you talk to God, you are praying; if God talks to you, you have schizophrenia." ~ Thomas Szasz
Cognitive Slippage
Disorganized
Speech
| Interviewer: Have you been nervous or tense lately? Schizophrenic: No, I got a head of lettuce. Interviewer: You got a head of lettuce? I don't understand. Schizophrenic: Well, it's just a head of lettuce. Interviewer: Tell me about the lettuce. What do you mean? Schizophrenic: Well, ...l lettuce is a transformation of a dead cougar that suffered a relapse on the lion's toe. And he swallowed the lion and something happened The ... see, the ... Gloria and Tommy, they're two heads and they're not whales. But they escaped with herds of vomit, and things like that. Interviewer: Who are Tommy and Gloria? Schizophrenic: Uh, ... there's Joe DiMaggio, Tommy Henrich, Bill Dickey, Phil Rizzuto, John Esclavera, Del Crandell, Ted Williams, Mickey Mantle, Roy Mantle, Bob Chance ... Interviewer: Who are they? Who are those people? Schizophrenic: Dead people ... they want to be fucked ... by this outlaw. Interviewer: What does all that mean? Schizophrenic: Well, you see, I have to leave the hospital. I'm supposed to have an operation on my legs, you know. And it comes to me pretty sickly that I don't want to keep my legs. That's why I wish I could have an operation. Interviewer: You want to have your legs taken off? Schizophrenic: It's possible, you know. Interviewer: Why would you want to do that? Schizophrenic: I didn't have any legs to begin with. So I would imagine that if I was a fast runner, I'd be scared to be a wife, because I had a splinter inside of my head of lettuce. (Neale & Oltmanns, 1980, pp 103-104) |
Symptoms - Negative
flat affect
poverty of speech
apathy/avolitional
social withdrawal
Personal
Stories
The
Artistic Mind of a Psychotic
Causes of Schizophrenia
Genetic Factors
| Risk Rates for Developing Schizophrenia | |
| Relationship to Person w/ Schizophrenia | % of Risk |
| Identical Twin | 48% |
| Offspring of 2 Schizophrenic Parents | 46% |
| Fraternal Twin | 17% |
| 1 Parent Schizophrenic | 13% |
| General Population | 1% |
Brain Abnormalities
Abnormal
Brain Activity
Prenatal Viral
Infection
(Schizophrenics more likely to be born in Mar. & Apr.)
Neurotransmitters
Dopamine
Hypothesis:
Schizophrenia is the result of excess levels of dopamine.
Evidence:
1. Phenothiazine reduces level of dopamine in the brain & reduces
severity of symptoms of schizophrenia.
2. Amphetamines increase level of dopamine & large doses produce schizophrenic-like
symptoms.
Environmental
(psychological)
lower social
class (Possible Explanations):
1.) The conditions of lower class existence are
themselves stressful and in addition tend to impair an individual's ability
to cope with stress.
2.)People with schizophrenia drift downward on the
socioeconomic ladder because the illness impedes effective coping with
life demands (work, investing money, etc.)
Relapse
expressed emotion
High Expressed
Emotion
"I always say, 'Why don't you pick up
a book, do a crossword or something like that to keep your mind
off it.' That's even too much trouble." "He went round the garden 90 times, in the door, back out the door. I said 'Have a chair, sit out in the sun.' Well he nearly bit my head off." |
Low Expressed Emotion
| "I know it's better for her to be on her own, to get away from
me and try to do things on her own." "Whatever she does suits me." "I just tend to let it go because I know that when she wants to speak she will speak." |
-Personality Disorders
Definition: Disorders
consisting of inflexible, long-standing, maladaptive personality traits
that cause significantly impaired functioning in one's personal &
social life
Types of Personality
Disorder
Paranoid
Personality Disorder
Schizoid
Personality Disorder
Schizotypal
Personality Disorder
Histrionic
Personality Disorder
Narcissitic
Personality Disorder
Avoidant
Personality Disorder
Dependent
Personality Disorder
Obsessive-Compulsive
Personality Disorder
Borderline
Personality Disorder
Antisocial
Personality Disorder
Antisocial Personality
Disorder
Cleckley's checklist
of characteristics:
Superficial
charm and good intelligence
Shallow
emotions, lack of empathy
Little life
plan or order
Failure
to learn from experience, lack of anxiety
Unreliability
and lying
-Sexual Disorders
Gender Identity
Disorder
Disorder in which there is a deeply felt incongruence between anatomic
sex & the sensed gender that leads to a belief that the person was
born with the wrong biological sex organs.
Sexual Deviations
(Paraphilias)
Atypical sexual activities that involve one of the following: 1) nonhuman
objects, 2) nonconsenting adults, 3) suffering or humiliation of oneself
or one's partner, or 4) children.
Exhibitionism
(indecent exposure, flashing): repeated exposure of genitals to unsuspecting
strangers, usually women and children. The exhibitionist may masturbate
while exposing his genitals but usually does not pursue further sexual
activity. Exhibitionists seem to desire surprise or shock in victims but
are usually not physically dangerous to them.
Fetishism: sexual arousal associated with nonliving objects, called fetishes,
such as stockings, shoes or boots. The fetishist often masturbates while
fondling the desired object.
Frotteurism: sexual arousal as a result of rubbing against or touching
a nonconsenting person. The behavior usually occurs in crowded places
like busy sidewalks or on public transportation. Victims may not protest
at first because they cannot believe that such provocative acts are occurring
in a public place.
Klismaphilia:
sexual arousal resulting from receiving or giving an enema.
Myosophilia: sexual arousal that involves the presence or use of filth.
Necrophilia: sexual pleasure from viewing or having sexual contact with
a corpse.
Pedophilia: sexual activity with a child who has not reached puberty.
Attraction to girls is twice as common as attraction to boys.
Sexual Masochism: sexual arousal that involves being humiliated, beaten,
bound, or made to suffer in other ways.
Sexual Sadism: sexual arousal associated with physical or psychological
suffering of victims.
Transvestic Fetishism: sexual arousal associated with cross-dressing,
that is, dressing in the clothes of the opposite sex.
Voyeurism (peeping):
sexual arousal as a result of observing unsuspecting individuals, most
often strangers, who are either naked, in the process of undressing, or
engaging in sexual activity. The voyeur usually does not seek any sexual
liaison with the observed person.
Zoophilia: sexual activity with animals.
Sources: American Psychiatric Association, 1994: Money, 1984.
Sexual Dysfunctions
Problems in experiencing sexual desire or arousal, or carrying through
with sexual acts to the point of satisfaction.
Hypoactive Sexual
Desire Disorder: Persistently or recurrently deficient or absent sexual
fantasies and desire for sexual activity.
Sexual Aversion Disorder: Persistent or recurrent extreme aversion to,
and avoidance or, all (or almost all) genital sexual contact with a sexual
partner.
Female Sexual Arousal Disorder: Persistent or recurrent inability to attain,
or to maintain until completion of the sexual activity, an adequate lubrication-swelling
response of sexual excitement.
Male Erectile Disorder: Persistent or recurrent inability to attain, or
to maintain until completion of the sexual activity, an adequate erection.
Female Orgasmic Disorder:Persistent or recurrent delay in, or absence
of, orgasm following a normal sexual excitement phase.
Male Orgasmic Disorder: Persistent or recurrent delay in, or absence of,
orgasm following a normal sexual excitement phase during sexual activity.
Premature Ejaculation: Persistent or recurrent ejaculation with minimal
sexual stimulation before, on or shortly after penetration and before
the person wishes it.
Dyspareunia: Recurrent or persistent genital pain associated with sexual
intercourse in either a male or a female.
Vaginismus: Recurrent or persistent involuntary spasm of the musculature
of the outer third of the vagina that interferes with sexual intercourse.
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