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Psychological Disorders and Abnormal Behavior

WHAT’S NORMAL, WHAT’S NOT

Psychological disorder

• Set of behavioral, emotional, and cognitive symptoms that are significantly distressing and disabling in terms of social functioning, work endeavors, and other aspects of life

Maladaptive behaviors

• Behaviors or actions that run counter to what is in one’s own best interest

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Psychological Disorders and Abnormal Behavior

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Think Again

THE INSANITY PLEA

• Insanity is a legal determination of the degree to which a person is responsible for his or her criminal behaviors.

• Those deemed legally insane are offered psychological treatment rather than criminal punishment.

Do you believe individuals whom the courts judge to be insane are still responsible for their actions?

INSANITY?In the summer of 2012, James Holmes walked into a movie theater in Aurora, Colorado, and opened fire on theaudience, killing 12 people.

Holmes’s attorneys entered a plea of insanity; they claim he committed the murders in a psychotic state. (Ingold, 2013,September 30)

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Psychological Disorders and Abnormal Behavior

DEFINING ABNORMAL BEHAVIOR

What is stigma?

• Refers to negative attitude or opinion about a group of people based on certain traits or characteristics

• Leads to discrimination, stereotypes, and negative characteristics

• Being a danger to self or others is atypical of people with serious psychological disorders and more commonly associated with substance abuse.

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Who uses the DSM–5,and how is it used?

• Mental health professionals use the DSM–5 to diagnose psychological disorders.

• Designed to summarize the signs and symptoms of disorders; an evaluative tool.

• DSM–5 criteria can help guide clinicians to accurate diagnoses and appropriate treatment.

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“ABNORMAL,” BUT NOT UNCOMMON

In any given year, many people are diagnosed with a psychological disorder.

The numbers here represent annual prevalence: the percentage of the US population affected by a disorder over a year.

Lifetime prevalence means the percentage of the population affected by a disorder anytime in life.

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Classifying and ExplainingPsychological Disorders

“ABNORMAL,” BUT NOT UNCOMMON

Comorbidity

• Occurrence of two or more disorders at the same time

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BIOPSYCHOSOCIAL PERSPECTIVE

The biopsychosocial perspective considers the complex interaction of biological, psychological, and sociocultural factors that may contribute to a specific disorder.

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Anxiety Disorders

EXTREME ANXIETY

People who suffer from anxiety disorders have extreme anxiety and/or debilitating, irrational fears.

How is an anxiety disorder differentiated from normal anxiety?

• Degree of dysfunction caused

• Distress created

• Degree of interference with everyday behavior

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Anxiety DisordersPANIC DISORDER - Psychological disorder that includes recurrent, unexpected panic attacks and fear that can cause significant changes in behavior

Panic attack• Sudden, extreme fear or discomfort that

escalates quickly, often with no obvious trigger, and includes symptoms such as increased heart rate, sweating, shortness of breath, chest pain, nausea, lightheadedness, and fear of dying

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Anxiety Disorders

SPECIFIC PHOBIAS - a persistent, irrational fear of some object, situation, or activity that poses little or no real danger

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AGORAPHOBIA - Intense fear of being in a situation from which escape is not possible if one experiences overwhelming anxiety or a panic attack

Often begins with repeated panic attacks

People sometimes plan their entire lives around avoiding feared situations

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Anxiety Disorders

SOCIAL ANXIETY DISORDER

• Social anxiety disorder (social phobia) has a distinct fear of social situations and scrutiny by others.

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Anxiety Disorders

GENERALIZED ANXIETY DISORDER

Generalized anxiety disorder

• Characterized by excessive amount of worry and anxiety about activities relating to family, health, school, and other aspects of daily life

• Psychological distress is accompanied by physical symptoms such as muscle tension and restlessness.

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Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD)

• Characterized by obsessions and/or compulsions that are time-consuming and cause a great deal of distress.

Obsession

• Thought, an urge, or an image that happens repeatedly, is intrusive and unwelcome, and often causes anxiety and distress

Compulsion

• Behavior or “mental act” that a person repeats over and over in an effort to reduce anxiety

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Obsessive-Compulsive Disorder

The role of reinforcement

• Compulsions negatively reinforced by reduction of fearnegative reinforcement leads to more compulsive behavior

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DSM–5 AND MAJOR DEPRESSIVE DISORDER

A major depressive episode may involve:

• depressed mood, which might result in feeling sad or hopeless

• reduced pleasure in activities almost all of the time

• substantial loss or gain in weight, without conscious effort

• changes in appetite

• sleeping excessively or not sleeping enough

• feeling tired, drained of energy

• feeling worthless or extremely guilt-ridden

• difficulty thinking or concentrating

• persistent thoughts about death or suicide

Depressive Disorders

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Depressive Disorders

DSM–5 AND MAJOR DEPRESSIVE DISORDER

Effects of MDD

• Is leading cause of disability for Americans aged 15 to 44 years and one of the most common disorders worldwide

• Impacts workforce productivity with average of 35 days of missed work or productivity

• Creates increased risk for suicide and health complications

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Suicide in the United States

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Suicide in the United States

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Suicide in the United States

Risk factors for suicide include:

• Previous suicide attempt(s)

• Family history of suicide or violence

• Alcohol or drug abuse

• Physical illness

• History of depression or other mental illness

• Feeling alone

(Centers for Disease Control and Prevention, 2012)

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Depressive Disorders

THE BIOLOGY OF DEPRESSION

Genetic factors

Neurotransmitters and the brain

• Norephinephrine, serotonin, and dopamine and irregularities in amygdala, prefrontal cortex, and hippocampus

Hormones

• Higher levels of cortisol.

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Depressive Disorders

PSYCHOLOGICAL ROOTS OF DEPRESSION

Learned helplessness

• Tendency for people to believe they have no control over the consequences of their behaviors, resulting in passive behavior

Beck’s triad definition of depression

• Negative view of experiences, self, and the future

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SELIGMAN’S RESEARCH ON LEARNED HELPLESSNESS

Dogs restrained in a hammock were unable to escape painful shocks administered by an electrical grid on the floor of a specially designed cage called a shuttle box.

The dogs soon learned that they were helpless and couldn’t control these painful experiences.

The figure here shows the electrical grid activated on side B.

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Bipolar Disorders

DSM–5 AND BIPOLAR DISORDERS

Manic episodes• States of continuous elation that are out of proportion to the

setting, and can include irritability, very high and sustained levels of energy, and an “expansive” mood

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DSM–5 AND BIPOLAR DISORDERS

Manic episodes symptoms

• Grandiose or extremely high self-esteem

• Reduced sleep

• Increased talkativeness

• A “flight of ideas” or the feeling of “racing” thoughts

• Easily distracted

• Heightened activity at school or work

• Physical agitation

• Display of poor judgment and engaging in activities that could have serious consequences (risky sexual activities, excessive shopping sprees)

Bipolar Disorders

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Bipolar Disorders

DSM–5 AND BIPOLAR DISORDERS

Bipolar cycling

• Some people with bipolar disorder cycle between extreme highs and lows of emotion and energy that last for days, weeks, or even months.

• Periods of mania and depression may be brought on by life changes and stressors.

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Bipolar Disorders

Using imaging techniques, researchers have identified certain brain irregularities that appear to be linked to bipolar disorder.

These MRI images highlight areas of decreased gray matter volume in prefrontal and temporal areas associated with high-level cognitive functioning and emotional regulation. (Rietschel, Maier, & Schulze, 2013)

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Schizophrenia

DEGREES OF PSYCHOPATHOLOGY

Schizophrenia

• Loss of contact with reality that is severe and chronic

• Hallmark features in disturbances in thinking, perception, and language

• Psychotic symptoms include delusions and hallucinations

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Schizophrenia

SYMPTOMS OF PSYCHOPATHOLOGY

Positive symptoms

• Excesses or distortions of normal behavior, and include delusions, hallucinations, and disorganized speech—all of which are generally not observed in people without psychosis

Negative symptoms

• Reduction or absence of normal behaviors. Common negative symptoms are social withdrawal, diminished speech or speech content, limited emotions, and loss of energy and follow-up.

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Schizophrenia

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Schizophrenia

UNTANGLING THE ROOTS OF SCHIZOPHRENIA

Diathesis–stress model

• Nested in biopsychosocial approach

• Suggests that developing schizophrenia involves genetic predisposition and environmental triggers

The brain of schizophrenics

• Thinning of cortex, enlarged ventricles and reduced size—may be tied to cognitive control

• Caution: May be due to long-term medication use

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Schizophrenia

UNTANGLING THE ROOTS OF SCHIZOPHRENIA

Theories

• Neurotransmitter theories

• Dopamine hypothesis

• Environmental triggers

• Exposure to virus in utero (i.e., HPV, influenza)

• Complications at birth, social stress, and cannabis abuse related to slightly increased risk of schizophrenia onset