Abnormal Psychology

Defining Abnormal BehaviorAbnormal behavior is a mental illness that affects or is manifested in a persons brain and can affect the way a person thinks, behaves, and interacts with people.

Characteristics ofAbnormal BehaviorStatistical Infrequency: people who are abnormal deviate much from the average in a particular trait or behavior patternViolation of Norms: the behavior violates social norms or threatens or makes anxious those observing itPersonal Distress: the behavior creates great distress and torment in the person experiencing itDisability or Dysfunction: the person is impaired in some important area of life (e.g., work or personal relationships) because of the abnormality

Classifying Abnormal Behavior with the DSM-IVAxis I: all diagnostic categories except personality disorders and mental retardationAxis II: personality disorders and mental retardationAxis III: general medical health conditionsAxis IV: psychosocial and environmental problems Axis V: current level of functioning (GAF)

The Psychological DisordersChildhood DisordersAnxiety DisordersDissociative Identity DisorderSchizophreniaMood DisordersPersonality Disorders

Childhood DisordersMental RetardationLearning DisordersPervasive Developmental Disorders (PDD)Attention-Deficit/Hyperactivity Disorder (AD/HD)

Mental RetardationSignificantly subaverage intellectual functioning along with

Deficits in adaptive behavior and

Occurring prior to age 18

Learning DisordersInadequate devt in a specific area of academic, language, speech or motor skills not due to MR, autism, a demonstrable physical disorder, or deficient educational opportunitiesChildren w/ these disorders are usually of average or above-average intelligence but have difficulty learning some specific skill and thus their progress in school is impeded.

Learning DisordersReading disorder (dyslexia)

Disorder of written expression

Mathematics disorder

Famous People with Dyslexia

PDD, Autistic Disordercharacterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests.

AD/HDA persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent or severe than is typically observed in individuals at a comparable level of development.Symptoms must be present before age 7 and interfere with functioning in at least 2 settings.

Symptoms of AD/HDFidgetsDifficulty remaining seatedEasily distractedDifficulty waiting turnBlurts out answersDifficulty following instructionsDifficulty sustaining attentionFlits fr. 1 uncompleted task to anotherDifficulty playing quietlyTalks excessivelyInterrupts othersDoesnt seem to listenLoses things needed for tasksEngages in physically dangerous activities

Case # 1Nine-year-old Cathy is described by everyone as a handful. She fidgets constantly in class, drumming her fingers on the desk, squirming around in her chair, and getting up and down. She has trouble waiting her turn at work or at play, and she sometimes has violent outbursts.

Case # 2A young man in an undergraduate course shows an unusual pattern of strengths and difficulties. His oral comments in class were exemplary, but his handwriting and spelling were sometimes indecipherable. The undergraduate explained that it took him longer to complete the weekly reading assignments and to write papers and exams.

The instructor decided to accord him additional time for preparing written work. The student was obviously of superior intelligence and highly motivated to excel. Excel he did, earning an A in the seminar and on graduation being admitted to a leading law school.

Case # 3Timmy was born with the umbilical cord wrapped around his neck, so he had been w/o oxygen for an unknown period of time. Nonetheless, he appeared to be a healthy little boy. He was a very good baby who rarely cried, although his mother was concerned that he didnt like to be picked up and cuddled. He wasnt talking at 2 years old. He didnt play with other children; he spent most of his time alone,

spinning plates on the floor, waving his hands in front of his face, and lining up blocks in a certain order. At age 3, Timmys behavior persisted. Neurological exams revealed nothing unusual. Still, Timmy was delayed in learning such basic skills as talking and feeding himself. By age 7, Timmy still didnt speak or play w/ other children, and he was developing aggressive and self-injurious behaviors.

Anxiety Disordershave some form of irrational or overblown fear as the central disturbance Some of the anxiety disorders:Panic DisorderSpecific PhobiaObsessive-Compulsive Disorder (OCD)Post-Traumatic Stress Disorder (PTSD)

Panic DisorderAnxiety marked by the sudden but brief attacks of intense apprehension or terrorPanic attacks often cause severe palpitations, chest pains, trouble in breathing, trembling, sweating, dizziness, and a feeling of helplessness.May be accompanied by agoraphobia, the fear of leaving familiar surroundings.Generally, a stressful event precedes the initial panic attack.

Phobic DisordersAn irrational, overwhelming, persistent fear of a specific object or situationFear is so intense that people w/ phobic disorder avoid it even though they know that the fear is unwarranted & unreasonable & disrupts their lives.Examples: claustrophobia, acrophobia, hydrophobia

Obsessive-Compulsive DisorderAnxiety-provoking thoughts (obsessions) are followed by urges to engage in repetitive, ritualistic behaviors (compulsions) to ward off an impending feared situationMost common compulsions:cleaning, maintaining order thru elaborate ceremoniesperforming repetitive, magical, protective practices like counting, saying certain numbers, touching a talisman or a particular part of the bodychecking, going back 7-8 times to verify that already performed acts were actually carried outperforming a particular act, such as eating extremely slowly

Post-Traumatic Stress DisorderRefers to anxiety symptoms that develop through exposure to a traumatic eventSymptoms include:reexperiencing the traumatic eventavoidance of stimuli associated w/ the event or numbing of responsivenesssymptoms of increased arousal

Case # 1Bernice: 46-year-old femaleher disorder began 12 years earlier shortly after her dads deathhad a fear of contamination, w/c she vaguely linked to her fathers death of pneumoniawas afraid of everything: germs could be anywherewas upset by touching wood, scratchy objects, mail, canned goods, and silver flecks (cant state why these were sources of possible contamination)to reduce discomfort, Bernice spends 3-4 hrs. in the CR washing and rewashing herself, scraping outer layer of soapDuring mealtime, she eats 3 bites of food at a time, chewing each mouthful 300 times

Case # 2The patient:27-year-old singer referred by friend for evaluation8 months before, her boyfriend was stabbed to death in a mugging, w/c she witnessed and escaped unharmedBegan to have recurrent nightmares & vivid memories of the night of the crimeNightmares: saw blood, pursued by cloaked figuresDuring the day: drifted off into daydreams, startled easily, preoccupiedOther symptoms:Left her change/groceries at the storeIf she was waited on, she couldnt remember what she came to buySlept restlesslyWork suffered because of poor concentrationWithdrew from friends and avoided work

Case # 3Darlene has always refused to use escalators. She knows they are quite safe but she walks far out of her way to find an elevator or stairs to avoid the anxiety she feels when she considers riding an escalator. Darlene wishes she could overcome this fear because she is a personal shopper and does most of her work at department stores in the mall.

Case # 4The patient is a 46-year-old widow who came for therapy. She reported suddenly experiencing labored breathing, heart palpitations, nausea, chest pain, feelings of choking and impending doom while driving the car, w/c lasted for a few minutes.

Dissociative Identity DisorderDID is characterized by two or more distinct personalities or selves.Each personality has its own memories, behaviors, and relationships.Shifts from one personality to another typically occur under stress.Most people with DID are female.The disorder is generally the result of extreme physical or sexual abuse in early childhood, although the majority of individuals who have been sexually abused do not develop dissociative identity disorder.

Demon Alters VS Actual Demon PossessionPersecutors, but could be strong allies

Initially appear to be ego dystonic; but in time, they become ego syntonicTend to be arrogant; theres no sense of relating w/ themAlways remain ego alien (forever outside of person)

Demon Alters VS Actual Demon PossessionConfusion & fear subside w/ appropriate therapyTend to conform to surroundings & cultureHave personalities w/ accompanying voices

Confusion & fear persist despite therapy, includes lustForce unwanted behaviors & blame the personalityHave a negative voice w/o a personality

Demon Alters VS Actual Demon PossessionIrritation, discontent, and rivalry aboundImages remain human in formHatred and bitterness abound

Images could become subhuman

SchizophreniaA severe psychological disorder characterized by distortions in thought, perception, communication, emotion, behavior, and social skills.The symptoms include:delusions hallucinations incoherent speech loose associations odd behaviors social withdrawal

I: Have you been nervous or tense lately?P: No. I got a head of lettuce.I: You got a head of lettuce? I dont understand.P: Well, its just a head of lettuce.I: Tell me about lettuce. What do you mean?P: Welllettuce is a transformation of a dead cougar that suffered a relapse on the lions toe. And he swallowed the lion and something happened. Thesee, theGloria and Tommy, theyre two heads and theyre not whales. But they escaped with herds of vomit, and things like that.

I: Who are Tommy and Gloria?P: Uhtheres Joe DiMaggio, Tommy Henrich, Bill Dickey, Phil Rizzuto, John Esclavera, Del Crandell, Ted Williams, Mickey Mantle, Roy Mantle, Ray Mantle, Bob ChanceI: Who are they? Who are those people?P: Dead peoplethey want to be fuckedby this outlaw.I: What does all that mean?

P: Well, you see, I have to leave the hospital. Im supposed to have an operation on my legs, you know. And it comes to be pretty sickly that I dont want to keep my legs. Thats why I wish I could have an operation.I: You want to have your legs taken off?P: Its possible, you know.I: Why would you want to do that?P: I didnt have any legs to begin with. So I would imagine that if I was a fast runner, Id be scared to be a wife, because I had a splinter inside of my head of lettuce.

Mood DisordersA group of disorders characterized by a primary disturbance of mood, that usually includes cognitive, behavioral, and somatic symptoms as well as interpersonal difficulties.Disorders can represent one extreme of emotion (depression) or both extremes (bipolar disorders).

Major Depressive DisorderAn individual suffers from depression without ever experiencing mania for at least 2 weeks duration and with at least five of nine symptoms present.

Symptoms of Depressiondepressed moodreduced interest or pleasure in all or most activities significant weight loss or decrease in appetite changes in sleep patternspsychomotor agitation or retardationloss of energyfeelings of worthlessness or excessive guilt difficulty concentratingsuicidal ideation.

Bipolar DisorderA disorder characterized by extreme mood swings that include episodes of mania alternating with episodes of depression.Mania is characterized by extreme feelings of euphoria, energy, and impulsivity.

Symptoms of ManiaIncrease in activity level at work, socially, or sexuallyUnusual talkativeness; rapid speechFlight of ideas or subjective impression that thoughts are racingInflated self-esteem; belief that one has special talents, powers, and abilities

Less than the usual amount of sleepDistractibility; attention easily divertedExcessive involvement in pleasurable activities that are likely to have undesirable consequences (e.g., reckless spending)

Case # 1T: Well, you seem pretty happy today.C: Happy! Happy! You certainly are a master of understatement, you rogue! [Shouting, literally jumping out of his seat.] Why, Im ecstatic. Im leaving for the West Coast today, on my daughters bicycle. Only 3,100 miles. Thats nothing, you know. I could probably walk, but I want to get there by next week. And along the way I plan to contact a lot of people about investing in my fish equipment. Ill get to know more people that wayyou know, Doc, know in the biblical sense [leering at the therapist seductively]. Oh, God, how good it feels. Its almost like a nonstop orgasm.

Case # 2Mrs. M, a 38-year-old factory worker was a mother of four children. She had returned to work three years earlier when the worsening economy made it impossible for her family to get by on just by her husbands earnings. But seven months before she visited the psychologist, she was laid off, and the familys financial situation deteriorated. Ever-present worries about money led to increased arguments with her husband, not only about their finances, but also about the children.

She had begun to have difficulty sleeping and lost her appetite, resulting in weight loss. She had little energy and no interest in activities that she normally enjoyed. Even though she sat for hours in front of the TV, she couldnt get interested in any of the programs that had been her favorites; she didnt even pay attention most of the time. Household chores became impossible for her to do, and her husband began to complain, leading to further arguments. Finally, realizing that something serious had happened to his wife, Mr. M cajoled her into making a first appointment with a psychologist.

Personality DisordersThey are chronic, maladaptive cognitive-behavioral patterns that are thoroughly integrated into the personality.Some Personality Disorders:Antisocial Personality DisorderBorderline Personality DisorderPassive-Aggressive Personality Disorder

Antisocial Personality DisorderCharacterized by a pattern of exploitive behavior, lack of guilt, self-indulgent behavior, and interpersonally intrusive behavior.The disorder generally begins before the age of 15 and continues into adulthood.

Borderline Personality DisorderBorderline personalities are emotionally unstable, impulsive, unpredictable, irritable, and anxious.

Passive-Aggressive Personality DisorderPassive-aggressive personalities are stubborn or are intentionally inefficient in an effort to frustrate others.

Case # 1Alan is involved in drugs and has casual sexual encounters. He feels empty unless he does dangerous and exciting things. He threatens to commit suicide if his girlfriend suggests getting help or if she talkjs about leaving him. He alternates between loving her and hating her. He has low self-esteem and has recently experienced high levels of stress.

Case # 2Matt is 19 and has been in trouble with the law since he was 14. He lies to his parents, vandalizes buildings in his community and when caught, shows no remorse. He frequently fights with others and doesnt care whom he injures.

Case # 3Mike, male, 52 is attending therapy at the request of his wife. She complains that he is "emotionally absent" and aloof. Mike shrugs: "We used to have a great marriage, but good things don't last. You can't sustain the same levels of passion and interest throughout the relationship." Isn't his family worth the effort? Another shrug: "It doesn't pay to be a good husband or a good father. Look what my loving wife did to me. In any case, at my age the future is behind me. Carpe Diem is my motto.

Does he consider his wife's demands to be unreasonable? He flares: "With all due respect, that's between me and my spouse." Then why is he wasting his time and mine? "I didn't ask to be here." Did he prepare a list of things he would like to see improved in his family life? He forgot. Can he compile it for our next meeting? Only if nothing more urgent pops up. It would be difficult to continue to work together if he doesn't keep his promises. He understands and he will see what he can do about it (without great conviction).

The problem is, he says, that he regards psychotherapy as a form of con-artistry: "psychotherapists are snake oil salesmen, latter-day witch doctors, only less efficient." He hates to feel cheated or deceived. Does he often feel that way? He laughs dismissively: he is too clever for run-of-the-mill crooks. He is often underestimated by them.

Do other people besides crooks underestimate him? He admits to being unappreciated and underpaid at work. It bothers him. He deserves more than that. Obsequious intellectual midgets rise to the top in every organization, he observes with virulent envy. How does he cope with this discrepancy between the way he perceives himself and the way others, evidently, evaluate him? He ignores such fools. How can one ignore one's co-workers and one's superiors? He doesn't talk to them. In other words, he sulks?

Not always. He sometimes tries to "enlighten and educate" people he deems "worthy". It often gets him into arguments and he has acquired a reputation as a cantankerous curmudgeon but he doesn't care. Is he an impatient or irritable person? "What do you think?" - he counters - "During this session did I ever lose my cool?" Frequently. He half rises from his chair then thinks better of it and settles down. "Do your thing" - he says sullenly and contemptuously - "Let's get it over with."