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Overview of abnormal psych
- 1. Overview of Abnormal PsychOverview of Abnormal Psych Unit 9 Lesson 1
- 2. ObjectivesObjectives Define abnormality. Review historical approaches to abnormality. Compare how different schools explain abnormal behavior. Identify how disorders are classified and problems with system. Discuss how society views mental illness.
- 3. What is normal?What is normal? “Normal” “Abnormal” ◦ Standard ◦ Socially acceptable behavior w/in a culture ◦ Deviation from normality ◦ Maladaptive behavior ◦ Distress
- 4. ReviewReview: History of Abnormal Behaviors: History of Abnormal Behaviors Earliest Explanation? ◦ Evil Spirits – Trephining Ancient World ◦ Greeks – (Humors) Natural not supernatural forces Middle Ages ◦ Demonic possession Renaissance ◦ Scientific approach – mind can be sick American Reform ◦ Benjamin Rush & Dorothea Dix – humane treatment, asylums Scientific Advances ◦ Biological Basis, Imaging & Genetics, Psychopharmacology http://www.youtube.com/watch?v=Bi-3LufJKVs&feature=related
- 5. TPS: Perspectives of DisordersTPS: Perspectives of Disorders Illness is the result of…. Can be treated by… Conceptual Model Psychoanalytic Behavioral Cognitive Psychosocial Neurobiology
- 6. Perspectives of DisordersPerspectives of Disorders Illness is the result of…. Can be treated by… Conceptual Model Psycho- analytic Unconscious conflicts over aggressive & sexual impulses. Psychotherapy (“talking cure”) Psychodynamic Model Behavioral Reinforcement of inappropriate or extinction of appropriate behaviors. Behavior Therapy: Apply principles of learning to change/modify behavior Learning Model Cognitive Irrational or maladaptive thought processes Cognitive Therapy: Change thought processes Psychosocial Biological, psychological, and sociocultural factors. Medication, Behavioral , Cognitive Therapies Vulnerability-Stress Model Neurobiology Genetic abnormalities in brain structure & biochemistry. Medication Medical Model
- 7. Conceptual ModelsConceptual Models Medical Model: Diagnose, treat, and cure mental illness. ◦ Diagnosis – distinguish among disorders ◦ Etiology – cause/origin of disorder ◦ Prognosis – course & outcome of disorder
- 8. Diagnosing Mental IllnessDiagnosing Mental Illness Objective & Projective Tests Diagnostic & Statistical Manual of Mental Disorders ◦ Classification system ◦ Psychologists & Psychiatrists
- 9. DSMDSM DSM-I (1952): ~60 mental disorders DSM-II (1968): Used Freudian terms psychoses (severe) & neuroses (mild) DSM-III (1980): Disorders caused by underlying psychological diseases. Intro 5 axes DSM-IV (1994): ~300 disorders, eliminated others (ex homosexuality)
- 10. DSM-IVDSM-IV Axis 1 –Severe Mental Disorders Axis 2 – Personality Disorders Axis 3 – Physical Disorders Axis 4 – Social Stress Scale Axis 5 – Global Assessment of Functioning (GAF)
- 11. Major DSM-IV DisordersMajor DSM-IV Disorders Anxiety Mood Eating Somatoform Substance-Related Schizophrenia Dissociative Personality Impulse Control Sleep Disorders Sexual & Gender Identity Disorders Delirium, Dementia & Amnesia Disorders Disorders Diagnosed in Childhood or Adolescence
- 12. Criticisms of DSMCriticisms of DSM Over diagnosis ◦ Normal behaviors classified as disease (hyperactivity normal in kids = ADHD) Huge spectrum ◦ Lump minor (caffeine-induced sleep disorder) with major disorders (schizophrenia) Labels Harmful ◦ Self-fulfilling prophecy Reliability ◦ Diagnosis seems scientific but it’s not, subjective Controversial Disorders
- 13. Mental Illness vs. InsanityMental Illness vs. Insanity Sane and Insane are legal terms Insanity – inability of defendant to distinguish right from wrong at time of crime TPS - Should the insanity plea be allowed or not?
- 14. Why Study Abnormal Psych?Why Study Abnormal Psych? Prevalence Stigma / Misconceptions http://www.youtube. com/watch? v=WUaXFlANojQ
- 15. Organizations & GoalsOrganizations & Goals APA National Mental Health Assoc NAMI – Family Org for People w/ Brian Disorders Educate public Confront discrimination Challenge negative stereotypes Emphasize treatment works Achieve parity w/physical diseases
- 16. ClosureClosure What steps can high school students take to lessen the stigma often associated with psychological disorders?
Notas del editor
- Normal? Standard by which to measure socially acceptable behaviors within a culture (can vary culture to culture) What is abnormal? Deviation from normality – Behavior that is unlike that of the average or majority. MUST BE CAREFUL, behaving differently doesn’t necessarily indicate poor mental health! Person who believes he’s a prophet and stands on street corner may be…kid in class who dresses differently and stays quiet may not be! Maladaptive behavior – Behaviors disrupt every day life, may be harmful to self or others. Distress - Failing to adjust physically, emotionally, socially to get along in the world. Defense mechanisms have failed to protect us from anxiety…or…defense mechanisms work so well, reality is altered!
- http://www.youtube.com/watch?v=Bi-3LufJKVs&feature=related
- How does each major school of thought describe mental illness? How does each major school of thought think mental illness can be treated? Conceptual model – psychologists use different models for understanding, describing, and treating psych disorders.
- Psychodynamic Model disorders result from maladaptive defenses against unconscious conflicts Learning Model disorders result from reinforcement of abnormal behavior Vulnerability-Stress Model Disorders result from interaction b/t biological and environmental factors. Biological vulnerability to certain disorder develops into disorder if certain environmental stressors present.
- Neurobiology in particular emphasizes that mental illness needs to be diagnosed on the basis of its symptoms and cured through therapy based on medical intervention. Psychological illnesses can be diagnosed (based on symptoms), treated, and cured (hopefully).
- Objective – pencil & paper standardized tests (MMPI) Projective – response to ambiguous stimuli, psychologist’s judgment (Rorschach, Association) See personality unit for more DSM allows for systematic classification of mental disorders into categories describe disorders, predict outcomes, consider treatments, encourage research into etiology (cause) Psychologist – Testing, research & therapy Psychiatrist – Medical degree, treats disorders, can prescribe medication
- APA published first edition in 1952. DSM II based upon Freud’s psychoanalytic theory – most mental illness due to biological or psychological causes. Severe forms called psychoses; biologic = organic psychoses, others = functional psychoses Less severe disorders called neuroses DSM III moved away from Freudian psychology – used general term disorders rather than psycho/neurosis. Took view that mental disorders are caused by underlying psychological diseases; viewed psycholgical problems as medical ones DSM IV based on much research – enables scientists to differentiate many kinds of disorders. Some disorders have also been eliminated.
- Multi-Axial system of Classification: Diagnoses made on several different dimensions or categories Axis 1 – Records patient’s primary diagnosis. 16 major categories of adult psychological disorders. Axis 2 – Records long-standing personality problems, developmental disorders, or mental retardation. Axis 3 – Records any medical conditions that might affect the patient psychologically (interact w/disorder). Axis 4 – Records any significant psychosocial or environmental problems experienced by the patient. Rating of recent stressors (death in family, unemployment) Axis 5 – Records an assessment of the patient’s level of functioning. Scale that ranges from 1 to 100 (1 represents severe dysfunction, 100 represents unimpaired function).
- Anxiety – GAD, Phobia, Panic, OCD, PTSD Mood – Depression, Bipolar Eating – Anorexia, Bulimia Somatoform – Physical symptoms that can’t be explained by medical diagnosis – Conversion, Hypochondriasis Substance – Abuse, Dependence Schizophrenia- Dissociative – Amnesia, Fugue, Identity Disorder (multiple personalities) Personality - Paranoid, Schizoid, Antisocial (sociopathic), Histrionic, Narcissistic, Avoidant, Dependent Impulse Control - Explosive, Kleptomania, Pyromania, Trichotillomania Sleep – Dyssomnia & Parasomnia Sex - Dysfunctions, Paraphilias, Gender Identity Childhood - Mental Retardation, Learning, Motor Skills, Communication, Pervasive Dvpt (Autism, Aspergers), Attention Deficit and Disruptive Behavior, Tic, Elimination
- British Law 1843 Used to be that prosecution had to prove defendant was sane…capacity to know act was wrong Now 75% of states say defense must prove insanity…show they didn’t understand wrongfulness of acts. Not guilty by reason of insanity - released Guilty but mentally ill – sent to treatment facility - if judged recovered before end of sentence, sent to prison Idaho, Montana, Utah don’t allow insanity pleas!
- Prevalence – 1. WHO estimates 400 million people worldwide suffer from disorders (~6.8 billion total) No culture free of depression or schizophrenia. 2. In US, ~15% of population in need of therapy, 1.9 million admitted to mental hospitals & psychiatric units/year, 2.4 million seek out-patient help, and in any given year, about 5 million adults and 3 million children suffer from acute episode of one of 5 serious disorders (schizophrenia, bipolar, depression, OCD, and panic) Stigma Misconceptions leads to misunderstanding and discrimination
- Some of many organizations making efforts to combat the misconceptions attached to disorders are APA, NMHA, specific organizations like Anxiety Disorders Association of America Goals Educate public about mental illness Confront discrimination in insurance coverage, housing, education, employment, and access to services Challenge negative stereotypes such as those portrayed in the media Emphasize that treatment works. Fact: current success rates 60% schizo, 65% bipolar, 80% depression. Achieve understnading that serious mental illnesses are no-fault, biologically based brain diseases which should receive the same attention, concern, and care dollars as other physical diseases.