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Abnormal Psych Chapter 16 Psychological Disorders Psychological Disorders 1. Define abnormal vs. normal 2. Distinguish b/w methods of deciding normality 3. Recognize and use the bell-shaped curve showing normal 4. Develop and analyze surveys to determine normal personality qualities and behaviors Psychological Disorders 1. 2. 3. 4. Normal/ Abnormal: Who decides? Group Survey Creation Individual survey Completion Results tabulation and presentation of results Psychological Disorders 1. Quiz 16-1/ Developmental Review Sheets on Desk/ EC on Desk 2. Calendar Review 3. Developmental Test Review 4. Abnormal Project HW: 16-2, Review U1 (Prologue & Ch 1) EC Due Psychological Disorders 16-1 619-626 Perspectives on Psychological Disorders: Medical Model, Pinel, BioPsycho-Social Perspective, DSM-IV, Diagnostic Labeling, Rosenhan  1. Identify the criteria for judging whether behavior is psychologically disordered.  2. Describe the medical model of psychological disorders, and discuss the bio-psycho-social perspective offered by critics of this model.  3. Describe the aims of DSM-IV and discuss the potential dangers associated with the use of diagnostic labels. Psychological Disorders  Psychological Disorder  a “harmful dysfunction” in which behavior is judged to be:  atypical--not enough in itself  disturbing--varies with time and culture  maladaptive--harmful  unjustifiable--sometimes there’s a good reason Psychological Disorders  5 Axes of the DSM-IV  Axis I- addresses clinical syndromes & major disorders: schizo, anxiety dis, dis diag in infancy, childhood, adolesc, somatoform dis, sexual dis, delirium, amnesia, dementia <<all disorders other than Personality & MR>>  Axis II- personality disorders; MR  Axis III – Gen Med Conditions relevant to understanding/ managing the disorder (Hypothyrodism-Depression)  Axis IV-Psychosocial & Environmental Problems that may affect diagnosis, treatment, prognosis of mental disorders (housing, economic, family)  Axis V-rep global assessment of person’s level of functioning. (90 indicates minimal symptoms & 1 maximal –ie. viol subj likely to harm others) Historical Perspective  Perceived Causes  movements of sun or moon  lunacy--full moon  evil spirits  Ancient Treatments  exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood, bloodletting Psychological Disorders  Phillipe Pinel –France early 1800s – said madness was sickness of mind, not demon posession, unchained patients and talked to them  Led to Medical Model in 1800s (hospitals replaced asylums)  Medical Model  concept that diseases have physical causes  can be diagnosed, treated, and in most cases, cured  assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital Psychological Disorders Cross-Cultural Analysis Environmental effects evident from cross-cultural analysis: Dep and Schizo present worldwide Anorexia & Bulimia – Western Susto- Latin America; severe anxiety, restlessness, fear of black magic  Taijin-kyofusho-Japan; social anxiety of appearance, blushing & fear of eye contact     Psychological Disorders  Today, mental health workers agree that disorders influenced by:  genes  physiological states  inner psychological dynamics  social-cultural  circumstances  Bio-Psycho-Social Perspective  assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Bio-Psycho-Social Perspective Psychological Disorders--Etiology  DSM-IV  American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)  a widely used system for classifying psychological disorders  presently distributed as DSM-IV-TR (text revision)  17 categories of mental disorders & neurotic disorders & psychotic disorders  Most Health insurance companies require diagnosis w DSM-IV to pay for therapy Anxiety Disorders  Anxiety Disorders  distressing, persistent anxiety or maladaptive behaviors that reduce anxiety  Generalized Anxiety Disorder  person is tense, apprehensive, and in a state of autonomic nervous system arousal Anxiety Disorders  Panic Disorder  marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation Anxiety Disorders  Phobia  persistent, irrational fear of a specific object or situation  Obsessive-Compulsive Disorder  unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Anxiety Disorders  Common and uncommon fears Anxiety Disorders Anxiety Disorders  PET Scan of brain of person with Obsessive/ Compulsive disorder  High metabolic activity (red) in frontal lobe areas involved with directing attention Mood Disorders  Mood Disorders  characterized by emotional extremes  Major Depressive Disorder  a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities  Dysthymic Disorder- less extreme than MJD, but longer lasting (“the blues”) Mood Disorders  Manic Episode  a mood disorder marked by a hyperactive, wildly optimistic state  Bipolar Disorder  a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania  formerly called manic-depressive disorder Mood DisordersDepression Mood DisordersDepression  Canadian depression rates Mood DisordersSuicide Mood DisordersBipolar  PET scans show that brain energy consumption rises and falls with emotional switches Depressed state Manic state Depressed state Mood DisordersDepression  Altering any one component of the chemistrycognition-mood circuit can alter the others Mood DisordersDepression  The vicious cycle of depression can be broken at any point Schizophrenia & Personality Disorders 1. 16-4 Quiz 2. Projects 3. HW: 17-1, Review Ch 5&6 Sensation & Perception Schizophrenia & Personality Disorders 16-4 646-657 Schizophrenia: Symptoms, Subtypes, Biological and Psychological Factors; Personality Disorders; Prevalence of Psych Disorders 1. Explain the development of mood disorders, paying special attention to the biological and social-cognitive perspectives. 2. Describe the various symptoms and types of schizophrenia, and discuss research on its causes. 3. Describe the nature of personality disorders, focusing on the characteristics of the antisocial personality disorder. 4. Describe the characteristics and possible causes of dissociative identity disorder. 5. Describe the prevalence of various disorders and the timing of their onset. Dissociative Disorders  Dissociative Disorders  conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings  Dissociative Identity Disorder  rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities  formerly called multiple personality disorder Schizophrenia  Schizophrenia  literal translation “split mind”  a group of severe disorders characterized by:  disorganized and delusional thinking  disturbed perceptions  inappropriate emotions and actions Schizophrenia  Delusions  false beliefs, often of persecution or grandeur, that may accompany psychotic disorders  Hallucinations  sensory experiences without sensory stimulation Schizophrenia Schizophrenia Schizophrenia Schizophrenia Personality Disorders  Personality Disorders  disorders characterized by inflexible and enduring behavior patterns that impair social functioning  usually without anxiety, depression, or delusions Personality Disorders  Antisocial Personality Disorder  disorder in which the person (usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members  may be aggressive and ruthless or a clever con artist Mood DisordersDepression  Boys who were later convicted of a crime showed relatively low arousal Personality Disorders  PET scans illustrate reduced activation in a murderer’s frontal cortex Normal Murderer Personality Disorders Rates of Psychological Disorders Chapter 17 Therapy 17-1 659-664 Psychological Therapies: Dix, Psychoanalysis - Methods, Psychodynamic Therapy; Freud, Humanistic-Client Centered Therapy, Active Listening, UPR, Maslow, Rogers 1. Discuss the aims and methods of psychoanalysis, and explain the critics’ concerns with this form of therapy, noting how psychodynamic therapists have tried to answer the criticisms. 2. Identify basic characteristics of the humanistic therapies and the specific goals and techniques of client-centered therapy.  17-2 664-673  Behavior Therapies: Classical Conditioning Therapies-Counterconditioning (Exposure Therapies--Systematic Desensitization, Vrtual Reality Exposure Therapy; Aversive Conditioning), Operant Conditioning Therapy-Token Economy, Cognitive Therapy, CBT, Group & Family Therapy   3. Identify the basic assumptions of behavior therapy, and discuss the classical conditioning techniques of systematic desensitization and aversive conditioning.  4. Describe therapeutic applications of operant conditioning principles, and explain the critics’ concerns with this behavior modification process.  5. Describe the assumptions and goals of the cognitive therapies and their application to the treatment of depression.  6. Describe the rationale and benefits of group therapy, including family therapy. 1. States of Consciousness Q/A 2. States of Consciousness Review Quiz 3. Review Test Essay 4. Project Presentations 5. HW: 17-4, Practice Essays – Bring on Disk or Flash Drive 1. States of Consciousness Q/A 2. States of Consciousness Review Quiz 3. IB Exam Prep 4. Review Test Essay 5. HW: 17-4, Practice Essays – Bring on Disk or Flash Drive  17-3 674-684  Evaluating Psychotherapy: Effectiveness of Psychotherapy, MetaAnalysis, Alternative Therapies: Therapeutic Touch, EMDR, Light Exposure Therapy, Commonalities of Therapies, Types of Therapists  7. Discuss the findings regarding the effectiveness of the psychotherapies, and explain why ineffective therapies are often mistakenly perceived to be of value.  8. Describe the commonalities among the psychotherapies, and discuss the role of values and cultural differences in the psychotherapeutic process. 1. 17-4 Quiz 2. Project Presentations 3. Essay Review 4. Review Confusing Pairs/ Fond Remb/ People Packet 5. HW: Disorders & Therapies- Take Home Tests on Web 2 Sheets of Paper Take Both, Check Answers, then create test review sheet and create notes for missed questions (if you missed 10 items, you should have 10 annotations for notes) 1. 17-4 Quiz 2. Project Presentations 3. Review M.C. 4. Review Confusing Pairs/ Fond Remb/ People Packet 5. HW: Online Disorders & Therapies- Take Home Tests on Web, can work w/ partner Review Essay Rubrics **FRI Review Session in S-7, 2:15-3:15 (Con’t be Late)….EC??? Deinstitutionalization – 50s, sparked by Thorazine Dissociative Disorders  Dissociative Amnesia – forget after trauma  Dissociative Fugue- flee and forget after trauma  Dissociative Identity Disorder-multiple personality disorder Conversion Disorder-convert psychological distress into medical problem Somatoform Disorders Hypochondriasis – misinterpret normal bodily changes/ functions as abnormal  Conversion Disorder-convert psychological distress into medical problem Extra Items Notes: Hans Selye  17-4 685-693  Biomedical Therapies: Drug Therapies-Anitpsychotics, Antianxietys, Antidepressants, Mood Stabilizers-lithium, ECT, Psychosurgery-lobotomy  9. Identify the common forms of drug therapy.  10. Describe the use of electroconvulsive therapy and psychosurgery in the treatment of psychological disorders. History of Treatment Therapy  Psychotherapy  an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties  Eclectic Approach  an approach to psychotherapy that, depending on the client’s problems, uses techniques from various forms of therapy TherapyPsychoanalysis  Psychoanalysis  Freud believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, allowing the patient to gain self-insight  use has rapidly decreased in recent years  Resistance  blocking from consciousness of anxiety-laden material TherapyPsychoanalysis  Interpretation  the analyst’s noting supposed dream meanings, resistances, and other significant behaviors in order to promote insight  Transference  the patient’s transfer to the analyst of emotions linked with other relationships  e.g. love or hatred for a parent Humanistic Therapy  Client-Centered Therapy  humanistic therapy developed by Carl Rogers  therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients’ growth Humanistic Therapy  Active Listening-empathic listening in which the listener echoes, restates, and clarifies Behavior Therapy  Behavior Therapy  therapy that applies learning principles to the elimination of unwanted behaviors  Counterconditioning  procedure that conditions new responses to stimuli that trigger unwanted behaviors  based on classical conditioning  includes systematic desensitization and aversive conditioning Behavior Therapy  Exposure Therapy  treat anxieties by exposing people (in imagination or reality) to the things they fear and avoid Behavior Therapy  Systematic Desensitization  type of counterconditioning  associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimuli  commonly used to treat phobias  Aversive Conditioning  type of counterconditioning that associates an unpleasant state with an unwanted behavior  nausea ---> alcohol (eg. Antabuse) Behavior Therapy  Systematic Desensitization Behavior Therapy  Aversion therapy for alcoholics (eg. Antabuse) Behavior Therapy  Token Economy  an operant conditioning procedure that rewards desired behavior  patient exchanges a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats Cognitive Therapy  Cognitive Therapy  teaches people new, more adaptive ways of thinking and acting  based on the assumption that thoughts intervene between events and our emotional reactions Cognitive Therapy  The Cognitive Revolution Cognitive Therapy  A cognitive perspective on psychological disorders Cognitive Therapy  Cognitive therapy for depression Cognitive Therapy  Cognitive-Behavioral Therapy  a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) Group and Family Therapies  Family Therapy  treats the family as a system  views an individual’s unwanted behaviors as influenced by or directed at other family members  attempts to guide family members toward positive relationships and improved communication Evaluating Psychotherapies  To whom do people turn for help for psychological difficulties? Evaluating Psychotherapies  Regression toward the mean  tendency for extremes of unusual scores to fall back (regress) toward their average  Meta-analysis  procedure for statistically combining the results of many different research studies Evaluating Psychotherapies Number of persons Average untreated person Poor outcome 80% of untreated people have poorer outcomes than average treated person Average psychotherapy client Good outcome Evaluating Psychotherapies Therapists and their Training  Clinical psychologists  Most are psychologists with a Ph.D. and expertise in research, assessment, and therapy, supplemented by a supervised internship  About half work in agencies and institutions, half in private practice Therapists and their Training  Clinical or Psychiatric Social Worker  A two-year Master of Social Work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems  About half have earned the National Association of Social Workers’ designation of clinical social worker Therapists and their Training  Counselors  Marriage and family counselors specialize in problems arising from family relations  Pastoral counselors provide counseling to countless people  Abuse counselors work with substance abusers and with spouse and child abusers and their victims Therapists and their Training  Psychiatrists  Physicians who specialize in the treatment of psychological disorders  Not all psychiatrists have had extensive training in psychotherapy, but as M.D.s they can prescribe medications. Thus, they tend to see those with the most serious problems  Many have a private practice Biomedical Therapies  Psychopharmacology  study of the effects of drugs on mind and behavior  Lithium  chemical that provides an effective drug therapy for the mood swings of bipolar (manic-depressive) disorders Biomedical Therapies  The emptying of U.S. mental hospitals Biomedical Therapies Biomedical Therapies Biomedical Therapies  Electroconvulsive Therapy (ECT)  therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient  Psychosurgery  surgery that removes or destroys brain tissue in an effort to change behavior  lobotomy  now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients Electroconvulsive Therapy Mind-Body Interaction