Abnormal Psychology Notes

Abnormal Psychology Notes Past and present: What is abnormal? 1.​ Psychological Disorders 2.​ Pattern of Abnormal Behavior (Disturbance of Behavior (impaired behavior) ●​ Holding a job ●​ Reality vs. fantasy (Disturbance of Psychological functioning (Emotional Distress) ●​ Anxiety ●​ Depression Criteria for Determining Abnormality The most commonly used criteria for determining abnormality include the following: 1.​ Unusualness 2.​ Social deviance 3.​ Faulty perceptions or interpretations of reality 4.​ Significant personal distress 5.​ Maladaptive or self-defeating behavior 6.​ Dangerousness What behaviors/beliefs/traditions do you or your family practice that may be considered “unusual” or “abnormal”? -Different religion beliefs 1/22/25 Historical perspectives: Early Demonological ●​ Supernatural / Evil spirits (demonology) - Trephination - cutting a hole in a person’s skull ●​ Ancient Greece: temples - Aesculapius - Incurables = storing Balance of humors (Hippocrates) ●​ Bodily fluids ●​ An imbalance = abnormal behavior - Low energy = excess of phlegm - Too much black bile = depression, or melancholia Middle Ages: Medieval Times ●​ Supernatural causes: - Possession by evil spirits of the Devil ●​ Roman Catholic Church ●​ Treatment of choice: - exorcism Witchcraft ●​ Late 15th - 17th centuries: massive persecutions ●​ Women accused ●​ Bewitched - pacts with the devil ●​ Diagnosis: Signs of possession/devil on skin - Stigmata diabolic Renaissance & Asylums ●​ Europe-late 15th & early 16th centuries, asylums, or madhouses ●​ St. Mary’s of Bethlehem Hospital - “bedlam” - public could buy tickets to observe inmates ●​ Chaining, beating, starving, bleeding A Step Backward ●​ Middle of 20th century: Deplorable hospital conditions remained ●​ Mid-1950s: population had risen to half a million patients ●​ Deinstitutionalization - 1950s policy burden of care = community-based treatment 1/24/2025 Identification, detection, classification and assessment of mental disorders ●​ 1952 ●​ Signs or symptoms ●​ Is descriptive, not explanatory - Uses term mental disorder - describe clinical syndromes: ●​ Distress/disability ●​ ●​ ●​ ●​ ●​ ●​ Cognitive Emotional Behavioral functioning Categorical model Clinicians make a categorical “yes-no” judgment Also rate severity of symptoms Culture-Bound Syndromes ●​ Belief/Behavior patterns -occur in some cultures ●​ ‘Ataque de nervious” (attack of the nerves) - Dhat syndrome(Indian) ●​ United States: - anorexia Evaluating The DSM System DSM ●​ Reliable - different evaluators using the same system - arrive at the same diagnosis ●​ Valid - diagnostic judgments correspond with observed behavior ●​ OR predict the course the disorder is likely to follow (predictive validity) Changes in the DSM-5 ●​ Expansion of diagnosable disorders - ex: binge eating disorder ●​ Changes in classification of mental disorders - ex: sexual orientation Advantages and Disadvantages of the DSM System Advantages of DSM: ●​ Specific diagnostic criteria - framework for treatment decisions Disadvantages/Criticisms of DSM: ●​ Stigma of labels - Sanism - The negative stereotyping of people - identified as mentally ill Methods of Assessment & Diagnosis Three Steps 1.​ Gather information 2.​ Organize and process information - clinical description 3.​ Compare description using a nosology - a diagnosis - Nosology: ●​ Classification system containing categories of disorders ●​ Rules for categorizing disorders depending on observable signs and symptoms Life Records & The Clinical Interview Life records ●​ ●​ 1.​ 2.​ 3.​ 4.​ 5.​ The most widely used means of assessment Most interviews cover these topics: Identifying data Description of the presenting problem(s) Psychological history Medical/psychiatric history Medical problems/medication Life Records -​ E.g., school grades, court records, police reports, medical records -​ Clinical interview Interview Formats ●​ Unstructured interview - clinician adopts his or her own style of questioning ●​ Semistructured interview - clinical follows a general outline but ask them in any order and to branch off in other directions ●​ Structured interview - follows a preset series of questions in a particular order - mental status examination (MSE) Assessment and Diagnosis Correct Diagnosis vs. Diagnostic Errors ●​ True positive - Clinician correctly concludes condition is present - sensitivity ●​ True negative - Clinician correctly concludes person does not have the condition - Specificity ●​ False positive: error - clinician diagnosis is a mental disorder when NO disorder is present ●​ False negative; error - clinician diagnosis NO disorder when the person actually has one Psychological Tests ●​ Structured method of assessment - stable units - E.g. intelligence and personality ●​ Standardized - compare clients’ Intelligence tests ●​ Score of 100 average ●​ 70 or less ●​ 130+ ●​ Wechsler Objective Tests ●​ Self-report personality tests - specific questions/statements - reflect personality - Examples : interests, thoughts,. Two most widely used: ●​ Minnesota Multiphasic Personality Inventory (MMPI) - abnormal behavior patterns - 567 true-false statements ●​ Million Clinical Multiaxial Inventory (MCMI) - Personality disorders - 195 true/false items Projective Tests ●​ Project personality and unconscious motives ●​ May offer clues to unconscious processes ●​ Rorschach ●​ Thematic Apperception TAT The Biological Perspective ●​ Biological defects/abnormalities - Nervous system ●​ Wilhelm Griesinger (1817-1868) diseases of the brain ●​ Emil Kraepelin (1856-1926) physical diseases The Biological Perspective: Support for the Medical Model ●​ Two influential discoveries: - Late 19th century advanced stage of syphilis led to a form of disturbed behavior (bacterium invades the brain) ●​ Alzheimer’s disease = major cause of dementia Behavioral Genetics ●​ Nature versus nurture ●​ Epigenetics - environmental factors influence genetic expression 1/29/25 Cerebral Cortex -​ Occipital lobe - Primarily processing visual stimuli -​ Temporal Lobe - Processing sounds or auditory stimuli -​ Parietal Lobe - processing sensations of touch, temperature, and pain -​ Frontal Lobe - Controls muscle movement - prefrontal cortex - higher mental functions thinking problem solving, and use of language Major Neurotransmitters and their functions -​ Serotonin (mood, sleep, appetite) -​ Low levels (belinia) -​ Dopamine (movement, learning, mood, pleasure) -​ Acetylcholine (involved in arousal, attention, memory, and controls muscle contractions) -​ Endorphin (involved in pain relief) -​ Norepinephrine (involved in arousal and mood) -​ GABA (involved in sleep, regulates anxiety, and inhibits movement) like drinking -​ Glutamate (involved in learning, memory formation, nervous system development, and synaptic plasticity) The Psychological Perspective ●​ Sigmund Freud (1856-1939) ●​ Psychodynamic model ●​ Roots of psychological problems: - unconscious motives and Awareness 1.​ Conscious 2.​ Preconscious 3.​ Unconscious Id: Original Psychic Structure “Pleasure” principle (I want it now) Ego: Seeks to curb demand of the id. “Reality” principle Superego: moral conscience Passes judgment on right/wrong Defense Mechanisms ●​ Reality-distorting strategies (ego) ●​ Protection ●​ Constrain impulses from id ●​ Freud: Slips of the tongue; ordinary forgetfulness Examples: -​ Represent hidden motives Types of Defense Mechanisms ●​ Repression ●​ Denial ●​ Regression/;pp- Section 1: Multiple Choice (2 points each) 1.​ Which of the following is an example of a disturbance in behavior?​ a) Experiencing anxiety​ b) Holding a job successfully​ c) Struggling to differentiate reality from fantasy​ d) Excess of phlegm 2.​ Which of these criteria is NOT commonly used to determine abnormality?​ a) Significant personal distress​ b) Faulty perceptions or interpretations of reality​ c) High intelligence​ d) Social deviance 3.​ What was trephination primarily used for in early demonological practices?​ 4.​ 5.​ 6.​ 7.​ a) To balance bodily humors​ b) To allow evil spirits to escape​ c) To treat melancholia​ d) To diagnose possession Hippocrates believed abnormal behavior was caused by:​ a) Possession by evil spirits​ b) Imbalances in bodily fluids (humors)​ c) Faulty interpretations of reality​ d) Religious practices What was the primary treatment for possession during the Middle Ages?​ a) Trephination​ b) Exorcism​ c) Witchcraft accusations​ d) Phlebotomy What does “Stigmata diabolic” refer to in the context of witchcraft?​ a) A pact with the devil​ b) Evidence of possession or marks on the skin​ c) Symptoms of melancholia​ d) A form of exorcism What was the purpose of asylums like St. Mary’s of Bethlehem?​ a) To provide humane care for the mentally ill​ b) To isolate and punish those with abnormal behavior​ c) To conduct scientific studies on mental illness​ d) To serve as temples for healing Section 2: True/False (1 point each) 8.​ Social deviance is always a definitive indicator of abnormality.​ (True / False) 9.​ Hippocrates’ theory of humors linked physical conditions to mental health.​ (True / False) 10.​During the Middle Ages, exorcism was a common treatment for psychological disturbances.​ (True / False) 11.​ Deinstitutionalization in the 1950s aimed to move care for the mentally ill to community-based settings.​ (True / False) Section 3: Fill-in-the-Blank (2 points each) 12.​Abnormal behavior characterized by significant personal distress and self-defeating actions is referred to as ________. 13.​Trephination involves cutting a hole in a person’s ________ to treat supposed possession or mental illness. 14.​During the Middle Ages, possession was believed to be caused by ________. 15.​The ________ movement of the mid-20th century aimed to reduce hospital populations by providing community care. Section 4: Short Answer (5 points each) 16.​List and explain three criteria commonly used to determine abnormality. 17.​ Describe the concept of balancing bodily humors as proposed by Hippocrates and provide one example of how an imbalance was believed to affect behavior. 18.​How did the treatment of individuals with abnormal behavior differ during the Renaissance compared to the Middle Ages? 19.​ Why was the policy of deinstitutionalization significant, and what were some challenges it created? 2/3/25 Abnormal Behavior in Childhood and Adolescence Neurodevelopmental Disorders There's disorders inclined: -​ Autism spectrum disorder -​ Intellectual disability Prevalence of Mental Health Problems in Children and Adolescents ●​ 1 in 7 children - severe enough to impair development (2023, National Survey of Children's Health) ●​ ●​ ●​ ●​ ●​ ●​ Children ages 6 to 17 - learning disabilities (17.8%) (CDC) Attention-deficit hyperactivity disorder (10.2%) Major depression 2.9 million ages 12 to 17 (2020, SAMHSA) 9.2% of the males 25.2% of the females Externalizing - Bx that is a nuisance ●​ Internalizing - Deficit - desired box - Subjective distress Risk and Protective Factors ●​ Factors - Genetic susceptibility - Environmental stressors ●​ neighborhoods - Family factors ●​ abuse ●​ Parents who suffer from depression - Children = higher risk ●​ Autism Spectrum Disorder (ASD) - range of autism-related disorders that vary in severity ●​ Autism Spectrum Disorder - Autistic thinking: ●​ center of the universe ●​ Children - unable to relate to others - private worlds ●​ More common in boys than in girls ●​ Evident in toddlers - 18 and 30 months of age ●​ Toddlerhood - difficulty playing social games (etc.) ●​ Atypical responses - Ex: May fail to seek comfort - Fail to respond to parents’ emotional displays ●​ Average diagnosis about age 6 ●​ Features of Autism -​ Behavioral: ●​ Inappropriate social interaction ●​ Poor eye contact ●​ Compulsive behavior ●​ Repetitive movements ●​ Self harm ●​ Persistent repetition of words or actions Developmental: learning disability or speech delay in a child Cognitive: intense interest in a limited number of things or problem paying attention Psychological: unaware of others’ emotions Also common: anxiety, change in your voice, sensitivity to sound Criteria ●​ A: Deficits in social communication/interaction across multiple context ●​ B: restricted range of behaviors, interest, or activities - Ex: rigid Vaccines and ASD ●​ Wakefield study (1998) ●​ What they reported: (MMR in particular) and ASD ●​ Facts: - vaccination rates began to drop - sample size (n=12) - uncontrolled design; selective sampling - Failed to disclose financial interests (funded by lawyers representing parents suing vaccine companies). ●​ retraction by The Lancet in 2010 ●​ Guilty of ethical violations 2/7/2025 Intellectual Disability ●​ Delay or impairment of: - intellectual (cognitive functioning) - adaptive abilities (behavior) ●​ Psychological - impoverished home environment Causes of Intellectual Disability: 1.​ Down Syndrome: Chromosomal Abnormalities ●​ Down syndrome - extra chromosome on the 21st pair - 1 in 775 births 2.​ Fragile X Syndrome: Genetic Abnormalities - Fragile X Syndrome = inherited form of intellectual disability - mutated gene on the X chromosome 3.​ Prenatal Factors ●​ Rubella (German measles) - brain damage ●​ Syphilis and genital herpes Learning Disorder ●​ Learning disorder = deficiency in a specific learning ability ●​ Normal intelligence Communication Disorders Behavioral Issues ●​ Seriously interfere with the child’s functioning in school, at home, and in the playground ●​ ADHD = Attention-Deficit Hyperactivity Disorder - Characterized by excessive motor activity - inability to focus one’s attention - 7% and 9% of school-age children - Over 60 million (6-17 yrs old) ●​ ADHD is divided into three subtypes: a) a predominantly inattentive type b) a predominantly hyperactive or impulsive type c) a combination type Stress Disorders ●​ The Nature of Stress - The nature and timing of stress - The person’s psychological characteristics and social situation - Biochemical variables that influence stress responses Traumatic Stress Disorders ●​ Maladaptive reactions to traumatic stress ●​ Typically involve: ●​ Two major types: 2/17/25 Acute Stress Disorder ●​ Person shows maladaptive pattern of behavior - 3 days to 1 month - exposure to a traumatic event ●​ Exposure to: - Actual or threatened event - Response to battlefield trauma ●​ “ In a daze “ ●​ Shock ●​ Unreal ●​ Dissociation - likelihood of later development of PTSD Common Features of Traumatic Stress Disorders ●​ Avoidance behavior ●​ Reexperiencing the trauma ●​ Emotional distress, negative thoughts, and impaired functioning ●​ Heightened arousal ●​ Emotional numbing Posttraumatic Stress Disorder ●​ Prolonged maladaptive reaction longer than 1 month ●​ Similar symptoms ASD - months, years, or decades ●​ Survivors of Domestic Violence Children & Violent Trauma ●​ 41.2% experienced a physical assault ●​ 10.1% experienced an assault-related injury ●​ 2% experienced sexual assault or sexual abuse ●​ 10.7% for girls aged 14 to 17 years 15.2% experienced maltreatment by a caregiver ●​ 5.8% witnessed violence between parents ●​ Safe, Stable, Nurturing, Relationships Trauma and the Brain ●​ The Amygdala ●​ Hippocampus 2/21/25 Anxiety Disorders ●​ Excessive or maladaptive anxiety reactions ●​ Anxiety - emotional state ●​ Physiological arousal unpleasant feelings of tension ●​ Unpleasant feelings of tension ●​ Apprehension or foreboding Overview of Anxiety Disorders ●​ Wide range of symptoms ●​ a) Physical features ●​ b) Behavioral features ●​ c) Cognitive features Panic Disorder ●​ Repeated episodes of intense anxiety or panic ●​ Intense anxiety reactions accompanied by physical symptoms, such as: - Pounding heart - Rapid respiration - Shortness of breath - Difficulty breathing - Heavy perspiration - Weakness or dizziness Features of Panic Attacks ●​ Strong bodily component ●​ Feelings of: - sheer terror - imminent danger or impending doom - urge to escape the situation - to escape the situation ●​ Agoraphobia - excessive, irrational fear of open or public places Treatment Approaches -​ Include drug therapy and cognitive-behavioral therapy for panic disorder -​ A potential problem: Phobic Disorders -​ Fear response to a particular threat ●​ Phobia: object or situation -​ Disproportionate to the threat it poses Examples: -​ Fear of dying during a head on collision -​ Fear of cars in general Specific Phobias -​ Fear of heights -​ Fear of enclosed spaces High levels of fear and physiological arousal -​ Encouraging te object -​ Urges to avoid the escape Systematic desensitization - Behavior therapy technique ●​ Deeply relaxed ●​ Fear-stimulus hierarchy = ordered series of increasingly fearful stimuli ●​ Gradual exposure - a stepwise process of exposure Learning-Based Approaches Flooding - A behavior therapy technique - exposure to high levels of fear-inducing stimuli Exposure therapy snake 2/26/25 Generalized Anxiety Disorder ●​ Generalized anxiety disorder (GAD) ●​ General feelings of dread and foreboding ●​ Heightened bodily arousal ●​ Not specific object, situation, or activity Obsessive-Compulsive and Related Disorders ●​ Pattern of compulsive or repetitive behaviors - significant personal distress - impaired functioning ●​ Disorders with this category: - (OCD) - recurrent obsessions, compulsions - Obsession ●​ Thought or image ●​ Uncontrollable ●​ Compulsion - repetitive or ritualistic behavior Trichotillomania - “hair pulling” disorder Excoriation - “Skin picking” disorder Characterized by recurrent picking one’s own skin -​ Common sites: face, arms, hands, other body sites DSM-V Criteria A.​ Recurrent skin picking resulting in skin lesions B.​ Repeated attempts to decrease or stop skin picking C.​ Major Depressive DisorderSymptoms: Depressive mood or a loss of interest or pleasure in daily activities for more than two weeks Impaired function: social, occupational, educational 1.​ Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). 2.​ Decreased interest or pleasure in most activities, most of each day 3.​ Significant weight change (5%) or change in appetite 4.​ Change in sleep: Insomnia or hypersomnia 5.​ Change in activity: Psychomotor agitation or retardation 6.​ Fatigue or loss of energy 7.​ Guilt/worthlessness