Abnormal Psychology

A Power Point With Stiles

Welcome to 1-800-PSYCH• Hello, welcome to the Psychiatric Hotline.• If you are obsessive-compulsive, please press 1

repeatedly.• If you are co-dependent, please ask someone to

press 2.• If you have multiple personalities, press 3,4,5, and 6.• If you are paranoid-delusional, we know who you

are and what you want. Just stay on the line so we can trace the call.

• If you are schizophrenic, listen carefully and a little voice will tell you which number to press.

Mental Health Statistics• 2 million “in-

patient” in psychiatric units

• 2.4 million group home residents

• 15% utilize treatments for psychological disorders

• 450 million world wide are in need of psychological assistance

Understanding Psychological Disorders

Ancient Treatments of psychological disordersinclude trephination, exorcism, being caged like

animals, being beaten, burned, castrated,mutilated, or transfused with animal’s blood.

Trephination (boring holes in the skull to remove evil forces)

• Circulating Swing

• Tranquilizing Chair – Benjamin Rush

• The Crib

Medical PerspectiveOpposition to brutal treatments.

Philippe Pinel (1745-1826) from France, insistedthat madness was not due to demonic possession,

but an ailment of the mind. This led to “moral treatment.”

Dance in the madhouse.

Medical ModelWhen physicians discovered that syphilis led to

mental disorders, they started using medical modelsto review the physical causes of these disorders.

1. Etiology: Cause and development of thedisorder.

2. Diagnosis: Identifying (symptoms) anddistinguishing one disease from another.

3. Treatment: Treating a disorder in a psychiatrichospital.

4. Prognosis: Forecast about the disorder.

• The city of San Diego evicted 54 year old Richard Thompson and all his belongings from his home. His belongings included shirts, pants, dozens of shoes, several bibles, a cooler, a tool chest, lawn chairs, a barbecue grill, tin plates, bird-cages, two pet rats, and his self fashioned bed. For the previous 9 months Thompson had lived happily and without any problems in a downtown storm drain (sewer). Because the city does not allow people to live in storm drains, Thompson was evicted from his underground storm-drain home and forbidden to return. Although Thompson later lived in several care centers and mental hospitals, he much preferred the privacy and comfort of the sewer. (Grimaldi, 1986)

• Is Thompson’s living in the sewer abnormal?

efining Abnormality

• Deviant (nudity) changes w/ culture and time

• Distressful

• Dysfunctional (key) interfering with work and leisure

Snowy Farr

Wodaabe Tribe

• In the Wodaabe tribe men wear costumes to attract women.

• In Western society this would be considered abnormal.

Modern Perspectives of Psychological Disorders

• Bio-psycho-social Model– Eclectic

– Drugs & cognitive Therapies

Biological(evolution, individual genes, brain

structures and chemistry)

Psychological(stress, trauma, learned helplessness, mood-related, perceptions and memories)

Sociocultural(roles, expectations, definition of normality and disorder

Labels Matter.1. Bias. (videotaped interviews)2. Stigmatize. (jobs, homes)3. Stereotypes. (Media bias)4. Labels not only bias perceptions, they can

change reality. (self – fulfilling prophecy)5. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.6. “Insanity” labels raise moral and ethical questions

about how society should treat people who have disorders and have committed crimes.

David Rosenhan: Pseudo-Patient Experiment

• Investigated reliability of psychiatric diagnoses

• Eight healthy people entered psychiatric hospitals complaining of hearing strange voices

• Once admitted to the hospital, they behaved normally and claimed that the voices had disappeared

Rosenhan: Results

• Staff treated patients as if they were really ill

• Staff noted “abnormal” symptoms

• Kept patients for an average of 19 days

• Discharged with diagnosis of “schizophrenia in remission”

Rosenhan: Nonexistent Impostor Experiment

• Told hospital staff to expect pseudo-patients (“impostors”)

• No pseudo-patients were actually sent, but staff identified 41 anyway (these were, in fact, real patients)

Rosenhan: Implications

• Psychiatrists disputed the results

• Prompted changes in psychiatric diagnosis

• The DSM-IV

• http://www.youtube.com/watch?v=jXp-ANr8jAQ

Classifying Psychological Disorders

The American Psychiatric Association rendereda Diagnostic and Statistical Manual of MentalDisorders (DSM) to describe psychological

disorders.

The most recent edition,DSM-IV-TR (Text Revision,

2000), describes 400psychological disorderscompared to 60 in the

1950s.

Goals of DSM

1. Describe disorders

2. Describe how prevalent the disorder is

• Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar

Multiaxial Classification: DSM-IV serves as guidelines for making decisions

about symptoms

Axis I

Axis II

Axis III

Axis IV

Axis V

Is a Clinical Syndrome (schizophrenia, anxiety, mood disorders) present?

Is a Personality Disorder or Mental RetardationPresent?

Is a General Medical Condition (diabetes, arthritis) also present?

Are Psychosocial or Environmental Problems(school or housing issues) also present?

What is the Global Assessment of the person’sability to function?

Clinical Diagnosis of Jeffrey Dahmer: Antisocial Personality Disorder

• Axis I: Unusual sexual symptoms may match those of a sexual disorder

• Axis II: Maladaptive Personality disorder

• Axis III: N/A• Axis IV: Loner, poor self

esteem, poor social skills which match psycho-social symptoms

• Axis V: Amazingly, Dahmer functioned well enough to hold a job & go unnoticed in his neighborhood

Therapies

Cognitive Model

– Irrational thought processes are the cause of psychological disorders

– Popular model– Rational Emotive

Therapy– Cognitive Therapy– RET 98%

OH NO! I only got 98%.

Psychoanalytic Model

– Inspired by Freud– “Talking Cure”– Dominated early to

mid 20th century– Insight Therapy– Long Term– Free Association– Dream Analysis

Dream Symbols

Biological/Biomedical

• Emphasizes the brain, brain structures, neurotransmitters.

• Therapy:– Drugs

– ECT

– Lobotomy

Humanistic Model• Emphasizes self exploration and

growth.

• 3 Components: Congruence, Unconditional Positive Regard, Empathy

• Client Centered Therapy

– Client can express themselves without having to worry about what the therapist thinks of them.

• Carl Rogers

Behavioral Model

– Emphasis on Learning

– Observational Learning

– Systematic Desensitization

– Aversion Therapy

– Token Economies

– Flooding

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