introduction - shoreline community college 220 unit... · e. mental illness f. deviation from an...
TRANSCRIPT
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Introduction
I. Defining Abnormality
II. History of Mental Disorders
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I. Defining Abnormality
A. Cultural Relativism
B. Unusualness
C. Discomfort & Suffering
D. Harm to Society
E. Mental Illness
F. Deviation from an Ideal
G. Maladaptive
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Maladaptive behaviors can…
• Cause the person physical harm
• Cause people emotional suffering
• Interfere with the person’s functioning in life
• Result in the person losing control of his/her behavior
• Involve losing touch with reality
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Maladaptive Behaviors & the Three D’s of Abnormality
• Distress
• Dysfunction
• Deviance
• Danger
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Parting initial thoughts on abnormality
• Abnormal behavior is a social construction
• This makes definitions of abnormality fluid as societies are fluid themselves
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II. History of Mental Disorders
A. Supernatural Theories
– trephination
B. Natural/Somatogenic Theory
– General paresis in 1897
C. Psychological Theories
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Theoretical Explanations for Abnormality
I. The Biological Model
II. The Psychodynamic Model
III. The Behavioral Model
IV. The Cognitive Model
V. The Humanistic-Existential Model
VI. The Sociocultural Model
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I. The Biological Model
A. Biochemical Theories
1. Basic Concepts
• Neuron
• Synapse
• Neurotransmitter
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I. The Biological Model
A. Biochemical Theories
2. Explanations for Abnormality
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I. The Biological Model
B. Structural Theories
1. Basic Concepts
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I. The Biological Model
B. Structural Theories
2. Explanations for Abnormality
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I. The Biological Model
B. Genetic Theories
1. Basic Concepts:
• Phenotype
• Genotype
• Heritability
• Proband
• Concordance rates
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I. The Biological Model
B. Genetic Theories
2. Explanations for Abnormality
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II. The Psychodynamic Model
A. Freud & Psychoanalysis
1. Basic Concepts:
• Unconscious/subconscious
• Impulse versus defense
• Sexuality
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II. The Psychodynamic Model
A. Freud & Psychoanalysis
2. Explanations for Abnormality
• Fixation
• Conflicts between impulses and defenses; neurotic anxiety
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II. The Psychodynamic Model
B. Neo-Freudians/Psychodyanamic Theories
1. Object Relations Theory
2. Ego Theorists
3. Attachment Theory
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III. The Behavioral Model
A. Classical Conditioning
1. Basic Concepts
• Ivan Pavlov
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III. The Behavioral Model
A. Classical Conditioning
2. Explanations for Abnormality
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III. The Behavioral Model
B. Operant Conditioning
1. Basic Concepts
• B.F. Skinner
• Edward Thorndike
• Reinforcers
• Punishments
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III. The Behavioral Model
B. Operant Conditioning
2. Explanations for Abnormality
• Negative Reinforcement
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III. The Behavioral Model
C. Modeling
1. Basic Concepts
• Albert Bandura
• Bobo Doll Study
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III. The Behavioral Model
C. Modeling
2. Explanations for Abnormality
• Suicide cluster
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IV. The Cognitive Model
A. Basic Concepts
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IV. The Cognitive Model
B. Explanations for Abnormality
– Aaron Beck & cognitive distortions
– Albert Ellis & irrational thought
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V. The Humanistic-Existential Model
A. Basic Concepts
– Carl Rogers & unconditional positive regard
– Abraham Maslow & self-actualization
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V. The Humanistic-Existential Model
A. Basic Concepts
– Carl Rogers & unconditional positive regard
– Abraham Maslow & self-actualization
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VI. The Sociocultural Model
A. Basic Concepts
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VI. The Sociocultural Model
B. Explanations for Abnormality
– Enmeshment
– Social support
– SES
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Assessment
I. Gathering Information
II. Important Characteristics of Tests
III. Assessment Tools
IV. Problems in Assessment
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I. Gathering Information
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II. Important Characteristics of Tests
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Reliability
• Addresses the question: how consistent is the test?
• Different types:
– Test-retest
– Inter-rater/Inter-judge reliability
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Inter-observer/Inter-rater Reliability
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Validity
• Addresses the question: How accurate is the test?
• Different types:
– Face Validity
– Concurrent Validity
– Predictive Validity
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III. Assessment Tools
A. Clinical Tests
B. Clinical Interviews
C. Clinical Observations
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A. Clinical Tests
1. Projective Tests
– Key assumption: people reveal their personalities when interpreting ambiguous stimuli
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Rorschach Inkblot Test
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Thematic Apperception Test (TAT)
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Thematic Apperception Test (TAT)
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A. Clinical Tests
2. Personality Inventories
– MMPI-II
– CPI
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A. Clinical Tests
3. Response Inventories/Symptom Questionnaires
– Beck Depression Inventory (BDI)
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A. Clinical Tests
4. Psychophysiological Tests
– Heart rate
– Blood pressure
– Respiration rate
– Galvanic skin response
– Polygraph/lie detector test
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A. Clinical Tests
5. Neuropsychological Tests
– Bender-Gestalt test
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A. Clinical Tests
6. Neurological Tests/Brain Imaging Techniques
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PET Scan
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CT Scan
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MRI
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fMRI
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Diffusion Tensor Imaging (MRI)
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Clinical Tests
7. Intelligence Tests
– WAIS, WISC, WPPSI, Stanford-Binet Intelligence test
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B. Clinical Interviews
1. Structured Interviews
– SCID, DIS
– Often include a mental status exam
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Some Factors Assessed on a Mental Status Exam
• Motor behavior
• Orientation
• Judgment
• Insight
• Physical appearance
• Mood & affect
• Form of thought/language
• Thought content
• Motivation
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B. Clinical Interviews
2. Unstructured Interviews
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C. Clinical Observations
• Behavioral Observations
• Self-monitoring
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IV. Problems in Assessment
• Assessing children
• Assessing people from other cultures
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Diagnosis & Classification
I. Diagnosis
II. Advantages of Diagnostic Systems
III. Disadvantages of Diagnostic Systems
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I. Diagnosis
• Diagnosis: Label we give to symptoms that tend to occur together
• Syndrome: Co-occurring symptoms that are thought to be the observable manifestation of an underlying biological disorder
• Most popular diagnostic system in the U.S.: DSM
• Alternative system: ICD
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DSM-IV TR
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DSM-IV Criteria for Schizophrenia
A. Core Symptoms: two or more of the following present for at least a 1-month period: 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms
B. Social/occupational functioning: significant impairment in work, academic performance, interpersonal relationships, and/or self-care
C. Duration: Continuous signs of the disturbance for at least 6 months; at least one month of this period must include symptoms that meet Criterion A above
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The DSM Multi-Axial System
• Axis I: Clinical Disorders
• Axis II: Personality Disorders & Mental Retardation
• Axis III: General Medical Conditions
• Axis IV: Psychosocial & Environmental Problems
• Axis V: Global Assessment of Functioning (GAF)
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II. Advantages of Diagnostic Systems
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III. Disadvantages of Diagnostic Systems
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Treatments for Abnormality
I. Biological Treatments
II. Psychological Treatments
III. Sociocultural Treatments
IV. Evaluating Psychotherapies
V. Therapy & Culture
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I. Biological Treatments
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II. Psychological Treatments
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III. Sociocultural Treatments
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IV. Evaluating Psychotherapies
• The “Dodo Bird” verdict
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Common Factors of Psychotherapy
• Positive relationship with a therapist
• Explanation for symptoms
• Hope
• Confrontation of negative emotions
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V. Therapy & Culture
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Anxiety Disorders
I. Introduction
II. Generalized Anxiety Disorder (GAD)
III. Phobias
IV. Panic Disorder
V. Obsessive-Compulsive Disorder (OCD)
VI. Post-Traumatic Stress Disorder (PTSD)
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I. Introduction
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II. Generalized Anxiety Disorder (GAD)
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A. Symptoms
Excessive anxiety & worry, difficulty in controlling the worry, and at least 3 of the following symptoms for at least 6 months:
– Restlessness & guilt
– Easily fatigued
– Difficulty concentrating, mind goes blank
– Irritability
– Muscle tension
– Sleep disturbance
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The Stroop Test
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Automatic Cognitive Processing & GAD
• Threat words
– disease
– failure
• Non-threat words
– library
– plant
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Percent of Parents Who Worry “A Lot” That Their Children Will…
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Percent of Parents Who Worry “A Lot” that Their Children Will…
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III. Phobias
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A. Symptoms
• Marked and persistent fear of a specific object or situation this is excessive of unreasonable, lasting at least 6 months
• Immediate anxiety usually produced by exposure to the object or situation
• Recognition that the fear is excessive or unreasonable
• Avoidance of the feared object or situation
• Significant distress or impairment
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Sample Stimulus Hierarchy
• Hearing the word “snake.” • Imagining a snake in a closed container at a
distance. • Imagining a snake uncontained at a distance. • Imagining a snake nearby in a closed container • Looking at a picture of a snake • Viewing a movie or video of a snake • Touching a snake • Handling a snake • Playing with a snake
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IV. Panic Disorder
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Symptoms of a Panic Attack
• Heart palpitations
• Pounding heartbeat
• Numbness/tingling sensation
• Chills or hot flashes
• Sweating
• Trembling/shaking
• Shortness of breath
• Feeling of choking
• Chest pain
• Nausea
• Feeling dizzy/lightheaded
• Fear of losing control
• Feelings of unreality
• Fear of dying
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Panic Disorder
• Recurrent unexpected panic attacks
• A month or more of one of the following after at least one of the attacks:
– Persistent concern about having additional attacks
– Worry about the implications or consequences of the attacks
– Significant change in behavior related to the attacks
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V. Obsessive-Compulsive Disorder (OCD)
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A. Symptoms
• Recurrent obsessions and/or compulsions
• Past or present recognition that the obsessions and/or compulsions are excessive or unreasonable
• Significant distress or impairment or disruption by symptoms for more than one hour a day
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VI. Post-Traumatic Stress Disorder (PTSD)
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A. Symptoms
• The person experienced, witnessed, or confronted a traumatic event
• Re-experiencing of the event
• Emotional detachment and numbing
• Hyper-arousal
• Significant distress or impairment, lasting at least one month