Psychopathology: scientific study of abnormal behavior Historically, things haven t always gone well Trepanning in ancient times (frees demons) Hippocrates: humors out of balance Middle Ages: demonic possession The Renaissance: Witchcraft! Death by hanging, stoning, burning or drowning. Yikes! So exactly is abnormal anyway? Average? Anyone at the extremes is? Violating social norms? Cultural Norms? Experiencing subjective discomfort? Maladaptive Behavior?
Lets us consider the top 5 criteria 1.Is behavior very unusual? 2.Does the behavior go against social norms? 3.Does it cause subjective discomfort 4.Is it maladaptive or impairing? 5.Does it make me a danger to self or others? If I hit 2 or more, bingo... Psychological disorder Note that the term Insanity is a legal term, not a psychiatric one. Right or wrong? Don t know? Note too that the insanity defense is rarely used, and is even more rarely successful.
What causes abnormal behavior? Biological model says chemical imbalances, or maybe genes or brain damage or malfunction. Psychodynamic model says repressed ideas, thoughts or urges surface: compensation ensues Behaviorists presume faulty learning or negative environmental influences are causal Cognitive models says illogical or irrational thinking patterns are the real culprits Is there a definitive way to denote pathology? You betcha! The DSM 5 will offer us a way to a diagnosis. No more 5 axes, but 20 different categories and over 250 disorders!
How common are psych disorders? Between 20% & 25% of adults in any given year (often suffering more than one issue) Such disorders are the leading cause of disability in this country We ve gotten more humane, and we ve got a rigorous diagnostic system and insurance. None the less, there is plenty of stigma to go around, and prejudice too. Once you are in the system it s tough to get out. Rosenhan s study a classic example.
Let s start with Anxiety Disorders Dominant symptom is excessive or unrealistic anxiety. Note, anxiety itself is not abnormal. Phobias may be specific, social (common) or a fear of no escape options (agoraphobia). Panic attacks: sudden onset, extreme fear Panic disorder if these are persistent and interfere with my daily life Obsessive Compulsive Disorder (GERMS!) Acute Stress Disorder Post Traumatic Stress Disorder (PTSD) Generalized Anxiety Disorder
What causes these types of disorders? Bio View: neurotransmitter imbalances with serotonin and GABA; genes (.3 to.44 quotient) Psychodynamic: repressed urges surfacing and tough to deal with Behaviorists: faulty learning, we get reinforced for responding badly in a given situation Cognitive: faulty thinking, particularly all- or nothing, magnification, or overgeneralization
Moving on to Mood Disorders A disturbance of affect (emotions) that may range from mild to severe Dysthymia: the mild side of depression Cyclothymia: the mild side of bipolar disorder Major Depression: most popular of this group, and women more vulnerable (social difference) Bipolar Disorder: (formerly manic depression) shares some symptoms with ADHD Seasonal Affective Disorder: regional specific and related to lower exposure to sunlight
Causal Factors for the Mood Disorders? Bio: 3 neurotransmitters; serotonin, dopamine & norepinepherine. STRONG genetic influences (.4 to.7 heritability) & particular genes (11&18) Psychodynamic: repressed anger associated with authority figures now aimed at oneself Behavioral: learned helplessness just like Seligman s punished dogs Cognitive: distorted thinking, and negative self defeating thoughts allowed to go unchecked
What about Eating Disorders? Anorexia Nervosa: starve myself (or purge my way to) 15% to 40% below ideal body weight Usually young, female (95%) who can be obsessed with exercise. Onset just after puberty Bulimia Nervosa: known for binging and purging. May actually be normal weight. Onset in early 20s. Outcomes VERY poor here: Anorexia is commonly lethal, and cures are rare. Bulimia can lead to heart, throat and intestine damage, as well as seizures. Cognitive therapy & re-setting serotonin levels helps
Howz about Dissociative Disorders? A split or break in regular consciousness, memory or sense of identity. Includes Amnesia: I forget some stuff, not other stuff. Fugue: where am I, and how did I get here? Dissociative Identity Disorder (used to be referred to as Multiple Personality Disorder) Biological factors: PET scans give evidence Psychodynamics: Defense Mechanisms Behaviorists: avoidance + reinforcement associated with getting treatment
Psychoses? Schizophrenia! A severe break with reality effecting thinking, emotions, behavior, communication & perception Prominent symptoms may be + (hallucinations and delusions) or (disorganized behavior, unable to differentiate reality from fantasy, etc.) Most popular type: Paranoid; delusions of persecution, hallucinations (usually auditory) Let s not forget Disorganized; bizarre behavior, speech and motor activities, confusion, and the ever popular hallucinations Catatonic: stupor alternates with bursts of energy
What s responsible for this mess? Bio: structural brain changes, dopamine issues, and genes (.48 heritability concordance) And lets also consider the Stress Vulnerability Model Prognosis is poor for most, and onset is most commonly during late adolescence and early adulthood Drugs (anti-psychotics) have emptied out our mental hospitals. What happened to all those disturbed folks? Community mental health?
1 More Group. Personality Disorders Characterized by rigid maladaptive behaviors and ways of relating to others. 3 basic types 1.Odd/Eccentric: paranoid & schizotypal 2.Dramatic/Erratic: antisocial and histrionic 3.Anxious/Fearful: avoidant, dependent, OCD Bio Causes? Genes and hormones maybe Environmental: childhood abuse, disturbed family relationships 4.Borderline is toughest: moody, manipulative, manic and depressive phases, suicidal, and inclined to abuse drugs & spend like crazy