4 th Edition Copyright 2004 - Prentice Hall12-1 Abnormal Psychology Anxiety & Mood Disorders Unit 5

4th Edition

Copyright 2004 - Prentice Hall 12-1

Abnormal Psychology

Anxiety & Mood Disorders

Unit 5


Criteria of Abnormal Behavior

• statistical rarity-- behavior is infrequent in population.

• Dysfunctional-- behavior interferes with daily functioning.


Abnormal Behavior

• personal distress – behavior is upsetting/confusing to patient

• Deviates from social norms = abnormal (deviant) behavior

• social norms can change over time and vary across cultures.


Abnormal Behavior

• Insanity - a legal ruling that an accused individual is not responsible for a crime.

• Criteria: unable to tell right from wrong when crime was committed

• Insanity pleas are infrequently used and rarely successful.


Abnormal Behavior Models

• medical model: abnormal behaviors are illnesses - prescribe medical treatments.

• psychodynamic model: unconscious conflicts from childhood.



• behavioral model: abnormal behaviors are learned (cond., modeling)

• cognitive model: our interpretation of events/ our beliefs influence our behavior.



• sociocultural model social /cultural factors considered

• Biopsychosocial—combination approach


Classifying and Counting Psychological Disorders

• The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) provides rules for diagnosing psychological disorders that have increased reliability.




Rorschach Test (Projective Tests)


Thematic Apperception Test



• Rosenhan's pseudopatient study questions our ability to distinguish normal and abnormal behaviors and how labels affect perception of behavior.



• Epidemiologists study prevalence & incidence of accidents, diseases, and psychological disorders.



• Phobias, substance abuse/dependence, and MDD are among most common d/o.



• Many suffer from more than one psychological disorder (co-morbidity).


Anxiety, Somatoform, and Dissociative Disorders

• Anxiety involves behavioral, cognitive, and physiological elements.

• Biopsychosocial model most effective.



• a chronically high level of anxiety = generalized anxiety disorder (GAD)

• Worry about 2 or more areas of life.



• Phobias are excessive, irrational fears of activities, objects, or situations.

• most frequently diagnosed phobia is agoraphobia (“fear of the marketplace”) No escape!



• The DSM-V: agoraphobia and specific phobia.

• conditioning and modeling may explain phobias.


Phobias


Psychologically Based Therapies

• Systematic desensitization

• relaxation techniques • asked to imagine or

approach feared situations gradually

• (Counter-conditioning)


Anxiety D/Os

Fear of being in situations that may subject one to scrutiny

•DSM-V: Social Anxiety D/O



• Frequent panic attacks (which resemble heart attacks) main symptom of panic disorder.

• Biological and cognitive explanations for this disorder have been proposed.


OCD

• Obsessions are thoughts, images, or impulses that occur repeatedly;

• compulsions are irresistible, repetitive acts (behaviors) trying to decrease thoughts.

Hoarding Disorder• Persistent difficulty parting

with possessions, regardless of their value

• Living areas become cluttered• Parting causes extreme

distress• New classification

Animal Hoarding


Anorexia/ Bulimia Nervosa

• Stress-related eating disorders• Anorexia Nervosa – self-starving (<85% of

normal body weight)• Bulimia Nervosa – binge and purge eating

• Type A Personality?• Control?• Identity issues?

Anorexia Nervosa• Hungry, but don’t eat for fear

of being fat• Distorted image of their body• No sign of other disease• Weight less than minimally

normal• Some starve themselves to

death (20% die total)

Why anorexia?• Neurotransmitter imbalance

• Brain images-no pleasure from food

• Societal pressures

• Low self esteem levels

• Stress and anxiety

Bulimia Nervosa• Binge eating with loss of control,

followed by vomiting, laxatives, exercise

• maintain normal weight, distorted image

• @ least once a week for 3 months

Binge Eating Disorder

• 3 or more of the following:• Very rapid eating • uncomfortably full• Large amounts of food, but not

hungry• Eating alone b/c embarrassment• Disgust, guilt, depression

afterwards• @ least once/week for 3 months

Post Traumatic Stress Disorder

• PTSD• exposure to actual or threatened death,

serious injury or sexual violation

• Doesn’t have to happen to you!

• clinically significant distress/ dysfunction: impairment in social interactions, capacity to work or other important areas of functioning


PTSD

• Trauma (violence, war, crime, disaster, etc.)

• 1st month after Trauma occurs = acute stress d/o

• Acute or Chronic PTSD after 1 mo.

• sleep disturbances, nightmares, flashbacks, irritability

TREATMENT• early intervention!!!

• -cognitive behavioral therapy: learn about own symptoms and disorder=control “reliving the events”

• -anti-anxiety/anti-depressant meds

• -virtual reality/exposure therapy


Biomedical Therapies

• antianxiety drugs:

• benzodiazepines (Valium, Xanax) (GABA agonists)

• Anti-depressants:

• SSRIs (Zoloft, Paxil, Prozac, Lexapro) may reduce symptoms (seratonin agonists)

• SNRIs (Cymbalta, Effexor, Pristiq)



• Somatic symptom disorder

• Many physical symptoms w/ no known medical causes – (headaches, pain, digestive, etc.) psychological factors (depression and/or anxiety) are involved.


Conversion Disorder

• Somatic disorder with loss of sensory or motor function without medical explanation.

• (blindness, deafness, paralysis)


Illness Anxiety D/O

• Somatoform disorder with belief of a specific, serious disease despite repeated medical findings to the contrary (DSM IV: hyponchondriac)


Dissociative Disorders

• Dissociative disorders involve disruptions in some function of awareness in the mind.

• Depersonalization D/O: “The Flash”- Existential moments• dissociative amnesia: memories

cannot be recalled• dissociative fugue: memory loss

accompanied by travel.



• Dissociative identity disorder (multiple personality) - presence of two or more personalities in one individual.

• The 3 Faces of Eve

• Sybil


Mood Disorders• lifetime prevalence of depression is twice

as high in women as men; prevalence rates around the world are increasing.


Mood Disorders

• symptoms of depression include sadness, reduced pleasure and energy levels, feelings of guilt, sleep and appetite changes (more than 2 weeks) and suicidal thinking.


Mood Disorders

• Suicide, often associated with depression, is a leading cause of death in US.


Suicide Rates


Mood Disorders

• Medical: low levels of norepinephrine or serotonin.

• Behavioral: learned helplessness

• Cognitive: people believe they cannot control outcomes


Mood Disorders

• Mood disorders tend to run in families (genetic)


Mood Disorders

• Mood disorder concordance rates in twins: 65% identical vs 14% fraternal.

• Depression comorbid with other disorders.


Depression Disorders

Dysthymic - chronic low mood

Unipolar-Major Depression

Double Depression – Dysthymic disorder w/ major depressive episode

SAD- melatonin/ phototherapy

Postpartum depression-hormones


Models on Mood Disorders

• Biological/ Medical – Concordance; SSRIs & Lithium (seratonin & norepinepherine)

• Psychodynamic – attachment issues • Cognitive—Explanatory styles (t/p, s/u, e/i) optimist/ hardy, hopelessness (arbitrary

inference: conc w/o supporting evidence)• Behavioral—Learned helplessness/

reinforcers• Biopsychosocial – interacting factors


Mood Disorders

• Bipolar disorder involves swings between depression and mania.

• symptoms of mania include euphoria, increased energy, poor judgment, decreased sleep, and elevated self-esteem

Documents

4 th Edition Copyright 2004 - Prentice Hall12-1 Abnormal Psychology Anxiety & Mood Disorders Unit 5