Table of Contents Exit Chapter 17 Abnormal Behavior: Deviance and Disorder.

Table of ContentsTable of Contents ExitExit

Chapter 17Abnormal Behavior: Deviance and Disorder


Key Questions How is normality defined, and what are the major

psychological disorders?

What is a personality disorder?

What are the most common sexual disorders?

What problems result when a person suffers high levels of anxiety?

How do psychologists explain anxiety-based disorders?

Is psychiatric labeling damaging?

What role does the concept of insanity play in criminal trials?


Facts on Psychopathology

During their lifetimes, 1 out of every 100 people will become so severely disturbed as to require hospitalization

Some 3-6% of the aged suffer from organic psychoses

In any given week, 7% of the population is experiencing an anxiety-related disorder

1 out of every 8 school-aged children is seriously maladjusted

10-20% or more of all adults will suffer a major depression in their lifetime

Each year over 2 million people in North America are admitted or readmitted for psychiatric treatment in hospitals


Andy Wilf Self-portraits

The self-portraits shown here were painted by Andy Wilf between 1978 and 1981.

During that time, Wilf is said to have increasingly abused

drugs and alcohol. This dramatic series of images is

a record of his self-destructive descent into a

private hell. The third painting shows a shrouded

skull-and foretells the artists fate.

Wilf died of a drug overdose early in 1982. Drug abuse is

but one of the many psychopathologies, or “problems in living,” psychologists seek to

alleviate


What is Normal? Psychopathology:

Scientific study of mental, emotional, and behavioral disorders


Defining Abnormality

Subjective Discomfort: Feelings of unhappiness, anxiety, depression, or

emotional distress (psychosis is exception)

Statistical Abnormality: Having extreme scores on some dimension, such as

anxiety or depression, see normal curve figure 17-1

Social Nonconformity: Disobeying societal standards for normal conduct; usually

leads to destructive or self-destructive behavior, note personal eccentricities can be charming and perfectly healthy


Fig. 17.1 The number of people displaying a personal characteristic may help define what is statistically abnormal. Social non-conformity does not automatically indicate psychopathology.


Does social non-conformity automatically

indicate psychopatholog

y?


What is Normal? (cont.) Situational Context:

Social situation, behavioral setting, or general circumstances in which an action takes place must be considered

Cultural Relativity: Judgments are made relative to the values of

one’s culture


Clarifying and Defining Abnormal Behavior (Mental Illness)

Maladaptive Behavior: Behavior that makes it difficult to function,

to adapt to the environment, and to meet everyday demands

Table 17-1 Levels of functioning (page 561)


DSM - IV The first axis incorporates clinical disorders.

The second axis covers personality disorders The remaining axes cover medical, psychosocial, environmental, and childhood factors functionally necessary to provide diagnostic criteria for health care assessments.

The DSM evolved from systems for collecting census and psychiatric hospital statistics, and from a United States Army manual. The DSM was substantially revised in 1980. The five revisions since its first publication in 1952 incrementally added to the number of mental disorders, though also removing those no longer considered to be mental disorders. The last major revision was the fourth edition ("DSM-IV"), published in 1994,


DSM-IV Common Axis I disorders include depression,

anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa, and schizophrenia (disorders you defined for homework, with exception of pxy disorder)

Common Axis II disorders include personality disorders

Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.


Axis IV: Severity of Psychosocial Stressors

Events in a persons life, such as death of a loved one, starting a new job, college, unemployment, and even marriage can impact the disorders listed in Axis I and II. These events are both listed and rated for this axis.

Axis V: Highest Level of Functioning

On the final axis, the clinician rates the person's level of functioning both at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected.


Shades of Abnormality Bob is a very intelligent, 25

year old member of a religious organization that is based on Buddhism. Bob's working for this organization caused considerable conflict between him and his parents, who are devout Catholics. Recently Bob experiences acute spells of nausea and fatigue that prevent him from working and which have forced him to return home to live with his parents. Various medical tests are being conducted, but as yet no physical causes of his problems have been found.

RATE each of these people using the following scale:

1 = Basically O.K. Psychotherapy is not necessary.

2 = Mild disturbance. Psychotherapy should be considered.

3 = Significant disturbance. Psychotherapy is definitely required.

4 = Severe disturbance. Hospitalize!


Shades of Abnormality Jim was vice president of the

freshman class at a local college and played on the school's football team. Later that year he dropped out of these activities and gradually became more and more withdrawn from friends and family. Neglecting to shave and shower, he began to look dirty and unhealthy. He spent most of his time alone in his room and sometimes complained to his parents that he heard voices in the curtains and in the closet. In his sophomore year he dropped out of school entirely. With increasing anxiety and agitation, he began to worry that the "Nazis" were plotting to kill his family and kidnap him.







Shades of Abnormality Mary is a 30 year old

musician who is very dedicated and successful in her work as a teacher in a local high school and as a part-time member of local musical groups. Since her marriage five years ago, which ended in divorce after six months, she has dated very few men. She often worries that her time is "running out" for establishing a good relationship with a man, getting married, and raising a family. Her friends tell her that she gets way too anxious around men, and that she needs to relax a little in general







Shades of Abnormality Larry, a homosexual who has

lived for three years with a man he met in graduate school, works as a psychologist in a large hospital. Although competent in his work, he often feels strained by the pressures of his demanding position. An added source of tension on the job is his not being able to confide in all his co-workers about his private life. Most of his leisure activities are with good friends who belong to the gay subculture







Clarifying and Defining Abnormal Behavior (Mental Illness)

Mental Disorder: Significant impairment in psychological

functioning

Those with mental illness lose the ability to adequately control thoughts, behaviors, or feelings


Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

Psychological problems can be grouped into broad categories.

DSM-IV is not the only system for classifying mental disorders. Nevertheless, most activities in mental health settings-from diagnosis to therapy to billing of insurance companies- are influenced by the DSM. DSM-IV is both a scientific document and a social one. Major disorders are well-documented problems. Some problems, however, have little to do with “mental illness.” Instead, they are primarily socially disapproved behaviors.


Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)

Major DSM-IV Categories Page 563-564


Clarifying and Defining Abnormal Behavior

(Mental Illness) (cont.)

Psychotic Disorder: Severe psychiatric disorder characterized by

hallucinations and delusions, social withdrawal, and a move away from reality

Organic Mental Disorder: Mental or emotional problem caused by brain

pathology (i.e., brain injuries or diseases)

Substance Related Disorders: Abuse or dependence on a mind- or mood-altering

drug, like alcohol or cocaine Person cannot stop using the substance and may

suffer withdrawal symptoms if they do


Fig. 17.2 This MRI scan of a human brain (viewed from the top) reveals a tumor (dark spot). Mental disorders sometimes have organic causes of this sort. However, in many instances no organic damage can be found.

© Scott Camazine/Photo Researchers


Clarifying and Defining Abnormal Behavior (Mental Illness) (cont.)

Mood Disorder: Disturbances in mood or emotions, like depression or

mania

Anxiety Disorder: Feelings of fear, apprehension, anxiety, and behavior

distortions


The Mad Hatter, from Lewis Carroll’s Alice’s Adventures in Wonderland. History provides numerous examples of psychosis caused by toxic chemicals. Carroll’s Mad Hatter character is modeled after an occupational disease of the eighteenth and nineteenth centuries. In that era, hatmakers were heavily exposed to mercury used in the preparation of felt. Consequently, many suffered brain damage and became psychotic, or “mad” (Kety, 1979).

© Bettmann/CORBIS


Alice in Wonderland Video (Johnny Depp)

Video (Disney)



Somatoform Disorder: Physical symptoms that mimic disease or

injury (blindness, anesthesia) for which there is no identifiable physical cause

Dissociative Disorder: Temporary amnesia, multiple identity, or

depersonalization (like being in a dream world, feeling like a robot, feeling like you are outside of your body)

Personality Disorder: Deeply ingrained, unhealthy, maladaptive

personality patterns



Sexual and Gender Identity Disorder: Problems with sexual identity, deviant sexual

behavior, or sexual adjustment

Neurosis: Archaic; once used to refer to anxiety, somatoform,

and dissociative disorders, also used to refer to some kinds of depression


Personality Disorders: Blueprints for Maladjusted

Paranoid person- Overly suspicious, mistrusting

Narcissistic person- Pre-occupied with their own self-importance. Absorbed in

fantasies of power, wealth, brilliance, beauty, and love

Borderline- Very unstable relationships, erratic emotions, self-damaging

behavior, impulsive

Histrionic Overly dramatic, attention seekers, easily angered,

seductive, vain, shallow and manipulative

TABLE 17-5 (Page 568)


Personality Disorders Borderline

Girl Interrupted

Narcissistic There Will be Blood

Histrionic Gone With The Wind


Let’s Have A Party Imagine a party where all the people had a

personality disorder


General Risk Factors for Contracting Mental Illness

Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions

Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems

Psychological Factors: Low intelligence, stress, learning disorders

Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability


Focus on a Controversy Are the Mentally Ill Prone to Violence?

Jeffrey Dahmer Page 565


Personality Disorders: Antisocial Personality Disorder (APD)

Antisocial Personality Disorder: A person who lacks a conscience (superego?);

typically emotionally shallow, impulsive, selfish, and manipulative toward others Oftentimes called psychopaths or sociopaths Many are delinquents or criminals, but many are

NOT crazed murderers displayed on television Create a good first impression and are often

charming Cheat their way through life (e.g., Dr. Michael

Swango, Scott Peterson)


APD: Causes and Treatments

Possible Causes: Childhood history of emotional deprivation, neglect,

and physical abuse Underarousal of the brain

Very difficult to effectively treat; will likely lie, charm, and manipulate their way through therapy


Antisocial Personality Disorder

CINEMA EDUCATION

Michael Swango

Clockwork Orange

The Joker

Ted Bundy


Fig. 17.3 Using PET scans, Canadian psychologist Robert Hare found that the normally functioning brain (left) lights up with activity when a person sees emotion-laden words such as “maggot” or “cancer.” But the brain of a psychopath (right) remains inactive, especially in areas associated with feelings and self-control. When Dr. Hare showed the bottom image to several neurologists, one asked, “Is this person from Mars?” (Images courtesy of Robert Hare.)

© Robert Hare


Anxiety-Based Disorders Anxiety:

Feelings of apprehension, dread, or uneasiness

Adjustment Disorders: When ordinary stress causes emotional

disturbance and pushes people beyond their ability to effectively cope Usually suffer sleep disturbances, irritability, and

depression Examples: Grief reactions, lengthy physical illness,

unemployment


Anxiety-Based Disorders (cont.)

Generalized Anxiety Disorder (GAD): Duration of at least six months of chronic, unrealistic,

or excessive anxiety

Free-Floating Anxiety: Anxiety that is very general and persuasive


Anxiety Neurosis Worksheet (Page 125)

Anxiety Neurosis


Panic DisordersPanic Disorder (without Agoraphobia):

A chronic state of anxiety with brief moments of sudden, intense, unexpected panic (panic attack)

Panic Attack: Feels like one is having a heart attack, going to die, or is going insane

Symptoms include vertigo, chest pain, choking, fear of losing control

Panic Disorder (with Agoraphobia): Panic attacks and sudden anxiety still occur,

but with agoraphobia


Agoraphobia Agoraphobia (with Panic Disorder):

Intense, irrational fear that a panic attack will occur in a public place or in an unfamiliar situation Intense fear of leaving the house or entering

unfamiliar situations Can be very crippling Literally means fear of open places or market (agora)

Agoraphobia (without Panic Disorder): Fear that something extremely embarrassing

will happen away from home or in an unfamiliar situation


Specific Phobias Irrational, persistent fears, anxiety, and avoidance that

focus on specific objects, activities, or situations

People with phobias realize that their fears are unreasonable and excessive, but they cannot control them Examples: (Table 17-7 page 573)

Animal type: Fear of a specific type Natural environment: Fear of heights, storms, ocean… Blood, injection, injury: Fear of blood, injections, treatments Situational: Fear of situations, airplanes, elevators, enclosed

spaces Other: Fear of other situations that lead to choking, vomiting,

sick


Social Phobia Intense, irrational fear of being observed, evaluated,

humiliated, or embarrassed by others (e.g., shyness, eating, or speaking in public)

Celebrities with Anxiety Disorders


Phobia Worksheet (Page 126)

Phobias


Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) Extreme preoccupation with certain thoughts and

compulsive performance of certain behaviors

Obsession: Recurring images or thoughts that a person cannot prevent

Cause anxiety and extreme discomfort Enter into consciousness against the person’s will Most common: Being dirty, wondering if you performed an

action (turned off the stove), or violence (hit by a car)

Compulsion: Irrational acts that person feels compelled to repeat against

his/her will Help to control anxiety created by obsessions Checkers and cleaners


Obsessive-Compulsive Disorder (OCD)

Cinema Education

The Odd Couple

Matchstick Men

As Good As It Gets


OCD & Profile of a Neurotic

Worksheet(129-131) Obsession/Compulsion and Hysteria The Case of A.H./Profile of a Neurotic


Stress Disorders Occur when stresses outside range of normal human

experience cause major emotional disturbance Symptoms: Reliving traumatic event repeatedly,

avoiding stimuli associated with the event, and numbing of emotions

Acute Stress Disorder: Psychological disturbance lasting up to one month

following stresses from a traumatic event

Post Traumatic Stress Disorder (PTSD): Lasts more than one month after the traumatic event has

occurred; may last for years Typically associated with combat and violent crimes

(rape, assault, etc.) Terrorist attacks on September 11th, 2001, likely led to

an increase of PTSD


Dissociative Disorders Dissociative Amnesia:

Inability to recall one’s name, address, or past

Dissociative Fugue: Sudden travel away from home and confusion about

personal identity


Dissociative Identity Disorder (DID)

Dissociative Identity Disorder (DID): Person has two or more distinct, separate

identities or personality states; previously known as Multiple Personality Disorder “Sybil” or “The Three Faces of Eve” are good examples Often begins with horrific childhood experiences (e.g.,

abuse, molestation, etc.) Therapy often makes use of hypnosis Goal: Integrate and fuse identities into single, stable

personality


Dissociate Identity Disorder (DID)

Sybil

3 Faces of Eve

Fight Club


Somatoform Disorders Hypochondriasis:

Person is preoccupied with having a serious illness or disease Interpret normal sensations and bodily signs as proof

that they have a terrible disease No physical disorder can be found

Somatization Disorder: Person expresses anxieties through

numerous physical complaints Many doctors are consulted but no organic or physical

causes are found


Somatoform Disorders (cont.)

Pain Disorder: Pain that has no identifiable organic, physical cause

Appears to have psychological origin

Conversion Disorder: Severe emotional conflicts are “converted” into

physical symptoms or a physical disability Caused by anxiety or emotional distress but not by

physical causes


Fig. 16.4 (left) “Glove” anesthesia is a conversion reaction involving loss of feeling in areas of the hand that would be covered by a glove (a). If the anesthesia were physically caused, it would follow the pattern shown in (b). (right) To test for organic paralysis of the arm, an examiner can suddenly extend the arm, stretching the muscles. A conversion reaction is indicated if the arm pulls back involuntarily. (Adapted from Weintraub, 1983.)


Theoretical Causes of Anxiety Disorders:

Psychodynamic Psychodynamic (Freud):

Anxiety caused by conflicts among id, ego, and superego Forbidden id impulses for sex or aggression are trying

to break into consciousness and thus influence behavior; person fears doing something crazy or forbidden

Superego creates guilt in response to these impulses Ego gets overwhelmed and uses defense mechanisms to

cope


Other Theoretical Causes of Anxiety Disorders

Humanistic: Unrealistic self-image conflicts with real self-

image

Existential: Anxiety reflects loss of meaning in one’s life

Behavioristic: Anxiety symptoms and behaviors are learned,

like everything else Conditioned emotional responses that generalize to

new situations


More Theoretical Causes of Anxiety Disorders

Avoidance Learning: When making a particular response

delays or prevents the onset of a painful or unpleasant stimulus

Anxiety Reduction Hypothesis: When reward of immediate relief from

anxiety perpetuates self-defeating avoidance behaviors


Cognitive Approach Cognitive:

When distorted thinking causes people to magnify ordinary threats and failures, leading to anxiety and distress


Insanity Insanity:

A legal term; refers to an inability to manage one’s affairs or to be aware of the consequences of one’s actions Those judged insane (by a court of law) are not held legally

accountable for their actions Can be involuntarily committed to a psychiatric hospital Some movements today are trying to abolish the insanity plea

and defense; desire to make everyone accountable for their actions

How accurate is the judgment of insanity?

Expert Witness: Person recognized by a court of law as being qualified to give

expert testimony on a specific topic May be psychologist, psychiatrist, and so on


Insanity Insanity Defense: Person was incapable of knowing

right from wrong while committing a crime

M’Naghten Rule: Standard for judging legal insanity in English common law Must understand wrongfulness of actions to be held

responsible for them If suffering from mental disease preventing person from

knowing right from wrong, can be deemed insane Taking of a life due to insanity is not murder

Irresistible Impulse: Uncontrollable urge to act

Diminished Capacity: Temporary loss of ability to control actions or to know right from wrong


Psychology and the Law The “Twinkie Defense”


Panic Disorder Part A read (Page 203-206)

Part B complete using Part A (Page 207-208)

Table of Contents Exit Chapter 17 Abnormal Behavior: Deviance and Disorder.

Documents

table of contents exit

disorder slide

healthy slide

everyday demands table

behavioral disorders

anxietybased disorders

values of ones culture

clinical disorders