Psychology Chapter on Abnormal Behavior

Abnormal Behaviors - Lesson Objectives

• Distinguish among mental disorders using the DSM 5.
• Describe the causes of abnormal behavior.
• Differentiate psychotherapies used to treat abnormal behaviors.

Defining Abnormal Behavior

• Statistical or Social Norm Deviance (Deviance): Frequently occurring behaviors are considered normal; rare behaviors are abnormal. Critical note: deviance isn't automatically abnormal.
• Subjective Discomfort (Distress): A subjective feeling of discomfort or emotional distress while engaging in a behavior. Critical note: not all thoughts or behaviors cause discomfort for someone.
• Inability to Function Normally (Dysfunction): Any behavior unacceptable in society is abnormal or considered maladaptive. This includes difficulty adapting to surroundings.
• Harming Oneself or Others (Dangerousness): Behavior that has the potential to harm self or others.

American Psychiatric Association Definition of Mental Disorder

• A mental disorder is a "clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects dysfunction in the psychological, biological, or developmental processes underlying mental functioning."

Models for Abnormality

• Biological: Suggests abnormality in behaviors has a biological/medical cause. Much of anxiety, depression, and schizophrenia are explained by faulty neurotransmitter systems, abnormal brain structures, inherited genes, brain damage, or combinations. Some abnormalities may be from inherited genes, faulty brain structure, or imbalances in chemicals.
• Psychological: Abnormal behaviors can arise from repressed thoughts from the unconscious mind. Behaviors are learned as normal behaviors are learned like classical or operant conditioning or extinction. Some abnormalities are from faulty beliefs or thinking.
• Socio-Cultural: Culture dictates what’s normal and abnormal. Abnormal behavior is influenced by family, social group, and culture at large. Cultural background is important for practitioners.
• Biopsychosocial: Combining biological, psychological, and social factors to understand and treat mental problems. Biological factors includes genetics and brain function. Psychological factors include reactions to stress and how to handle it. Social factors include culture, acceptable behaviors and how one learns to behave.

Diagnosable Abnormal Behaviors

• Anxiety, Trauma, and Stress Disorders: Excessive or unrealistic anxiety.
  • Phobic Disorders: Irrational, persistent fear of something (object or situation). Subcategories include social anxiety disorder, specific phobia, and agoraphobia.
  • Panic Disorder: A surge of intense fear or discomfort that peaks within minutes. Symptoms include racing heart, rapid breathing, sensation of being out of one's body, dulled senses and sweaty palms.
  • Generalized Anxiety Disorder: Feelings of dread, impending doom and physical stress lasting 6 months or more.
  • Obsessive-Compulsive Disorder (OCD): Intruding, recurring thoughts (obsessions) causing anxiety relieved by performing repetitive or ritualistic behavior or mental acts (compulsions).

Symptoms for Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD)

• The symptoms appear one month after the stressful event and lasts up to 6 months. Posttraumatic can last more than a month.
• Symptoms include anxiety, dissociation, recurring nightmares, sleep disturbances, problems concentrating, "reliving" the event in dreams and/or flashbacks

Causes of Anxiety and Stress Disorders

• Psychological Factors: Learned through conditioning; illogical, irrational thought processes.
• Biological Factors: Anxiety disorders, phobias and OCD frequently occur in families, suggesting a genetic cause.

Dissociative Disorders

• Dissociative Amnesia: Inability to remember personal information (like name or events), typically episodic long-term memory. Causes are psychological, not physical.
• Dissociative Identity Disorder (DID): A disorder with two or more distinct personalities (alters) within one body. May result from repeated traumatic experiences.
• Causes for Dissociative Disorders: Psychodynamic explanation suggests repression of threatening or unacceptable thoughts; losing memory or awareness of a traumatic or stressful event as a coping mechanism to reduce emotional pain. Cognitive and behavioral explanation includes feelings of guilt, shame, or anxiety when thinking about disturbing experiences or thoughts, leading to avoiding them.

Mood Disorders

• Disturbances in emotions, also called affective disorders. Mood disorders can be mild/moderate or extreme.

  • Major Depressive Disorder (MDD): Sadness and hopelessness lasting at least 2 weeks. Symptoms include depressed mood, diminished pleasure, weight loss/gain, sleep disturbances, psychomotor agitation, fatigue, worthlessness, concentration problems and recurrent thoughts of death.
  • Persistent Depressive Disorder: Long-term (at least 2 years) low-level depression. Symptoms include poor appetite, sleep difficulties, low energy, self-esteem, concentration, and feelings of hopelessness.
  • Bipolar Disorder (BD): Episodes of major depressive disorder punctuated by manic episodes.
    • Manic Episodes: Characterized by restless activity, excitement, laughter, excessive self-confidence, rambling speech, and loss of inhibitions lasting at least a week.

Causes of Depressive Disorders

• Biological Factors: Heritability for depression is moderate. Early onset depression is linked to family history. Effects of neurotransmitters such as serotonin, norepinephrine, and dopamine.
• Cognitive Behavioral Explanation: Linked to learned helplessness and distortions of thinking which minimize good or positive events and exaggerate negative events.

Suicide

• Suicide is among the three leading causes of death among people aged 15-44, associated mostly with mood disorders. Individuals with comorbid conditions have higher risk. Factors that increase risk include stressful life events, impulsivity, feelings of hopelessness, genetic factors, and low neurotransmitter levels (serotonin).
• Distinguishing suicide: completed suicide, suicide attempts, suicidal ideation or thoughts. Gender differences: women more likely make unsuccessful attempts; men more likely to complete suicide.
• Difficulty to study suicide: low occurrence, selectively remembering information victims left behind, and limited notes from individuals who attempted.
• Treatment: Immediate care needed, hospitalization if attempted or undergoing the act. Medications and psychotherapy (Dialectical Behavior Therapy).

Other Diagnosable Mental Disorders

• Schizophrenia Spectrum Disorders:
  • Schizophrenia: Split between emotional and intellectual experiences. Daily functioning is deteriorated for at least 6 months. Symptoms include delusions, hallucinations, disorganized speech and behavior, weak emotional expression and socialization
  • Brief Psychotic Disorder: Symptoms last less than 1 month.
  • Schizophreniform Disorder: Similar to schizophrenia, but symptoms last between 1 and 6 months.
  • Schizoaffective Disorder: Schizophrenia symptoms accompanied by mood episodes (major depressive or bipolar).
  • Delusional Disorder: Characterized by delusions, without hallucinations or other significant symptoms of schizophrenia.
• Causes for Schizophrenia Spectrum Disorders: Genetics and environment play a role. Prenatal or neonatal influences produce abnormalities in the developing brain. Brain abnormalities include variations in brain structures. Dopamine hypothesis suggests excess dopamine activity.

Treatment for Abnormal Behaviors

• Standard Treatment: Medications and Psychotherapy.
• People Involved: Psychiatrists (prescribe medications and therapy), Clinical Psychologists (conduct psychotherapy to treat psychological disorders), Guidance Counselors (deliver psychotherapy to help individuals reach their full potential).
• Psychotherapy A personal therapeutic relationship between therapist and client to help understand themselves better; possibly involving couples or small groups.
• Types of Psychotherapy:
  • Insight Therapies: Psychodynamic therapies which include psychoanalysis, dream analysis, free association, and transference. Person-centered therapy.
  • Action Therapies: Behavior therapy (systematic desensitization, modeling, exposure therapy), cognitive therapy (Cognitive Behavioral Therapy).
  • Group Therapies: Family therapy and group therapy.
  • Biomedical Therapies: Pharmacotherapy (antipsychotic, anti-anxiety, mood stabilizers, and antidepressant drugs) and Psychosurgery and Electroconvulsive Therapy.

Which treatment Works Best?

• Best treatment depends on the specific abnormal behavior, willingness to treat, and the therapist.

What to Do if a Friend is Suicidal?

• Take the person seriously.
Get immediate help.
Express concern.
Pay attention.
Ask direct questions (plan and how to do the act).
Acknowledge their feelings. Reassure that things will get better. Do not promise confidentiality.
Make sure the means for suicide are not available. Do not leave them alone. Take care of yourself.