Abnormal Behaviors - Final Lesson 13 PDF

Abnormal Behaviors Final Lesson 13  distinguish among the mental Lesson disorders under the DSM 5; Objectives describe the causes for abnormal behavior; and Abnormal Behaviors differentiate the psycho...

Abnormal Behaviors Final Lesson 13  distinguish among the mental Lesson disorders under the DSM 5; Objectives describe the causes for abnormal behavior; and Abnormal Behaviors differentiate the psychotherapies utilized to treat abnormal behaviors. What comes to mind when you encounter the word mental health? How do we know if a behavior/s could be considered abnormal?  Statistical or Social Norm Is such behavior Deviance considered Subjective Discomfort abnormal? Inability to function normally  Frequently occurring behaviors are considered normal Statistical or Social Rare behaviors would be abnormal. Norm Deviance Criticism: (DEVIANCE) Deviance is any form that must not be equated immediately as abnormal or negative.  subjective feeling of discomfort or expressing emotional discomfort while Subjective engaging in a particular Discomfort behavior. Criticism: (DISTRESS) Not all thoughts or behaviors could cause subjective distress in a person.  any form of behavior that is not acceptable or fitting to Inability to function society can be labeled as normally abnormal or can be considered maladaptive. (DYSFUNCTION) Persons who feel they have difficulties in adapting to their surroundings. Harming oneself or others Behavior may potentially harm oneself or others. (DANGEROUSNESS) American Psychiatric Association definition of “Mental Disorder” American Psychiatric Association (2013, p. 20) A mental disorder as a “clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.” Models for Abnormality  Biological Models for Psychological Socio-Cultural Abnormality BioPsychoSocial  The Biological Model suggests that abnormality in behaviors have a biological or medical cause. Much of the disorders such as anxiety, depression, and schizophrenia can be explained because ○ of faulty neurotransmitter systems, ○ abnormal brain structures, ○ inherited genes, brain damage, ○ or any combination of these. The Biological Model: Some abnormality in behaviors may be due to inherited genes, faulty brain structures, imbalances of biochemicals.  Biological Models for Psychological Socio-Cultural Abnormality BioPsychoSocial  Psychodynamic View Disordered thinking may be due to repressed threatening thoughts, memories, and concerns to the unconscious mind. These repressed thoughts try to resurface, and disordered functioning develops as a way to keep these in check. The Psychological Model: Some abnormality in behaviors are due to repressed thoughts coming from the unconscious.  Behaviorism Behaviorists would explain that abnormal behaviors are learned just as normal behaviors are. It may be classically conditioned, operantly conditioned and the principles of extinction would apply to unlearn the disordered thinking. The Psychological Model: Some abnormality in behaviors may be learned from the environment.  Cognitive Perspective Suggests that abnormal behaviors are due to maladaptive functions resulting from illogical thinking. Some particular thinking patterns may put an individual to be at more risk for depression and anxiety than those who think more logically. The Psychological Model: Some abnormal behaviors are due to faulty beliefs and thinking.  Biological Models for Psychological Socio-Cultural Abnormality BioPsychoSocial  Socio-Cultural Perspective Assumes that culture dictates what is normal and abnormal behaviors. Thus, what is normal in one culture may be abnormal in another culture. It focuses on family influences, social groups, and the culture at large. Culture is an important factor for psychology practitioners to consider with working with a client from a different cultural background. The Sociocultural Model: Think of what our culture sees behaviors as abnormal.  Biological Models for Psychological Socio-Cultural Abnormality BioPsychoSocial  The Biopsychosocial Model By Biological we mean our genes, brain structures, viral and bacterial infections, poor nutrition, inadequate sleep, and other factors that affect brain functioning. By Psychological, we mean our reaction to stressful events and how we cope with these. By Social, we mean that culture plays a factor in what specific behaviors are considered acceptable or not. We learn from our culture how to behave normally. Diagnostic Criteria for Abnormal Behaviors Diagnostic Criteria for Abnormal Behaviors Psychiatrists or Clinical Psychologists must first decide whether the client’s psychological function is pathological or an extreme normal human variation. If they deemed that client is suffering from a psychiatric disorder, a particular disorder must be diagnosed, and its appropriate treatment must be administered. Diagnosing psychiatric disorders are guided with the use of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 (APA, 2013).  DSM 5 -TR Manual for clinical professionals (psychologists, psychiatrists, and other mental health professionals) Used as a basis to make assessments for a mental health condition.  3 main difficulties in diagnosing Patients who suffer from the same Other disorders may be present, disorder manifests different leading to comorbidities. symptoms, Patients who suffer from different Take note in diagnosing a particular disorders may manifest the same disorder would require multiple sources symptoms, of information gathered from the The patient’s cultural background patient, must be put into consideration.  Assessment Methods for Diagnosis Clinical Interviews, Psychological Assessment, Neuropsychological Testing, Clinical Judgement, and Various medical equipment to rule out other possible disorders. Pros and Cons of using Labels in Disorders Pros and Cons of using Labels in Disorders. Pros helps professionals correctly diagnose the disorder and recommend appropriate and effective treatment plans for the client. creating a common language professional would use for clarity and efficiency of exchange of information. Pros and Cons of using Labels in Disorders. Cons may be a source of prejudice for many. Labels attached to a diagnosis may be detrimental and may have long-lasting effects on the individual and how others may see them May be used for self-diagnosis Diagnosis is reserved for the trained professionals who have taken serious training and certification to become clinicians. Diagnosable Abnormal Behaviors Diagnosable Abnormal Anxiety, Trauma, Stress Disorders Behaviors Dissociative Disorders Mood Disorders Schizophrenia Spectrum Disorders Disorders of Anxiety, Trauma, and Stress Anxiety class of disorders in which the primary symptom is excessive or unrealistic anxiety. It may take forms such as fear toward a specific object, can be felt as a general emotion, and be experienced by an individual who is worried but cannot tell why. Then talking about anxiety disorders, the anxiety is either excessive—greater than it should be given the circumstances—or unrealistic  FEAR - known or understood threat. Fear vs Anxiety What are the differences? ANXIETY - unknown, expected, or poorly defined threat  Phobic Disorders an irrational, persistent fear of something. Something may include an object or a situation  Phobic Disorders Social anxiety disorder Specific phobia Agoraphobia  Panic Disorder abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, Symptoms racing heart, rapid breathing, a sensation of being “out of one’s body,” dulled hearing and vision, sweating, and dry mouth.  Generalized Anxiety Disorder Disorder in which a person has feelings of dread and impending doom along with physical symptoms of stress, which lasts 6 months or more. Other Anxiety-Related Disorders  Obsessive- Compulsive Disorder (OCD) a disorder in which intruding, recurring thoughts or obsessions create anxiety that is relieved by performing a repetitive, ritualistic behavior or mental act (compulsion). Stress-Related Disorders  Acute Stress Disorder (ASD) disorder resulting from exposure to a major stressor Symptoms for as long as 1 month following. anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to “relive” the event in dreams and flashbacks Posttraumatic Stress Disorder (PTSD) disorder resulting from exposure to a major stressor Symptoms lasting for more than 1 month; symptoms may appear immediately, or not occur until 6 months or later after the traumatic event. anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to “relive” the event in dreams and flashbacks  PTSD Acute Stress Disorder Onset of 1 month Trauma Cause of Anxiety and Stress-Related Disorders  Cause of Anxiety and Stress-Related Disorders Psychological Factors Biological Factors anxious behavioral reactions are anxiety disorders, phobias, learned through the principles of and OCD tend to run in learning like conditioning. families, pointing to a Cognitive psychologists believed genetic basis for these that anxiety disorders are the result disorders. of illogical, irrational thought processes. Diagnosable Abnormal Anxiety, Trauma, Stress Disorders Behaviors Dissociative Disorders Mood Disorders Schizophrenia Spectrum Disorders  Dissociative Amnesia the individual cannot remember personal information such as one’s name or specific personal events—the kind of information contained in episodic long-term memory. The cause of dissociative amnesia is psychological rather than physical.  Dissociative Identity Disorder (DID) disorder occurring when a person seems to have two or more distinct personalities (alters) within one body. May developed as a result from repeated traumatic experiences Causes for Dissociative Disorders  Causes for Dissociative Disorders Psychodynamic Explanation Cognitive and Behavioral Explanation repression of threatening or unacceptable thoughts and feelings of guilt, shame, or dissociation is a way to cope with anxiety when thinking these. about disturbing experiences or thoughts Loss of memory or disconnecting makes one start to avoid one’s awareness from a stressful or thinking about them. traumatic event is adaptive in that it reduces the emotional pain. Let us have a 5 minute break!  Tried to define abnormal behaviors So far.... Models for Abnormal Behaviors DSM - V ○ Anxiety, Trauma, & Stress Disorders ○ Dissociative Disorders Diagnosable Abnormal Anxiety, Trauma, Stress Disorders Behaviors Dissociative Disorders Mood Disorders Schizophrenia Spectrum Disorders  Mood Disorders are disturbances in emotion and are also referred to as affective disorders. Mood disorders can be relatively mild or moderate or they can be extreme.  Mood Disorders Major Depressive Disorders (MDD) Bipolar Disorders (BD) Major Depression  Major Depressive Disorder (MDD) Feel sad and helpless most of the day every day for at least 2 weeks Symptoms (At least 5 or more) Depressed mood most of the day Diminished Pleasure in activities Significant weight loss or gain Sleep disturbances Psychomotor agitation Fatigue Feelings of worthlessness Poor concentration Recurrent thoughts of death  Persistent Depressive Disorder low-level depressive episodes must be persistent at least for 2 years. Symptoms (At least 2 or more) Poor appetite Sleep disturbances Low energy Low self-esteem Poor concentration feelings of hopelessness *Full criteria for MDD can be met within the 2 year period - Double Depression Bipolar Disorders  Bipolar Disorders (BD) Diagnosis of Bipolar Disorders would require episodes of Major Depressive Disorder (MDD) punctuated with manic episodes.  Bipolar Disorders (BD) Manic or Mania is characterized by restless activity, excitement, laughter, excessive self-confidence, rambling speech, and loss of inhibitions for at least a week (APA, 2013).  Bipolar Disorders (BD) BIPOLAR I BIPOLAR II A manic episode that would last A full-blown manic for only 4 days would be called episode with MDD a Hypomanic episode. would be sufficient for Thus, a full-blown hypomanic episode with MDD would be a diagnosis for Bipolar I sufficient diagnosis for Bipolar disorder. II disorder. Causes for Depressive Disorders  Causes for Depressive Disorders Biological Factors Cognitive Behavioral moderate heritability for depression. Explanation People with early onset (beginning depression may be linked early on) of depression have a high to learned helplessness or probability that their relatives could distortions of thinking such as blowing negative also develop depression events out of proportion effects of neurotransmitters such as and minimizing positive, serotonin, norepinephrine, and good events. dopamine; What about Suicide?  Among the three leading causes Suicide of death of people ages 15 to 44 Suicide is mostly associated "death from injury, poisoning, or with mood disorders. suffocation where there is evidence (either explicit or implicit) that the injury was ○ Risk is higher for people with self-inflicted and that the decedent in- comorbidities. tended to kill himself/herself."  Suicide Ways to distinguish suicide: Completed Suicide Suicide Attempts Suicidal Ideation or Thought Gender Differences: Women are more likely make unsuccesful attempts for suicide Men are more likely to complete a suicide.  Suicide Difficult to understand it because: 1. Rare enough to make studies about it. 2. People that were left behind often selectively remember information about the victim and forget other information. 3. Those who have attempted rarely left notes.  Suicide Factors that increase the risk for suicide: Stressful Life events Impulsivity comorbid with other disorders. Feelings of Hopelessness Possible Genetic Factors Low level - Neurotransmitter Serotonin  Suicide Treatment? Immediate Care is needed. ○ Hospitalization is needed if they have attempted or are undergoing the act. Medications help Psychotherapy (Dialectical Behavior Therapy) What to do if a Friend is suicidal? - Depression and Bipolar Support Alliance (2008) 1. Take the person seriously. 2. Get immediate help 3. Express Concern 4. Pay Attention 5. Ask direct questions if they have a plan, if yes, ask how will they do it. 6. Acknowledged their feeling in a non-judgmental way. 7. Reassure that things will get better, 8. Do not promise confidentiality 9. Make sure the means for suicide are not available 10. Do not leave them alone. 11. Take care of yourself. Let us have a 5 minute break!  Tried to define abnormal behaviors So far.... Models for Abnormal Behaviors DSM - V ○ Anxiety, Trauma, & Stress Disorders ○ Dissociative Disorders ○ Mood Disorders Diagnosable Abnormal Anxiety, Trauma, Stress Disorders Behaviors Dissociative Disorders Mood Disorders Schizophrenia Spectrum Disorders Schizophrenia Spectrum Disorders Schizophrenia is also a Greek term for “split mind” in which the patient suffers from a split between their emotional and intellectual experiences. Moreover, their emotional expression seems to be unconnected with the current experience.  Schizophrenia Spectrum Disorders DSM 5 criteria for full-blown schizophrenia requires the patient to experience deteriorated daily functioning for at least 6 months  Schizophrenia Spectrum Disorders they must have met at least 2 or more of the following for one month and at least one of these must be (1), (2), or (3) that must persist for at least 1 month: Delusions - unjustifiable beliefs that are held too strongly despite conflicting evidence. Hallucinations - false sensory experiences Disorganized Speech - incoherent speech, tangential responses Grossly Disorganized Behavior Weak emotional, expression speech, and socialization  Schizophrenia Spectrum Disorders Brief Psychotic Disorder - less than 1 month Schizophreniform Disorder - more than 1 month but less than 6 months Schizoaffective Disorder - with MDD or BD Delusional Disorder - with delusions, w/o hallucinations Causes for Schizophrenia Spectrum Disorders Genetics and Environment Neurodevelopmental The more closely related Hypothesis one is biological to Prenatal or neonatal someone with influences (both schizophrenia, the greater genetic and one’s probability to develop schizophrenia environmental) later in their life. produce ○ Twin Studies abnormalities in the ○ Adoption Studies developing brain.  Causes for Schizophrenia Spectrum Disorders Brain Abnormalities Many but not all people with schizophrenia had been observed to have mild, variable abnormalities in their brain structures including the gray matter, hippocampus, amygdala, and thalamus. The gray matter is reduced, and the ventricles are enlarged. Causes for Schizophrenia Spectrum Disorders Dopamine Hypothesis Holds that schizophrenia and its variants are due to excess activity at dopamine synapses. The concentration of dopamine is higher than normal. Increase the use of stimulant drugs such as amphetamine, methamphetamine, or cocaine can induce substance-induced psychotic disorders Treatment for Abnormal Behaviors Standard treatment for mental disorders: Medications and Psychotherapy. People involved in Treatment of Abnormal Behaviors Psychiatrist who has a medical degree can prescribe medications and administer therapy; the preference depends on the individual practitioner. Clinical Psychologists, on the other hand, conduct psychotherapy to treat psychological disorders. Guidance Counselors, also conduct psychotherapy into helping individuals develop into a well-functioning person. They also help them reach their potential to the fullest in accordance with their abilities, interests, and needs. People involved in Treatment of Abnormal Behaviors They are trained to assess, identify, and treat mental health conditions. Who would be better?  Treatment Options Psychotherapy Treatment of psychological disorders by methods that include a personal therapeutic relationship between the therapist and client, it may also involve couples or a small group. The goal of most psychotherapy is to help both mentally healthy and psychologically disordered persons understand themselves better.  Treatment Options Psychodynamic Psychotherapies Insight Therapies Psychodynamic Therapies ○ Psychoanalysis Dream Analysis Free Association Transference Person-Centered Therapy ○ Genuine, Empathetic, Unconditional Positive Regard  Treatment Options Behavioral Psychotherapies Action Therapies Behavior Therapy ○ Systematic desensitization ○ Modeling ○ Exposure Therapy Cognitive Therapy ○ Cognitive Behavioral Therapy  Treatment Options Interpersonal Psychotherapies Group Therapies Family Therapy Group Therapy  Treatment Options Biomedical Therapies Psychopharmacology / Pharmacotherapy Antipsychotic Drugs Antianxiety Drugs Mood-Stabilizers Anti-Depressant Drugs  Biomedical Therapies Psychosurgery Electroconvulsive Therapy  Which treatment works best? Some treatments works best for specific abnormal behaviors. Depends on the diagnosis. Depends on the willingness of the client to be treated. Depends on the competency of the therapist.  Biological Models for Psychological Socio-Cultural Abnormality BioPsychoSocial  distinguish among the mental Lesson disorders under the DSM 5; Objectives describe the causes for abnormal behavior; and Abnormal Behaviors differentiate the psychotherapies utilized to treat abnormal behaviors.