Abnormal Psychology (PSYC 2002) Lecture Slides PDF

20/01/2025 Abnormal Psychology [PSYC 2002] Lecture 1 HISTORICAL VIEWS OF ABNORMAL BEHAVIOUR CRITERIA OF MENTAL HEALTH (DSM-5) “All of us are mad. If it weren’t for the fact that every one of us is slightly abnormal, there wouldn’t be any point of giving e...

20/01/2025 Abnormal Psychology [PSYC 2002] Lecture 1 HISTORICAL VIEWS OF ABNORMAL BEHAVIOUR CRITERIA OF MENTAL HEALTH (DSM-5) “All of us are mad. If it weren’t for the fact that every one of us is slightly abnormal, there wouldn’t be any point of giving each person a separate name.” Uggo Betti (n.d.) 1 ABNORMAL PSYCHOLOGY INTRODUCTION COURSE OVERVIEW 2 ABOUT ME AND EXPECTATIONS 3 1  20/01/2025 ASSESSMENT 40% Coursework 60% Final 1. Tutorial Presentation and Active Participation (10%) 2. Midterm Exam (MCQ) – Week 5 (TBA) (30%) 3. Final Examination (MCQ and/or Brief Answer Questions & Essay) (60%) 4 You are hereby prohibited from reproducing, re-publishing, re- broadcasting, re-posting, re- transmitting or transferring in whole or in part any Course Outlines, Course Materials or Lectures which have been IMPORTANT provided to you as part of your course NOTICE TO of study at The University of the West Indies (The UWI), without the prior STUDENTS permission of The UWI its authorised agents or copyright holders. 5 At the end of this course, students will be able to: ✓Define abnormal behaviour and explain the rationale behind it by recognizing the importance of culture. ✓Describe the DSM-5 Criteria of mental disorders. ✓Outline the historical viewpoints in abnormal behaviour. Learning ✓Assess the work and contributions of the Outcomes humanitarians. 6 2  20/01/2025 Class Discussion What Comes to mind when you hear the word “ABNORMAL” in the context of Human Behaviour? A word or Phrase or Statement? 7 It can be said that the most distinguished comment that could be made against classifying individuals as normal and abnormal in terms of mental health was made by Herman Normal vs Melville: “Who in the rainbow can draw the line where Abnormal the violet tint ends and the orange tint begins? Distinctly we see the difference of the colors, but where exactly does the one first blendingly enter into the other? So with sanity and insanity.” (as cited in Dutton 2019). 8 “I should like to make clear, therefore, that although I consider the concept of mental illness to be unserviceable, I believe that Is the psychiatry could be a science. I concept of also believe that psychotherapy is an effective method of helping ‘Mental people – not to recover from an Disorder’ ‘illness’ but rather to learn about themselves, others and life” problematic? (Szasz, 1960). 9 3  20/01/2025 What Is Mental Health? In the American Psychological Association The most widely used definition of mental (APA) Psychology Dictionary, it is defined as health is defined by WHO “a state of well- “a state of mind characterized by being in which an individual realizes his/her emotional well-being, good behavioral abilities, copes with the normal stresses of adjustment, relative freedom from anxiety life, works productively and efficiently, and and disabling symptoms, and a capacity to contributes to the society in which he/she establish constructive relationships and lives” (WHO 2001a). cope with the ordinary demands and stresses of life.” (APA 2021). 10 What do we mean by Abnormality? What is Abnormality: https://www.youtube.com/watch?v=0ISeDqCJvqY No one definition of abnormality is perfect Many definitions are possible. Definitions are not necessarily mutually exclusive Abnormality as: A statistical deviation Maladaptive behaviour Norm or value violation Deviation from an ideal Personal distress/ discomfort Medical disorder 11 The Elements of Abnormality Suffering Maladaptiveness abnormality include: Deviancy Elements of Violation of the Standards of Society Social Discomfort Irrationality and Unpredictability Dangerousness © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved. 12 4  20/01/2025 Points to remember! No one element is The sufficient to define or Elements of determine abnormality Abnormality Definition of deviant changes as society changes © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved. 13 Is this abnormal behavior? “I enjoy wearing diapers and being treated like a toddler. My wife has no problem changing my wet or soiled diapers, bathing me, feeding me, or giving me my bottle and putting me down for a nap. I work in sales and have no problem acting like an adult, though I wear diapers 24 hours a day” – 23-year old male married for two years 14 Is this abnormal behavior? “I’m afraid of birds. I try to avoid going outside as you never know when a bird might swoop down. The U campus is especially scary because there are so many pigeons roosting along the roof tops of campus buildings, and you never know when someone will be feeding them along the sidewalks. I use tunnels to get to classes held in different buildings, and arrange my class schedule so I don’t have to go outside to get from one class to another. Winter is heaven for me.” -21-year old college student 15 5  20/01/2025 Is this abnormal behavior? My neighbour and I have been best friends for 20 years. He contracted the COVID-19 virus in July 2021 and recovered. Since then I have stopped talking to him and no one in my family is allowed to interact with his family because I am fearful of contracting the virus. I have not left my house since the start of the pandemic except to receive my vaccination and booster shot. I adhere to all the covid-19 protocols even at home. I wash my hands ceaselessly, wear my mask and watch my distance with my family members. This has created a challenge for members in my household and everyone including my wife believe that my behaviour is overwhelming and unwarranted. Thankfully, I can work from home and thoughts of returning to my office make me anxious. 38 year old engineer 16 The DSM-5 Definition The accepted standard for defining various types of mental disorders is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The DSM-5, was published in 2013. Its revision had been a topic of much debate and controversy and the DSM-5-TR was published in March 2022. 17 The DSM-5 Definition Biological, Clinically psychological, significant or disturbance in developmental behavior, dysfunction in emotional individual regulation, or MENTAL cognitive DISORDER function Associated with distress or disability © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved. 18 6  20/01/2025 The DSM-5-TR Criteria DSM-5-TR is divided into 20 Disorder Chapters organized in sequence with the developmental lifespan DSM-5-TR are sequenced in recognition of the advances in our understanding of the underlying vulnerabilities and symptom characteristics of disorders. The chapters are also grouped by broad categories that— in some cases—indicate the common features within larger disorder groups. The new framework is intended to encourage research within and across diagnostic groupings with the hope of advancing our understanding of the relationships between disorders. 19 The DSM-5-TR Update The revised version includes a new diagnosis (prolonged grief disorder). Clarifying modifications to the criteria sets for more than 70 disorders, addition of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) symptom codes for suicidal behavior and nonsuicidal self-injury, and updates to descriptive text for most disorders based on extensive review of the literature. DSM-5-TR includes a comprehensive review of the impact of racism and discrimination on the diagnosis and manifestations of mental disorders. Language throughout the DSM-5-TR was updated to promote inclusivity for People of Color and marginalized groups 20 Why Do We Need to Classify Mental Disorders? Classification System: Provide nomenclature that allows information structuring Have social and political implications Classify disorders, not people 21 7  20/01/2025 What Are the Disadvantages of Classification? Disadvantages: Stigma associated with diagnosis Stereotypes based on diagnosis Labelling can negatively impact self-concept 22 How Does Culture Affect What Is Considered Abnormal? Cultural factors influence Presentation of disorders found worldwide Certain forms of highly culture-specific psychopathology 23 Culture-Specific Disorders Taijin kyofusho in Japan Certain forms of psychopathology Examples highly specific to certain cultures Ataque de nervios in Latinos and Latinas especially from the Caribbean 24 8  20/01/2025 Question How do you think we can reduce Prejudicial Attitudes Toward the Mentally ill? 25 Terms Principal Diagnosis – the disorder that is considered to be the primary reason the individual seeks professional help Differential diagnosis – the process of systematically ruling out alternative diagnoses Comorbidity - the situation that occurs when multiple diagnostic conditions occur simultaneously within the same individual 26 Terms cont’d 27 9  20/01/2025 Historical Viewpoints Demonology, Gods, & Magic Abnormal behavior often attributed to possession “Good” or “Bad” possession depended on the person’s symptoms Treatment Trephining allowed the evil spirit to escape the head Exorcisms used to cast demons out of the body 28 Historical Viewpoints Hippocrates (460-377 B.C.) Father of modern medicine Mental disorders due to natural causes and required treatments like other diseases. He believed that the brain was the central organ of intellectual activity and mental disorders were due to brain pathology: Head injuries could lead to sensory and mental disorders Emphasized the importance of heredity and predisposition Classified mental disorders into three (3) general categories: mania, melancholia and phrenitis (brain fever) 29 Historical Viewpoints Hippocrates (460-377 B.C.) Hippocrates believed in the existence of four bodily fluids or humors: blood (sanguis) , black bile, yellow bile, and phlegm. He believed that when the humors were adversely mixed or otherwise disturbed, physical or mental disease resulted. Hippocrates also considered dreams to be important. 30 10  20/01/2025 Historical Viewpoints Plato (427-347 B.C.) He believed that mentally ill persons were not responsible for their acts. Mentally ill persons should not receive punishment in the same way as normal persons. He made provision for mental cases to be cared for in the community. Plato shared the belief that mental disorders were in part divinely caused. 31 Historical Viewpoints Aristotle (384-322 B.C.) Aristotle is the celebrated Greek Philosopher and one of Plato’s pupils and wrote extensively on mental disorders. Put forth the whole notion of consciousness He generally believed in the Hippocratic theory of disturbances in the bile. 32 Historical Viewpoints Galen (A.D. 130-200) He elaborated on the Hippocratic tradition but he did not contribute much that was new to the treatment or clinical descriptions of mental disorders. He made a number of original contributions concerning the anatomy of nervous system. He also maintained a scientific approach to the field dividing the causes of psychological disorders into physical and mental categories. 33 11  20/01/2025 The Middle ages (500-1500 AD) Historical Viewpoints During the Middle ages, the more scientific aspects of Greek medicine survived in the Islamic and middle east. The first mental hospital was established in Baghdad in 792 A.D. In Europe, scientific inquiry into abnormal behaviour was limited 34 The Middle ages (500-1500 AD) Historical During the last half of the middle ages Viewpoints in Europe, a peculiar trend emerged in efforts to understand abnormal behviour. Tremendous revival of ancient superstition of demonic forces occurred to conform to theological demands. Human beings became the battle ground of ancient spirits and demons of possession of spirits. 35 The Middle ages (500-1500 AD) Historical Mass Madness-widespread occurrence of group Viewpoints behaviour disorders that were apparently cases of hysteria Tarantism- uncontrollable impulse to dance often attributed to the bite of the southern European tarantula or wolf spider Lycanthropy-a condition in which people believed themselves to be possessed by wolves and imitated their behavior Black Death – another occurrence which killed millions and severely disrupted social organization. 36 12  20/01/2025 The Middle ages (500-1500 AD) Historical Exorcisms were performed by Viewpoints the gentle “laying on of hands.” Witchcraft-many mentally disturbed people were accused of being witches and thus were punished and often killed. 37 Towards Humanitarian Approaches The resurgence of Scientific inquiry in Europe Paracelsus (1490-1541)- Swiss Physician Early critic of superstitious belief about possession Rejected demonology Johann Weyer (1515-1588)- German Physician Disturbed by the imprisonment, torture and burning of persons accused of witchcraft Wrote extensively against demonology and the belief in witchcraft Clergy questions practices of the time- e.g. Saint Vincent de Paul (1576-1660) Christianity demands the humane and powerful to protect…. The Establishment of Early Asylums-16th -18th Century Early asylums were begun as a way of removing from society troublesome individuals who could not care for themselves. Prisons or storage places with filthy conditions and cruel patient treatment 38 Humanitarian Reform France Philippe Pinel England Humanitarian Reform William Tuke America Benjamin Rush Dorothea Dix 39 13  20/01/2025 Philippe Pinel (1745-1826)– Moral Management The humanitarian treatment of patients received great impetus from the work of Philippe Pinel in France. Humanitarian Approaches He considered treating the mentally-ill patients with kindness and consideration. Chains were removed from the patients. 40 William Tuke (1732-1822) –York Retreat Tuke, an English Quaker Humanitarian established the “York Retreat” Approaches Pioneered pleasant country houses where mental patients lived, worked, and rested in a kindly religious atmosphere. 41 Rush (1745-1813)- Founder American Psychiatry Rush used moral management based on Pinel’s humanitarian methods to treat the mentally ill. Humanitarian Rush encouraged more humane Approaches treatment of the mentally ill. Wrote the systematic treatise on psychiatry in America. 42 14  20/01/2025 Dorothea Dix (1802-1887)- Mental Hygiene Movement In 1841 Dix began to teach women’s prison. Humanitarian She launched a campaign Approaches between 1841 and 1881 that aroused the people and the legislatures to an awareness of the inhumane treatment accorded to the mentally ill. She is credited with the establishment of some thirty-two mental hospitals. 43 Activity Take 5 minutes to write 2-5 statements that can summarise this lecture. Share your response 44 END OF LECTURE 1 45 15  27/01/2025 ABNORMAL PSYCHOLOGY (PSYC 2002) Lecture 2 CONTEMPORARY VIEWS, CAUSAL FACTORS AND VIEWPOINTS 1 Learning Objectives At the end of this lecture, you will be able to: Part One Describe the four major themes in abnormal psychology which generated powerful influences on the contemporary perspectives. Describe the causes and risk factors for abnormal behaviour Distinguish between necessary, sufficient and contributory causes Explain the Diathesis Stress Model Part Two Discuss the biological, psychological and sociological Models of Psychopathology 2 PART ONE 3 1  27/01/2025 The Emergence of Contemporary Views of Abnormal Behavior Recent changes Biological discoveries Development of mental disorders classification system Emergence of psychological causation views Experimental psychological research developments 4 Establishing the Link Between the Brain and Mental Disorder Technological discoveries Understanding Scientific increased advancements Discovery of connection between general paresis and syphilis 5 The Development of a Kraepelin classification Compendium der Psychiatrie System (1883): forerunner to DSM Specific types of mental disorders identified 6 2  27/01/2025 Development of Mesmerism the Psychological Basis of Mental Diseases treated by “animal magnetism” Disorder Source of heated discussion in early nineteenth century 7 Nancy School Development of the Psychological Basis of Mental Disorder Hysteria could be caused and removed by hypnosis 8 Development First major steps toward of the understanding psychological Sigmund Freud Psychological factors in mental disorders (1856-1939) Basis of Mental Disorder Psychoanalytic perspective Emphasizes inner dynamics of unconscious motives 9 3  27/01/2025 Development Catharsis of the Psychological Basis of The unconscious Mental Psychoanalysis Disorder Free association Dream analysis 10 Experimental Psychology Wilhelm Lightner Wundt: First Witmer: First experimental American psychological psychological laboratory clinic J. McKeen First Cattell: psychologica Wundt’s l journals methods to U.S. © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved. 11 Early Views of Psychopathology Somatogenesis is the Psychogenesis is the view that disturbed belief that mental body function disturbance has produces mental psychological origins. abnormality. 12 4  27/01/2025 Causes and Risk Factors for Necessary, sufficient, Abnormal and contributory Behavior causes Study of causes and Feedback and bi- risk factors for directionality in abnormal behavior abnormal behavior includes: Diathesis-stress models 13 Etiology: Causal pattern of abnormal behavior Necessary, Sufficient, and Necessary cause Contributory Causes Sufficient cause Contributory cause 14 It is important to distinguish Necessary, between Sufficient, and Contributory distal causal Causes factors proximal (immediate) causal factors 15 5  27/01/2025 Feedback and Bi- directionality in Abnormal Behavior In the study of abnormal psychology, why is it difficult to specify which conditions are causes and which are effects? 16 Cause and Risk Factor Patterns The Causes and Risk Factors are Multiple Etiology (causal pattern underlying behavior) Linear (A causes B causes C etc.) Circular (Both A and B are reciprocal in their cause. ) 17 A predisposition toward developing a disorder is termed diathesis. It can derive from biological, psychosocial and/or sociocultural factors. The Diathesis Mental disorders are a product of stress operating Stress upon an individual with a diathesis for the type of Model disorder that emerges. 18 6  27/01/2025 The cause of Abnormal behavior according to the Diathesis-Stress Model is: oDiathesis- previous biological and environmental factors that The predispose an individual towards developing a disorder. Diathesis oStress-trigger that taxes or exceeds the individuals’ personal Stress resources and abnormal behavior. results in Model 19 Predisposition toward a given disorder = a diathesis Stresses + diathesis produce a disorder The Stress is a response to an Diathesis adjustment demand Stress Stressors are challenges, threats, or obstacles Model 20 The https://www.youtube.com/w atch?v=8iAhy8zy1MY Diathesis Stress Model 21 7  27/01/2025 Diathesis Stress Model 22 Vulnerability is the diathesis factor or predisposition to developing a disorder. Protective Factors modify a person’s response to an The environmental stressor, making it less likely that the Diathesis person will experience the adverse effects of the stressor. Stress Resilience is the ability to adapt successfully to very Model difficult circumstances. 23 Diathesis-Stress Models Diathesis: Relatively distal necessary or Stress: Response of contributory cause individual to taxing but is generally not demands sufficient to cause disorder Diathesis- stress models: Combination of diathesis and stress to cause disorder 24 8  27/01/2025 PART TWO 25 Contemporary views Functions Definition Viewpoints for Understanding the Causes of Abnormal Behavior 26 There are a variety of perspectives from which to view abnormal behavior. Models of Psychopathology PART TWO Each perspective considers several elements: Etiology (causes) Goals of Methods of of the abnormal treatment treatment behavior 27 9  27/01/2025 Causal Factors of Abnormal Behaviour The Biological/Medical Model/Viewpoints and Causal Factors The Psychosocial Models/Viewpoints and Causal Factors 28 Biological Viewpoint and Causal Factors Four categories of biological factors relevant to maladaptive behavior include: Neurotransmitter Brain dysfunction and hormonal Genetic Temperament and neural abnormalities in vulnerabilities plasticity brain 29 Neurotransmitter and Hormonal Abnormalities Do you know how neurons communicate? 30 10  27/01/2025 Biological Causal Factors Neurotransmitter imbalances Synapse Neurotransmitter 31 Neurotransmitter and Hormonal Abnormalities Neurotransmitter brain Some forms of abnormalities can psychopathology have result in abnormal also been linked to behavior hormonal abnormalities 32 Biological Causes: Major Glands of Endocrine System 33 11  27/01/2025 Biological Causal Factors Genetic Vulnerabilities Cell-Nucleus-Chromosomes-DNA Meiosis (germ cells and crossover) Germ cell can result in 8 million combinations Therefore over 64 trillion combinations are possible Mitosis (cell division) Male –XY Female- XX 34 The Relationship Genotypes to Phenotypes Genotype: Phenotype: Observed Total genetic structural and endowment functional characteristics 35 Gene Defects Faulty genes Dominant vs. Recessive Genes Recent studies have Biological suggested that heredity is an important predisposing causal factor in several Causal disorders, particularly depression, schizophrenia and alcoholism. Factors 36 12  27/01/2025 Chromosomal Abnormalities oDown Syndrome Trisomy in the 21st pair Causes intellectual disability Biological oTrisomy 13 An extra chromosome in the Causal 13th pair Causes fatal conditions associated with major brain Factors abnormality. 37 Chromosomal Abnormalities Cont’d o Trisomy 18 An extra chromosome in the 18th pair. Associated with severe heart malformation. o Trisomy 23 An extra chromosome in males. Known as Klinefelter’s Syndrome, a condition associated with under-developed testicles and Biological lack of body hair. o Monosomy 23 Causal Cells are missing on all or part of an X chromosome in females. Causes Turner’s Syndrome-associated with short stature, webbed necks and under- Factors developed ovaries. 38 Biological Causal Factors Temperament Temperament: Child’s reactivity and characteristic ways of self-regulation Early temperament is basis from which personality develops 39 13  27/01/2025 Biological Causal Factors Brain Dysfunction and Neural Plasticity True or False? Subtle deficiencies of brain function are rarely implicated in mental disorders. Genetic programs for brain development are not as rigid and deterministic as was once believed. Neural Plasticity- flexibility of the brain in making changes in organization and/or function in response to pre-and postnatal experience (stress, diet, drugs, maturation). 40 The Psychological Viewpoints Psychodynamic Perspective Behavioural Perspective Cognitive Behavioural Perspective Humanistic Perspective Emphasis is placed on Psychological Treatment Psychotherapy Behavioural therapy Cognitive Behavioural Therapy 41 The Psychodynamic approaches to personality and abnormality began with the work of Sigmund Freud. Concerned with the psychological forces that consciously or unconsciously influence the The mind Psychodynamic Perspective Psychoanalytic thinking is based on a minimum number of assumptions that one must make: Topographic Economic Genetic Structural Dynamic Adaptive 42 14  27/01/2025 The Psychodynamic Perspective The Psychoanalytic Assumptions Topographic Point of View Conscious Preconscious Unconscious Economic Point of View Highlights a continuum of available/free versus unavailable/limited libido {basic energy} Genetic Point of View Highlights the historical and developmental origins of personal conflicts 43 Revision: The Psychodynamic Perspective The Psychoanalytic Assumptions (Cont’d) Structural Point of View Id Ego Superego Dynamic Point of View Highlights the context of basic conflict Adaptive Point of View Highlights the essential problem solving - goal directed context of inner reality 44 Anxiety Reality Anxiety Neurotic Anxiety Moral Anxiety Revision: The Psychodynamic Defense Mechanisms (Refer to Perspective Handout) oThey discharge or soothe anxiety, but push painful ideas out of consciousness rather than by dealing directly with the problem. 45 15  27/01/2025 Revision: The Oral stage (ages 0 to 2) Psychodynamic Perspective Anal stage (ages 2 to 3) Freud conceptualized Phallic stage (ages 3 to five psychosexual 5 or 6) stages of development Latency period (ages 6 to 12) Genital stage (after puberty) 46 Revision: The Psychodynamic Perspective Ego psychology Attachment Object-relations theory theory Interpersonal perspective 47 The Behavioural Perspective Only the study of directly observable behaviour and the stimuli and reinforcing conditions that control it could serve as a basis for understanding human behaviour, normal or abnormal. Learning, the modification of behaviour as a consequence of experience, provides the central theme of the behavioural approach. This model regards symptoms of abnormal disorders as learned habits or maladaptive learned responses. Behaviourists emphasize the key importance of classical conditioning and operant conditioning in explaining maladaptive responses 48 16  27/01/2025 Revision: The Behavioural Perspective Classical Conditioning (Ivan Pavlov) Many physiological and emotional responses can be conditioned, including those related to fear, anxiety, sexual arousal and those stimulated by drugs or abuse 49 Revision: The Behavioural Perspective Operant behavior "operates" on the environment and is maintained by its consequences. A positive reinforcer is an event whose onset increases the probability that a response preceding it will occur again. A negative reinforcer is an event whose removal increases the probability of recurrence of a response that precedes it. Positive Punishment occurs when a behavior (response) is followed by a stimulus, such as introducing a shock or loud noise, resulting in a decrease in that behavior. Negative punishment occurs when a behavior (response) is followed by the removal of a stimulus, such as taking away a child's toy following an undesired behavior, resulting in a decrease in that behavior. 50 The Cognitive Perspective Cognitive psychology involves the study of basic information processing (attention, memory) and higher mental processes (thinking). The cognitive school is a modern outgrowth from, and reaction to behaviourism. Cognitive psychologists believe that cognitive processes influence behaviour, both normal and abnormal. Many forms of mental disorders are caused by difficulties in the effective processing of information or at the level from errors or biases in thinking. 51 17  27/01/2025 Revision: The Cognitive Behavioural Perspective Albert Bandura: Cognitive-Behavioural Perspective Social Cognitive Theory Human functioning is molded by the reciprocal interaction of three (3) factors: personal factors, environmental factors and behavioural factors. 52 The Cognitive Behavioural Perspective Aaron Beck’s Schema Negative thoughts, generated by dysfunctional beliefs are typically the primary cause of depressive symptoms. A direct relationship occurs between the amount and severity of someone's negative thoughts and the severity of their depressive symptoms. Beck’s model articulates the ‘Negative Triad’ – negative view of self; negative view of the world; negative view of the future. Attribution Theory -Different forms of psychopathology are associated with distinctive and dysfunctional attributional styles. 53 Revision: The Humanistic Perspective This approach reflects the fundamental belief that individuals are motivated towards personal growth and self-sufficiency. Psychological problems develop when a person refuses or is unable to accept responsibility for all his thoughts and actions. The disparity between one’s ‘self image’ and the ‘ideal self’ may produce emotional distress. The humanistic-existential (finding meaning in life) theory of psychopathology focus on personal growth, self-awareness, and the inherent capacity for making meaningful choices 54 18  27/01/2025 Maslow’s Hierarchy of needs: Other needs: Aesthetic Cognitive Neurotic The Humanistic Perspective 55 Psychosocial Causal Factors Early Deprivation and Trauma Parental deprivation can lead to trauma in children. Institutionalization Inadequate Parenting Deviations in parenting can have profound effects on a child’s subsequent ability to cope with life’s challenges, and thus create vulnerability to various forms of psychopathology. Marital Discord and Divorce Damaging to both adults and child psychological well-being 56 The Sociological Models Sociocultural Model Social and Cultural Influences Societal norms and Sub-group influences Family dynamics expectations Emphasizes Systems Approaches to Treatment Community Family Therapy Couples Therapy Group Therapy Interventions 57 19  27/01/2025 END OF LECTURE 2 58 20  2/3/2025 ABNORMAL PSYCHOLOGY (PSYC 2002) PANI C, ANXI ETY , OBSESSI ONS AND THEI R DI SORDERS Lect ur e 4 Lecture 3 Panic, Anxiety, Obsessions and their Disorders 1 Learning Outcomes Be At the end of this session, you will be able to: Distinguish between fear and anxiety; panic attacks and Distinguish agoraphobia. Identify Identify the DSM-5 Classification of Anxiety Disorders. Describe the clinical picture of Specific Phobia and Social Phobia by Describe assessing symptoms, etiology and treatment Describe symptomatology, etiology and treatment of Panic Describe Disorder and Agoraphobia. Compare Compare and contrast the clinical picture of Generalised Anxiety and Disorder with Obsessive Compulsive Disorder contrast 2 Anxiety Anxiety is a mood state characterized by marked negative affect and bodily symptoms of physical tension in which a person apprehensively anticipates future danger and misfortune. Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened. It involves cognitive/subjective, physiological, and behavioral components. 3 1  2/3/2025 4 Fear Fear is an alarm reaction that occurs in response to immediate danger. It protects by activating a massive response from the autonomic nervous system {ANS} which, along with our subjective sense of terror, motivates us to escape (flee) or possibly, to attack (fight). This emergency reaction is often called the flight or fight response. 5 Fear and Anxiety Response Patterns What is the difference between fear and anxiety? Let’s take a look: https://www.youtube.com/watch?v=0v5E6syVppI 6 2  2/3/2025 Historically, distinction centered on whether source of danger is obvious Less obvious danger Obvious danger leads to leads to anxiety fear Fear and Anxiety Response Patterns 7 Fear and Anxiety Response Patterns Unlike fear, anxiety is a complex blend of unpleasant emotions and cognitions more oriented to the future and much more diffuse than fear. Unlike fear, more often than not, the reason the individual feels anxious cannot be pinpointed. Similar to fear, it has not only cognitive/subjective components but also physiological and behavioural components. 8 Panic Attacks and Agoraphobia When the fear response occurs in the absence of any obvious external danger, we say the person has had a spontaneous or uncued panic attack. Three basic types of panic attacks: Situationally bound Unexpected Situationally predisposed Agoraphobia entails anxiety about being in places or situations from which escape might be difficult. 9 3  2/3/2025 Overview of the Anxiety The DSM-5 recognizes Disorders and FIVE primary types of anxiety disorders. Their Commonalities How many of these can you identify? 10 Anxiety Disorders Classified on the DSM-5 Specific Phobia Social Anxiety Disorder (Social Phobia) Panic Disorder Agoraphobia Generalized Anxiety Disorder (GAD) 11 Overview of the Anxiety Disorders and Their Commonalities Commonalities Basic biological causes Basic psychological causes Effective treatments 12 4  2/3/2025 Specific Phobias In specific phobia, there is strong and persistent fear recognized as excessive or unreasonable brought on by certain objects or situations. Exposure to the object or situation brings about an immediate reaction-endure intense anxiety or to avoid the object or situation entirely. Subtypes of specific phobias identified by DSM-5: Animal Situational Natural Environment Blood-Injection-injury Other 13 Symptoms Excessive or irrational fear of a specific object/situation Avoiding the object or situation Physical symptoms- panic attack, nausea or diarrhea. Anticipatory anxiety Etiology Psychological Causal Factors Phobias represent a defense against anxiety that stems from repressed Specific impulses from the id. Phobias are learned behaviour. Phobias Individual differences in learning Evolutionary Preparedness 14 Etiology (Cont’d) Biological Causal Factors Genetic and temperamental variables affect the speed and strength of conditioning strength. Treatment Exposure Therapy (Behavioural) Specific Participant modelling Phobias Virtual reality components Cognitive Therapy (combined) 15 5  2/3/2025 Social Anxiety Disorder (Social Phobias) Social Phobia is disabling fears of one or more specific social situations Fear of exposure to scrutiny and potential negative evaluation of others Meeting new people, talking in a group, or speaking in public can cause their extreme shyness. 16 Symptoms Intense worry for days, weeks, or even months before an upcoming social situation. Fear that you will act in ways that that will embarrass or humiliate yourself. Physical changes such as shortness of breath, nausea, racing heart, shaky voice. Etiology Psychological Causal Factors Social phobias are learned behaviours Social Evolutionary factors Perceptions of uncontrollability and Phobias unpredictability Cognitive biases toward “danger schemas” 17 Etiology (Cont’d) Biological Causal Factors Genetic and temperament Factors Treatment Cognitive and Social Behavioural Therapy Phobias Medications Anti-depressants 18 6  2/3/2025 Occurrence of panic attacks that seems to come “out of the blue” DSM-5 Criteria Recurrent, unexpected attacks Worry about additional attacks Panic Must be abrupt onset of 4 out of 13 symptoms (See Chapter 6 of Disorder Text). 19 HOW MUCH DO YOU KNOW ABOUT AGORAPHOBIA? 20 Agoraphobia Anxiety about being in places from which escape might be difficult or embarrassing. In DSM-5, agoraphobia now includes the experience of intense fear or anxiety in at least two agoraphobic situations: being outside the home alone public transportation (airplanes, buses, subways, etc.) open spaces public places (stores, theaters, or cinemas) crowds or standing in a line with other people The person will also need to be exhibiting avoidance behaviours. Frequent complaint of people with panic disorder but a distinct disorder in DSM-5 21 7  2/3/2025 Symptoms Panic attack symptoms can include any of the 13 symptoms. Panic attacks involve short Panic periods of intense anxiety symptoms. Disorder Etiology Psychological Causal Factors Comprehensive learning theory Cognitive theory 22 Etiology (Cont’d) Biological Causal Factors Brain Activity Biochemical Abnormalities and Neurotransmitters Panic Genetic Factors Disorder Treatment Cognitive-Behavioral Therapy (CBT) Medications including antidepressant drugs 23 The Panic Circle 24 8  2/3/2025 In GAD, excessive worry and anxiety must be present for at least 6 months. Generalized This anxiety is less intense than a panic attack, but Anxiety much longer lasting, making normal life difficult and relaxation impossible. Disorder The person finds it difficult to control the worry and (GAD) impairs social, occupational and other important areas of functioning. 25 Symptoms Must have at least three or more of the six symptoms; restlessness, being easily fatigued, difficulty concentrating, irritability, muscle Generalized tension, sleep disturbances. Anxiety Etiology Psychological Causal Factors Disorder Unconscious conflict between the ego and the id impulses that is not adequately dealt with by defense mechanisms. (GAD) Perceptions of uncontrollability and unpredictability Cognitive Biases for Threatening Information 26 Etiology (Cont’d) Biological Causal Factors Generalized Genetic Factors Neurotransmitters and Anxiety neurochemical abnormalities Disorder Treatment (GAD) Medications Cognitive-Behavioural Therapy 27 9  2/3/2025 New category of disorders in DSM-5 OCD focuses on avoiding frightening or repulsive intrusive thoughts (obsessions) or neutralizing these thoughts through the uses of ritualistic behaviour (compulsions). Obsessive- Obsessions are involuntary, seemingly uncontrollable thoughts, images, or Compulsive impulses that occur over and over again in your mind. Disorder Compulsions are behaviors or rituals that (OCD) you feel driven to act out again and again. Frequently co-occurs with other anxiety disorders and mood disorders; co-occurs with body dysmorphic disorder 28 Obsessive- Obsessions Compulsive Contamination fears Disorder Fears of harming oneself or others Lack of symmetry Pathological doubt Compulsions Cleaning Checking Repeating Ordering/arranging Counting 29 Obsessive-Compulsive Disorder (OCD) Etiology o Psychological Causal Factors OCD is learned behaviour Cognitive Biases Psychodynamic theories stress obsessions and compulsions are signs of unconscious conflict. o Biological Factors Genetic factors Abnormalities in the brain Neurotransmitter abnormalities 30 10  2/3/2025 Obsessive-Compulsive Disorder (OCD) Treatment Behavioural Therapy (e.g. Exposure and response prevention) Cognitive- Behavioural Therapy Medication 31 Body Dysmorphic Disorder Obsessed with perceived or imagined flaw in appearance Causes clinically significant distress May focus on any body part Typically begins in adolescence Shares body image distortions with eating disorders Similar behaviors and causes as OCD 32 Hoarding Disorder Acquire and fail to discard limited value possessions Disorganization in living space interferes with daily life Poorer prognosis for treatment than OCD 33 11  2/3/2025 There is a strong urge to pull out hair from any body location Trichotillomania Preceded by tension and followed by pleasure Must cause clinically significant distress 34 Question IN WHAT WAYS DO YOU THINK THE PANDEMIC HAS FUELED A RISE IN ANXIETY DISORDERS? 35 END OF LECTURE 3 36 12  2/10/2025 LECTURE 4 ABNORMAL PSYCHOLOGY (PSYC 2002) TRAUMA AND STRESS-RELATED DISORDERS 2 Learning Outcomes At the end of this class you will be able to: Describe the Categories of Stress Outline the Factors Predisposing a Person to Stress Explain how we can Cope with Stress Explain Decompensation Under Excessive Stress Describe the Clinical Picture of Adjustment Disorders & Post Traumatic Stress Disorder (PTSD) 3 HOW OFTEN DO YOU FEEL STRESSED? 4 1  2/10/2025 5 What is Stress? Stress refers to: External demands placed on an organism Organism’s internal biological and psychological responses to such demands To avoid confusion, we refer to the adjustive demands, as stressors to the effects they create within an organism as stress. The efforts to deal with stress as coping strategies. 6 Stress not only occurs in negative situations but in positive ones (Hans Seyle, 1956,1976). Stress can be broken down further into: oEustress – positive stress What is oDistress – negative stress Stress? Both kinds of stress tax the individual’s resources. 7 2  2/10/2025 Stress and the DSM Stress and DSM Significant component of multiple DSM diagnostic categories DSM-5: Trauma- and stressor-related disorders 8 Factors Creating Predisposition to Stress Nature of stressor Experience of crisis Life changes Individual perception of stressor Individual stress tolerance Lack of external resources and social supports 9 Characteristics of Stressors Severity Chronicity Timing Key characteristics of stress involve: Degree of impact Level of expectation Controllability 10 3  2/10/2025 Characteristics of Stressors Life changes Perception of Crises benefits 11 The Body’s Response to Stress How Does your brain and body React to stress: (152) How stress affects your brain - Madhumita Murgia – YouTube https://www.youtube.com/watch?v=WuyPuH9ojCE What have you learnt from this video? 12 Stress and the Stress Response Two of body’s systems respond when stressor is perceived Sympathetic-adrenomedullary (SAM) system Hypothalamic-pituitary-adrenal (HPA) axis 13 4  2/10/2025 Stress as a Biological Response 14 Stress as a Biological Response 15 The Hypothalamic- Pituitary-Adrenal (HPA) Axis 16 5  2/10/2025 The Mind- Body Connection True or False? Stress may cause overall vulnerability to disease. 17 Adjustive demands or stressors stem from sources that fall into 3 categories: Frustrations Conflicts Categories of Pressures Stressors 18 Frustrations 19 6  2/10/2025 Conflicts 20 Conflicts Approach-Avoidance Conflicts A choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects. Involve strong tendencies both to approach and to avoid the same goal. Double-Approach Conflicts Involves choosing between two or more desirable goals. 21 Double-Avoidance Conflicts oThis conflict is one in which the choice is between more or less equally undesirable alternatives. Conflicts oNeither choice will bring satisfaction, so the task is to decide which course of action will be least disagreeable- the least stressful. 22 7  2/10/2025 Pressures Pressures force a person to speed up, intensify effort, or change the direction of goal-directed behaviour. Pressures can seriously tax our coping resources and if they become excessive, they may lead to maladaptive behaviour. Pressures may originate from internal or external behaviour. 23 Class Activity Can you give an example of a situation that has caused a frustration or conflict or pressure? Let’s think of situations that we have confronted during or post-pandemic. 24 Coping with Stress 25 8  2/10/2025 Coping with Stress Task- Behaviour is directed primarily at dealing Oriented with the requirements of the stressor. Response Defense- Behaviour is directed primarily at protecting the self from hurt and disorganization Oriented Two types of defense-oriented responses: Crying, repetitive talking and mourning Response Ego- or self-defense mechanisms 26 Effects of Severe Stress Decompensation Lowering of adaptive efficiency Under Excessive Depletion of adaptive resources Wear and tear on the system Stress Biological Decompensation General adaptation syndrome (GAS) Personality or Psychological Decompensation 27 Decompensation Under Excessive Stress  Biological Decompensation (Cont’d) oAlarm Reaction-the body’s defensive forces are “called to arms” by the activation of the autonomic nervous system. oStage of Resistance-biological adaptation is at the maximal level in terms of bodily resources used. oExhaustion-biological resources are depleted and the organism loses its ability to resist, further exposure to stress can lead to illness and death. 28 9  2/10/2025 Decompensation Under Excessive Stress Personality or Psychological Decompensation o Alarm and mobilization Resources for coping with trauma are alerted/mobilized. Emotional arousal, increased tension and determined efforts at self-control. Symptoms of maladjustment may appear. o Resistance If stress continues, resistance may be achieved temporarily by concerted, task-oriented coping measures or the use of ego-defense mechanisms or both. o Exhaustion In continued excessive stress, adaptive resources are depleted. Coping patterns used in the stage of resistance begin to fail. Involves psychological disorganization and a break in reality. 29 Trauma & Stress- Related Disorders Adjustment disorder Some DSM disorders are triggered by exposure to stress Posttraumatic stress disorder 30 A person whose response to a common stressor is maladaptive and occurs within three months of the stressor can be said to have an adjustment disorder. Adjustment Disorders The person’s maladjustment lessens or disappears when: the individual the stressor has learns to adapt to subsided. the stressor. 31 10  2/10/2025 Acute Stress Disorder mainly differs from PTSD in terms of how long the symptoms last. Acute Stress Acute Stress Disorder also differs from PTSD Disorder & in terms of the severity of the symptom Post Traumatic pattern shown. Stress Disorder Acute stress disorder occurs within 4 weeks (PTSD) of the traumatic event and lasts for a minimum of 2 days and a maximum of 4 weeks. PTSD is not diagnosed unless the stress symptoms last for at least 1 month. 32 Something How does Childhood Trauma New: affect the developing brain? Childhood Let’s take a look: Trauma and Childhood Trauma and the Brain | UK Trauma the Brain Council - YouTube 33 Prevalence of PTSD in General Population Lifetime prevalence rate in the U.S. is 6.8% Higher rates in women despite finding that men are more likely to be exposed to traumatic events What contributes to this gender difference? 34 11  2/10/2025 Rates of PTSD After Exposure to Specific Stressors Military combat Prisoner of war, concentration camp, and torture experience Traumas caused by human intent Accidents or natural disasters 35 True or false? Causal Factors in Not everyone exposed Posttraumatic to a trauma will Stress Disorder develop PTSD! 36 Causal Factors in Posttraumatic Stress Disorder Individual risk factors Nature of Sociocultural trauma risk factors Causal factors may include: © 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved. 37 12  2/10/2025 Prevention & Treatment Advanced preparation of stressor Psychological Debriefing: Strategies of relief Critical Incident Stress Debriefing Medications Cognitive-behavioral treatments 38 Activity Take 5 minutes to write two statements that can summarise this lecture. Share your response 39 REVIEW 40 13  2/10/2025 END OF LECTURE 4 41 14