L1&2 PSYC114 REVIEWER PDF - Abnormal Psychology

What is ABNORMAL psychology?  E.G. Drinking & driving / — Abnormal Psychology homosexuality ❀ A branch of psychology that deals with  Until 1980 homosexuality was psychopathology and abnormal be...

What is ABNORMAL psychology?  E.G. Drinking & driving / — Abnormal Psychology homosexuality ❀ A branch of psychology that deals with  Until 1980 homosexuality was psychopathology and abnormal behavior. considered a psychological disorder ❀ It studies unusual patterns of emotion, by the World Health Organization behavior and thought which may or may not (WHO) but today is considered be understood as precipitating a mental acceptable. disorder. ❀ A division of psychology that studies 3. failure to function adequately people who are "abnormal" or "atypical" ❀ A person is considered abnormal if they compared to the members of a given society. are unable to cope with the demands of ❀ The term covers a broad range of everyday life. disorders, from depression to obsession- ❀ They may be unable to perform the compulsion to sexual deviation. behaviors necessary for day-to-day living ❀ Counselors, clinical psychologists and (e.g. self-care, hold down a job, interact psychotherapists often work directly in this meaningfully with others, make themselves field. understood etc.) What is abnormal? characteristics that define failure to function adequately There are many ways in which ABNORMALITY can  Suffering be defined:  Maladaptiveness (danger to self)  Vividness & unconventionality (stands 1. Statistical infrequency out) ❀ A person’s trait, thinking or behavior is  Unpredictably & loss of control classified as abnormal if it is rare or  Irrationality/incomprehensibility statistically unusual  Causes observer discomfort  Violates moral/social standards — Limitations: abnormal behavior may actually be helpful, function and adaptive for the individual.  For example, for people with OCD, — Limitations: this definition fails to distinguish hand-washing may make him between desirable and undesirable behavior. cheerful, happy and better able to  Many rare behaviors or characteristics cope with his day. (e.g. left handedness) have no bearing  Many people engage in behavior on normality or abnormality. that is maladaptive/harmful or  Some characteristics are regarded as threatening to self, but we don’t abnormal even though they are quite classify them as abnormal (e.g frequent. Depression may affect 27% adrenaline sports, smoking, drinking of elderly people (NIMH, 2001). This alcohol) would make it common but that does not mean it isn’t a problem 4. deviation from ideal mental health ❀ Under this definition, rather than defining 2. violation of social norms what is abnormal, we define what is ❀ A person's thinking or behavior is normal/ideal and anything that deviates classified as abnormal if it violates the from this is regarded as abnormal. (unwritten) rules about what is expected or ❀ These often includes characteristics such acceptable behavior in a particular social as: group.  Positive view of the self ❀ Their behavior may be incomprehensible  Capability for growth and to others or make others feel threatened or development uncomfortable.  Autonomy and independence ❀ Social behavior varies markedly when different cultures are compared. — Limitations: Social norms change over time. Behavior that was once seen as abnormal may, given time, become acceptable and vice versa. ideal mental health Multiaxial assessment  Accurate perception of reality classification system  Positive friendships and relationships  Diagnostic and Statistical Manual of  Environmental mastery – able to meet Mental Disorders (DSM) developed by the varying demands of day-to-day the American Psychiatric Association situations  International Classification of Diseases — Limitations: It is practically impossible for any (ICD) developed by the World Health Organization individual to achieve all of the ideal characteristics all of the time. Purposes of Classifying Mental Disorders  For example, a person might not be ❀ To distinguish one psychiatric diagnosis the ‘master of his environment’ but from another so that clinicians can offer the be happy with his situation. most effective treatment  The absence of this criterion of ideal ❀ To provide a common language among mental health hardly indicates he is health care professionals suffering from a mental disorder. ❀ To explore the still unknown causes of In summary… many mental disorders Until now, there is still no universal agreement by what is meant by abnormality or disorder but it has Multiaxial evaluation been related to the following concepts: ❀ DSM-IV-TR is a multi-axial system that  SUFFERING evaluates patients along several variables  MALADAPTIVENESS and contains 5 axes.  DEVIANCY ❀ Axis I and II make up the entire  VIOLATION OF STANDARDS OF SOCIETY classification of mental disorder: 17 major  SOCIAL DISCOMFORT classifications and more than 300 specific  IRRATIONALITY & UNPREDICTABILITY disorders  SUBJECTIVE TO SOCIAL JUDGMENTS  AXIS I – consists of Clinical Disorders and other conditions that may be a Dsm’s definition of mental disorder focus of clinical attention  A clinically significant behavioral or psychological syndrome or pattern Axis I diagnoses  Associated with distress or disability  Disorders first diagnosed in infancy, (impairment in one or more areas of childhood or adolescence (excluding functioning) M.R)  Delirium, dementia, amnestic and other  Not simply a predictable or culturally cognitive disorders sanctioned response to a particular  Mental Disorder due to a general event (e.g. grieving) medical condition  Considered to reflect behavioral,  Substance-related disorders psychological or biological dysfunction  Schizophrenia & other psychotic in an individual disorders dsm 5 definition  Mood Disorders  Anxiety Disorders ❀ A mental disorder is a syndrome characterized  Somatoform Disorders by clinically significant disturbance in an  Dissociative Disorders individual's cognition, emotion regulation, or  Sexual & Gender Identity Disorders behavior that reflects a dysfunction in  Eating Disorders psychological, biological, or developmental  Sleep Disorders processes underlying mental functioning.  Impulse-control disorders  Adjustment disorders  Usually associated with significant  Other conditions that may be a focus of distress and disability in social, clinical attention occupational, other important activities.  Not an expectable, culturally approved response to an event, nor socially deviant behavior (political, religious, sexual) and conflicts between an individual and society unless it results from a dysfunction of the individual.  AXIS II – consists of personality disorders  AXIS V – is a global assessment of and mental retardation. The habitual functioning 100-pt. scale in which use of a particular defense mechanism clinicians judge patients’ overall level of can be indicated on Axis II. functioning during a particular time o Functioning refers to a Axis II diagnoses composite of 3 major areas:  Paranoid Personality Disorder social, occupational &  Schizoid Personality Disorder psychological  Schizotypal Personality Disorder  Antisocial Personality Disorder Axis V GAF SCALE  Borderline Personality Disorder 91–100: superior functioning, no  Histrionic Personality Disorder symptoms  Narcissistic Personality Disorder 81–90: absent /minimal symptoms, good functioning in all areas, socially effective,  Avoidant Personality Disorder generally satisfied with life  Dependent Personality Disorder 71–80: symptoms present are transient &  Obsessive Compulsive Personality expectable reactions to psychosocial Disorder stressors  Personality Disorder (Not otherwise 61–70: some mild symptoms OR some specified) difficulty in social, occupational / school  Mental Retardation functioning, meaningful interpersonal relationships  AXIS III – lists any physical disorder or 51–60: moderate symptoms OR moderate general medical condition that is present difficulty in social, occupational/school in addition to the mental disorder functioning (few friends, conflicts with peers) o It may be a cause (kidney 41–50: symptoms (suicidal ideations, failure causing delirium) frequent shoplifting) or serious o Or a result (alcohol gastritis impairment in social, occupational/school secondary to alcohol functioning (no friends, can’t keep a job) dependence) 31–40: some impairment in reality testing and communication or major impairment o Or unrelated to the mental in several areas (work/school, family disorder relations, judgment, thinking, mood) o If it is causative, it is listed in 21–30: behavior is influenced by both Axis I & III delusions/hallucinations, serious impairment in communication &  AXIS IV – is used to code the judgment, inability to function in almost psychosocial and environmental all areas problems that contribute significantly to 11–20: some danger of hurting self or the development / exacerbation of the others OR occasionally fails to maintain minimal personal hygiene, gross current disorder. impairment in speech 1–10: persistent danger of severely Axis IV EXAMPLES hurting self or others OR persistent  Problems with primary support inability to maintain minimal personal group hygiene  Problems related to the social 0: inadequate information environment  Educational problems  Occupational problems  Housing problems  Economic problems  Problems with access to health care services  Problems related to interaction with the legal system  Other psychosocial & environmental problems  What are signs & symptoms? I. c. Disturbances in suggestibility — Signs: are observations and objective findings  Folie a deux (folie a trois) – communicated elicited by the clinician such as a patient’s emotional illness between 2-3 persons  Hypnosis – artificially induced modification of constricted affect / psychomotor retardation consciousness characterized by increased — Symptoms: are subjective experiences suggestibility described by the patient, often expressed as chief complaints (depressed mood or lack of ii. emotion energy) ❀ Complex feeling state with psychic, somatic, and behavioral components that is descriptive terms related to affect & mood. ❀ Descriptions in signs & symptoms in o A. Affect: observed expression of psychiatry remain fairly constant. However, emotion, possibly inconsistent with some terms evolve & have been eliminated in the patient’s description of emotion revisions II. a. affect “organic mental disorder”  Appropriate  Inappropriate “psychogenic”  Blunted affect – severe reduction in intensity “neurosis”  Restricted/constricted – reduction in intensity less severe than blunted 1. Neurosis  Flat affect – absence/near absence of expression ❀ A chronic or recurrent non-psychotic (monotonous voice, immobile face) disorder characterized mainly by anxiety,  Labile – rapid & abrupt changes unrelated to which is experienced or expressed directly or external stimuli is altered through defense mechanisms o B. Mood: Pervasive & sustained ❀ It appears as a symptom (obsession, emotion. compulsion), phobia or sexual dysfunction  Subjectively experienced or reported by the patient & observed 2. psychosis by others  E.g. depression, elation, anger ❀ Traditional meaning means loss of reality testing and impairment of mental II. b. MOOD functioning manifested by:  Dysphoric – unpleasant mood  Euthymic – normal range Delusions  Expansive – expression of feelings without restraint Hallucinations  Irritable – state easily annoyed or provoked to Confusion anger Impaired social & personal  Mood swings / labile mood  Elevated – air of confidence / enjoyment functioning  Euphoria – intense elation & feelings of grandeur ❀ According to the APA, Psychotic = grossly  Depression – psychopathological feelings of impaired reality testing sadness  Anhedonia – loss of interest & withdrawal from regular & pleasurable activities I. A. Disturbances of Consciousness  Grief – sadness associated with real loss (mourning  Disorientation (to time, place, person) / bereavement)  Stupor – lack of reaction/awareness to  Alexithymia – inability/ difficulty to describe & be surroundings aware of emotions  Delirium – bewildered, restless confused  Suicidal ideation reaction associated with fear/hallucination  Elation – euphoria, intense satisfaction, optimism  Coma – profound unconsciousness  Mania – elation, agitation, hyperactivity,  Twilight state – disturbed consciousness w/ hypersexuality, accelerated thinking & speech hallucinations  Melancholia – severe depressive state  Somnolence – abnormal drowsiness  Drowsiness – impaired awareness associated II. c. OTHER EMOTIONS with desire / inclination to sleep  Anxiety – apprehension caused by anticipated internal or external danger I. b. Disturbances in attention  Free floating anxiety  Distractibility – attention is drawn to  Fear – anxiety caused by realistic danger unimportant external stimuli  Agitation – motor restlessness  Selective inattention – blocking out things that  Panic – acute, episodic, intense attack of anxiety generate anxiety  Apathy – dulled emotional tone  Hypervigilance – excessive attention to  Ambivalence – co-existence of 2 opposing feelings internal & external stimuli, secondary to at the same time delusions  Abreaction – emotional release after recalling a  Trance – focused attention or altered painful experience consciousness  Shame – failure to live up to self-expectations  Disinhibition – loss of control of impulses  Guilt – emotion secondary to doing perceived wrong  Impulse Control – ability to resist an impulse/drive iIi. MOTOR BEHAVIOR (CONATION) SPECIFIC DISTURBANCES IN content of thought ❀ Impulses, motivations, wishes, drives,  Obsession – pathological persistent of thought/feeling that cannot be eliminated instincts & cravings as expressed by a from consciousness; associated with anxiety person’s behavior or motor activity.  Compulsion – pathological need to act on impulse, repetitive behavior in response to an III. MOTOR BEHAVIOR obsession  Echopraxia – pathological imitation of movement  Coprolalia – compulsive utterance of obscene  Catatonia & postural abnormalities words  Catalepsy – general term for immobile position  Phobia – persistent, irrational exaggerated constantly maintained pathological dread of a specific stimulus or  Akinesia – lack of physical movement in the situation extreme  Mannerism – ingrained, habitual, involuntary movement V. DISTURBANCES IN speech  Negativism – motiveless resistance to all attempts  Pressure of speech – rapid & increased to be moved  Poverty of speech – decreased amount  Overactivity (agitation, hyperactivity, tic etc.)  Stuttering – frequent repetition or  Compulsion – uncontrollable impulse to perform an prolongation of a sound or syllable act repetitively (kleptomania)  Motor aphasia (Broca’s aphasia)  Sensory aphasia (Wernicke’s aphasia) iV. DISTURBANCES IN THINKING ❀ In Form / Process of Thinking Vi. DISTURBANCES IN perception  Hallucination – false sensory perception not ❀ In Form of Thought associated with external stimuli ❀ In Content of Thought o can be auditory, visual, olfactory, gustatory, or tactile (phantom limb, IV. DISTURBANCES IN Form / Process of Thinking crawling sensations under the skin)  Psychosis  Illusion – misperception / misinterpretation  Impaired Reality testing of real external stimuli  Illogical thinking  Autistic Thinking – preoccupation with inner, Vii. DISTURBANCES IN memory private world  Amnesia – partial/ total inability to recall past  Magical Thinking – thinking similar to experiences (anterograde/retrograde) preoperational children  Paramnesia – falsification of memory by  Lack of Emotional Insight distortion of recall (déjà vu / jamais vu / false SPECIFIC DISTURBANCES IN FORM OF THOUGHT memory)  Word salad – incoherent mixture of words and  Repression – defense mechanism phrases characterized by unconscious forgetting  Circumstantiality – indirect speech delayed in  Blackout – amnesia experienced by alcoholics reaching the point during drinking bouts  Incoherence – thought that is generally not understandable Viii. intelligence  Echolalia – pathological repeating of words  Mental Retardation – sufficient lack of  Flight of ideas – constant shifting from 1 idea to intelligence to interfere with social & another vocational performance  Clang association – use of words similar in sound  Dementia – organic & global deterioration of but no logical connection intellectual functioning Specific Disturbances in Content of Thought ix. insight o Delusion: false belief, based on incorrect inferences about external reality, not ❀ Ability to understand the true cause & consistent with patient’s intelligence & meaning of a situation cultural background, cannot be corrected by o Intellectual Insight reasoning o True Insight Types of delusion o Impaired Insight  Bizarre – an absurd, totally implausible, strange false belief (aliens) x. judgment  Systematized – false belief united by a single event/theme ❀ Ability & to act assess a situation correctly  Delusion of poverty – false belief that s/he is and to act appropriately in the situation bereft/deprived of material things o Critical Judgment  Somatic – false beliefs about functioning of the body o Automatic Judgment  Paranoid – delusion of persecution, of grandeur, of reference o Impaired Judgment  Delusion of control – false feeling that person’s thoughts, will or feelings are controlled by external forces (thought withdrawal, insertion, broadcasting, control)  Delusion of infidelity  Erotomania – false belief that someone is deeply in love with them  Hypochondria – exaggerated concern about one’s health based on unrealistic interpretations of physical signs/sensations