Abnormal Psychology PDF

Psychology 1.​ Abnormal Behavior -​ How do we define abnormality We usually define abnormality as something that falls outside the boundaries of what is accepted in society. This can change over time and between cultures. Some behaviors might be accepted but still harmful to a person. Abnor...

Psychology 1.​ Abnormal Behavior -​ How do we define abnormality We usually define abnormality as something that falls outside the boundaries of what is accepted in society. This can change over time and between cultures. Some behaviors might be accepted but still harmful to a person. Abnormality depends on the situation. -​ Abnormality as inadequate functioning “(Rosenhan and Seligman, 1989)” Proposes seven criteria to establish abnormality: -​ Suffering -​ Maladaptiveness -​ Unconventional behavior -​ loss of control -​ Irrationality -​ Observer discomfort -​ Violation of moral standards Limitations: -​ Abnormal behavior can sometimes be helpful. -​ Behaviors may be harmful but we don’t classify them as abnormal (extreme sports) -​ Some might be uncomfortable for others, but not cause suffering (like PDA). -​ Abnormality as a deviation from ideal mental health In the 1950s, humanists believed psychology should focus on positives, not negatives like mental illness. Marie Jahoda (1958) listed six traits of ideal mental health: -​ Self-awareness -​ Realistic self-esteem -​ Self-control -​ Seeing the world accurately -​ Healthy relationships -​ Independence and productivity Strength: -​ Mental health is defined positively, through what a person needs to achieve. -​ Describes the key parts of mental health in a clear and balanced way. Weakness: -​ It might be impossible to meet all six signs of mental health, so most people would likely be seen as not normal as abnormal -​ The factors are hard to measure or count. -​ Terms such as “efficient”, “realistic” and “accurate” require implementation. -​ Abnormality as statistical infrequency A behavior or personality trait is called abnormal if it is very rare. In statistics, a person is considered outside the "normal" range if they are different from 95% of the population Limitations: -​ Statistical norms change -​ Statistically infrequent behavior can sometimes be useful (High IQ) Strength: A way to measure abnormality -​ The medical model of abnormality Each disorder is studied by looking at its symptoms. Many doctors work together over time. The idea is that disorders have a cause, but we can only guess it based on the symptoms we can see. Strengths: -​ Flexibility -​ It helps diagnose illnesses no matter what you think caused them. Limitations: -​ Harder to apply to mental illness than physical diseases. -​ Mental illness symptoms are less obvious.  -​ Hard to decide which symptoms match which disorder and how long they should last. 2.​ Clinical and patient bias -​ Clinician Variables (Attitudes and Beliefs) The clinician’s attitudes and beliefs about certain groups of individuals or disorders, for example, the psychiatrist's professional background or main approach -​ Attitude and Belief Research “Langweiler and Linden (1993)” Aim: To study how clinician variables (like background and beliefs) affect the diagnosis and treatment of depression. Method: Four clinicians with different professional backgrounds were shown a fake patient and asked to diagnose and treat them. Results:​ The clinicians gave different diagnoses and treatments, even though the patient’s situation was the same. The first diagnosis appeared in less than three minutes, and the final diagnosis was influenced by the clinician’s background and personal attitudes, showing how biases can affect clinical decisions. -​ Clinician Variables - Abilities The clinician’s abilities, such as understanding others' viewpoints, self-reflection, accepting uncertainty, and accepting differences. -Cognitive Biases Two examples of cognitive bias that could be important in a clinical setting are -​ Confirmation bias: the tendency to look for information that supports one's existing beliefs  -​ Illusory correlation: the tendency to believe there is a connection between two things when there isn't. - Cognitive Bias Research “Chapman and Chapman (1969)” Aim: The study aimed to see if clinicians' previous beliefs or stereotypes affected how they connected test responses to psychological disorders. Method: Clinicians and students were shown randomly paired test data with no real correlation, and their perceptions of patterns were observed. Result: The study found that participants often saw false connections, such as linking "eyes" with paranoia, showing that cognitive biases like illusory correlation affected clinical decisions instead of objective data. -​ Patient Variables Can come from the fact that different groups of people act differently in a clinical interview. Some groups may feel symptoms in different ways, while others may not want to share their emotional struggles. Patient variables are connected to things like: -​ How symptoms are shown -​ Bias in reporting symptoms -​ Turning emotional problems into physical ones (somatization)  -​ Reporting bias You only get professional help for mental health issues if you think you have one. This can cause reporting bias, where some symptoms exist but are not reported, making it seem like a certain disorder is less common than it really is. Furnham and Malik (1994) Aim:​ Wanted to understand why British Asians were rarely diagnosed with depression. Method: 152 women (half British, half Asian) filled out questionnaires about their depression symptoms and beliefs about depression. Result: Asian women reported feeling depressed less often, likely because of cultural views. The study linked these differences to the role of family in Eastern cultures. -​ Somatization -​ Is when mental health issues appear as physical symptoms. -​ Some cultures, people may report these symptoms to doctors instead of mental health professionals. -​ Some studies see it as a cultural difference in how mental illness shows. Kleinman (1982) found that Chinese patients showed signs of depression and other mental health issues mostly through physical symptoms, like saying "I have a headache" instead of "I am sad." He explained this as a result of the strong stigma around mental illness in China. Lin, Carter and Kleinman (1985) Aim To find out if somatization was common in Chinese, Filipino, Vietnamese, and Laotian patients in US primary care, and compare refugees to immigrants. Method The researchers looked at patient records and defined somatization as unclear physical symptoms (like headaches and pain) without a clear cause. Results 35% of patients showed somatization. Refugees were more likely to have it than immigrants. Patients with somatization often had larger families and lower education levels. Somatization was a major issue for Asian refugees and immigrants, especially from traditional societies. 3.​ Vocabulary ( Abnormal psychology) -​ Prevalence -​ Is the proportion of people in a population who have a condition at a specific time, including both new and existing cases -​ Helps to understand the spread of a disease and predict how likely it is for someone in that group to have the condition. It is often shown as a percentage (like 5%) or as the number of cases per 10,000 or 100,000 people, depending on how common the condition is. -​ Incidence Refers to the number of new cases of a condition that appear in a specific population over a set time period. Difference between Prevalence and Incidence : Incidence only counts new cases, while prevalence includes all cases, both new and old. -​ Diagnosis -​ Process of identifying a disease or disorder by its signs and symptoms using tests and other evidence. -​ It involves classifying people based on a disease, disorder, or specific characteristics. -​ Psychological diagnoses are listed in guides like the DSM-IV-TR, DSM-5, and DSM-5-TR. -​ Etiology -​ Is the study of the causes of diseases or mental disorders. These can be caused by internal issues, loss, pain, or the environment. -​ Key models explaining mental disorders include behavioral, cognitive, psychodynamic, and biological -​ Comorbidity -​ Is when someone has two or more illnesses at once, physical or mental. For example, depression and multiple sclerosis. -​ It's common, with 80% of Medicare spending on patients with four or more conditions. Having multiple disorders can make treatment harder and longer. -​ Prognosis -​ Prognosis is a prediction about how a disease or condition will progress and its outcome. It helps patients choose the best treatment. -​ It can also mean any general prediction.  -​ Risk Factors Risk factors increase the chances of negative outcomes. These can be biological, psychological, family, community, or cultural. -​ In relationships: drug/alcohol use, mental illness, child abuse, lack of supervision. -​ In communities: poverty, violence. -​ In society: substance use laws, racism, lack of jobs. 4.​ Anxiety ( characteristics of diagnosis, effectiveness treatment ) Generalized Anxiety (GAD): a.​ Excessive Anxiety and Worry: occurring more days than not for at least 6 months. This worry is happening during a variety of normal activities (e.g. work, school, social interaction) b.​ Difficulty Controlling Worry: individuals find it hard to control the worry. c.​ Associated Symptoms: anxiety and worry are related with 3 or more of the following 6 symptoms (some symptoms happen more days than not for ^ months)(only one symptom is required for children) -​ Restlessness or feeling keyed or on edge (unable to relax or anxious) -​ Being easily fatigued -​ Difficulty concentrating or mind going blank -​ Irritability -​ Muscle tension -​ Sleep disturbance d.​ Significant Distress or Impairment: the anxiety and worry can cause clinically significant distress or impairment in social, occupational and other areas of functioning.  e.​ Exclusion of other causes: the disturbance is not attributable to the physiological effects of a substance (drug abuse or medication, other medical conditions) -​ Prevalence Global prevalence: 4% United states: 5.7% lifetime prevalence (women 3.4%)(men 1.9%) Specific Phobia: a.​ Marked Fear or Anxiety: specific anxiety about an object or situation (e.g. flights, animals, seeing blood, heights) b.​ Immediate Fear Response: the phobic or situation almost always provoques immediate fear or anxiety. c.​ Avoidance or Endurance with Distress: the phobic object or situation is actively avoided or endures with intense fear or anxiety. d.​ Out of proportion: fear or anxiety is out of proportion to the actual danger. e.​ Persistent (duration): fear and anxiety or avoidance is persistent, typically lasting 6 months or more. f.​ Significant Distress or Impairment: fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. g.​ Exclusion of Other Mental Disorders: -​ Obsessive-Compulsive Disorder (ODC) (e.g. fear of contamination) -​ Posttraumatic Stress Disorder (PTSD) (e.g. avoidance of trauma reminders) -​ Social Anxiety Disorders (e.g. fear of public speaking) -​ Panic Disorder (e.g. fear of panic-like symptoms) SPECIFIC TYPE OF PHOBIAS  -​ Animal Type (e.g. dogs, spiders, snakes) -​ Natural Environment Type (e.g. heights, storms, deep water) -​ Blood-Injection-Injury Type (e.g. fear of needles, blood, medical procedures) -​ Situational Type (e.g. airplanes, elevators, enclosed spaces) -​ Other Type (e.g. fear of choking, vomiting, loud sounds) -​ Prevalence Across national of lifetime prevalence of specific phobia: 7.4% United states: 9.1% adults in a year, and lifetime prevalence 12.5% Social Anxiety a.​ Marked Fear Of Anxiety In Social Situations: marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. -​ Social Interactions (e.g. having a conversation, meeting unfamiliar people) -​ Being Observed (e.g. eating or drinking) -​ Performing in front of others (e.g. giving a speech) b.​ Fear of negative Evaluation: individual fears that they will act in a way or show anxiety symptoms that will negatively evaluated (e.g. humiliation, embarrassment, rejection or offending others) c.​ Social Situation Almost Always Trigger Fear or Anxiety: the referred social situations almost always provoke fear or anxiety. d.​ Avoidance or Endurance with Distress: the social situations are either avoided or endured with intense fear or anxiety. e.​ Fear is out of Proportion: the fear or anxiety is out of proportion to the actual threat posed by social situation and sociocultural context. f.​ Persistent (Duration): fear, anxiety or avoidance is persistent, typically lasting 6 months or more.  -​ Specifier Performance Only: use this specifier if the fear is restricted to public speaking or performing in front of others. -​ Prevalence United States Adults: 7.1% (15 million individuals) United States Adolescents: lifetime SAD varies by age group -​ 17-18 years old: 6.9% -​ 18-29 years old: 13.6% 5.​ Treatment of Anxiety Disorders -​ Biological treatments Primarily involve medications a.​ SSRIs (Selective Serotonin Reuptake Inhibitors) Works by increasing serotonin levels on the brain. SSRIs block the nerve cells (known as “reuptake”), meaning more serotonin is available to pass further messages between nearby cells and the brain. Ej: Fluoxetine (prozac), Sertraline (Zoloft), Escitalopram (lexapro) ➔​ Effectiveness: ​ Considered first time treatment for GAD. ​ Studies show reduction in symptoms for 60% to 70% of patients. ​ Reducing social fears and avoidance behaviors. ​ Response rates range from 50% to 70%. ➔​ Strengths: ​ High tolerability. ​ Low risk of dependence or abuse.  ​ Improvement in comorbidities. ➔​ Limitations: ​ Takes longer to start working. ​ Symptom relief may take 4 to 6 weeks to become noticeable. ​ Doesn't fully work or has little effect. ​ Around 30% to 50% of patients may not fully respond. ​ They might need a different dose, therapy added, or new treatments. ​ Side effects: -​ Náusea -​ Insomnia -​ Sexual dysfunction -​ weight gain b.​ Benzodiazepines Makes your nervous system less active (calms you down) by releasing the neurotransmitter of GABA. Many countries classify them as controlled substances. -​ Higley addictive. -​ If you suddenly stop consuming it, it can be deadly. lead to anxiety, trouble sleeping. Ej: Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam) The slowed activity can have the following effects: -​ Amnestic (blockage of new memory formation) -​ Anxiolytic (loosening anxieties hold on you) -​ Hypnotic (sleepy) -​ Sedative (helps nervous system to “settle down”) ➔​ Effectiveness: ​ Quick reduction of symptoms of excessive worry, tension, and anxiety symptoms.  ​ short-term symptoms relife in 70% to 80% of patients. ​ Reduces panic attacks. ​ Temporary treatment until other options start working. ​ Used for sudden out-brakes or when symptoms need quick control. ➔​ Strengths: ​ works quickly (effective within minutes to hours) ​ Effective for physical symptoms ​ Complement to other treatments. ➔​ Limitations and risks: ​ Short-term use only. ​ Risk of dependency. ​ Side effects include sleepiness,weakness , and memory or coordination problems. ​ Manage symptoms, but do not address the causes of anxiety. ​ Less effective than SSRIs and CBT. c.​ Beta-Blockers Beta-blockers like propranolol and atenolol reduce anxiety by blocking adrenaline, slowing the heart, and sometimes relaxing blood duct to lower blood pressure ➔​ Effectiveness: Most effective when physical symptoms dominate, such as: ​ Public speaking ​ Stage performances ​ Test-taking ​ Job interviews These medications help reduce the “fight or flight” response. ➔​ Limitations:  ​ Not for GAD ​ Short- term use. ​ They only treat symptoms, not the original cause. -​ Psychological treatments a.​ CBT (Cognitive Behavioral Therapy) CBT aims to show us how our thinking influences our mood. Teaches us to think in a different way and reframe these thoughts. We can also face stressors and learn how to challenge them. The most effective treatment for anxiety. ➔​ Techniques: ​ Cognitive restructuring (reframing negative thoughts) ​ Thought records (to identify patterns) ​ Behavioral experiments ​ Graded exposure (facing fears in a controlled manner) ​ Activity scheduling (planning activities to boost mood) ➔​ Effectiveness: ​ Higley effective for GAD, social anxiety and panic disorders. ​ 60% to 80% of patients report improvement. ​ Directly targets the mechanism that maintains anxiety. ➔​ Limitations: ​ Some individuals may prefer other types of therapies. ​ Requires active participation. ​ Effectiveness can vary.