|
|
|
General Overview Question How can I detect abnormal behavior in others and how can I deal with them effectively? |
|
The goals of this section are to learn what is meant by the terms psychological disorder and abnormal behavior, they types, and causal factors. |
|
Psychological Disorders or Abnormal Behavior refers to behavior that is either deviant, maladaptive, or personally distressful. In single month - about 15% US adults meet criteria for psychological disorder. |
|
The are 5 characteristics of abnormal behavior but one does not need to meet all 5 to be classified as abnormal. 1. Atypical (So unusual as to be statistically rare)2. Socially unacceptable (varies according to cultural values) 3. Distressing (to self or others) 4. Maladaptive (self-defeating) 5. Result of distorted thoughts (e.g., people out to get; unlovable) |
|
Models of Abnormality - Model refers to an analogy, a perspective or an approach. The basic models are: |
Sort of reminds you of the blind men and the elephant story. How can there be so many different models or ways of looking at abnormal behavior?
|
1. Medical - Biological Model Early approach assumed the person was possessed by demons and they were exercised by trephination.The medical model changed this since they assume the presence of a biochemical imbalance. Thus, the illness needs to be diagnosed, treated, & then cured. In search of a cause they focus on biological conditions (Genetic abnormalities, CNS problems, hormonal changes). Treatment: emphasizes hospitalization & drug treatment. |
Any time the abnormal behavior is referred to as an illness there is an implied imbalance that needs to be treated biochemically. Are there such illnesses and can they be treated? Can they be cured?
|
2. Psychodynamic Cause: anxiety produced by unresolved conflictsRooted in Freud's theory. Person may be unaware of conflicts Treatment: become aware of conflicts & desires 3. Humanistic (humanists i.e. Rogers - uniqueness & decision-making) Cause: expectations far exceed achievementsRogers believes that emotional distress results from deviation between the perceived self and the ideal self. Treatment: formulate more realistic expectations and more realistic ideal self. 4. Behavioral Cause: ineffective learning and/or the reinforcement of maladaptive behaviorTreatment: learn & substitute more effective behaviors |
These models shift from thinking of it as an illness to unconscious conflicts, unrealistic self-concept, or reinforcement of maladaptive behaviors. You can see if a different cause is assumed then a different treatment is required.
|
5. Cognitive (thought processes) (individuals decide how to behave) Cause: false assumptions and inappropriate self-instruction.Treatment: develop new thought processes (self-instruction). 6. Sociocultural Stresses importance of context (family, society, culture)Cultural variables |
|
7. Legal
Insanity defense - if at the time of the crime the person lacked the capacity to recognize right from wrong or to obey the law. |
Insanity is strictly a legal term. If a person does not know right from wrong at the time they committed an illegal act they can not be held responsible. What about young children, retarded individuals?
8. Interactionist / Eclectic
|
Diagnosis DSM-IVthe DSM-IV is an guide to diagnosis developed by psychiatrist who use the medical model.A committee has established identifiable criteria for each psychiatric disorder which serves as a guide to diagnosis. Their goal was to improve reliability of diagnoses by outlining specific behaviors. Make diagnoses consistent with research evidence. It consists of lists of criteria which categorizes disorders according to behaviors Established by committees Changes over time Lists 16 major categories with 200 subcategories. One of the major drawbacks is that the end product is a label Forces medical model & psychiatric terms. |
Since the DSM-IV is a guide to diagnosis, then it is most appropriate for those that adhere to the medical model. Unfortunately, insurance companies and attorneys also use this and try to force psychologists to go along. The alternative is to consider a disorder as a process which is imposed on the individuals behavior.
|
Delirium, dementia, & other cognitive |
There are lots of categories but many relate to anxiety (most), some to learning (personality disorders), and others to biochemical imbalances (mood disorders and schizophrenia). Try to think of the characteristics of these three broad categories with regard to cause, management and treatment.
|
Anxiety Disorders generalized feeling of fear & apprehensionoften accompanied by increased physiological arousal anxiety can be motivating or debilitating Generalized Anxiety Disorders - feel anxious almost constantly |
People don't stay at this level long but tend to develop other methods for dealing with anxiety such as phobias, OCD, etc. Why do you think that is? What would these other disorders provide that would be different from a generalized anxiety disorder?
|
fear + avoidance of object or situation fear is excessive / unreasonable 1. Agoraphobia - fear of being alone in places from which escape might be difficult or embarrassing. Post-Traumatic Stress Disorder |
|
Acrophobia (high places) |
The important question is, what does the development of a phobia offer the individual? What would cause them to develop such a thing that could lead to rather severe and maladaptive behavior? How does anxiety figure in?
| persistent & uncontrollable thoughts (obsessions) that cause performance of inappropriate rituals (compulsions) that interfere with daily life rituals reduce anxiety (e.g.: obsessed with germs; wash hands hundreds of times) |
|
physical symptoms with no identifiable physical cause Somatization Disorders multiple physical complaints over several years medical help ineffective |
| loss or alteration of physical function with no apparent physiological cause (e.g.: loss of use of hand / loss of vision) |
|
preoccupation with health & illness worry over minor aches believe have serious disease |
|
Sudden & temporary alteration in consciousness, identity, sensory/motor behavior, memory Dissociative AmnesiaSudden inability to recall important personal informationOften brought about by trauma Dissociative Identity Disorder/Multiple PersonalityMore than one distinct personalityEach dominant at specific time Controversial Extremely rare |
You can ask the same questions for all of the above that were asked about phobias. Are these disorders maladaptive ways to deal with anxiety? If so, what would be more adaptive ways? Why do some people develop these disorders and others not?
|
Types of Personality Disorders Paranoid Personality DisorderUnwarranted feelings of persecution & mistrust almost everyone. Hypersensitive to criticismFears of being exploited & losing control & independence. Sometimes appear cold, humorless, & scheming. Difficulty forming close personal relationships. Dependent Personality DisorderFearful & anxious Submissive & clinging & let others make major decisions.Act meek, humble, & affectionate Battered wives often suffer Cause - overprotective, authoritative parents. Histrionic Personality DisorderDramatic, emotional & erratic behavior.Stormy personal relationships, excessively emotional & demand praise. Narcissistic Personality DisorderExtremely exaggerated sense of self importance.Show lack of caring for others. |
While the true cause of such disorders is not known, learning certainly appears to be a possibility. It is definitely not biochemical and it is hard to see how anxiety is a major contributor. What kind of treatment would you think would be effective with this type of disorder?
|
Antisocial Personality Disorder Most widely recognized.Egocentric & irresponsible behavior that violates rights of others (lying, theft, delinquency) Lack of guilt feelings (lack of fear of punishment) Superficially charming but with destructive & reckless behavior. Relatively unsocialized adults who lie, don't follow rules & have much conflict. They blame others for any problems as well as their behavior. May be genetic factor - autonomic nervous system has decreased arousal. First seen in family interactions. (must be over 18). Child Abuse (may be physical, sexual, or emotional) Not a personality disorder but is symptom of those with. |
|
Personality & Sexual Disorders May appear quite normal in most situationsTend to rely on ineffective child management techniques.Some hope in training. Sexual Deviations Fetishism - sexual gratification from objects rather than people. Transvestic Fetishism - cross dressing Voyeurism - peeping Toms.ExhibitionismPedophilia - sex with children.Sexual sadism & sexual MasochismLearnedRapeA violent crimeGenerally not impulsive but planned. |
| Flash Cards |
Bipolar Disorderswere known as manic-depressive disorders Manic phase - rapid speech, impulsivity, reduced sleep Easily distractedGet angry when things don't go their way Seem to have boundless energy. Depressed phase - moody, sad & feelings of hopelessness.Major Depressive Disorders - 14 millionExtreme & persistent sadness, despair, & loss of interest. Seem to be constantly depressed |
Most of the evidence for mood disorders and schizophrenia suggests a biochemical imbalance is an important contributor. There is a strong genetic component indicated. Suppose someone had a genetic predisposition for one of these disorders, what could they do to prevent their development?
Dysthymic disorderLoss of interest in almost all of life activities.Sad, hopeless, poor sleep, loss of appetite, energy Feelings of unworthiness & guilt. Delusions - often induce feelings of guilt, shame, & persecution. Poor at reality testing Onset & Duration Onset before 40 May occur in episodes Women twice a likely to suffer from depression. Has increased 10 fold in 2 generations US prevalence appears related to loss of faith in family, country, & religion Evaluation Causes Biological Theories Genetic relationship N biochemical hypothesis - level too low. May be many different causes. Learning & Cognitive Theories Exposed to depressive models Few positive reinforcements Develop negative expectations Learned Helplessness Happens whenever all goals and plans are thwarted. Acquire low self esteem Caused by environment |
In addition to a major depressive disorder, consider depression as on a continuum from very mild to incapacitating.
Considered Psychotic Essential CharacteristicsThought disorder - Difficulty maintaining logical thought & coherent conversation - DelusionsPerceptual Disorder - Hallucinations Emotional Disorders - Inappropriate Affect |
|
Types of Schizophrenia Disorganized TypeParanoid type Catatonic Type Undifferentiated Type |
| Flash Cards |
|
Normal or Abnormal? 2. Wanda has visions and hallucinations that she often uses to guide her important decisions. 3. Alana always covers her face when she goes out in public. 4. Tanya hears voices speaking only to her whenever she turns on television, but she is not upset about it. 5. Sam is afraid of snakes. 6. Sally is vaguely dissatisfies that she is not living up to her potential. 7. Sandy has been plotting to assassinate the governor next time she appears locally. 8. Harry is so fearful of crowds that he can no longer ride the bus to work. 9. Luke often urinates on the street. |
You can see from the above questions that abnormal behavior is on a continuum from very mild to very severe. What are the primary characteristics that allow you to make the distinction from normal to abnormal?
| Use your clinical skills HERE |