Tripken Abnoraml 16 Review geuide and study guid [Type text]

Abnormal Behavior - Definition: Behavior that is judged to be atypical, disturbing, maladaptive and unjustifiable. OR, distressful, deviant and dysfunctional (3 DDD)

Perspectives: IMPORTANT!!!!!!!!!!

Biological (medical model): Abnormal behavior has a biochemical or physiological basis.

Diathesis-stress model: people biologically or genetically predisposed to a disorder can develop that disorder when exposed to stress.

Psychoanalytic Model : Abnormal behavior is a result of unconscious conflicts.
Behavioral Model : Abnormal behavior is a result of faulty learning.

Cognitive Model : Abnormal behavior is a result or irrational or maladaptive ways of thinking.

Classifying Psychological Disorders

Neurotic AND TENDENCIES vs. psychiatric / Psychotic Disorders

DSM-IV: The American PsychologicalAssociation’s (APA) Diagnostic &Statistical Manual of Mental Disorders

AND ICD, International Classification of Diseases

The DSM-IV is a multiaxial system that allows assessment on several axes, each of which refers to a different domain of information that may help the clinician plan treatment and predict outcome. There are five axes included in the DSM-IV multiaxial classification:

AXIS I:Clinical Disorders. Axis I is for reporting all the various disorders or conditions except for Personality Disorders and Mental Retardation. For Example: Mood Disorders, Eating Disorders, Anxiety Disorders, etc.

AXIS II:Personality Disorders and Mental Retardation. Listing these disorders on a separate axis ensures that consideration will be given to the possible presence of Personality Disorders and Mental Retardation that might otherwise be overlooked when attention is directed to the usually more florid Axis I disorders.

AXIS III:General Medical Conditions. Axis III is for reporting medical conditions that are potentially relevant to the understanding and management of the individual’s mental disorder.

AXIS IV:Psychosocial and Environmental Problems. Axis IV is for reporting psychosocial or environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders (Axis I and Axis II). For example: educational problems, housing problems, problems with access to health care services, problems with (or lack of) primary support group, legal problems, etc.

Axis V:Global Assessment of Functioning. Axis V is for reporting the clinician’s judgment of the individual’s overall level of functioning using the Global Assessment of Functioning (GAF) scale. Clinicians rate the patient on a scale of 1 to 100 with 1 = “persistent danger of severely hurting self or others OR occasionally fails to maintain minimal personal hygiene OR gross impairment in communication” and 100 = “superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms”.

Psychological Disorders – all mental illness fall into at least one of these catagories.

Anxiety Disorders – AXIS I

Generalized Anxiety Disorder
Panic Disorder (with or without Agoraphobia)
Obsessive-Compulsive Disorder
Post-traumatic Stress Disorder
Phobias
Social Phobia
Specific Phobias

Mood (Affective) Disorders - AXIS I

Major Depressive Disorder
Mania
Bi-polar Disorder
Dysthymia
Cyclothymia

Dissociative Disorders - AXIS I

Amnesia
Fugue
Dissociative Identity Disorder

Somatoform(Body)Disorders - AXIS I

Somatization Disorder
Conversion Disorder
Hypochondriasis

Schizophrenic Disorders - AXIS I

Paranoid
Disorganized
Catatonic
Undifferentiated
Residual

Personality Disorders – AXIS II – 10 OF THEM (Description Below)

1)Schizoid

2)Paranoid

3)Dependent

4)Narcissistic

5)Histrionic

6)Obsessive-compulsive

7)Avoidant

8)Schizotypal

9)Antisocial

10)Borderline

Disorders of Childhood & Adolescence – AXIS II

Autism
Attention-deficit Hyperactivity Disorder
Learning Disabilities
Conduct Disorder

Anxiety Disorders – High metabolic/movement area in the frontal lobe = attention area of brain

Generalized Anxiety Disorder : continual tenseness & nervousness.

Panic Disorder : intense fear or terror that seems to come “out of the blue”.

Obsessive-Compulsive Disorder : person is compelled to think disturbing thoughts (obsessions) and perform senseless rituals (compulsions)

Post-Traumatic Stress Disorder : anxiety
& nightmares result from some disturbing incident from the past.

Phobic Disorder : irrational fear & avoidance of a specific object or situation.

Social Phobia (ex: public speaking)
Simple (and specific) Phobia (snakes, heights, etc.)

Agoraphobia : fear of leaving home or being in open spaces.

Explaining Anxiety Disorders

Behavioral (learning) Model: Phobia is actually anxiety based-not fear based

classical conditioning
operant conditioning (reinforcement)
generalization

observational learning (Bandura)
Biological Model:

evolution

genetics

physiology

Psychoanalytic : anxiety is a result of repressed impulses(GUILT) that begin to come into consciousness.

Somatoform Disorders – soma = body disorders

Somatization Disorder : vague, recurring physical symptoms for which no medical cause can be found.

Conversion Disorder : specific and dramatic physical disability for which no medical cause can be found (e.g., blindness, and paralysis).

Hypochondriasis : small & insignificant symptoms are interpreted as signs of serious illness.

Somatoform Disorders

Disorders in which there is an apparent physical disorder for which there is no organic basis.

Somatization Disorder:
Disorder characterized by recurrent vague somatic complaints without a physical cause (e.g., back pain, dizziness, abdominal pain, etc.)

Conversion Disorder:
Disorder in which a dramatic specific disability has no physical cause and instead seems related to psychological problems (e.g., paralysis, blindness, deafness, false pregnancy, etc.)

Hypochondriasis:
A condition in which a person interprets small and insignificant symptoms as signs of serious illness in the absence of any organic symptoms of such illness (e.g., headache = brain tumor, abdominal pain = stomach cancer).

Dissociative Disorders

Disorders in which some aspect of the personality seems fragmented from the rest, as in amnesia or multiple personality.

Dissociative Amnesia:
Loss of memory for past events. The events are usually traumatic in nature.

Dissociative Fugue:
Loss of all episodic memory. The sufferer often moves away from their hometown and begins a new life with an entirely new identity.

Dissociative Identity Disorder (formerly known as Multiple Personality Disorder):
Condition in which more that one personality seems present in a single person.

Dissociative Disorders - Disorders in which some aspect of the personality seems separated or fragmented from the rest.

Dissociative Amnesia : selective memory loss often brought about by severe stress. Dissociative Fugue : amnesia accompanied by flight from one’s home and identity. Dissociative Identity Disorder (multiple personality disorder): more than one personality seems to be present in a single individual.

Major Depressive Disorder : two or more weeks during which a person is over- whelmed by feelings of sadness, apathy, worthlessness and guilt.

Mania : state in which a person is overly excited, hyperactive, and optimistic. Bipolar Disorder : the person alternates between periods of depression & mania.

Explaining Affective Disorders (affective disorders are those with a depressive or manic component)

Disorders that effect the AFFECT - Concerned with or arousing feelings or emotions; emotional - Influenced by or resulting from the emotions, as of a psychological disorder.

Biological Model:

Genetics—runs in families, higher concordance rate in identical than fraternal twins.

Biochemical----serotonin & norepinephrine levels in the brain are low during periods of depression & high during periods of mania.

Behavioral Model:

operant conditioning—reinforcement

learned helplessness (Seligman)
Cognitive Model:

negative & irrational attributions—
explain bad events in terms that are stable, global, and internal (Beck)

Depression’s vicious cycle: stress--> negative explanations-->depressed mood-->cognitive & behavioral changes-->stress

Criteria for a Manic Episode

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting atleast one week (or any duration if hospitalization is necessary).

B. During the period of mood disturbance, three (or more) of the following symptoms havepersisted (four if the mood is only irritable) and have been present to a significant degree:

1. inflated self-esteem or grandiosity

2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

3. more talkative than usual or pressure to keep talking

4. flight of ideas or subjective experience that thoughts are racing

5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6. increase in goal-directed activity (either socially, at work or school, or sexually) orpsychomotor agitation

7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, orfoolish business investments)

C. The symptoms do not meet the criteria for a "mixed episode"

D. The mood disturbance is significantly severe to cause marked impairment in occupational
functioning or in usual social activities or relationships with others, or to necessitate
hospitalization to prevent harm to self or others, or there are psychotic features.

E. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse,
a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).

Criteria for a Hypomania

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least
four days, that is clearly different from the usual nondepressed mood.

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if
the mood is only irritable) and have been present to a significant degree:

1. inflated self-esteem or grandiosity

2. decreased need for sleep (e.g., feels rested after only 3 hours of sleep)

3. more talkative than usual or pressure to keep talking

4. flight of ideas or subjective experience that thoughts are racing

5. distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli)

6. increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation

7. excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g.,
engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)

C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person
when not symptomatic.

D. The disturbance in mood and the change in functioning are observable by others.

E. The episode is not severe enough to cause marked impairment in social or occupational functioning,
or to necessitate hospitalization, and there are no psychotic features.

F. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse,
a medication, or other treatment), or a general medical condition (e.g., hyperthyroidism).

Major Depressive Disorder

Patients with this disorder have had one or more Major Depressive Episodes, but have never had a manic episode, mixed episode, or hypomanic episode.

Criteria for a Major Depressive Episode

  1. Five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
  1. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or by observation made by others e.g., "appears tearful").
  2. markedly diminished interest or pleasure in all, or almost all, activities most of the day nearly every day (as indicated by either subjective account or observation made by others).
  3. significant weight loss while not dieting or weight gain (i.e., a change of more then 5% of body weight in a month), or a decrease or increase in appetite nearly every day.
  1. insomnia or hypersomnia (too much sleep) nearly every day.
  2. psychomotor agitation(pacing, jitters) or retardation (lethargic) nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

6. fatique or loss of energy nearly every day.

7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

8. diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

9. recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

B. The symptoms do not meet the criteria for a "mixed episode".

C. The symptoms cause clinically significant distress or impairment in social, occupational,or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance abuse or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by bereavement, (i.e., after the loss of a loved one).

Criteria for Bipolar Disorder

For the purposes of tests in this class and the AP Psychology Exam, you only need know that bipolar disorder is:

An affective disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

In actuality there are two broad categories of bipolar disorder: Bipolar I and Bipolar II.

Bipolar I Disorder:

In general, the individual suffers from Manic Episodes along with Major Depressive Episodes or Mixed Episodes. (Or, the patient cycles between manic episodes normal mood.)

Bipolar II Disorder

Patients with this disorder have had at least one Major Depressive Episode, at least one Hypomanic Episode, and no Manic Episodes or Mixed Episodes.

Personality DisordersAXIS II, 10 of them

A person exhibits inflexible & maladaptive ways of thinking and behaving that impair social functioning.

Dependent: Disorder in which a person in unable to make choices and decisions independently and cannot tolerate being alone.

Histrionic: Disorder characterized by excessive emotionality and attention-seeking behavior.

Narcissistic: Disorder in which a person has an exaggerated sense of self-importance and needs constant admiration.

Antisocial: Disorder characterized by a pervasive pattern of disregard for and violation of the rights of others, deceitfulness, irresponsibility, impulsiveness, and lack of remorse.

Obsessive-compulsive: Disorder characterized by perfectionism and inflexibility.

Passive-aggressive: Disorder characterized by passive resistance to performing tasks or doing things others request. Anger is expressed by covert means.

Schizoid: Disorder characterized by limited emotion and a lack of interest in close relationships with others.

Avoidant: Disorder characterized by discomfort in social situations, fear of evaluation, and timidity.

Paranoid: Disorder in which a person is inappropriately suspicious and mistrustful of others.

Schizotypal: Disorder in which a person exhibits extremely odd behavior and thought patterns, but the person is not actively psychotic.

Borderline: Disorder characterized by a pervasive pattern of instability in interpersonal relationships, self-image, emotional control, and self-control.

Schizophrenic Disorders – AXIS I

Disturbances in thought, communication, emotions, & perceptions. May include:

Hallucinations: false sensory perceptions

Delusions: false beliefs about reality
Positive Symptoms(add to the disorder…..+speech, delusions, etc) : incoherent speech, hallucinations, delusions, “strange”

behavior

Negative Symptoms(take away….no appetite, sleeplessness) : motionlessness, stupor, lack of emotion (flat affect)

Schizophrenic Subtypes

1)Disorganized : bizarre speech & behavior— Flat or inappropriate affect.

2)Catatonic : disturbed motor behavior— immobility or excessive movement. Mimicking of others’ speech & movements or “waxy flexibility”.

3)Paranoid : excessive suspiciousness & complex, bizarre delusions.

4)Undifferentiated : symptoms from more than one of the above categories.

Symptoms of Schizophrenia

Positive vs. Negative Symptom

Positive Symptoms reflect an excess or distortion of normal functioning. Positive symptoms include: (1) delusions, or false beliefs about reality; (2)hallucinations, or false sensory perceptions; and (3) severely disorganized thought processes (thought disorder), speech, and behavior.

Negative Symptoms reflect a restriction or reduction of normal functions, such as greatly reduced motivation, movement, emotional expressiveness ( flat or blunted affect), or speech (poverty of speech).

Delusions and Hallucinations

Delusions: Falsely held beliefs that persist in spite of contradictory evidence.

  • Delusions of Grandeur: Sufferers believe they are extremely powerful, important, wealthy, or famous. People may believe they are the reincarnation of some famous or powerful person, such as Jesus Christ, the Virgin Mary, Satan, Marilyn Monroe, or Elvis Presley.
  • Delusions of Persecution: Sufferers believe that others are plotting against them or trying to harm them. For example, sufferers might believe that the CIA is after them, that aliens are harming them with "cosmic rays", or that family members are trying to poison them.

Hallucinations: False or distorted perceptions that seem vividly real to the person experiencing them. Over 60% of schizophrenics report auditory hallucinations; 30% report visual hallucinations; 15% report tactile hallucinations; and about 10% report gustatory and/or olfactory hallucinations.

Onset, Course, and Prognosis

Chronic (or Process) Schizophrenia: Symptoms develop gradually, emerging from a long history of social inadequacy. Those with chronic (process) schizophrenia have a much poorer prognosis. Recovery is unlikely. (While not a hard and fast rule, these individuals tend to exhibit more of the "negative" symptoms described above.)

Acute (or Reactive) Schizophrenia: Symptoms develop suddenly, seemingly as a reaction to stress. Those with acute (reactive) schizophrenia have a better prognosis. They tend to respond more positively to drug therapy. (Again, while not a hard and fast rule, these individuals ten to exhibit more of the "positive" symptoms described above.)

Development of Schizophrenia
Acute (reactive) : Sudden onset—best prognosis.

Chronic (process) : Slower development over a long period of time—worse prognosis

Explaining Schizophrenia

Brain anatomy:
large ventricles & shrinkage of

cerebral tissue

Genetics:
more common in people with a closerelative who has the disorder (e.g., 50%concordance in identical twins, 16% infraternal twins.

Prenatal virus: (still under study)

Biochemical: too many dopamine receptors in the brain.

___ 1. / Which of the following is true concerning abnormal behavior?
A) / Definitions of abnormal behavior are culture-dependent.
B) / A behavior cannot be defined as abnormal unless it is considered harmful to society.
C) / Abnormal behavior can be defined as any behavior that is distressful.
D) / Definitions of abnormal behavior are based on physiological factors.