Chapter 10

Abnormal Psychology
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Topics to Explore

1. Defining & Classifying Disorders
2. Three Categories of Disorders
3. Treatment of Mental Disorders



Part 1
Defining & Classifying
Mental Disorders
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Abnormal Psychology: the scientific study of mental
disorders and their treatment
What is Abnormal Psychology?
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Subjective Discomfort: Feelings of anxiety, depression,
or emotional distress. But people we would consider
definitely abnormal may not feel subjective discomfort.
Social Nonconformity: Disobeying societal standards for
normal conduct; usually leads to destructive or self-
destructive behavior. But it doesnt always. Is being a
nonconformist always a disorder? 1984!
Statistical Abnormality: Having extreme scores on some
dimension, such as intelligence, anxiety, or depression.
But having a numerically rare characteristic isnt always a
disorder (e.g., having an IQ of 180)
Ways of Defining Abnormal
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Statistically Abnormal
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Situational Context: Social situation, behavioral setting, or
general circumstances in which an action takes place
Is it normal to walk around strangers naked? If you are in a
locker room and in the shower area, yes!
Cultural Relativity: Judgments are made relative to the
values of ones culture
Two Considerations
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Maladaptive Behavior: Behavior that makes it difficult to
function, to adapt to the environment, and to meet everyday
demands

Significant impairment in psychological functioning:
Those with mental illness lose the ability to control thoughts,
behaviors, or feelings adequately

Atypical behavior: behavior that is not typical of the
majority of the population
Three Criteria for Abnormality
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DSM-IV
DSM-IV: Diagnostic and Statistical Manual of Mental
Disorders.
Published by the American Psychiatric Association.
Provides a classification system of mental disorders.
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Some DSM-IV Categories
Mood Disorders
Anxiety Disorders
Somatoform Disorders
Factitious Disorders
Dissociative Disorders
Sexual & Gender Identity
Disorders
Eating Disorders
Sleep Disorders
Adjustment Disorders
Personality Disorders
Disorders First Diagnosed in
Childhood
Organic Mental Disorders
Substance Related Disorders
Schizoprenia Disorders
Paranoid Disorders
Impulse Control Disorders
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Social Conditions: Poverty, homelessness, overcrowding,
stressful living conditions
Family Factors: Parents who are immature, mentally ill,
abusive, or criminal; poor child discipline; severe marital or
relationship problems
Psychological Factors: Low intelligence, stress, learning
disorders
Biological Factors: Genetic defects or inherited vulnerabilities;
poor prenatal care, head injuries, exposure to toxins, chronic
physical illness, or disability
General Risk Factors
for Mental Illness
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Incidence of Mental Disorders
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Insanity: A legal term; refers to an inability to manage ones affairs
or to be aware of the consequences of ones actions
Those judged insane (by a court of law) are not held legally
accountable for their actions
Can be involuntarily committed to a psychiatric hospital
Some movements today are trying to abolish the insanity plea and
defense; desire to make everyone accountable for their actions

Neurosis: Archaic; once used to refer to excessive anxiety,
somatoform, dissociative disorders, and some kinds of depression

Clarifying Some Terms



Part 2
Three Major Categories
of Mental Disorders
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Anxiety: Feelings of apprehension, dread, or uneasiness
Anxiety Disorder: a disorder in which excessive anxiety
leads to personal distress and atypical, maladaptive, and
irrational behavior
Anxiety Disorders
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Specific Phobias: Irrational, persistent fears, anxiety, and
avoidance that focus on specific objects, activities, or
situations

People with phobias realize that their fears are unreasonable
and excessive, but they cannot control them
Specific Phobias
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Some Phobias
See in class!
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Social Phobia: Intense, irrational fear of being observed,
evaluated, humiliated, or embarrassed by others (e.g., shyness,
eating, or speaking in public)

Those with social phobia avoid social situations, such as eating,
writing, or speaking in public.

Social phobias impair functioning at work, at school, and in
personal relationships.

Estimate that 13% of all adults affected by social phobias at
some time. Examples: Barbra Streisand, Woody Allen perhaps?
Social Phobia
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Agoraphobia: Intense, irrational fear that a panic attack will
occur in a public place or in an unfamiliar situation
Intense fear of leaving the house or entering unfamiliar
situations
Can be very crippling
Literally means fear of open places or market (agora)
Can occur with or without accompany panic disorder.
Agoraphobia
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Panic Disorder: A chronic state of anxiety with brief moments
of sudden, intense, unexpected panic (panic attack)

Panic Attack: Feels like one is having a heart attack, going to
die, or is going insane. Symptoms include vertigo, chest pain,
choking, fear of losing control
Panic Disorder
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Generalized Anxiety Disorder (GAD): Duration of at least six
months of chronic, unrealistic, or excessive anxiety

Symptoms: sweating, racing heart, clammy hands, dizziness,
upset stomach, rapid breathing, irritability, poor concentration.

More common in women than in men.
Generalized Anxiety Disorder
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Obsessive-Compulsive Disorder (OCD): Extreme preoccupation
with certain thoughts and compulsive performance of certain
behaviors
Obsession: Recurring images or thoughts that a person cannot
prevent.
Cause anxiety and extreme discomfort
Enter into consciousness against the persons will
Most common: Being dirty, wondering if you performed an action
(turned off the stove), or worrying about violence (being hit by a car)
Compulsion: Irrational acts that person feels compelled to repeat
against his/her will
Help to control anxiety created by obsessions
Most compulsions involve either checking or cleaning something.
Obsessive-Compulsive Disorder
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Mood Disorders: Major disturbances in emotion, such as
depression or mania
Depressive Disorders: Sadness or despondency that are
prolonged, exaggerated, or unreasonable
Bipolar Disorders: Involve both depression and mania or
hypomania
Mood Disorders
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Maternity Blues: Mild depression that lasts for one to two days
after childbirth
Marked by crying, fitful sleep, tension, anger, and irritability
Brief and not too severe
Postpartum Depression: Moderately severe depression that
begins within three months following childbirth
Marked by mood swings, despondency, feelings of
inadequacy, and an inability to cope with the new baby
May last from two months to one year
Part of the problem may be hormonal
Childbirth-related
Mood Disorders
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Psychosis: Loss of contact with shared views of reality
Delusions: False beliefs that psychotic individuals insist are
true, regardless of overwhelming evidence against them
Hallucinations: Imaginary sensations, such as seeing,
hearing, or smelling things that do not exist in the real world
Most common psychotic hallucination is hearing voices
Note that olfactory hallucinations sometimes occur with
seizure disorder (epilepsy)
Psychotic Disorders
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Flat Affect: Lack of emotional responsiveness; face is frozen in
blank expression
Disturbed Verbal Communication: Garbled and chaotic
speech; word salad
Personality Disintegration: Uncoordinated thoughts, actions,
and emotions
Other Psychotic Symptoms
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The Mad Hatter
In Lewis Carrolls time, hatmakers were heavily exposed to mercury
used in making felt. Many suffered brain damage and became
psychotic; thus, the Mad Hatter.
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Schizophrenia: Psychotic disorder characterized by
hallucinations, delusions, apathy, thinking abnormalities, and
split between thoughts and emotions

Does NOT refer to having split or multiple personalities
Schizophrenia:
The Most Severe Disorder
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Disorganized Type: Incoherence, grossly disorganized
behavior, bizarre thinking, and flat or inappropriate emotions
Catatonic Type: Marked by stupor, unresponsiveness,
posturing, and mutism
Paranoid Type: Preoccupation with delusions; also involves
hallucinations that are related to a single theme, especially
grandeur or persecution
Undifferentiated Type: Any type of schizophrenia that does
not have paranoid, catatonic, or disorganized features or
symptoms
Four Types of Schizophrenia
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Psychological Trauma: Psychological injury or shock, often
caused by violence, abuse, or neglect
Disturbed Family Environment: Stressful or unhealthy
family relationships, communication patterns, and emotional
atmosphere
Deviant Communication Patterns: Cause guilt, anxiety,
anger, confusion, and turmoil
Stress-Vulnerability Hypothesis: Combination of
environmental stress and inherited susceptibility cause
schizophrenic disorders
Causes of Schizophrenia
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Stress-Vulnerability Model
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Biochemical Abnormality: Disturbance in brains chemical
systems or in the brains neurotransmitters
Dopamine: Neurotransmitter involved with emotions and
muscle movement. Works in limbic system
Dopamine overactivity in brain may be related to
schizophrenia
Biochemical Causes
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Genetic Predisposition
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PET Scans of
Normal & Schizophrenic Brains
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Schizophrenic Patients
10 Years Later



Part 3
Treatment of Mental Disorders
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Types of Therapists
Clinical psychologist: has doctoral degree in clinical psychology;
provides therapy for people with mental disorders
Counseling psychologist: has doctoral degree in psychological or
educational counseling; counsels people with milder problems
Psychiatrist: has medical degree with residency in mental health,
provides therapy for people with mental disorders and is only type of
therapist who can prescribe drugs or other biomedical treatment
Psychoanalyst: Any of the above types of credential, but with
training in psychoanalysis from a psychoanalytic institute
Clinical social worker: has masters or doctoral degree in social
work with specialized training in counseling; provides help with social
problems, such as family problems.
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Biomedical Therapies
Biomedical therapies: medical treatment for mental disorders;
includes drug therapy and medical procedures treating the brain
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Pharmacotherapy: Use of drugs to alleviate emotional
disturbance; three classes:
Antianxiety (Minor Tranquilizers): Produce relaxation or reduce
anxiety (Valium, Lithium, Zanax)
Antidepressants: Elevate mood and combat depression (Elavil,
Paxil, Prozac, Zoloft)
Antipsychotics (Major Tranquilizers): Tranquilize and also
reduce hallucinations and delusions in larger dosages
(Thorazine, Clozaril)

Pharmacotherapy
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Problems with Drug Therapy
There can be serious side-effects (tranquilizers can cause
neurological disorders; Clozaril associated with a fatal blood
disorder)
Drugs do not cure the disorder; they only ameliorate the
symptoms.
Reliance on drugs increase belief in the quick fix; belief that
any disorder can be cured with a pill.
Generally, psychotherapy is needed in addition to medication.
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Electroconvulsive Therapy (ECT): Electric shock is passed
through the brain inducing a convulsion.
Based on belief that seizure alleviates depression by altering
brain chemistry
Used in treatment of depression
Produces only temporary improvement
Causes permanent memory loss in many patients
Should only be used as a last resort
Shock Therapy
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Psychosurgery: Any surgical alteration of the brain

Prefrontal Lobotomy: Frontal lobes in brain are surgically cut
from other brain areas
Supposed to calm people who did not respond to other forms
of treatment
Was not very successful

Deep Lesioning: Small target areas in the brain are destroyed
by using an electrode
Psychosurgery
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Psychotherapy: Any psychological technique used to facilitate
positive changes in personality, behavior, or adjustment;
Some types of psychotherapy:
Psychoanalysis: therapy based on Freuds theory
Client-centered therapy: based on Humanism
Behavioral and Cognitive therapies
What is Psychotherapy?
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Main Goal of Psychoanalysis: To resolve internal conflicts that
lead to emotional suffering
Free Association: Saying whatever comes to mind, regardless
of how embarrassing it is. By doing so without censorship and
censure, unconscious material can emerge
Dream Analysis: Dreams express forbidden desires and
unconscious feelings
Latent Content: Hidden, symbolic meaning of dreams
Manifest Content: Obvious, visible meaning of dreams
Dream Symbols: Images in dreams that have personal or
emotional meanings
Psychoanalytic Techniques
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Analysis of Resistance: analysis of blockage in flow of ideas;
topics the client resists thinking about or discussing.
Resistances reveal particularly important unconscious conflicts

Analysis of Transference: analysis of tendency to transfer
feelings to a therapist that match those the patient has for
important people in his or her past. The patient might act like
the therapist is a rejecting father, loving mother, etc.
Psychoanalytic Techniques,
continued
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Client-Centered Therapy (Rogers): Nondirective and based on
insights from conscious thoughts and feelings
Effective therapist must have four basic conditions
Unconditional Positive Regard: Unshakable acceptance of
another person, regardless of what they tell the therapist or how
they feel
Empathy: Ability to feel what another person is feeling; capacity to
take another persons point of view
Authenticity: Ability of a therapist to be genuine and honest about
his or her feelings
Reflection: Rephrasing or repeating thoughts and feelings of the
clients; helps clients become aware of what they are saying
Client-Centered (Humanistic)
Therapies
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Existential Therapy: An insight therapy that focuses on
problems of existence, such as meaning, choice, and
responsibility; emphasizes making difficult choices in life
Therapy focuses on death, freedom, isolation, and
meaninglessness
Free Will: Human ability to make choices. You can choose to
be the person you want to be
Confrontation: Clients are challenged to examine their values
and choices
Humanistic Therapies
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Behavior Therapy: Use of learning principles to make
constructive changes in behavior
Behavior Modification: Using any classical or operant
conditioning principles to directly change human behavior
Deep insight is often not necessary
Focus on the present; cannot change the past, and no reason
to alter that which has yet to occur
Can also use classical conditioning techniques
Behavioral Therapies
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Aversion Therapy: Associate a strong aversion to an
undesirable habit like smoking, overeating, drinking alcohol, or
gambling
Flooding: client is exposed to feared object or situation.
Behavioral Therapies
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Systematic Desensitization: Guided reduction in fear, anxiety,
or aversion; attained by approaching a feared stimulus gradually
while maintaining relaxation
Best used to treat phobias: intense, unrealistic fears
Hierarchy: Rank-ordered series of steps, amounts, or degrees
Reciprocal Inhibition: One emotional state is used to block
another (e.g., impossible to be anxious and relaxed at the same
time)
Behavioral Therapies
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Cognitive Therapy: Therapy that helps clients change
thinking patterns that lead to problematic behaviors or
emotions
Selective Perception: Perceiving only certain stimuli in a
larger group of possibilities
Overgeneralization: Allowing upsetting events to affect
unrelated situations
All-or-Nothing Thinking: Seeing objects and events as
absolutely right or wrong, good or bad, and so on
Cognitive therapy is VERY effective in treating depression,
shyness, and stress
Cognitive Therapy
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Rational Emotive Behavior Therapy (Albert Ellis): Attempts to
change irrational beliefs that cause emotional problems

Common Sense:
Activating Event Consequence (feelings, behavior)

Rational Emotive View:
Activating Event Beliefs Consequence (feelings, behavior)

Rational Emotive Therapy
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Rational Emotive Therapy