Abnormal Psychology - Lecture notes - Lecture 1 PDF

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PSYC 180: Lecture 1 What is abnormal? It is predicted that 2020, mental disorders will affect of the population Medical Student Syndrome when you see symptoms of a disorder you read in a text and you believe you have that disorder Defining Abnormal Behavior o Psychopathology examines the nature and ...

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PSYC 180: Lecture 1    

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What is abnormal? It is predicted that by 2020, mental disorders will affect 46.4% of the population Medical Student Syndrome – when you see symptoms of a disorder you read in a text and you believe you have that disorder Defining Abnormal Behavior o Psychopathology examines the nature and development of abnormal  Behavior  Thoughts  Feelings o Definitions of abnormality vary widely and may not capture all aspects of psychopathology Is this behavior abnormal? o Robert has been coming to work late this week, and his eyes are puffy and he looks miserable. He tries to work, but he mostly sits at his desk weeping o Lisa is uncomfortable riding elevators o Mary was caught sitting in the corner of her bedroom sucking on her thumb o Ken was arrested last week because he was painted blue and sitting naked in a tree  It depends on the context What is Abnormal? o Statistical deviance  Statistical infrequency suggests that rare behaviors are abnormal  Normal curve indicates that behaviors are common while others are rare o Common behaviors are at the middle of normal curve o Rare behaviors fall at the tails of the curve  Disorders affect almost half of lifetime o Violation of societal norms (Szasz) o Dysfunctional impairment/maladaptiveness o Distress/suffering o Danger (self and other) o Social discomfort o Treatment seeking o Irrationality and Incomprehensibility o Closeness to prototype of abnormality What is Abnormal? o Contrasting abnormal with normal  Rosenhan (1973) “On being sane in insane places”  Rosenhan Study: Notes about patient  “This white 39 year old…manifests a long history of considerable ambivalence in close relationships, which begins in early childhood. A warm relationship with his mother cools during his adolescence. A distant relationship with his father is described as becoming very

intense. Affective stability is absent. His attempts to control emotionality with his wife and children are punctuated by angry outbursts and, in the case of the children, spankings. And while he says that he has several good friends, one senses considerable ambivalence embedded in those relationships also…” 

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Myths o Mentally disturbed people can always be recognized by their consistently deviant abnormal behavior Reality o Distinguishing patients from staff even within psychiatric wards is often difficult o There is no clear dividing line between “normal” and “abnormal” Myth o The mentally disturbed person is unstable and potentially dangerous Reality o It is the occasional mental patient who commits a crime o This myth has been perpetuated by the media Why Do We Need Diagnoses? o Nomenclature to structure information  Describe, explain and predict  Formulate theories  Advance research  Advance treatment Disadvantages of Diagnoses o May not apply to individual o Difficult to capture developmental changes o Serve as a label for administrative functions o Stigma o Stereotyping o Misuse of labels The Four Characteristics of Stigma o Distinguishing label is applied o Label refers to undesirable attributes o People with the label are seen as different o People with the label are discriminated against Diagnostic classification systems do not classify people; they classify the disorders that people have DSM-5 Definition o Biological, psychological, or developmental dysfunction in individual  Clinically significant disturbance in behavior, emotional regulation, or cognitive function  Associated with distress or disability o Not just: culturally inappropriate, statistically deviant, conflict between individual and society DSM-5 Categories o Anxiety disorders

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Obsessive-compulsive and related disorders Trauma and stressor-related disorders Dissociative disorders Depressive disorders Bipolar and related disorders  Bipolar and related disorders Substance-use and addictive disorders Somatic symptom disorders Feeding and eating disorders  Involve under- or over-eating Sexual dysfunctions Gender dysphoria Paraphilic disorders Schizophrenia-spectrum and other psychotic disorders  Involves faulty contact with reality  May involve delusions (disordered thoughts) Personality disorders  Involve enduring, inflexible and maladaptive patterns of behavior and inner experience  Neurodevelopmental disorders  Elimination disorders  Sleep-wake disorders  Disruptive, impulse-control and conduct disorders  Neurocognitive disorders

Lecture 2: Research Methods in Clinical Psychology  

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Scientific Method: Observation, manipulation, and measurement (OMM) Case study: the in-depth study of one individual o Good way for beginning hypothesis; but not the best for an entire/general experiment o Really looking at where, when, who, why, how Jeff Ingram o Woke up in Denver with $8 and no memory of how he got there or who he was. Wandered the streets until he was picked up and placed in a hospital for testing. Made public appeals on TV for anyone who might know his identity o His fiancé’s brother saw him and called her o Denver police detectives accompanied him on a flight back to Olympia, Washington to be reunited with Penny o Had previous episodes in 1995, disappearing for 9 months, ending up in a Seattle hospital o This time (September, 2006), had started a trip to Alberta, Canada to visit a friend dying of cancer o His car, a greenish-blue colored Neon, is still missing. His ability to cook is gone as well as his driving skills  Dissociative fugue Case Study o Advantages  Rich detail and history  Can be hypothesis driven  Useful for rare disorders  Formulation of new hypothesis/treatment development o Disadvantages  Uncontrolled environment  Cannot infer causality  Cannot rule out alternative hypotheses or placebo effects; may be many “active” ingredients  Effect may be specific to case and not generalizable Correlational Method o Do variable X and variable Y vary together?  Are they related in a systematic way?  Do people who experience more stress have more headaches> o Variables measured but not manipulated o Cannot determine cause or effect Correlational vs. Experimental Studies o Correlation  All participants complete same measures  measure recent life stress  measure blood pressure  correlate life stress and blood pressure o Experiment

All participants randomly assigned   give speech in front of an audience OR sit quietly  measure blood pressure  compare blood pressure readings of the two groups Measuring Correlation o Correlation Coefficient  Varies from -1.0 to +1.0  E.g, +.9, -.65, +.32, -.70 o Strength  The higher the absolute value the stronger the relationship  (-.9 > +.6; +.9 > -.8) o Direction  Positive  Higher scores on Var X associated with higher scores on Var Y  Negative  Higher scores on Var X associated with lower scores on Var Y Scatter Diagrams 

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o Correlation can be miscalculated; for example: the relationship between stork populations and human birth rates

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o o Outliers can help misconstrue information on a graph/regression plot line o Other outside/confounding variables can affect correlation Correlational Method o Advantages  Non-invasive  Get information about degree and pattern of a relationship between variables  Feasible o Disadvantages  Cannot infer causality  Variable A could cause variable B  Variable B could cause variable A  Variable A and variable B could both be caused by variable C  Variables A and B could both be involved in a complex pattern of variables influencing A and B in similar ways Epidemiological Research o Epidemiology  Study of the distribution of disorders in a population o Three features of a disorder  Prevalence: Proportion of active cases of a disorder  Incidence: Occurrence/Number of new cases (onset) of a disorder  Risk factors Mental disorders in America o National Comorbidity Survey – Replicaation  Lifetime prevalence: 46.4% (age 18 and older)  Lifetime comorbidity: co-occurrence of 2 or more disorders  28% had 2+ disorders  17% had 3+ disorders  50% all lifetime cases start by age 14 and 75% by age 24  Comorbidity: the occurrence of 2 or more diseases in an individual

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Most Common Individual DSM-IV Disorders o Major depressive disorder o Alcohol abuse o Specific phobia o Social phobia o Conduct disorder Observational design o 2 Populations  2 samples  data collection (survey/assessment)  analyze responses  compare responses between groups Longitudinal Design: study same participants over time (Harvard) o Advantages  Study changes over time  “Real life” value  Temporal order in prospective designs o Disadvantages  Not a controlled experiment  Multiple factors of influence  Feasibility (attrition, cost)  Changes in assessment/diagnostic criteria over time o Harvard study – 4 month old babies studied in terms of social interaction until 18 years old Quasi-experimental design o 2 Populations  2 samples  Baseline assessment  treatment condition  postassessment  compare responses between groups Experimental Design o Population  sample  baseline assessment  Treatment condition AND control condition  post-assessment of both groups  compare responses between groups The Experiment o Provides information about causal relationships o Involves  Independent variable  Random assignment  Dependent variable o Can evaluate treatment effectiveness o Experimental effect  Differences between groups o Internal validity  Extent to which experimental effect is due to independent variable o Control group  Participants who do not receive treatment  Standard against which treatment effectiveness is judged o Placebo  Change or improvement due to participants’ expectations o External validity

Extent to which results generalize beyond the study  Would Pennebaker results apply to non-college age participants? Analogue Experiment o Experiments not always possible in psychopathology  Ethical or practical constraints o Examine related or similar behavior in the lab  Elicit stress or sadness  College students who tend to be anxious  Animal research Single-Subject Experimental Research o Examine how individual participants to changes in the independent variable o Reversal (ABAB) design Experimental Design o Example  Double-blind, randomized, placebo-controlled trial of Prozac treatment in 96 children with depression  “Much” or “very much” improved:  56% of children taking Prozac  33% of children taking placebo  Double-blind, randomized, placebo-controlled trial of St. John’s wort  Full response:  31.9% of the placebo-treated patients  23.9% of the St. John’s wort-treated patients o Advantages  Controlled environment  Closest we can get to inferring causality o Disadvantages  Feasibility  Artificial environment  Demand effects Integrating Findings from Multiple Studies o Meta-analysis  Identity relevant studies  Compute effect size  Transforms results to a common scale o Smith et al. (1980)  Meta-analyzed 475 outcome studies  Results: psychotherapy is effective o The researcher defines which studies will be included  the effect size within each study is calculated  the average effect size across studies is calculated 

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Lecture 3: PSYC 180 – Historical Overview 

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Historical Views of Abnormal Behavior o Ancient Treatment  Stone age trephining involved chipping away a circular section of skull  The Edwin Smith and Ebers papyri indicate that the Egyptians used surgery and prayers o People were treated differently if thought to be possessed by good spirits rather than evil spirits o Exorcism was the primary treatment for demonic possession o Hippocrates’ early medical concepts included  Proposing that mental disorders had natural causes  Categorizing disorders as mania, melancholia or phrenitis  Associating dreams and personality  Cause for disorder (Hippocrates/Galen): 4 humors – blood/phlegm/bile/black bile o Plato  Viewed psychological phenomena as responses to the whole organism  Emphasized individual differences and sociocultural influences  Discussed hospital care o Aristotle wrote a lasting description of consciousness o Later Greek and Roman Thought  Egyptians proposed a wide range of therapeutic measures  Galen provided an anatomy of the nervous system  Comfort was key to Roman medicine Abnormality During the Middle Ages o The Middle East had a scientific approach o Europe was plagued with mass madness such as  Tarantism/Saint Vitus’ dance  Lycanthropy o Exorcism was still a popular European treatment o The extent of people’s fear of witchcraft is now questioned Toward Humanitarian Approaches o The Renaissance led to a resurgence of scientific questioning in Europe o The sixteenth century saw the establishment of early asylums and shrines  These were often no more than prisons, e.g. Bedlam in London or Lunatic’s Tower in Vienna or very crude treatments Humanitarian Reform o In France, Pinel successfully experimented with treating mental patients with kindness o A man named Tuke performed similar work in England o Benjamin Rush pushed moral management in America  From 1841 to 1881, Dorothy Dix carried on a zealous campaign about the inhumane treatment of the mentally ill Nineteenth-Century Views of Mental Disorders o Medical professionals, or alienists, gained control of the asylums

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o Alienists touted morality as important to good mental health Changing Attitudes Toward Mental Health in the Early 20th Century o Clifford Beers described his own mental collapse in A Mind That Found Itself o Beers then began a campaign for reform Mental Hospital Care in the 20th Century o In 1940, most mental hospitals were harsh, inhumane, and ineffective o Mary Jane Ward published The Snake Pit, which called attention to the plight of mental patients o The organization of the National Institute of Mental Health and the passage of the HillBurton Act further reformed care o The Community Health Services Act was passed in 1963 o Deinstitutionalization lead to mixed results Contemporary Views of Abnormal Behavior o Recent changes include:  Biological discoveries  The development of a classification system for mental disorders  The emergence of psychological causation views  Experimental psychological research developments Establishing the Link Between the Brain and Mental Disorder o Understanding was greatly increased by  Technological discoveries  Scientific advancements in the biological sciences o The discovery of a connection between general paresis and syphilis was a major milestone o Emil Kraepelin’s Lehrbuch der Psychiatrie marked the beginning of a classification system Early Biological Treatments o Insulin-coma therapy o ECT o Surgical methods; e.g. lobotomy Causation Views Establishing the Psychological Basis of Mental Disorder o Mesmerism  Involved treating diseases by “animal magnetism”  Was a source of heated discussion in the 19th century o Scientists at the Nancy School proposed that hysteria could be both caused and removed by hypnosis Early Views of Psychopathology o Somatogenesis is the view that disturbed body function produces mental abnormality o Psychogenesis is the belief that mental disturbance has psychological origins Models of Psychopathology o Biogenic  Neuroanatomical  Biochemical  Genetics

Psychosocial Explanations  Psychoanalytic models  Humanistic existential models  Behavioral models  Cognitive models  Family systems models  Multicultural models Causation Views: Establishing the Psychological Basis of Mental Disorder o Sigmund Freud (1856-1939) took the first major steps toward understanding psychological factors in mental disorders o His theories have evolved into the psychoanalytic perspective o Psychoanalysis emphasizes the inner dynamics of unconscious motives The Psychoanalytic Paradigm o The core assumption of the psychoanalytic paradigm is that abnormal behavior reflects unconscious conflicts within the person o The psychoanalytic paradigm is derived from the theories of personality developed by Sigmund Freud Freud’s Legacy o Freud enduring contributions include:  Childhood experiences help shape adult personality  There are unconscious influences on personality  Defense mechanisms help to control anxiety  The causes and purposes of human behavior are not always obvious Evolution of the Psychological Research Tradition o Wilhelm Wundt established the first experimental psychological laboratory at the University of Leipzig o J. McKeen Cattell brought Wundt’s methods to the United States o Lightner Witmer established the first American psychological clinic at the University of Pennsylvania o Soon after, the first psychological journals hit the press Behavior Paradigm o Focus on environmental influences and observable behavior; Behaviorism o Learning  The process whereby behavior changes in response to the environment o Key Figures  Pavlov  Watson  Thorndike  Skinner  Bandura The Behavioral Perspective o Classical conditioning  Ivan Pavlov demonstrated that dogs will salivate to a nonfood stimulus once regularly accompanied by food o

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 John B. Watson emphasized the study of overt behavior Operant Conditioning  E.L. Thorndike and B.F. Skinner studied how the consequences of behavior influence behavior Modeling/observational learning  Bandura

PSYC 180 Lecture 4: Current Paradigms: Causal Factors and Viewpoints 

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Etiology: Causal pattern of abnormal behavior o Necessary cause o Sufficient cause  You have almost no sufficient clause o Contributory cause Diathesis-Stress Model o Integrative mode that incorporates multiple causal factors o Diathesis  Underlying predisposition  May be biological or psychological  Increases one’s risk of developing disorder o Stress  Environmental events  May occur at any point after conception  Triggering event Which of the following is a sufficient element to determine abnormality? o Suffering, maladaptiveness, deviancy, there is no single sufficient element  D. There is no single sufficient element All of the following are disadvantages of classifying and diagnosing mental disorders except o Structure o (Stereotyping, stigma, and labeling are disadvantages) The emergence of humanism brought about changes in all of the following except o An increase in the belief in supernatural causes o Scientific questioning o More human treatment o Fewer superstitious beliefs about demonic possession What is Clifford Beers known for? o He publicized the brutal treatment that many mental patients received Diathesis-Stress Models o Additive Model vs Interacting Model

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Models of Psychopathology:  Biogenic  Neuroanatomical  Biochemical  Genetics  Psychosocial Explanations  Psychoanalytic models  Hymanistic existential models  Behavioral models  Cognitive models  Family systems models  Multicultural models Psychodynamic Paradigm Freud’s Model of the Mind o Freud suggested that the mind is composed of three parts:  Id is the raw energy that powers the mind  Id seeks gratification of basic urges for food, water, warmth, affection, and sex  Id processes are unconscious  Ego is a conscious part of the mind that deals with reality  Superego is the final part of the mind to emerge and is similar to the conscience Freud’s Model of Personality Structure o Conscious – contact with outside world o Preconscious – Material just beneath the ...