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(Out lined)By: Claire Irish D. BorjaReference: Bar low D, Durand and Hofmann S (2 0 1 8). Abnormal psychology: an int egrat ive appr oach, 8 th ed. NewYork: Nelson Educat ion, Lt d.A bnormal P sych ol ogyUNDERSTANDING PSYCHOPATHOLOGYWhat is Psychological Disorder? Psychological Disorder It is a psyc...

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| A bnormal P sych ology 1

A bn or ma l P sych ol ogy (Out lined)

By:

Claire Irish D. Borja

Ref erence: Barlow D.H, Durand and Hofmann S.G (2 0 1 8 ). Abnormal psychology: an int egrat ive approach, 8 t h ed. New York: Nelson Educat ion, Lt d.

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Abnormal Behavior in Historical Context 1. 2. 3.

UNDERSTANDING PSYCHOPATHOLOGY What is Psycholo gical Diso rder? Psycho lo gical Diso rder It is a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is not typical or culturally expected 1.

2. 3. 4.

Psycho lo gical Dysfunctio n - refers to a breakdown in cognitive, emotional, or behavioral functioning. Distress or Impairment Atypical or No t Culturally Expected An accepted definitio n - describes behavioral, psychological, or biological dysfunctions that are unexpected in their

cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death , pain, or impairment. The Science of Psychopathology Psycho patholo gy - is the scientific study of psychological disorders. - With in th is field are specially trained professionals, including clinical and counseling

psychologists, psychiatrists, psychiatric social workers, and psychiatric nurses, as well as marriage and family therapists and mental health counselors. 1. Scientist-Practitio ners - mental h ealth professionals take a scientific approach to th eir clinical work 2. Clinical Description - represents the unique combination of behaviors, thoughts, and feelings that make up a specific disorder Progno sis anticipated course of disorder 3. Causatio n, Treatment, and Etiolo gy Outco mes Etio lo gy - study of origins, h as to do with why a disorder begins (what causes it) and includes biological, psychological, and social dimensions. Histo rical Conceptio ns Supernatural Model - th e driving forces behind are these agents, wh ich might be divinities, demons, spirits,

or other phenomena such as magnetic fields or the moon or the stars Ancient Greece - th e mind has often been called th e soul or the psyche and considered separate from the body. (3) Three models:

the supernatural the biological the psychological

THE SUPERNATURAL TRADITION Demo ns and Witches last quarter of the 14th century, religious and lay auth orities supported these popular superstitions and society as a whole began to believe more strongly in th e existence and power of demons and witches.

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Cath olic Church had split Roman Church fought back against th e evil in th e world magic and sorcery to solve their problems. Treatments included exorcism

Stress and Melancholy Treatments fo r Possessio n reflected th e enlightened view th at insanity was a natural ph enomenon, caused by mental or emotional stress, and that it was curable

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Mental depression and anxiety were recognized as illnesses

Treatments fo r Po ssessio n A creative th erapist decided th at hanging people over a pit full of poisonous snakes might scare evil spirits right out of their body Mass Hysteria characterized by large-scale outbreaks of bizarre behavior the ph enomenon of emotion contagion, in which the experience of an emotion seems to spread to th ose around us Modern Mass Hysteria problem, oth ers will probably assume that their own reactions have the same source. In popular language, this shared response is sometimes referred to as mob psychology. The Moo n and the Stars the movements of the moon and stars had

functioning.

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lunatic, which is derived from the Latin word .

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Anxiety Disorder

Apprehension over an anticipated problem Comorbid to Bipolar disorder, Substance Abuse, Personality Disorder and also Medical Conditions

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Separation Anxiety Diso rder Developmentally inappropriate and excessive fear/anxiety in anticipating or experiencing separation from the individual to whom they are attached. Applied only under 18 (DSM IV-TR)

Symptoms present for at least 4 weeks in children/adolescents and 6 months or more in adults Selective Mutism Rare childh ood anxiety disorder in which a child unable to speak in certain situation/people Symptoms for at least 1 month not st month in school Specific Phobia Disproportionate fear caused by specific object/situation At least 6 months Object/situation is avoided/endured with intense anxiety Only under age 18 (DSM IV-TR)

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Generalized Anxiety Diso rder Uncontrollably/persistent worrying about

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minor things At least 3 months (6 Months in DSM IVTR) With muscle tension Worry cognitive tendency to chew on a problems unable to let her go of it

Agorapho bia Anxiety about situations in which it would be embarrassing or difficult to escape if anxiety symptoms occurred At least 6 months Panic Diso rder Characterized by frequent panic attacks

that are unrelated to specific situation and by worrying about h aving more panic attacks At least 1 month Social Anxiety Diso rder Persistent, unrealistically intense fear of social situations that might involve being sanitized by exposed to unfamiliar people. At least 6 months SOCIOCULTURAL FACTORS Women twice likely as men Problems vary from culture to culture TAIJIN KYO-FUSHO Japan (fear of displeasing/ embarrassing others) GENETIC FACTORS Twin studies heritability suggest 20-40% NEUROBIOLOGICAL FACTORS Fear circuit involved amygdala (more activity) Medial prefrontal cortex (less activity) PERSONALITY FACTORS Behavioral inhibition during infancy Neuroticism COGNITIVE FACTORS Sustained negative beliefs about the future Perceived control Attention to threat

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Trauma and Stressor-Related Disorders STRESS a psychological responses to adjusted demands

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NO TRAUMATIC EXPERIENCE Reactive Attachment Diso rder Disturbed, developmentally inappropriate attachment behavior to the caregivers Persistent social and emotional disturbance At least 9 months of age Disinhibited Social Engagement Overly familiar actively approached and interacts with strangers or unfamiliar adults Willingness to go off At least 9 months of age Adjustment Diso rder Emotional and behavioral symptoms with significant impairment in functioning after an identifiable stressor (mostly normal stressors)

WITH TRAUMATIC EXPERIENCE Po sttraumatic Stress Diso rder Exposure to a traumatic events/ severe stressor (witnessed/personal0 cause an extreme response

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At least 1 intrusion and 1 avoidance symptom At least 3 (or 2 in children) negative alterations in cognition and mood and alteration in arousal and reactivity More th an 1 month

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Obsessive-Compulsive and Related Disorders Obsessions are intrusive and recurring th oughts images or impulses that are persistent and uncontrollable usually irrational Compulsio ns repetitive, clearly excessive behavior or mental acts that th e person feels driven to perform to reduce the anxiety caused by obsessive th oughts to prevent some calamity from occurring Obsessive-co mpulsive Diso rder Characterized by obsessions or compulsions th at are time-consuming (requires 1 hour per day)

Recognize as the product of their mind Common in women than in men *chronic Begins in childh ood Body Dysmo rphic Diso rder Preoccupied with an imagined, exaggerated defect in th eir appearance Has performed repetitive behaviors or mental acts in response to the appearance concerned Sligh tly common in women than in men but is very rare Hoarding Diso rder Persistent difficulty discarding or parting with possessions

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Strong urges to save items More often to women than in men

Exco riatio n (skin-picking diso rder) -

results in skin lesions and causes significant Tricho tillo mania (hair-pulling diso rder) Characterized by compulsive, mild to severe from anywhere on the body; can results in h air loss to ALOPECIA (bald spots on the scalp)

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Somatic Symptom and Related Disorder An excessive concern about physical symptoms or health that had no known physical cause

Somatic Symptom Diso rder Having a significant focus on physical symptoms (pain, shortness or weakness of breath ) resulting to major distress and problem in functioning

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Excessive th oughts, feelings or behaviors relating to physical symptoms At least 1 symptoms More th an 6 month s Usually begins by age of 30

Somatic delusio n Delusion whose content pertains to bodily functioning, bodily sensations or ph ysical appearance. Usually the false belief is th at

the body is somehow diseased, abnormal or changed. Illness Anxiety Diso rder

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excessively that you are or may seriously ill/ having serious medical condition At least 6 months Begins early adulthood Common in men than women Conversion Diso rder (Functio nal Neurolo gical Diso rder) A psychological condition that causes symptoms that appear to be neurological (paralysis, speech impairment, tremors) At least 2 sensory or motor impairment symptoms Caused by psychological reaction to a highly stressful event Women have higher risk Incompatibility of evidence between symptoms and recognized medical condition Factitious Diso rder Falsification of psychological/physical symptoms or signs for secondary gain as emotional attention and affection

| A bnormal P sych ology 9 Psycho lo gical Factor Affecting Other Medical Conditio ns Wh en a medical condition is adversely affected by psychological/behavioral factors eith er by making it worst or stopping recovery

Factors include psychological distress interpersonal problems, coping styles and maladaptive h ealth behavior Malingering Th ere is personal gain in th e deception/ pretending to have psych ological/physical condition Not considered mental illness

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Dissociative Disorder Disso ciatio n- involves the failure of consciousness to perform its usual role of integrating our cognitions, emotions, motivations and other aspects of experiences

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in our awareness

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Disso ciative Identity Disorder Have at least 2 separate identities/ personalities or alters-different modes of being, th inking, feeling and acting th at exist independently of one anoth er, emerged at different time

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2 of the alters recurrently take control Inability of at least 1 to recall important information

Depersonalizatio n/Derealizatio n Diso rder Depersonalization

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Disso ciative Amnesia

Unable to recall important personal information usually about some traumatic experience Fugue is a severe subtype Localize/selective amnesia for specific events Explicit memory conscious recall of experiences

Persistent or recurrent experiences of ocesses or body Loss of sense of self Derealization

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Persistent or recurrent experiences of unreality of surroundings Sensation that the word becomes real

Disso ciative Fugue (DSM IV-TR) Memory loss revolves around an unexpected trip Th ey just take off and find themselves in a new place but unable to remember how they got

there

Mood Disorders DEPRESSIVE DISORDERS cardinal symptoms of depression include profound sadness and/or an inability to experience pleasure 1. Disruptive Mood Dysregulatio n Diso rder - Severe recurrent temper outburst and persistent negative mood

- Atleast 1 year - Before age 10 2. Majo r Depressive Diso rder - Sad mood or loss of pleasure in usual activities - At least 5 symptoms - Nearly every day for at least 2 weeks (episodic) recurring - With suicidal thoughts

| A bnormal P sych ology 11 3.Persistent depressio n Diso rder (Dysthymia) - Depressed mood for most of th e day - At least 2 years in adult & 1 year for children and adolescents) - At least 2 symptoms 4.Premenstrual Dysphoric Diso rder - Depressive or ph ysical symptoms in the week before menstruation - Marked affective lability 5.Seaso nal Affective Diso rder - Seasonal subtype of Mood

- Winter blues - Depression during 2 consecutive winters then clears during summers

BIPOLAR DISORDER people experiencing mania and depression during th eir lifetime Mania- state of intense elation/irritability Hypomania 1.

Bipolar I Diso rder

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3.

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At least 1 lifetime manic episode

Bipolar II Diso rder At least 1 lifetime major depressive episode and one h ypomanic episode

=MANIA ↑serotonin = ANTIDEPRESSANT

SOCIAL FACTORS Stressful life events Interpersonal problems with in the families Constant reassurance-seeking of care PSYCHOLOGICAL FACTORS Neuroticism Negative thoughts and beliefs (pessimistic & self-critical th oughts) Hopelessness  Desirable outcomes will not occur  Ni response to change th e situation Rumination  Repeatedly dwell on sad experiences or thoughts  To chew on material again and again  Tendency to brood/regretfully ponder why an episode happened BIOLOGICAL TREATMENT Electro cumulative therapy (ECT) Repetitive Transcranial Magnetic Stimulation

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(rTMS) Vagus Nerve Stimulation

Cyclothymic Diso rder Frequent mild symptoms of depression

alternating with mild symptoms of mania At least 2 years (1 year for children and Adolescents) *chronic Rapid Cycling experiencing 4 or more episodes of mania/depression in 1 year

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NEUROBIOLOGICAL FACTORS Genetic heritability among twins Neurotransmitters ↓norepineph rine ↓dopamine

=DEPRESSION ↑norepineph rine ↑dopamine

Suicide THREE OTHER IMPORTANT INDICES OF SUICIDAL BEHAVIOR ARE:

1.

suicidal ideation (thinking seriously about suicide)

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suicidal plans (the formulation of a specific meth od for killing oneself) 3. suicidal attempts (the person survives) TYPES OF SUICIDE (Durkh eim) 1.

Altruistic Suicide for the benefit of the community e.g as the ancient custom of hara-kiri in Japan, in which an individual who brought dishonor to himself or his family was expected to impale himself on a sword.

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Egoistic Suicide low social integration. e.g Older adults who kill themselves after losing touch with their friends or family fi t into th is category. Anomic suicides are th e result of marked disruptions or disappointments, such as the sudden loss of a high-prestige job. (Anomie is

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feeling lost and confused.) Fatalistic Suicides result from a loss of

1997 is an example of th is type because th e lives of those people were largely in th e hands of Marshall Applewh ite, a supreme and charismatic leader.

Feeding and Eating Disorders

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BULIMIA NERVOSA - Out of control eating or binges followed by self-induced vomiting, excessive use of laxatives, or oth er attempts to purge (get rid of) th e food.

ANOREXIA NERVOSA - The person eats only minimal amounts of food or exercises vigorously to offset food intake so body weight sometimes drops dangerously.

BINGE EATING DISORDER - Individuals may binge repeatedly and find it distressing, but they do not attempt to purge the food.

OBESITY - is not considered an official disorder in DSM, but we consider it here because it thought to be one of th e most dangerous epidemics confronting public health auth orities around the world today. PICA eating of one or more nonnutritive food, nonfood substances on a persistent basis RUMINATION DISORDER repeated regurgitation of food occurring after feeding or eating (re-chewed, re-swallowed and re-spit out)

AVOIDANT/ RESTRICTIVE FOOD INTAKE DISORDER avoidance of restriction of food intake manifested by persistent failure to meet appropriate nutritional and/or energy needs associated w/ one or more: 9weight loss, nutritional deficiency, dependence on enteral feeding/ oral nutritional supplements and marked interfere w/ psychosocial functioning

Ego dystonic with stress and anxiety Ego syntonic without stress and anxiety

BULIMIA NERVOSA -eating a larger amount of food typically more junk food than fruits and vegetables than most people would eat under similar circumstances. -ashamed of both their eating issues and their lack of control Purging techniquescompensate for the binge eating and potential weight gain, almost always. Include self-induced vomiting immediately after eating. Subtypes: 1. Purging type 2. Non purging type Medical Consequences CHRONIC BULIMIA with PURGING 1. Salivary gland enlargement caused by repeated vomiting, which gives the face chubby appearance. 2. Repeated vomiting also may erode the dental enamel on th e inner surface of the front teeth as well as tear the esoph agus. 3. Continued vomiting may upset th e chemical balance of bodily fluids, including sodium and potassium

levels. Electrolyte imbalance- results in serious medical complications if unattended. (e.g. cardiac arrthymia or disrupted heartbeat, seizures and renal/kidney failure ANOREXIA NERVOSA - Proud of both their diets and their extraordinary control.

- Intense fear of obesity and relentlessly pursue thinness. *individuals with bulimia have a history of anorexia; that is, they once used fasting to reduce their body weight below desirable levels. Medical Consequences Cessation of menstruation Medical signs and symptoms: 1.Dry skin 2.Brittle h air and nail 3.Sensitivity to or intolerance of cold temperature. Lanugo 1. Downy hair on th e limbs and cheeks Cardiovascular problems Electrolyte imbalance BINGE- EATING DISORDER Experience marked distress because of binge eating but do not engage in extreme

| A bnormal P sych ology 14 compensatory behaviors and therefore cannot be diagnosed with bulimia. Found in weigh control programs

CAUSES OF EATING DISORDERS A. Social Dimensio ns For young women:  Looking good th an being health y  Self-worth, happiness and success are largely determining by BODY measurements and fats. 1. Dietary restraint if cultural pressures to be thin are is important as th ey seem to be in trigger eating disorders, then such disorders would be expected to occur where th ese pressures are particularly severe (e.g ballet dancers; under extraordinary pressures to be th in) 2. Family influences typical family of someone with anorexia is successful, hard driving, concerned about external appearances and eager to maintain harmony. B. Bio lo gical dimensions  Genetic component  Eating disorders runs in families  Hypoth alamus and Major n eurotransmitter; norepinephrine, dopamine and serotonin. Th at passes th rough it to determine whether something is malfunctioning wh en eating disorders occur.  Low levels of serotonergic activity - the system most often associated with eating disorders. -associated with impulsivity generally and binge eating disorders  Association between ovarian h ormones and dysregulated or impulsive eating in women prone to binge episodes.

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C. Psycho lo gical Dimensions Young women with eating disorder diminished a sense of personal control and confidence in their own abilities and talents. More perfectionist attitude which may reflect attempts to exert control over important events in their lives. Preoccupied ...