Unit 15- Stress and Abnormal Behaviour

Question 1

Four components of stress

Answer 1

Physiological
Behavioural
Emotional
Cognitive

Question 2

Stressors

Answer 2

Any stimuli that cause stress. Changes in the environment brought about by cultural changes have helped to make stress commonplace, however stress is a product of natural selection, which helps us confront or escape threatening situations.

Question 3

What is stress (maybe more biological)

Answer 3

is a biological response that is experiences as an emotion, although the form it takes varies depending on the nature of the stressors. In some situations we may feel frightened and in others we may feel inspired or exhilarated

Question 4

Our physical response to stress is governed by

Answer 4

the automatic nervous system which is controlled by the hypothalamus.

Question 5

when an individual senses a stressor

Answer 5

the hypothalamus sends signals to the autonomic nervous system and to the pituitary gland both of which respond by stimulating body organs to change their normal activities.

Question 6

Biological steps to stress/ These physiological responses are adaptive which prepares us to either confront a stressor or run from it.

Answer 6

1. Heart rate increases, blood pressure rises, blood vessels constrict, blood sugar levels rise and blood flow is directed away from extremities and towards major organs.
2. Breathing becomes deeper and faster and air passage dilate, which permit more air to enter the lungs.
   3.Digestion stops and perspiration increases.
3. The edrenal glands secrete adrenaline (epinephrine) which stimulates the heart and organs

Question 7

There are two instances in which such responses are maladaptive

Answer 7

First stress can produce anxiety which may impair one’s ability to perform a task. Secondly the effects of prolonged and severe stress place people at increased risk of illness.

Question 8

Selye found that chronic exposure to stressors produces a sequence of three physiological stages collectively

Answer 8

1. Alarm
2. Resistance
3. Exhaustion known as General Adaptation Syndrome (GAS

Question 9

Much of what we know about stress is attributed to

Answer 9

Canadian endocrinologist Hans Selye (1907- 1982).

Question 10

The responses in the alarm stage involve arousal of the autonomic nervous system and occur when the organism is first confronted with a stressor.

Answer 10

During this stage the organism’s resistance to the stressor temporarily drops below normal and the organism may experience shock. With continued exposure to the stressor, the organism enters the stage of resistance, during which the autonomic nervous system returns to normal functioning. Resistance to the stressor increases and eventually levels at about normal levels. The stage of resistance then reflects the organism’s adaptation to environmental stressors, however with continued exposure to the stressor, the organism enters the stage of exhaustion. During this stage the organism loses its ability to adapt and resistance drops to below normal levels, leaving the organism susceptible to illness and even death.

Question 11

Why then can they harm our health/ fight or flight response

Answer 11

our emotional responses are designed primarily to cope with short-term events. The physiological responses that accompany the negative emotions prepare us to confront or run away from threatening situations

Question 12

some diseases that attributed to stress

Answer 12

coronary heart disease, hypertension, skin cancer and many psychophysiological illnesses, as well as autoimmuniological diseases

Question 13

Post traumatic stress disorder

Answer 13

The aftermath of tragic and traumatic events such as wars and natural disasters often include psychological symptoms that persist long after the event occurred. is an anxiety disorder in which the individual has feelings of social withdrawal accompanied by untypically low levels of emotion

Question 14

The symptoms produced by PTSD

Answer 14

recurrent dreams, or recollections of the event (flashback episodes) lead the person to avoid thinking about the traumatic event which often results in diminished social activities, feeling of detachment from others, suppressed emotional feelings and a sense that the future is black or empty. Particular psychological symptoms include difficulty falling or staying asleep, irritability, outbursts of anger, difficulty in concentrating and heightened reactions to sudden noises or movements. Children may show particular symptoms not usually seen in adults, including loss of recently acquired language skills or toilet training, stomach aches and headaches.

Question 15

Coping

Answer 15

means dealing with a situation, for the psychologist is the process by which a person takes some action to manage environmental and internal demands that cause or might cause stress.

Question 16

Coping involves five important components

Answer 16

1.It is constantly evaluated; and is therefore a strategy or process
2. It involves managing a situation, not bringing it under complete control
3. It requires effort, it does not happen automatically
4. It aims to manage behavioural as well as cognitive events
5. It is a learned process

Question 17

Vulnerability

Answer 17

is the extent to which people are easily impaired by an event and thus respond maladaptively. Whether a person is vulnerable or not depends on his coping skills. In some cases people develop a sense of learned helplessness which results from learning that rewards and punishment are not contingent on behaviour. A person’s vulnerability is affected by the extent to which he or she has social support. Group therapy can be especially effective in alleviating anxiety.

Question 18

According to psychologist Richard Lazarus (1982) People faced with constant stress have two coping strategies

Answer 18

1) defense or (2) task oriented coping strategies

Question 19

Defense oriented coping strategies/ emotion focused strategy

Answer 19

distortion of reality in order to defend themselves against life’s pressures and to tolerate and deal with psychological disturbances. Freud and other personality theorists call these strategy defense mechanisms.

Question 20

Task- oriented/ problem focused coping strategies:

Answer 20

: use of therapists, stress management seminars, peer counselling, psychiatrist etc. The general intention is to source the help from external sources. Most psychologists especially behavioural psychologists recommend task oriented coping strategy.

Question 21

on coping with stress and reducing physical symptoms

Answer 21

Applied psychologists such as Schier and Carver (1985) claim that simply maintaining a positive attitude can have beneficial effects

Question 22

How people develop learned helplessness

Answer 22

showed that people who engaged in small self deception however may be healthier than those who focus on their anxiety. People who emphasize the negative aspect of their existence may develop learned helplessness, they may chose inaction because they feel helpless or powerless in controlling events

Question 23

Resistance to stress stages

Answer 23

1.Alarm stages-stressor disrupts body’s stability, temporarily lowering resistance.
2.Resistance stages- Adaptation resources are mobilised to combat stressor, and body maintains a higher level of resistance
3. Exhaustion stages- Body runs out of adaptation energy stores for adjusting for stressor, and resistance drops below normal.

Question 24

General Adaptation Stress

Answer 24

the first stage he describes as the Alarm stage. This is the individual’s first encounter with the stressful situation arousing the autonomic nervous system. The individual’s resistance to stress dips below their normal level resulting in a state of shock e.g. at the first instance of physical abuse, the person might experience a state of shock.
The second stage of the prolonged stress is known as the Resistance stage. This is where the individual begins to adapt to the situation and the resistance levels goes back to being normal e.g. after being abused for several times, a person may get accustomed to the situation and its triggers.
The last stage of Seyle’s discovery is the Exhaustion stage. At this stage the individual loses all control and is unable in any way to adapt to the overwhelming stressful situation, leading to a complete break-down or even death e.g. after increasing physical abuse the situation will more than likely end in some kind of violent outburst or even turn into a deadly event.

Question 25

Factors that cause stress

Answer 25

There are several factors that may bring about stress in the lives of an individual such as-: poverty, unemployment, financial issues and/or bankruptcy, marital and relationship issues, substance abuse, death and the list goes on, in fact any emotion or physical event that triggers a change in an individual’s equilibrium causes some kind of stress.

Question 26

How we handle stress is based on this

Answer 26

(1) we fight the stressors or
(2) we run away from our stressors, this is known as the fight-or-flight response, a phrase coined by Walter Cannon.

Question 27

Explain what our response to stress is operated by

Answer 27

is operated by our autonomous nervous system which is in turn operated by our hypothalamus. The hypothalamus then sends signals to our adrenal glands producing hormones like adrenaline and cortisol, which is then released into our bloodstream.
As these hormones are released into our bloodstream certain physical reactions occur with our bodies, for instance; our heart rate is increased, our blood pressure is increased and our metabolism is sped up, breathing becomes harder and faster, digestion stops and perspiration increases, all of which is known as our stress response, to the event.

Question 28

Effects of stress

Answer 28

The effects of stress are also multi-dimensional, in that an individual experiencing a stressful situation can develop health problems (both physical and mental), family life can be affected, it can affect one’s self esteem and self confidence, it can affect one’s relationships with co-workers, peers, friends, intimate partners and family members, it can affect one’s autonomy and their ability to co-exist in their environment, their perception about things and also the individual’s inner peace and harmony.

Question 29

Categories of symptoms of stress

Answer 29

Physical symptom-vomiting, Fatigue, Headaches
Backaches, Muscle tension ,Heart palpitation’
High blood pressure, Indigestion, Ulcers
Difficulty sleeping, Low immunity to colds

2. Emotional symptoms-hostility, restlessness, depression, Anxiety, Fear, Nervousness, Tiredness, Anger, Frustration,
3. Cognitive symptoms - preoccupation, forgetfulness, errors in judging, disorganised thoughts, attention deficit, Loss of sense of humour, Low self-esteem, Confusion
   Unwanted or repetitive thoughts, Lack of motivation
4. Behavioural symptoms- nervous laughter, impatience with dealing with people, aggressiveness, increased smoking, doing things out of the ordinary, Mood swings, defensiveness
   Nervous habits (nail biting, feet or finger tapping)
   Change in appetite, Loss of libido ,Increase alcohol consumption

Question 30

Some of the more life threatening physical effects of prolonged stress are

Answer 30

Heart Failure: this condition stems from stress hormones reaching up to levels of 30 times the normal level causing toxin levels to overwhelm the heart’s ability to pump blood throughout the body, thus decreasing the oxygen supply throughout the body, eventually resulting in shock or heart failure.Cancer: this is linked indirectly to stress because of the effects of negative behavioural patterns of the individual like over-eating , smoking or alcohol abuse which increases a person’s risk of being diagnosed with cancer.

Question 31

Stress can be catergorized into four (4) different experiences

Answer 31

Distress: this is severe stress and almost all of the times are harmful to the individual and only produces negative effects such as health issues, physical and/or physiological e.g. the stress of traffic everyday to work or having to work under a stressful boss.
Eustress: this is short-term stress where there is relief in the foreseeable future and it is normally used as a motivation for optimal performance, e.g. stress associated with studying for exams.
Hyper-stress: this is an insurmountable amount of stress pushing the individual to their emotional limit thereby resulting in an emotional break-down e.g. prolonged abuse or living with an abusive partner for a number of years.
Hypo-stress: this is when an individual is experiencing a lack of stress and it is normally associated with boredom and restlessness e.g. housewives are assumed to have no stressful situations and tends to become bored.

Question 32

Categories of coping with stress

Answer 32

1) Emotion Focus Coping
2) Problem Focus Coping

Question 33

Method of coping with stress

Answer 33

1) HARDINESS
A person variable or characteristic is based on the idea of control that may explain individual differences and vulnerability to stress. It can also be described as the characteristic ways people interpret potentially stressful events. Higher levels of hardiness protect people from experiencing some of the adverse consequences of stress.
Hardy people develop fewer physical complaints under highly stressful conditions. It consists of three sets of cognitive styles.
1. Commitment - the tendency to find meaning and purpose in potentially stressful events 2. Control - the tendency to believe that one is capable of managing the response to
the stressful event
3. Challenge the tendency to see potentially threatening events as opportunity for

Question 34

Another method of coping with stress

Answer 34

(2) SOCIAL SUPPORT
A mutual network of caring; there are various types:
1. Emotional Support - trust, concern, listening
2. Appraisal Support - affiliation of feedback
3. Informational Support - advise, suggestion, directiveness/directives
4. Instrumental Support - money, labour, time
Social support enables individuals to meet their goals and to deal with the demands of the environment. It’s taught to buffer feelings eg. Psychological distress and feeling of depression and facilitate coping by modifying the effects of stressors on mental health.

Question 35

Defense and task oriented mechanism for strategies to combat stress

Answer 35

(1) Defense oriented coping strategies/emotion focused, the use of personal defense mechanism like blocking out the stressful event altogether, hiding the stressful events deep into the subconscious or, a distortion of the true version of the events so that the situation becomes tolerable and easier to live with on a daily basis, or sometimes ignoring/pretending the stressful event does not exist/did not occur, e.g. a young girl who was raped may push that event deep down into her sub-conscious mind to avoid remembering or reliving such a traumatic and painful incident; and (2) Task oriented/problem focused coping strategies, the use of external assistance like therapy, counseling, stress management seminars or even visiting a psychiatrist for support e.g. victims of abuse, rape or any form of violence are recommended to seek some kind of professional therapy to help with the healing process.

Question 36

Schier and carver

Answer 36

Adding to this, applied psychologists Schier & Carver (1985) claimed that individuals who maintain a positive outlook and attitude about their life experiences whether in the form of good stress or bad stress tend to have reduced levels of physical symptoms

Question 37

Type A and B individuals

Answer 37

Another psychologist Rodin (1986) also corroborated this by claiming that individuals who exhibit high levels of self-control and self-esteem are more relaxed and live healthier lives or what is called having a Type B (self-healing) Personality, as opposed to individuals who focus their energies on the negative aspects of their lives. As these individuals focus on negativity or what is called having a Type A (disease-prone) Personality, automatically fall into a state of learned helplessness - this is where individuals condition themselves to be helpless and powerless choosing inaction, constantly making excuses for their state of despair and generally convincing themselves that they cannot rise above their situation, thus having the stressful situation overcome their lives.

Question 38

Ways to feel less stressed

Answer 38

1) Always have a support network: as an individual we all must have another source to align ourselves with. We need support in a variety of ways emotional support (a network of family members, friends or acquaintances is extremely essential to one’s mental stability, more often than not people need to talk about their issues and like the old saying, “laughter is the best medicine” and individual need to laugh at least once per day, even if it is at themselves), instrumental support or support with things like money, shelter, time etc. (these two are important in everyday lives and especially important to individuals in stressful situations), informational support or advice and suggestions from others and finally appraisal support or affiliation of feedback.
(2) An individual must develop a positive perspective about themselves and their life, always view new situations and events as challenges and use them as opportunities to overcome and grow into a better human being.
(3) Individuals must also be able capable enough to control their stressful situations, only after taking control and managing the stressful situations can the decision-making process begin.
(4) Having a strong will or hardiness helps in stressful
situations, as these characteristics make the individual able to face their stressful situations head-on with less physical manifestations of stress.

Question 39

What is stress management about?

Answer 39

In fact, the simple realization that you can be in control of your life is the foundation of stress management. Managing stress is all about taking charge – of your thoughts, emotions, schedule and the way you deal with problems.

Question 40

Types of causes of stress

Answer 40

External and internal

Question 41

External causes

Answer 41

Getting diagnosed with a serious illness
Moving
Failing a test
Having a baby
Sleeping through the alarm clock
Losing a job
Being in an automobile accident
Being late to class
Having a fight with your significant other

Question 42

Internal causes

Answer 42

Physical changes that occur in the body-
- Illness
- Injury
- Being in poor physical condition
- Worrying excessively
- Thinking negatively
- Decision making
- Setting unrealistic expectation for
oneself

Question 43

Four basic areas that cause stress

Answer 43

Environmental Stressors – (noise, pollution, traffic, crowding and the weather)
- Physiological Stressors – (illness, menopause, injury, hormonal fluctuations, and
inadequate sleep and nutrition)
- Cognitive Stressors/Your Thoughts – (the way you think affect you respond.
Negative self-talk, catastrophising and professionalism are contributors to stress
- Social Stressors – (financial problem, work demands, family demands, social
events, job interviews, examination, losing a loved one

Answer 44

• Muscle tension - Increase in blood pressure
  
  • Increase in heart rate - Cold and/or clammy feet or hands
  • Sweating - Queasy stomach
  • Rapid and shallow breathing - Feeling Fidgety

Question 45

Why is it important to know why and when you’re stressed

Answer 45

It is important to be aware of when and where you are feeling stressed, to recognize the symptoms and then to recognize the ‘triggers’ of our stress. Increasing our awareness of our symptoms and triggers enables us to develop the skills to deal with stress in our lives and implement changes that will enable us to move through stressful situations with a sense of calmness and control.

Question 46

How does stress management help

Answer 46

It gives the opportunity to explore the underlying causes of stress and anxiety
It can help examine your thoughts, feelings and behaviours that contribute to stress
You can gain self-understanding and insight, including identifying stress triggers
It offers tailor-made coping strategies for managing stressful situations
It improves your ability to handle stress and moderate the way you react to them
You can learn techniques and tools that are effective in your long-term run

Question 47

How to get stress under control

Answer 47

• Find out what id causing stress in your life
  
  • Look for ways to reduce the amount of stress in your life
  • Learn healthy ways to reduce stress or the harmful effects of it

Question 48

How do you measure your stress level

Answer 48

Sometimes it is clear where stress is coming from. You can count on stress during a major life change such as the death of a loved one, getting married or having a baby. But other times it may not be so clear where the stress is coming from. It is important to figure out what causes stress for you. Everyone feels and responds to stress differently. Journaling when stressed may be an effective a technique for some. Keeping a stress journal may help you find what is causing your stress and how stress you feel. Then you can take steps to reduce the stress or handle it better.

Question 49

Unhealthy coping mechanisms

Answer 49

Smoking Using pills or drugs to relax
- Consuming too much alcohol - Sleeping too much
- Over-eating or under-eating - Procrastinating
- Zoning out of hours in front of the TV or computer -
Continually avoiding problems
- Withdrawing for friends, families and activities - Taking out your stress on others
- Acting out behaviour (including aggression) - Quitting jobs, relationships etc.
- Excessive worrying - Denying that a problem exists

Question 50

Four A’s in stress- alter, avoid, adapt and accept

Answer 50

it is helpful to think of the four A’s – alter-. Figure out what you can do to change things so the problem doesn’t present itself in the future. by compromising, managing time , communicating instead of bottling up feelings and being more assertive , avoid, adapt-If you can’t change the stressor, change yourself. You can’t adapt to the stressful situations and regain your sense of control by changing your expectations and attitudes by looking at the big picture, reframing problems and adjusting standards and attitude.
or accept by looking on the positive side, learning to forgive, try not to control the uncontrollable and share your feelings, adopt a healthy lifestyle by cutting out sugar and coffee, avoiding alcohol, getting sleep

Question 51

Stress management techniques

Answer 51

• Organise yourself. Take better control of the way you’re spending your time and energy so you can handle stress more effectively.
  
  • Control your environment by controlling who and what is surrounding you. In this way, you can either get rid of stress or get support for yourself.
  • Love yourself by giving yourself positive feedback. Remember, you are a unique individual who is doing the best you can.
  • Reward yourself by planning leisure activities into your life. It really helps to have something to look forward to.
  • Exercise you body since your health and productivity depends on you body’s ability to bring oxygen and food to its cells. Therefore, exercise your heart and lungs regularly. A minimum of 3 times a week for 15 – 30 minutes. This include things such as swimming, running, walking, jogging, cycling aerobics etc.

Question 52

Proven tips for stress

Answer 52

1. Have an optimistic view of the world. Believe that most people are doing are doing the best they can.
2. Get up 15 minutes earlier in the morning. The inevitable morning mishaps will be less stressful.
3. Prepare for the morning the evening before, set the breakfast table, make lunches, put out clothes you plan to wear.
4. Don’t rely on your memory. Write down appointment times, when to pick up the laundry, when library books are due, etc.
5. Do nothing which, after being done, leads you to lie.
6. Make duplicates of all keys. Bury a house key in a secret spot in the garden and carry a duplicate car key in your wallet, apart from your key ring
7. Practice preventative maintenance. Your car, appliances, home, and relationships will be less likely to break down/fall part ‘at the worse possible moment.’

Question 53

DSM-IV definition of mental disorder

Answer 53

▸ A clinically significant behavioural or psychological syndrome or pattern.
▸ Associated with distress or disability.
▸ Not simply a predictable and culturally sanctioned response to a particular event.
▸ Considered to reflect behavioral, psychological, or biological dysfunction in the individual.
▸ Culture affects the definition of abnormality.

Question 54

The Five Axes of DSM-IV-TR

Answer 54

▸ Axis I - Particular clinical syndromes
▸ Axis II - Personality disorders and mental Retardation
▸ Axis III - General medical conditions
▸ Axis IV - Psychosocial/environmental problems
▸ Axis V - Global assessment of functioning

Question 55

Important terms for abnormal behaviour

Answer 55

Comorbidity-existence of two or more
disorders
▸ Acute- describes a disorder of sudden onset, usually with intense symptoms
› Chronic-describes a long-standing or frequently recurring disorder, often of progressing seriousness
▸ Mild/Moderate/Severe- describes a disorder of a low order of severity, intermediate order of severity, and a high degree of seriousness.
Episodic Disorder- describes a disorder that tends to abate and to recur
▸ Recurrent-describes a disorder pattern that tends to come and go.

Question 56

Definitions based on abnormal behaviour and disorders

Answer 56

Etiology -the causes and progress of a disease or disorder.
Epidemiology-the study of the incidence and distribution of specific diseases and disorders. Theepidemiologistalso seeks to establish relationships to such factors as heredity, environment, nutrition, or age at onset. Results of epidemiological studies are intended to find clues and associations rather than necessarily to show causal relationships.
Clinical Diagnosis
The process of identifying and determining the nature of a disorder through the study of the symptom pattern, review of medical and other records, investigation of background factors, and, where indicated, administration of psychological tests.
Comorbidity-the simultaneous presence in an individual of more than one illness, disease, or disorder.
Affect -any experience of feeling or emotion, ranging from suffering to elation, from the simplest to the most complex sensations of feeling, and from the most normal to the most pathological emotional reactions. Often described in terms ofpositive affectornegative affect, both mood and emotion are considered affective states. Along withcognitionandconation, affect is one of the three traditionally identified components of the mind.

Question 57

Historical Viewpoints
Demonology, Gods, & Magic

Answer 57

Abnormal behavior often attributed to possession “Good” or “Bad” possession depended on the person’s symptoms
* Treatment
Trephining allowed the evil spirit to escape the head
Exorcisms used to cast demons out of the body

Question 58

Historical Viewpoints
Hippocrates (460-377 B.C.)

Answer 58

> Father of modern medicine
› Mental disorders due to natural causes:
⚫ Brain
⚫ Mental disorders
Pointed out that head injuries could lead to sensory and motor disorders
Emphasized the importance of heredity and predisposition

Question 59

Historical Viewpoints
Plato (427-347 B.C.)

Answer 59

He believed that mentally ill persons were not responsible for their acts.
▸ Mentally ill persons should not receive punishment in the same way as normal persons.
▸ He made provision for mental cases to be cared for in the community.
▸ Plato shared the belief that mental disorders were in part divinely caused.

Question 60

Historical Viewpoints
The Middle ages (500-1500 AD)

Answer 60

The more scientific aspects of Greek medicine survived in the Islamic and middle east
▸ The first mental hospital was established in Baghdad in 792 A.D
‣ In Europe, scientific inquiry into abnormal behaviour was limited.
Mass Madness-widespread occurrence of group behaviour disorders that were apparently cases of hysteria
▸ Tarantism- uncontrollable impulse to dance often attributed to the bite of the southern European tarantula or wolf spider
Lycanthropy-a condition in which people believed themselves to be possessed by wolves and imitated their behavior
Black Death another occurrence which killed millions and severely disrupted social organization.
▸ Exorcisms were performed by the gentle “laying on of hands.”
▸ Witchcraft-many mentally disturbed people were accused of being witches and thus were punished and often killed.

Question 61

Humanitarian Approaches

Answer 61

Philippe Pinel (1745-1826)-Moral Management The humanitarian treatment of patients received great impetus from the work of Philippe Pinel in France.
He considered treating the mentally-ill patients with kindness and consideration.
▸ Chains were removed from the patients.

William Tuke (1732-1822)-York Retreat
▸ Tuke, an English Quaker established the “York Retreat”
▸ Pioneered pleasant country houses where mental patients lived, worked, and rested in a kindly religious atmosphere.

Rush (1745-1813)-Founder American Psychiatry He used moral management based on Pinel’s humanitarian methods to treat the mentally ill.
Rush encouraged more humane treatment of the mentally ill.
▸ Wrote the systematic treatise on psychiatry in America.

Dorothea Dix (1802-1887)- Mental Hygiene
Movement
> In 1841 she began to teach women’s prison.
> She launched a campaign between 1841 and 1881 that aroused the people and the legislatures to an awareness of the inhumane treatment accorded to the mentally ill.
She is credited with the establishment of some thirty-two mental hospitals.

Question 62

Abnormal Behaviour

Answer 62

Abnormal behaviour can be described when one deviates from the norm or average. Their characteristics and behaviours are statistically infrequent and usually not acceptable by society.

Question 63

Abnormal Behaviour is characterised by

Answer 63

(1) unusual (2) socially unacceptable (3) distressing to the person affected as well as family and friends.

Question 64

History of Abnormal Behaviour

Answer 64

For much of human history, abnormality has been seen as a sign of possession by demons or evil spirits. But by the 18th century this view began to dissipate, as abnormality was seen as a kind of illness based on the pathology of the brain and treatable by appropriate medical techniques

Question 65

Modernity of Abnormal Behaviour

Answer 65

. Psychologists today take a number of perspectives on the different causes of abnormal behaviour and the stance they take on how it is treated; this includes the psychodynamic, the medical, the humanistic, the behavioural and the cognitive perspective

Question 66

How does the study of abnormal behaviour help your society?

Answer 66

The Police service, the Ministry of Social Development and the government of this country need to educate not just the schools and parents on the social and psychological issues that are affecting our young people concerning this disorder, but more people need to go into the social services and psychological fields. Studying abnormality at its core will benefit those who may not realise it, but need the help.

Alcoholics Anonymous hold meetings throughout the country on a Wednesday night to aid alcoholics in their fight against this addiction. Hulsie Bhaggan has also contributed to our society by forming a rehabilitation centre in Mt. Hope for many substance abuse users. If studies were not done on the abnormal behaviour that plagues our society, we would not have come this far.

Abnormal behaviour will forever be prevalent in societies, more so because those who suffer from abnormal behaviours do not always admit it and those of us who are normal cannot easily identify those who have it. Citizens need to be aware that both mental and personality disorders can be classed as diseases, they can cause physical, emotional and psychological harm not just to the sufferers but to those around them. Members of our society need to be educated about these dark hidden disorders, about their causes and in what way we can contribute to help our fellow citizens live healthy, wholesome, happy lives.

Question 67

Most commonly used system in north America-DSM

Answer 67

the American Psychiatric Association’s, Diagnostic and Statistical Manual IV (DSM-IV). The DSM-IV is a widely used manual for classifying psychological disorders. It is the latest version of a classification scheme that was devised to provide a reliable, universal set of diagnostic categories having criteria specified as explicitly as possible. It describes an individual’s psychological condition using five different criteria, called axes. Personality disorders, of which fall into three clusters, are in the DSM-IV AXIS II category. Main handbook used in the U.S. To diagnose Psychiatric Illness Published by the APA. Covers all (recognized) categories of Mental Disorders, with symptoms, descriptions and criteria for Diagnosis, Common Treatment approaches,. Applicable to both Adults and Children and assists with the administrative costs as well for patients. The DSM-IV- TR had the desire to reframe the evaluation system to include a comprehensive approach in the assorted aspects of the patient’s lives.

Question 68

What is a personality disorder

Answer 68

by long standing, inflexible, maladaptive patterns of behaviour beginning early in life and causing personal distress or problems in social and occupational functioning

Question 69

Major defining Features of personality disorders

Answer 69

According to DSM 5, there are four core features of personality disorders, these four features are found in all categorized personality disorders:
Problematic Emotional Responses
Distorted Thinking Patterns
Impulse Control (over/under-regulation)
Interpersonal Difficulties
DSM 5 further groups the personality disorders together into three groups according to the symptoms called “CLUSTERS”.
N.B. Children cannot be diagnosed with a personality disorder, children may present with similar symptoms, or behaviours types but no formal diagnosis can be given until the age of 18years.

Question 70

What are people with personality disorders like

Answer 70

People with personality disorders often cause at least as much difficulty in the lives of others as in their own lives. Other people find their behaviours confusing, exasperating, unpredictable and in varying degrees unacceptable. Their behavioural deviations are persistent and seem to be intrinsic to their personalities. Particular trait patterns that develop are obstinacy, covert hostility, suspiciousness, or fear of rejection. These patterns colour their reactions to each new situation and lead to a rejection of the same maladaptive behaviours.

Question 71

What can cause personality disorders

Answer 71

Studies have shown that personality disorders can stem from temperament or character traits, genetic transmission or environmental and social factors.

Question 72

Clusters

Answer 72

Cluster A- described as : Odd/Eccentric, Cluster B- Described as Dramatic/Emotional, Cluster C- described as Fearful/Anxious

Cluster A consists of Paranoid Personality Disorder; Schizoid Personality Disorder and Schizotypal Personality Disorder, Cluster B consists of Antisocial Personality Disorder; Borderline Personality Disorder; Histrionic Personality Disorder ; Narcissistic Personality Disorder, Cluster C consists of Avoidant Personality Disorder; Dependent Personality Disorder; Obsessive-Compulsive Disorder.

Cluster A- common features are social awkwardness and social withdrawal, Cluster B- Impulse control and emotional regulations, Cluster C- Anxious thoughts and behaviours

Cluster A- other notes: These behaviours are similar to schizophrenia, but not as extensive or impactful to daily functioning, Cluster B- other notes : Inability to establish healthy relationships because of the dramatic emotional and irrational nature of these disorders and Cluster C- other notes : Most treatment options available.

Question 73

Some personality disorders

Answer 73

Antisocial personality disorder, Histrionic, Narcissistic, Borderline, Paranoid, Schizoid, Schizotypal, Avoidant, Dependant and Obsessive-compulsive personality disorder.

Question 74

Cluster A Paranoid personality disorder

Answer 74

Paranoid Personality Disorder (Cluster A)
Marked distrust or suspicion of others/ doubtful of intentions of others even when true loyalty is shown. Individuals interpret external motivations and interactions as detrimental (high scepticism of others and their motives) .Individual is averse to establishing relationships because of fears of external mal-intent .Persons believe that they have been hurt by others without supporting evidence. .Does not confide in others readily
Overall skewed perception. Hold grudges / Defensive.

Question 75

Cluster A Schizo-Personality disorders

Answer 75

Schizoid Personality Disorder (Cluster A)
Avoid Social Relationships (continuously) and even within their social relationships they display a limited range of emotions. Limited quantity of close relationships. Lack the desire to engage in social behaviours/ prefer to engage in solitary behaviours. (viewed as loners) .Lack of interest in engaging in sexual experiences with others
Indifferent to external criticism or praise. Rarely display facial expressions. Limited need for attention or acceptance.

Schizotypal Personality Disorder (Cluster A)
Range of impairment in social and interpersonal relationships due to discomfort in relationships along with odd cognitive or perceptual distortions and eccentric behaviours (APA, 2013)
Tend to be solitary with few relationships outside family members. Ideas of reference: this is a concept where the individual may attribute meanings to random events or situations (it may also lead to infatuation and preoccupation with paranormal or Magical theories/concepts. May experience Auditory Hallucinations, unusual speech patterns or incoherence. May experience: Paranoia or be highly suspicious of others, along with Social Anxiety and tend to self isolate because of social anxiety. May exhibit socially inappropriate behaviour, or behaviour that isn’t typical for the social scenarios.

Question 76

Antisocial personality disorder (Cluster B)

Answer 76

Psychopaths or sociopaths as they are contemporarily called are characterized by a failure to conform to common standards of decency, repeatedly lying and stealing, a failure to sustain long lasting and loving relationships, low tolerance of boredom and a complete lack of guilt. They continually violate and show disregard for the rights of others through deceitful, aggressive, or antisocial behaviour, typically without remorse or loyalty to anyone. They tend to be impulsive, irritable and aggressive, and show a pattern of generally irresponsible behaviour

Question 77

Difference between sociopaths and psychopaths

Answer 77

Short version
Sociopaths-Hot-headed, Need for validation
Emotional, Erratic, Fearful
Psychopaths-Cold-hearted, Need for stimulation/entertainment, Controlled
Calculating and manipulative, Fearless

Long version
Sociopaths-Driven by Need for validation, attention, and admiration; immediate gratification; control
Anger: Prone to emotional outbursts
Behaviour: Erratic
Criminal Behaviour: Opportunistic likely to engage in criminality.
Violent Behaviour: High propensity for violence; prompted by anger, fear or perceived threat; reactive; defensive
Relationships: Difficulty maintaining normal relationships
Attachments: May form attachments with particular individual or group; values relationships that benefit them; does
not want relationships to end.
Fearfulness : Fearful; vulnerable to anxiety and rejection; easy to humiliate.
Nature: Nurture; adverse environment; tend to come from dysfunctional families and disadvantaged groups.

Psychopaths- Driven by: Stimulation; control
Anger: Controlled
Behaviour: Calculating and manipulative.
Criminal Behaviour: premeditated; may or may not engage in criminality
Violent Behaviour: Varied propensity for violence; predatory; absent of emotion or threat; proactive; attack
Relationships: Able to appear normal in relationships.
Attachments: Unable to form attachments; incapacity for love or emotional relationships; often social predators
Fearfulness: Fearless; arrogant; confident; impossible to humiliate
Nature/Nurture: biological in origin; numbers remain stable: across cultures and time

Question 78

More on Anti-social personality disorder

Answer 78

According to the DSM-IV, psychopaths with ASPD would have been showing behavioural patterns before the age fifteen. The person must have had symptoms of conduct disorder, a similar disorder occurring in children and young adolescents who show persistent patterns of aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violation of rules at home or in school. The DSM-IV includes evidence of at least three types of antisocial behaviour by age 15 and at least four after age 18.

Question 79

Adults with ASPD

Answer 79

. The adult however, is unable to sustain consistent work behaviour, lacks the ability to function as a responsible parent, repeats criminal activity, such as theft, pimping, or prostitution; is unable to maintain enduring attachment to a sexual partner; volatility and violence, including fights or assault; cannot honour financial obligations; impulsiveness and failure to plan ahead; habitually lies and uses aliases; and consistently reckless or drunken driving. In addition to meeting four of these criteria, the person must have displayed a “pattern of continuous antisocial behaviour in which the rights of others are violated, with no intervening period of at least five years without antisocial behaviour”. Some people with antisocial personalities however, have enough intelligence and social charm to devise and carry out elaborate schemes for conning large numbers of people. Imposters frequently fit into this category.

Question 80

How do people with affect ASPD affect others

Answer 80

. Psychopaths feel no anticipatory fear of punishment, so he/she would more likely commit acts that normal people would be afraid to commit. For example, they habitually tell lies when there is no need for doing so and even when the lie is likely to be discovered. They steal things they don’t need and when confronted they do not act ashamed or embarrassed and usually shrug the incident off as a joke or simply deny it, however obvious their guilt might be. They are unconcerned for other people’s feelings and suffer no remorse or guilt if their actions hurt others. Although they may be superficially charming, they do not form real friendships; thus, they often become swindlers or confidence artists.

Psychopaths do not easily learn adaptive behaviour from experience; they continue to get into trouble throughout their lives, although there is some decline in criminal activity around age 40. They do not appear to be ‘driven’ to perform their antisocial behaviours; but often appear to be acting on a whim. When someone with ASPD commits a heinous crime like murder or rape, one might think the criminal would have a reason for committing such an act. Criminal psychopaths have none; they might say “He had a car that I wanted so I killed him for it” or “I just felt like it”. They do not show much excitement or enthusiasm about what they are doing and do not appear to derive much pleasure from life.

Question 81

Characteristics of ASPD

Answer 81

1. Superficial charm and good “intelligence”
2. Absence of delusions and other signs of irrational thinking
3. Absence of “nervousness”
4. Unreliability
5. Untruthfulness and insincerity
6. Lack of remorse or shame
7. Inadequately motivated antisocial behaviour
8. Poor judgement and failure to learn by experience.
9. Pathological egocentricity and incapacity for love.
10. General poverty in major affective reactions
11. Specific loss of insight
12. Unresponsiveness in general interpersonal relations
13. Fantastic and uninviting behaviour….
14. Suicide rarely carried out.
15. Sex life impersonal, trivial and poorly integrated
16. Failure to follow any life plan.

Question 82

Genetic and environmentally causes of ASPD

Answer 82

Genetically, these people often but not always come from grossly disturbed families that contain alcoholics and other psychopaths. Studies were done to examine the criminal records of men who had been adopted early in life and found that the likelihood of their being convicted of a crime was directly related to the number of convictions of their biological fathers.

Environmentally, parenting plays an important part of the personality development of a child especially those with ASPD. The quality of parenting, especially as it relates to providing supervision for children, is strongly related to the development of antisocial personality disorder. Children whose parents ignore them or who leave them unsupervised for prolonged periods, often develop patterns of misconduct and delinquency. When parents do pay attention to their children, it tends to be in the form of harsh punishment or verbal abuse in response to their misdeeds. Thus, the children of these parents live in an environment that ranges from no attention at all to attention in the form of physical punishment and tongue lashings. In response, the children develop a pattern of behaviour that is characterised by increased aggression, distrust of others, concern only for themselves, and virtually no sense of right or wrong.

Question 83

borderline personality disorder (Cluster B)

Answer 83

Borderline personality disorder refers to people who seem to teeter between severe neurotic traits such as emotional instability and bouts of psychosis.

Question 84

People with borderline personality disorder

Answer 84

Instability is a main characteristic in the borderline personality disorder. A person diagnosed with this disorder suffers from instability, severe depression and anxiety and anger, which seems to arise frequently without good reason. Interpersonal relationships are extremely unstable and the person can switch from idealizing other people to despising them. People with Borderline Personality Disorder feel desperately empty and will cling to new acquaintances or a therapist in the hope that the void they feel inside will be filled. They also tend to have self-mutilation and suicidal tendencies.

Question 85

How do people with BPD view others

Answer 85

According to the perspective of the psychoanalytic theorists, individuals suffering from BPD have poorly developed views of the self and others, due to poor early relationships with caregivers. Other researchers suggest that many sufferers of BPD have had a history of physical and sexual abuse during childhood. In addition, a child whose parents alternate between abusive and being loving, could allow the child to develop a mistrust of others and a tendency to see others as all good or all bad.

Question 86

Histrionic Personality Disorder (Cluster B)

Answer 86

Histrionic Personality Disorder exhibits excessive emotionality and attention seeking
Individual needs to be the centre of attention and is usual highly sexual, dramatic, and theatrical even to the point of creating fictitious stories.
These persons are easily suggestible, malleable and influenced.

Question 87

Narcissistic Personality Disorder (Cluster B)

Answer 87

Individuals with NPD tend to be Grandiose, overvalue their sense of worth; boastful and pretentious. False sense of Identity, need to be admired
Fragile self esteem , dependent on the perception and validation of others; Sense of entitlement; may become angry when their needs are not met.
Lack empathy, may (not) recognize the desires of others
May become envious of others with greater achievements or status.

Question 88

Avoidant Personality Disorder (Cluster C)

Answer 88

Social anxiety due to feelings of inadequacy/high sensitivity to negative evaluations.
Extreme fear of rejection leads to reduced effort in activities and activity seeking
Very few friends, despite the desire for friendships
Negatively Skewed self perception about their abilities
Misattributed reasoning for external reactions rather than logical reasoning

Question 89

Dependent Personality Disorder (Cluster C)

Answer 89

Extreme need to be taken care of by others
Submissive and Clinging Behaviours
Fear of abandonment
Don’t make decisions without consulting, need for approval
Fear of loss of relationship is greater than the need challenge a decision that they may not agree with
Feels at a loss without a relationship, seeks out another and reenacts the subservient role
Low self confidence, will engage in subservient task with the intention of belonging and getting reassurance.

Question 90

Obsessive-Compulsive Personality Disorder (Cluster C)

Answer 90

Preoccupation with orderliness perfectionism ability to control situations
Tends to be inflexible, rigid,; ethically and moralistically inflexible
Preoccupation with lists; details; rules; order and organization leads to loss of Big Picture perspective.
Need for perfection, which leads to task repetition and lack of completion of said task
View others as unable to assist (incompetent), because of the quality of work necessitated .
May display characteristics of hoarders and display tendencies for extreme financial preparedness
OCD and OCPD are not the same, OCPD lacks definitive obsessions and compulsions therefore it is more generalized. OCPD patients tend to have a higher onset of depression, general anxiety disorder or substance abuse disorder

Question 91

Etiology Personality Disorders

Answer 91

Biological causes of personality disorders have not been identified in most disorders, the exception being schizotypal which has similar biological causes as schizophrenia and antisocial and borderline personality disorders which have similar neurological changes.
Psychological causes of personality disorders include negative early childhood experiences; maladaptive thought patterns and cognitive distortions; and modeling, reinforcement, and lack of social skills.
Social causes of personality disorders include high levels of psychological and social dysfunction within families and maltreatment.

Question 92

Comorbidity- personality disorders

Answer 92

Mood disorders, anxiety disorders, and substance abuse disorders have a high comorbidity with personality disorders.
Substance abuse disorders occur less frequently across the ten personality disorders but when they do, are comorbid with antisocial, borderline, and schizotypal personality disorders.

Question 93

Treatment- Personality Disorders

Answer 93

Individuals with a Cluster A personality disorder do not often seek treatment and when they do, struggle to trust the clinician (paranoid and schizotypal) or are emotionally distant from the clinician (schizoid). When in treatment, cognitive restructuring and cognitive behavioral strategies are used.
In terms of Cluster B, treatment options for antisocial are limited and generally not effective, borderline responds well to dialectical behavioral therapy (DBT), histrionic patients seek out help but are difficult to work with, and finally narcissistic are the most difficult to treat.
For Cluster C, cognitive techniques aid with OCPD while gradual exposure to various social settings and social skills training help with avoidant. Clinicians use cognitive strategies to challenge thoughts on helplessness in patients with dependent personality disorder.

Question 94

DESCRIBE 2 CLASSES OF MENTAL DISORDERS BASED ON DSM IV CLASSIFICATION

Answer 94

Mental Disorder -Attempts to understand the causes of mental disorders generally fall under one of the approaches to psychology. The biological perspective also called the medical or disease model, suggests that bodily disturbances cause disordered thoughts behaviour and emotion. Researchers using this approach look for genetic irregularities that may cause a person to develop mental disorders. The psychoanalytic perspective on mental disorders emphasizes unconscious conflicts, usually originated in early childhood. The cognitive perspective suggests that some mental disorders originate from disordered cognitive processes. Some mental disorders are schizophrenia, mood disorders, anxiety disorders, somatoform disorders, dissociative disorders, sexual disorders, sleep disorders and eating disorders.

Question 95

Some mental disorders

Answer 95

Schizophrenia, mood disorders, anxiety disorders, somatoform disorders, dissociative disorders, sexual disorders, sleep disorders and eating disorders.

Question 96

Mood disorders

Answer 96

are one of the mental disorders. Individuals with mood disorders may be severely depressed or manic or may experience periods of depression as well as periods of mania. It is divided into depressive disorders, in which the individual has one or more periods of depression without a history of manic episodes and bipolar disorders, in which periods of depression and periods of mania, usually with a return to normal mood between the two extremes. Manic episodes without some history of depression are very uncommon.

Question 97

Depression disorders

Answer 97

are relatively common, with about 17% of people having an episode of severe depression at some time in their lives. Mild depression symptoms are normal responses to many of life’s stresses. Some situations that cause depressive symptoms are failure at school, or work, and the loss of a loved one. Depression becomes a disorder when the symptoms become so severe that they interfere with normal functioning and when they continue for weeks at a time. There are actually four sets of symptoms; emotional, cognitive, motivational and physical. The more of these symptoms an individual has the more intense they are. The depressed person gradually loses interest in hobbies, recreation and family recreation and family activities.
The cognitive symptoms consist of negative thoughts. Depressed individuals tend to have low self-esteem, feel inadequate and blame themselves for their failures. Motivation is at a low ebb (weakened or depressed state). The depressed person tends to be passive and has difficulty initiating activities. The physical symptoms of depression include changes in appetite, sleep disturbances, fatigue and loss of energy.

Question 98

Anorexia nervosa

Answer 98

It is an eating disorder characterized by a severe decrease in eating. The meaning of anorexia suggests a loss of appetite, but people with this disorder generally do not lose their appetites. They enjoy thinking about food, preparing meals for others to consume but they do not eat it themselves. They have an intense fear of becoming obese and their fear continues even though they are really thin. Most psychologists believe that the emphasis our society places on slimness is largely responsible for this disorder. Anorexia is difficult to treat and many people with anorexia suffer from osteoporosis and bone fractures. Also when weight loss becomes severe women with the disorder cease menstruation. Reports show evidence of brain tissue loss among young women with anorexia nervosa.

Question 99

Bulimia nervosa

Answer 99

Bulimia nervosa is another eating disorder. It is characterized by a loss of control of food intake. People with bulimia nervosa gorge (eat a large amount greedily) themselves with food, especially desert or snack food. This is usually followed by self-induced vomiting or the use of laxatives along with feelings of depression and guilt. This disorder is seldom fatal.

Question 100

Schizophrenia

Answer 100

The word schizophrenia comes from two Greek words that together mean “split mind” Schizophrenia is considered the most devastating, puzzling and frustrating of all mental disorders. People with this disorder lose touch with reality and are often unable to function in a world that makes no sense to them. A person with schizophrenia is said to have a schizophrenic disorder that is because schizophrenia is really a range of disorders.

Question 101

Schizophrenia is characterised by

Answer 101

a lack of mental awareness and by deterioration of social and intellectual functioning beginning before age 45 and lasting at least six months .People diagnosed as having a schizophrenic disorder often show serious personality disintegration; they may become psychotic which affects their ability to meet the demands of everyday life. Schizophrenia begins slowly with more symptoms developing as times passes it affects 2.5 million Americans and accounts for 25% of all mental hospital admission each year.

Question 102

There are five sub-types of Schizophrenia:

Answer 102

(1) CATATONIC
(2) PARANOID
(3) HEBEPHRENIC/DISORGANIZED/ SIMPLE
(4) UNDIFFERENTIATED
(5) RESIDUAL

Question 103

Subtypes of Schizophrenia

Answer 103

(1) Catatonic Type…..characterized by either displays of excited or violent motor activity or stupor. There are actually two sub-types (1) excited (2) withdrawal
(2) Paranoid Type …..one of the most difficult to identify and study because outward behavior often seems appropriate to the situation. The paranoid type is characterized by hallucinations and delusions of persecutions or grandeur (or both) and sometime irrational jealousy rather than withdrawing from social interaction. Patients with paranoid schizophrenia have a better chance of recovery than do patients with other types
(3) Simple/Disorganized/ Hebephrenic Type…….characterized by severely disturbed thought processes, frequent incoherence, disorganized behavior and inappropriate affect. Patients may exhibit bizarre emotions with periods of giggling, crying or irritability for no apparent reason. They show a severe disintegration of normal personality, a total lack of awareness and often poor personal hygiene. The chances of recovery are poor.
(4) Undifferentiated type……the patient affected by this type exhibits behavior which do not meet the criteria for any other types or which meets the criteria for more than one type.
(5) Residual Type…….this type commonly displays emotional bluntness, social withdrawal, illogical thinking , eccentric behavior, flat affect or poverty of speech. They may however show no strong positive symptoms.

Question 104

Types of symptoms

Answer 104

(1) Positive symptoms : Such as delusions or hallucinations, which are known as seeing or believing things that are not real
(2) Negative symptoms: Such as social avoidance, emotional avoidance or lack of feeling or emotion…..things that are missing.
(3) Disorganized symptoms: Confused in thinking and speech. Acting in ways that do not make sense

Question 105

Psychosis

Answer 105

Psychosis” is a common condition in schizophrenia- it is a state of mental impairment marked by hallucinations, which are disturbances of sensory perception and of delusions which are false yet strongly held that results from an inability to separate real from imaginary.

Question 106

Acute phase

Answer 106

the sudden onset of severe psychotic symptoms.

Question 107

Causes of Schizophrenia

Answer 107

Environment…..may begin at birth or before. Women who are exposed to influenza during pregnancy, complications at birth, meningitis, or any event that affects brain development.
Often victims were exposed to violence, sexual abuse, death , divorce, separation or other stresses

Heredity ….some individuals inherit a potential for developing schizophrenia. Identical twins more likely to develop the condition than fraternal. If both parents develop the condition then the children are more likely to suffer from the condition (46%) chance.

Brain Chemistry….. while there might not be unusually high levels of the neurotransmitter dopamine, because of the extra dopamine receptors, schizophrenics may get psychedelic effects from normal levels

Question 108

Treatments of Schizophrenia

Answer 108

(1) Social support from family, friends and significant others
(2) Medication…antipsychotic medicine to relieve positive symptoms e.g. Clozapine, resperedine, haldol, haloperidol and lithium among other dopamine antagonist.
(3) Dietary supplement….omega 3fatty acids, balanced diet
(4) Electroconvulsive therapy (ECT)…..shock- induced seizures alter the biochemical balance in the brain bringing an end to severe depression and suicidal behavior.
(5) Professional attention from psychiatrist, psychologist and other caregivers.

Question 109

5 CHARACTERISTICS OF A NORMAL HEALTHY PERSON

Answer 109

1.Appropriate perception of reality – one where the individuals are fairly realistic in appraising their reactions and capabilities and interpreting what is going on in the world around them.
2.Ability to exercise voluntary control over behaviour – Normal individuals feel confident about their ability to control their behaviour.
3.Self esteem and acceptance – Normal individuals feel accepted by those around them and they have appreciation of their own worth
4.The ability to form affectionate relationships – Normal individuals are sensitive to the feelings of others and do not make demands on them to satisfy their needs.
5.Productivity – They are enthusiastic about life and do not need to drive themselves to meet the demands of the day.