Unit 5 Abnormal Behavior Flashcards
HOW DO WE DEFINE BEHAVIOR AS ABNORMAL?
A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual that is ASSOCIATED WITH PRESENT DISTRESS or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom
WHAT ARE THE CRITERIA FOR DEFINING A PSYCHOLOGICAL DISORDER.
- Uncommon behavior
- Unacceptable behavior
- Displays faulty perception (e.g. hallucinations)
- Displays faulty interpretation of reality (e.g. delusions)
- Displays self-defeating behavior
- Displays dangerous behavior
- Displays extreme personal distress
“…there is more to a disorder than being ___.”
atypical
What is the most common type of hallucination?
auditory
Give an example of a delusion or faulty perception of reality.
“I know you’re all aliens. You don’t look like aliens. But I know you’re aliens.”
“I’m king of the world.”
Give an example of a self-defeating behavior.
heroin addiction, other additions (alcohol, other drugs)
What types of faulty perceptions or hallucinations might one have?
auditory, visual, tactile
HOW DID SOCIETY APPROACH ABNORMAL BEHAVIOR BEFORE THE “MEDICAL MODEL” BECAME COMMONLY ACCEPTED?
Through the 18th century abnormal behavior was most often attributed to “evil” influences.
Depending on the cosmology of the times the aberrant actions were managed, punished or exorcised.
The typical response called for protecting the public by isolating the abnormal individual.
These asylums were initially intended to contain and isolate the insane.
What was the number one function of an asylum?
to protect the public (the non-abnormal)
Asylums perpetuated the belief about people with mental illness being ___.
evil
WHAT CHANGE OCCURRED IN THE 18TH CENTURY AND WHO WAS PHILIPPE PINEL?
In the 18th century a dramatic change occurred in the management of those with psychological disorders.
In 1793, Philippe Pinel was appointed médecin des infirmeries of the Hospice de Bicêtre, and he implemented his ideas on the humane treatment of the insane.
At the Bicêtre Pinel had the chains removed from his patients.
WHAT ARE THE BENEFITS OF USING A DIAGNOSTIC SYSTEM?
- treatment
- cause
- efficient communication about the patient’s condition
- it makes it possible for the mental health profession to function
WHAT IS THE MINIMUM THAT A DIAGNOSIS SHOULD ACCOMPLISH?
at a minimum, the diagnostic system should be able to discriminate between normal and abnormal
WHAT WAS ROSENHAN’S PROCEDURE AND WHAT WERE HIS FINDINGS?
(1972) The pseudopatient arrived at the admissions office complaining that he had been hearing voices saying “empty,” “hollow,” and “thud.“
Beyond claiming to hear voices and falsifying name, vocation, and employment, everything else was true and accurate.
The pseudopatients were never detected.
Admitted, except in one case, with a diagnosis of schizophrenia, each was discharged with a diagnosis of schizophrenia “in remission.”
If the pseudopatient was to be discharged, he must naturally be “in remission” but be was not sane, nor, in the institution’s view, had he ever been sane. Staff did not view patients as people.
IS THERE ANY COUNTER ARGUMENT FOR ROSENHAN’S POSITION?
Robert Spitzer responded:
First, the primary reason the pseudopatients were admitted was the request to be admitted when there was no obvious benefit, other than treatment, to be gained from admission.
They entered a hospital in personal distress, seeking help.
In order to be admitted the patients had to be diagnosed and Spitzer points out that the diagnostic system responded appropriately in identifying schizophrenia.
Specifically:
-There was no indication of substance abuse
-The patients were normal in memory and attention thus the symptom wasn’t due to neurological trauma
-There was no recent emotional trauma to produce a transient psychosis
-There was no evidence of significant mood disorder
-Thus, the remaining diagnosis that matched the symptom was schizophrenia.
WERE THE PSEUDOPATIENT’S DETECTABLE AS SANE PEOPLE?
Yes, other patients, real patients detected them.
It was quite common for the patients to “detect” the pseudopatients’ sanity. “You’re not crazy. You’re a journalist, or a professor [referring to the continual note-taking]. You’re checking up on the hospital.
IS THERE A “BIAS” IN THE DIAGNOSTIC SYSTEM?
Rosenhan (1972) went to a new hospital and made sure the staff had heard about his findings.
This staff reported that such an error would not occur in their hospital.
He waned them that at some time during the following 3 months he would send pseudopatients to the hospital.
Each staff member was asked to rate each patient according to the likelihood that the patient was a pseudopatient.
Judgments were obtained on 193 patients
Forty-one patients were alleged, with high confidence, to be pseudopatients by at least one member of the staff.
Twenty-three were considered suspect by at least one psychiatrist.
Nineteen were suspected by one psychiatrist and one other staff member.
Actually, no pseudopatient were sent to the hospital.
The conclusion was that there had to be a comprehensive revision of the diagnostic system.
DEFINE AND ILLUSTRATE THE ANXIETY DISORDERS (5).
Anxiety disorders are characterized by fear, feelings of dread and over arousal of the sympathetic nervous system. Anxiety disorders are psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. The anxiety disorders are -Phobic disorder -Panic disorder -Generalized anxiety disorder -Obsessive-Compulsive disorder -Post Traumatic Stress Disorder
PHOBIC DISORDER
excessive, irrational fear of an object or activity
PANIC DISORDER
intermittent episode of severe fear or terror
GENERALIZED ANXIETY DISORDER
continuous fear or anxiety that is not associated with an identifiable object or activity
This disorder certainly includes a non-specific over arousal of the sympathetic nervous system.
The person displays
-Hyper vigilance and scanning
-Motor tension and hyperactivity
-Apprehension and expectation
OBSESSIVE-COMPULSIVE DISORDER
-recurring thoughts or images (obsessions)
-irresistible urges to act (compulsions)
To cope with the fear the person may engage in highly ritualized behavior.
When these mental or behavioral rituals begin to disrupt daily function the disorder is fully pathological.
Intrusive (logical..not necessarily healthy) Thoughts.
HOW IS PTSD LIKE THE ANXIETY DISORDERS?
POST-TRAUMATIC STRESS DISORDER, while not considered part of the Anxiety Disorders, includes vigilance, anxiety, partial memories of the trauma, and social withdrawal.
PTSD also seems to potentiate addiction.
DEFINE AND ILLUSTRATE THE MOOD DISORDERS.
Major depressive disorder
Dysthmic disorder
Mania
Bipolar disorder
The MAJOR DEPRESSIVE DISORDER, and the closely related DYSTHMIC DISORDER are both forms of ___ ____, and they are the most common disorder seen in today’s culture
clinical depression
All depression includes… (5)
lethargy, loss of motivation, change in appetite, changes in sleeping, and changes in self-care
A ___ episode is less severe but persistent and may last for two years or more.
Dysthmic
A ___ ___ ___ is severe, rapid in onset and typically lasts two weeks or more without obvious environmental origin (e.g. grief) or drug use.
Major Depressive episode
Major depression can be so severe that the person looses contact with reality. This ___ ___ is debilitating and can lead to suicidal thoughts and actual suicide.
PSYCHOTIC DEPRESSION
Major Depression is a recognizable and treatable disorder; a ___ fraction of suicides with Major Depression received adequate antidepressant treatment prior to their deaths
small
most depressed suicide attempters receive inadequate ____ treatment
antidepressant
Women tend to seek medical care (including therapeutic care) ____ than men.
sooner
Men kill themselves at about ___ times the rate for women.
four
Suicide is ___ leading cause of death in the US.
eighth
The largest increase in suicide in the last 30 years has been among people between 15-24 years old, but the highest rates are still among the ___.
elderly
You are ___ as likely to kill yourself than be killed by someone else.
twice
Those who succeed at suicide generally use lethal methods (guns, hanging, drowning, jumping) and are disproportionately older and ___.
male
Almost a ___ fully intend to kill themselves; fewer than half of these succeed.
third
One third clearly do not want to die.
Their “suicidal gesture” is…
a cry for help or attention.
One third of suicidal people are tossing the dice.
They don’t much care if they live or die, as long as the pain stops.
They tend to be…
impulsive, not plan carefully (if at all), and leave their survival to chance.
Teenagers ATTEMPT suicide roughly __ times more frequently than adults, but their fatality rate is about the same.
10
Suicide is the ___ leading cause of death among 15-19 year-olds.
third
MANIA
euphoria,
hyperactivity and
wildly unreasonable optimism
If the Mania appears without periods of depression the person is simply ___
manic
WHAT IS “FLIGHT OF IDEAS?”
The patient is speaking faster than the average person can follow, so only a select few of the ideas come through. They are not disconnected from reality.
BIPOLAR DISORDER
alternating pattern between depression and mania
WHAT DIFFERENT INTERVENTIONS ARE LOGICALLY RELATED TO THE VARIOUS COMPONENTS OF DEPRESSION?
COGNITIVE THERAPY
PHARMACOLOGICAL THERAPY
BEHAVIORAL THERAPY
If a person has a negative explanatory style, what would the therapy seek to do for the person? What type of therapy is this?
Changing the individual’s “way of thinking” is the goal of COGNITIVE THERAPY.
If the person is actually depressed and serotonin levels are low then the logical intervention would be ____ with drugs to elevate serotonin levels. These drugs (SSRIs such as Paxil, Zoloft, etc.) now represent more than ___% of the pharmacological intervention for depression.
PHARMACOLOGICAL THERAPY; 80
If the person is “acting depressed” with low levels of activity, sleeplessness, poor appetite, and flat affect then ____ can change the person’s actions. If an individual is reinforced for activity then what happens to activity levels?
BEHAVIORAL THERAPY; They go up!
WHAT IS SCHIZOPHRENIA?
which means “split mind,” is a severe mental illness characterized by some or all of the following:
- Bizarre behavior.
- Disorganized thinking.
- Disorganized speech.
- Decreased emotional expressiveness.
- Diminished or loss of contact with reality.
- Diminished to total social withdrawal.
The prevalence of schizophrenia is ___ ___ ___ ___ sex, race, and culture.
the same regardless of
Schizophrenia afflicts approximately __% of the world’s population.
1
____ experience less severe disruptions due to the illness and are less likely to be hospitalized and maintain better social functioning.
Women
In the United States, ___ of all beds in psychiatric hospitals are occupied by schizophrenic patients.
one-third
people with schizophrenia account for at least __% of the homeless population in the United States
10
Schizophrenia is progressive as evidenced by:
- Have a history of bizarre thoughts, speech, or viewpoints in childhood.
- Have a hard time keeping up at school.
- Have a history of being disliked at school
- Have a history of social isolation.
- Are less likely to marry and more likely to divorce.
- Have a hard time keeping a job, perform poorly at work and miss work frequently.
- More prone to attempt suicide.
Schizophrenia is progressive or sudden?
progressive
The illness usually develops slowly over months or years.
Schizophrenia usually develops between the ages of __ and __
15 and 30
Once people develop schizophrenia, they usually suffer from the illness for the rest of their lives.
T/F
True
Is there a cure for schizophrenia?
Although there is no cure, treatment can help many people with schizophrenia lead productive lives.
