5.

1 Abnormal Psychology: Psychological disorders

 Abnormality defined by the APA as behavior that causes distress, loss of freedom, physical or
emotional pain, increased risk of death or injury to self or causes a disability of some sort

 7 Criteria for Abnormal Behavior (Rosenhan & Seligman, 1984)

o Suffering

o Maladaptiveness

o Irrationality

o Unpredictability

o Vividness and unconventionality

o Observer discomfort

o Violation of moral or ideal standards

 6 Characteristics of Mental Health (Jahoda, 1958)

o Efficient self-perception

o Realistic self-esteem and acceptance

o Voluntary control of behavior

o Accurate perception of the world

o Sustaining relationships and providing affection

o Self-direction and productivity

o Evaluation

 Actually applying these criteria means most people would be considered

 Normalness is culturally determined

Discuss validity and reliability of diagnosis

 Problems with classification

o No physical signs of disorders making it difficult to diagnose

o Lack of agreement using same classification system

 ICD-10 - 36% agreed

 Great Ormond Street System - 88% agreed

Discuss cultural and ethical considerations in diagnosis

Culture-bound Syndrome

 Shenjing shuairuo accounts for over 50% of outpatient cases in China

o Not included in DSM-IV but many symptoms are similar to the crtieria for a combo of
mood and anxiety disorder in DSM-IV

Ethical Considerations in Diagnosis

 Self-fulfilling prophecy

o People who believe they are 'abnormal' may begin to act abnormal thus fulfilling the
prophecy they have a psychological illness (Scheff, 1966)

 Racial and ethnic (Jenkins-Hall & Sacco, 1991)

o African American women rated more negatively and less socially competent than
European women by therapists watching them on videos of a clinical interview

 Only women were used, possible gender difference

 Confirmation bias

o Cognitive bias that leads practioners to assume that patients seeking help are sick and
thus look for signs/symptoms that can lead to a diagnosis even if patient is 'normal'
(Rosenhan, 1973)

 Powerlessness and depersonalization

o Makes assessing patients properly difficult

o Effect of institutionalization where patient has little choice, few rights, not much privacy
and a lack of constructive activities affects their 'normal' behavior
5.2

Describe symptoms and prevalence of one disorder from two of the following groups

Anxiety disorders - PTSD

Symptoms

 Affective - anhedonic (=inability to experience pleasure), callousness

 Behavioral - flashbacks, paranoia and hypervigilance, nightmares

 Cognitive - intrusive memories of traumatic event, problems concentrating, hyperarousal

 Somatic - lower back pain, digestion issues, insomnia, losing ability to control bladder

Prevalence

 US - 1-3% with lifetime prevalence of 5% in men and 10% in women

 Affects 15-24% of people who experience a traumatic event (Davidson et al., 2007; Breslau et
al., 1998)

 Usually cooccurs with other disorders like depression andsubstance abuse

Affective disorders - Unipolar Depression

Symptoms

 Affective - sadness, inability to find joy in things once found enjoyable

 Behavioral - lacking desire to do any activities, extremely passive and idle

 Cognitive - negative thoughts, attribute failures to self, poor self-esteem, possible suicidial
thoughts, hopelessness and lack of confidence in their condition improving

 Somatic - low energy levels, insomnia or hypersomnia (=sleeping all the time), lack of sex drive

Prevalence

 US - lifetime prevalence of 15% (Charney & Weismann, 1988)

 2-3x more likely to occur in women

 80% diagnosed will experience a subsequent episode

Eating disorders - Bulimia

Symptoms
  Affective - feelings of inadequacy, guilt, shame

 Behavioral - binge eating, vomiting after eating, laxative use, excessive exercising

 Cognitive - distorted perception of body, perfectionism

 Somatic - irregular menstrual cycle, tooth enamel erosion, gastrointestinal problems, risk of
heart palpitations

Prevalence

 Affects 2-3% of women

 Roughly 5 million experience an eating disorder in US

 Some symptoms reported in up to 40% of college women in US (Keel et al., 2006)

 5.79% for women aged 15-29 in Japan

Analyse etiologies (in terms of biological, cognitive and/or sociocultural factors) of one disorder from
two of the following groups

Anxiety disorders - PTSD

Biological

 Twin research showed a potential genetic disposition (Hauff & Vaglum, 1994)

 High levels of noradrenaline cause individuals more openly and PTSD patients had above
average noradrenaline levels (Geracioti, 2001)

 PTSD patients have Increased sensitivity in noradrenaline receptors (Bremner, 1998)

Cognitive

 PTSD patients believe they have no control over their lives

 Intrusive memories in the form of flashbacks occur because of cue-dependent memory

o Cues in the real world are similar to the cues of the traumatic experience which cause
the same level of panic as the cues in the traumatic event (Brewin et al., 1996)

 Recovering from child abuse may be related to the patient's tendency to think the abuse was
their fault - patients who did not think it was their fault were more likely to recover

Sociocultural

 People exposed to racism and oppression are more likely to develop PTSD
 o Vietnam War veterans (Roysircar, 2000)

 20.6% black developed PTSD

 27.6% hispanic developed PTSD

 13% white developed PTSD

 Threat of death linked to PTSD so patients should avoid situations that cause anxiety and panic
(Dyregrov)

o Sarajevo, Bosnia 1998

 35% boys had PTSD

 73% girls had PTSD

 Higher rate linked to girls being threated with rape (Kaminer et al.,
2000)

Cultural Considerations

 Non-western variants of PTSD should be treated for somatic symptoms even if atypical somatic
symptoms are not in the DSM

 Non-westerners exhibit body memory symptoms

Gender Considerations

Affective disorders - Unipolar Depression

Biological

 Recent research shows too much serotonin in a different serotonin receptor subtype has been
linked to depression summary (Barter et al., 2008