Chapter Thirteen

Module 13.1

What Is Abnormal Behavior?

Criteria to Identify Abnormal Behavior

• Unusualness

• Social deviance

• Emotional distress

• Maladaptive behavior

• Dangerousness

• Faulty perceptions or interpretations of reality

– Hallucinations

– Delusions

Culture and Abnormal Behavior

• Variations between cultures

– What behaviors are considered abnormal

– How abnormal behavior is expressed or experienced

– Culture-bound syndromes

• Variations over time, history

Early Models of Abnormal Behavior

• 15th – 17th centuries

• Abnormal behaviors caused by supernatural forces

– Demonic spirits

• Exorcism

– Witchcraft

Medical Model of Abnormal Behavior

• 18th – 19th centuries

• Time of rapid advances in medical science

• Developed medical model

– Abnormal behavior patterns represent mental illnesses

– Biological basis

Psychological Models of
Abnormal Behavior

• Psychodynamic model (Freud)

– Unconscious conflicts

• Behaviorist model (Pavlov)

– Role of learning

• Humanistic model (Rogers, Maslow)

– Conscious choices and self-actualization

• Cognitive theories (Ellis, Beck)

– Distorted thinking and maladaptive behavior

Sociocultural Model of
Abnormal Behavior

• Importance of social and cultural context of abnormal behavior

• Social ills, failures of society

• Social and cultural influences

– Social class

– Poverty

– Ethnic and cultural background

– Discrimination

– Effects of labeling

• Rosenhan (1973) study with pseudopatients

Biopsychosocial Model of
Abnormal Behavior

• Multiple factors interact

• Example: diathesis-stress model

– Diathesis: vulnerability or predisposition

– Stress: from life experiences

Psychological Disorders

• Distinctive patterns of abnormal behavior

– Mental disorders or illnesses

• Rates of disorders

– Rather common

– About 50% in lifetime

• Classification

– Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)

Module 13.2

Anxiety Disorders

Types of Anxiety Disorders

• Phobias

– Social phobias

– Specific phobias (acrophobia, claustrophobia)

– Agoraphobia

• Panic disorder

• Generalized anxiety disorder (GAD)

• Obsessive-compulsive disorder (OCD)

Causes of Anxiety Disorders

• Biological factors

– Disturbances in neurotransmitter functioning

– Genetic influences

• Psychological factors

– Classical and operant conditioning

– Cognitive factors

Module 13.3

Dissociative and Somatoform Disorders

Dissociative Disorders

• Problems with memory

• Changes in consciousness or self-identity

• Disruption of cohesive sense of self

• Dissociative identity disorder (DID)

– Multiple or split personality

• Two or more distinct personalities

– May have core and alternate personalities

– Women average 15; men average 8

Dissociative Amnesia

• Loss of memory about self or experience

– Typically stressful or traumatic event

• No physical cause for amnesia

Causes of Dissociative Disorders

• Traumatic experiences

– Childhood sexual abuse

– Psychological pain or conflict

• Inadvertently cued by therapists

– Issue of debate

Somatoform Disorders

• Physical symptoms without medical causes

• Types

– Conversion disorder

– Hypochondriasis

Conversion Disorder

• Loss of functioning, feeling, or movement in specific body part

– Paralysis

– Numbness

– Loss of sensation

• Lack of concern with symptoms

– La belle indifference

• Way of avoiding anxiety associated with stressful situation

Hypochondriasis

• Preoccupied with idea of health problems

• Excessive worries about disease

• Anxiety may cause symptoms

– Sweating

– Dizziness

– Increased heart rate

Causes of Somatoform Disorders

• Unconscious conflicts

– Defense mechanisms

– Secondary gain

• Learning theories

– Reinforcement for “sick role”

– Cognitive factors

• Misinterpreting bodily symptoms

Module 13.4

Mood Disorders

• Severe or persistent disturbances of mood

– Limit ability to function

• Include

– Depressive disorders

– Bipolar disorders

Depressive Disorders

• Major depressive disorder

– Depressed mood for at least two weeks

• Sadness

• Worthlessness

• Changes in sleep, appetite

• Lethargy

• Loss of interest, concentration

• Seasonal affective disorder (SAD)

• Dysthymic disorder

Bipolar Disorders

• Bipolar disorder

– Alternate between

• Depression

• Manic episodes

– Euphoria

– Restlessness, excitement

– Reckless behavior

• Cyclothymic disorder

Causes of Mood Disorders: Psychological Factors

• Freud’s classic psychodynamic theory

– Anger turned inward against self

• Behavioral view

– Loss of reinforcement

• Especially social reinforcement

• Examples

– Loss of friends

– Moving away from home

• Lack of social skills

• Cognitive view

– Negative way of interpreting events

– Distorted or biased way of thinking

– Cognitive distortions, such as

• All-or-nothing thinking

• Misplaced blame

• Jumping to conclusions

• Catastrophizing

• Shouldisms

Causes of Mood Disorders: Psychological Factors

• Learned helplessness model (Seligman)

– Belief that one is helpless to control reinforcements Laboratory studies with shocked animals

• Attributional style

– Internal versus external

– Global versus specific

– Stable versus unstable

Causes of Mood Disorders: Biological Factors

• Chemical imbalances in brain (neurotransmitters)

– Norepinephrine

– Serotonin

• Treatment with antidepressants

– Prozac

• Hereditary influences

Suicide

• Who is most at risk?

– Age

• Older adults

– Gender

• Women attempt more

• Men more completions, more lethal methods

– Race/ethnicity

• More frequent: White and Native American

• Less frequent: African American and Hispanic Americans

• Factors related to suicide

– Mood disorders

• Lack of serotonin, disinhibition effect

– Alcohol dependence

– Exit events

• Losses of supportive persons

– Teens and copycat suicides

Module 13.5

Schizophrenia

• About one of one hundred people

• Psychotic disorder

• Symptoms

– Hallucinations

– Delusions

– Thought disorder, loose associations

– Positive versus negative symptoms

Types of Schizophrenia

• Disorganized type

– Confused behavior, incoherent speech

– Vivid, frequent hallucinations

• Catatonic type

– Bizarre movements, postures, grimaces

– Waxy flexibility

• Paranoid type

– Delusions of grandeur, persecution, jealousy

Causes of Schizophrenia

• Genetic factors

• Biochemical imbalances

– Neurotransmitter dopamine

– Effects of antipsychotic drugs

• Brain abnormalities

– Prefrontal cortex, limbic system

• Psychosocial influences

– Stressful life experiences

– Diathesis-stress model

Module 13.6

Personality Disorders

• Rigid patterns of behavior, personality

– Self-defeating

– Deeply ingrained maladaptive personality traits

• Various disorders (10 in DSM) including

– Narcissistic personality disorder

– Paranoid personality disorder

– Schizoid personality disorder

– Borderline personality disorder

– Antisocial personality disorder

Antisocial Personality Disorder

• Also called psychopaths, sociopaths

• Symptoms

– Disregard for rules

– Lack of concern for others

– Act on selfish impulse

– Irresponsible

– Lack remorse for mistreatment of others

– May be highly intelligent and charming

Causes of Antisocial
Personality Disorder

• Brain abnormalities

• Genetic contributions

• Exaggerated cravings for stimulation

• Environmental factors

– Neglectful, harsh family

– Emotional, physical abuse

Module 13.7

Application: Suicide Prevention

Warning Signs

• Disposing of possessions

• Sorting out affairs related to death

• Purchasing guns

• Suddenly seem at peace

– Sense of relief from ending life’s problems

Facing the Threat of Suicide

• Recognize the seriousness

• Take implied threats seriously

• Express understanding

• Focus on alternatives

• Assess the immediate danger

• Enlist agreement to seek help

• Accompany the person to seek help