Abnormal Psychology

Abnormal Psychology
Defining Abnormal Behavior
 Abnormal behavior is a mental illness
that affects or is manifested in a
person’s brain and can affect the way
a person thinks, behaves, and
interacts with people.
Characteristics of
Abnormal Behavior
 Statistical Infrequency: people who are
abnormal deviate much from the average in a
particular trait or behavior pattern
 Violation of Norms: the behavior violates
social norms or threatens or makes anxious
those observing it
 Personal Distress: the behavior creates great
distress and torment in the person
experiencing it
 Disability or Dysfunction: the person is
impaired in some important area of life (e.g.,
work or personal relationships) because of the
abnormality
Classifying Abnormal Behavior
with the DSM-IV
 Axis I: all diagnostic categories except
personality disorders and mental
retardation
 Axis II: personality disorders and mental
retardation
 Axis III: general medical health conditions
 Axis IV: psychosocial and environmental
problems
 Axis V: current level of functioning (GAF)
The Psychological Disorders
 Childhood Disorders
 Anxiety Disorders
 Dissociative Identity Disorder
 Schizophrenia
 Mood Disorders
 Personality Disorders
Childhood Disorders
 Mental Retardation
 Learning Disorders
 Pervasive Developmental Disorders
(PDD)
 Attention-Deficit/Hyperactivity
Disorder (AD/HD)
Mental Retardation
1. Significantly subaverage intellectual
functioning along with

2. Deficits in adaptive behavior and

3. Occurring prior to age 18

Learning Disorders
 Inadequate dev’t in a specific area of
academic, language, speech or motor skills
not due to MR, autism, a demonstrable
physical disorder, or deficient educational
opportunities
 Children w/ these disorders are usually of
average or above-average intelligence but
have difficulty learning some specific skill
and thus their progress in school is
impeded.
Learning Disorders
 Reading disorder (dyslexia)

 Disorder of written expression

 Mathematics disorder
Famous People with Dyslexia
PDD, Autistic Disorder
 characterized by impaired social interaction,
problems with verbal and nonverbal
communication, and unusual, repetitive, or
severely limited activities and interests.
AD/HD
 A persistent pattern of inattention
and/or hyperactivity-impulsivity that
is more frequent or severe than is
typically observed in individuals at a
comparable level of development.
 Symptoms must be present before
age 7 and interfere with functioning
in at least 2 settings.

Symptoms of AD/HD
 Fidgets
 Difficulty remaining
seated
 Easily distracted
 Difficulty waiting turn
 Blurts out answers
 Difficulty following
instructions
 Difficulty sustaining
attention
 Flits fr. 1 uncompleted
task to another
 Difficulty playing
quietly
 Talks excessively
 Interrupts others
 Doesn’t seem to listen
 Loses things needed
for tasks
 Engages in physically
dangerous activities
Case # 1
Nine-year-old Cathy is described by
everyone as a “handful.” She
fidgets constantly in class,
drumming her fingers on the desk,
squirming around in her chair, and
getting up and down. She has
trouble waiting her turn at work or
at play, and she sometimes has
violent outbursts.
Case # 2
A young man in an undergraduate course
shows an unusual pattern of strengths
and difficulties. His oral comments in
class were exemplary, but his
handwriting and spelling were
sometimes indecipherable. The
undergraduate explained that it took
him longer to complete the weekly
reading assignments and to write
papers and exams.
The instructor decided to accord him
additional time for preparing written
work. The student was obviously of
superior intelligence and highly
motivated to excel. Excel he did,
earning an A in the seminar and on
graduation being admitted to a leading
law school.
Case # 3
Timmy was born with the umbilical cord
wrapped around his neck, so he had
been w/o oxygen for an unknown
period of time. Nonetheless, he
appeared to be a healthy little boy. He
was a very good baby who rarely cried,
although his mother was concerned
that he didn’t like to be picked up and
cuddled. He wasn’t talking at 2 years
old. He didn’t play with other children;
he spent most of his time alone,
spinning plates on the floor, waving his
hands in front of his face, and lining up
blocks in a certain order. At age 3,
Timmy’s behavior persisted.
Neurological exams revealed nothing
unusual. Still, Timmy was delayed in
learning such basic skills as talking and
feeding himself. By age 7, Timmy still
didn’t speak or play w/ other children,
and he was developing aggressive and
self-injurious behaviors.
Anxiety Disorders
 have some form of irrational or
overblown fear as the central
disturbance
 Some of the anxiety disorders:
 Panic Disorder
 Specific Phobia
 Obsessive-Compulsive Disorder (OCD)
 Post-Traumatic Stress Disorder (PTSD)
Panic Disorder
 Anxiety marked by the sudden but brief
attacks of intense apprehension or terror
 Panic attacks often cause severe
palpitations, chest pains, trouble in
breathing, trembling, sweating, dizziness,
and a feeling of helplessness.
 May be accompanied by agoraphobia, the
fear of leaving familiar surroundings.
 Generally, a stressful event precedes the
initial panic attack.
Phobic Disorders
 An irrational, overwhelming, persistent fear
of a specific object or situation
 Fear is so intense that people w/ phobic
disorder avoid it even though they know
that the fear is unwarranted & unreasonable
& disrupts their lives.
 Examples: claustrophobia,
acrophobia, hydrophobia
Obsessive-Compulsive
Disorder
 Anxiety-provoking thoughts (obsessions) are
followed by urges to engage in repetitive, ritualistic
behaviors (compulsions) to ward off an impending
feared situation
 Most common compulsions:
 cleaning, maintaining order thru elaborate
ceremonies
 performing repetitive, magical, protective
practices like counting, saying certain numbers,
touching a talisman or a particular part of the
body
 checking, going back 7-8 times to verify that
already performed acts were actually carried out
 performing a particular act, such as eating
extremely slowly
Post-Traumatic Stress Disorder
 Refers to anxiety symptoms that
develop through exposure to a
traumatic event
 Symptoms include:
 reexperiencing the traumatic event
 avoidance of stimuli associated w/ the
event or numbing of responsiveness
 symptoms of increased arousal
Case # 1
 Bernice:
 46-year-old female
 her disorder began 12 years earlier shortly
after her dad’s death
 had a fear of contamination, w/c she vaguely
linked to her father’s death of pneumonia
 was afraid of everything: germs could be
anywhere
 was upset by touching wood, scratchy objects,
mail, canned goods, and silver flecks (can’t
state why these were sources of possible
contamination)
 to reduce discomfort,
 Bernice spends 3-4 hrs. in the CR washing and
rewashing herself, scraping outer layer of soap
 During mealtime, she eats 3 bites of food at a
time, chewing each mouthful 300 times
Case # 2
 The patient:
 27-year-old singer referred by friend for
evaluation
 8 months before, her boyfriend was stabbed to
death in a mugging, w/c she witnessed and
escaped unharmed
 Began to have recurrent nightmares & vivid
memories of the night of the crime
 Nightmares: saw blood, pursued by cloaked
figures
 During the day: drifted off into daydreams,
startled easily, preoccupied
 Other symptoms:
 Left her change/groceries at the store
 If she was waited on, she couldn’t remember
what she came to buy
 Slept restlessly
 Work suffered because of poor concentration
 Withdrew from friends and avoided work
Case # 3
Darlene has always refused to use
escalators. She knows they are quite
safe but she walks far out of her way
to find an elevator or stairs to avoid
the anxiety she feels when she
considers riding an escalator. Darlene
wishes she could overcome this fear
because she is a personal shopper and
does most of her work at department
stores in the mall.
Case # 4
The patient is a 46-year-old widow who
came for therapy. She reported
suddenly experiencing labored
breathing, heart palpitations, nausea,
chest pain, feelings of choking and
impending doom while driving the car,
w/c lasted for a few minutes.
Dissociative Identity Disorder
 DID is characterized by two or more distinct
personalities or selves.
 Each “personality” has its own memories,
behaviors, and relationships.
 Shifts from one personality to another typically
occur under stress.
 Most people with DID are female.
 The disorder is generally the result of extreme
physical or sexual abuse in early childhood,
although the majority of individuals who have
been sexually abused do not develop
dissociative identity disorder.
Demon Alters VS Actual Demon
Possession
 Persecutors, but
could be strong
allies

 Initially appear to
be ego dystonic;
but in time, they
become ego
syntonic
 Tend to be
arrogant; there’s
no sense of
relating w/ them
 Always remain ego
alien (forever
outside of person)
Demon Alters VS Actual Demon
Possession
 Confusion & fear
subside w/
appropriate
therapy
 Tend to conform to
surroundings &
culture
 Have personalities
w/ accompanying
voices

 Confusion & fear
persist despite
therapy, includes
lust
 Force unwanted
behaviors & blame
the personality
 Have a negative
voice w/o a
personality
Demon Alters VS Actual Demon
Possession
 Irritation,
discontent, and
rivalry abound
 Images remain
human in form
 Hatred and
bitterness abound

 Images could
become subhuman
Schizophrenia
 A severe psychological disorder
characterized by distortions in thought,
perception, communication, emotion,
behavior, and social skills.
 The symptoms include:
 delusions
 hallucinations
 incoherent speech
 loose associations
 odd behaviors
 social withdrawal
I: Have you been nervous or tense lately?
P: No. I got a head of lettuce.
I: You got a head of lettuce? I don’t
understand.
P: Well, it’s just a head of lettuce.
I: Tell me about lettuce. What do you mean?
P: Well…lettuce is a transformation of a dead
cougar that suffered a relapse on the lion’s
toe. And he swallowed the lion and
something happened. The…see, the…Gloria
and Tommy, they’re two heads and they’re
not whales. But they escaped with herds of
vomit, and things like that.
I: Who are Tommy and Gloria?
P: Uh…there’s Joe DiMaggio, Tommy
Henrich, Bill Dickey, Phil Rizzuto,
John Esclavera, Del Crandell, Ted
Williams, Mickey Mantle, Roy Mantle,
Ray Mantle, Bob Chance…
I: Who are they? Who are those people?
P: Dead people…they want to be
fucked…by this outlaw.
I: What does all that mean?
P: Well, you see, I have to leave the hospital.
I’m supposed to have an operation on my
legs, you know. And it comes to be pretty
sickly that I don’t want to keep my legs.
That’s why I wish I could have an
operation.
I: You want to have your legs taken off?
P: It’s possible, you know.
I: Why would you want to do that?
P: I didn’t have any legs to begin with. So I
would imagine that if I was a fast runner,
I’d be scared to be a wife, because I had a
splinter inside of my head of lettuce.
Mood Disorders
 A group of disorders characterized by
a primary disturbance of mood, that
usually includes cognitive, behavioral,
and somatic symptoms as well as
interpersonal difficulties.
 Disorders can represent one extreme
of emotion (depression) or both
extremes (bipolar disorders).
Major Depressive Disorder
 An individual suffers from depression
without ever experiencing mania for
at least 2 week’s duration and with at
least five of nine symptoms present.
Symptoms of Depression
 depressed mood
 reduced interest or
pleasure in all or
most activities
 significant weight
loss or decrease in
appetite
 changes in sleep
patterns
 psychomotor
agitation or
retardation
 loss of energy
 feelings of
worthlessness or
excessive guilt
 difficulty
concentrating
 suicidal ideation.
Bipolar Disorder
 A disorder characterized by
extreme mood swings that
include episodes of mania alternating
with episodes of depression.
 Mania is characterized by extreme
feelings of euphoria, energy, and
impulsivity.
Symptoms of Mania
 Increase in activity
level at work, socially,
or sexually
 Unusual talkativeness;
rapid speech
 Flight of ideas or
subjective impression
that thoughts are
racing
 Inflated self-esteem;
belief that one has
special talents,
powers, and abilities

 Less than the usual
amount of sleep
 Distractibility;
attention easily
diverted
 Excessive involvement
in pleasurable
activities that are
likely to have
undesirable
consequences (e.g.,
reckless spending)
Case # 1
T: Well, you seem pretty happy today.
C: Happy! Happy! You certainly are a master
of understatement, you rogue! [Shouting,
literally jumping out of his seat.] Why, I’m
ecstatic. I’m leaving for the West Coast
today, on my daughter’s bicycle. Only
3,100 miles. That’s nothing, you know. I
could probably walk, but I want to get
there by next week. And along the way I
plan to contact a lot of people about
investing in my fish equipment. I’ll get to
know more people that way—you know,
Doc, “know” in the biblical sense [leering
at the therapist seductively]. Oh, God, how
good it feels. It’s almost like a nonstop
orgasm.
Case # 2
Mrs. M, a 38-year-old factory worker was
a mother of four children. She had
returned to work three years earlier
when the worsening economy made it
impossible for her family to get by on
just by her husband’s earnings. But
seven months before she visited the
psychologist, she was laid off, and the
family’s financial situation
deteriorated. Ever-present worries
about money led to increased
arguments with her husband, not only
about their finances, but also about
the children.
She had begun to have difficulty sleeping
and lost her appetite, resulting in
weight loss. She had little energy and
no interest in activities that she
normally enjoyed. Even though she sat
for hours in front of the TV, she
couldn’t get interested in any of the
programs that had been her favorites;
she didn’t even pay attention most of
the time. Household chores became
impossible for her to do, and her
husband began to complain, leading to
further arguments. Finally, realizing
that something serious had happened
to his wife, Mr. M cajoled her into
making a first appointment with a
psychologist.

Personality Disorders
 They are chronic, maladaptive
cognitive-behavioral patterns that are
thoroughly integrated into the
personality.
 Some Personality Disorders:
 Antisocial Personality Disorder
 Borderline Personality Disorder
 Passive-Aggressive Personality Disorder
Antisocial Personality Disorder
 Characterized by a pattern of
exploitive behavior, lack of guilt, self-
indulgent behavior, and
interpersonally intrusive behavior.
 The disorder generally begins before
the age of 15 and continues into
adulthood.
Borderline Personality Disorder
 Borderline personalities are
emotionally unstable, impulsive,
unpredictable, irritable, and anxious.
Passive-Aggressive Personality
Disorder
 Passive-aggressive personalities are
stubborn or are intentionally
inefficient in an effort to frustrate
others.
Case # 1
Alan is involved in drugs and has casual
sexual encounters. He feels empty
unless he does dangerous and
exciting things. He threatens to
commit suicide if his girlfriend
suggests getting help or if she talkjs
about leaving him. He alternates
between loving her and hating her.
He has low self-esteem and has
recently experienced high levels of
stress.
Case # 2
Matt is 19 and has been in trouble with
the law since he was 14. He lies to his
parents, vandalizes buildings in his
community and when caught, shows
no remorse. He frequently fights with
others and doesn’t care whom he
injures.
Case # 3
Mike, male, 52 is attending therapy at
the request of his wife. She complains
that he is "emotionally absent" and
aloof. Mike shrugs: "We used to have a
great marriage, but good things don't
last. You can't sustain the same levels
of passion and interest throughout the
relationship." Isn't his family worth the
effort? Another shrug: "It doesn't pay
to be a good husband or a good father.
Look what my loving wife did to me. In
any case, at my age the future is
behind me. Carpe Diem is my motto.“
Does he consider his wife's demands to
be unreasonable? He flares: "With all
due respect, that's between me and
my spouse." Then why is he wasting
his time and mine? "I didn't ask to be
here." Did he prepare a list of things
he would like to see improved in his
family life? He forgot. Can he compile
it for our next meeting? Only if nothing
more urgent pops up. It would be
difficult to continue to work together if
he doesn't keep his promises. He
understands and he will see what he
can do about it (without great
conviction).

The problem is, he says, that he regards
psychotherapy as a form of con-
artistry: "psychotherapists are snake
oil salesmen, latter-day witch doctors,
only less efficient." He hates to feel
cheated or deceived. Does he often
feel that way? He laughs dismissively:
he is too clever for run-of-the-mill
crooks. He is often underestimated by
them.

Do other people besides crooks
underestimate him? He admits to
being unappreciated and underpaid at
work. It bothers him. He deserves
more than that. Obsequious
intellectual midgets rise to the top in
every organization, he observes with
virulent envy. How does he cope with
this discrepancy between the way he
perceives himself and the way others,
evidently, evaluate him? He ignores
such fools. How can one ignore one's
co-workers and one's superiors? He
doesn't talk to them. In other words,
he sulks?

Not always. He sometimes tries to
"enlighten and educate" people he
deems "worthy". It often gets him into
arguments and he has acquired a
reputation as a cantankerous
curmudgeon but he doesn't care. Is he
an impatient or irritable person? "What
do you think?" - he counters - "During
this session did I ever lose my cool?"
Frequently. He half rises from his chair
then thinks better of it and settles
down. "Do your thing" - he says
sullenly and contemptuously - "Let's
get it over with."