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A couple of odd birds by Janet Waring
What the college board is asking for: A way to introduce the study of abnormal psychology is with a discussion of the definition and diagnosis of abnormal behavior. Criteria that identify behavior as abnormal could be statistical comparisons, sociological norms, or adaptive behavior. Criteria of abnormality are given differing degrees of salience in the many different categories of abnormality specified in the Diagnostic and Statistical Manual (DSM) published by the American Psychiatric Association. A survey of these disorders, based on the most recent edition of the DSM, is an important component of this section of the course. Specific attention needs to be given to etiology and diagnostic criteria for the folowing disorders: mood, personality (found on personality page), dissociative, somatoform, anxiety, organic, and psychotic. Could they make this sound anymore boring?

Lets begin with some important terms. Psychopathalogy is the field concerned with the nature and development of mental disorders. Affect and mood: Mood is the current emotional state, while affect is the expression of that state. Mood and affect should agree or be "congruent". Psychosis is a serious condition in which thinking and emotional states are impaired to the extent that the person is out of contact with reality. (Carolyn Turner, TLU)

The modern defining of abnormal behavior is difficult. Some would say that we are normalizing pathalogy, while others believe we are pathologizing normal behavior. Abnormal behavior is defined by the following five components: statistical infrequency, violation of norms, personal distress, distressing to person or others, unexpectedness.

The DSM-IV

Blake's early example of mental disorder is a long way from our classification system within the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). The DSM identifies five factors or dimensions that describe a client's behavior. These are called Axes and are numbered I-V. Axis I lists and describes all mental disorders (called syndromes), except for those listed under Axis II. Axis II lists personality disorders. Axis III lists any physical or medical disorders that may be present and complicating the mental disorder. Axis IV briefly describes any stressors in the individual's life circumstances. Axis V is where a clinician is asked to rate the individual's highest level of functioning during the past year as compared with the individual's present level of functioning.

King Nebuchadnezzar by William Blake, 1795

Mood Disorders

There are two main categories: Depressive and Bipolar. Depressive involves dysphoria or sadness, while bipolar involves alternating "poles" of mood.

Major depression must account for 5 of 9 symptoms in DSM-IV and continuining for at least 2 weeks. Symptoms include lethargy, loss of interest or pleasure, eating and sleeping disturbances, loss of concentration, excess guilt, intense negative self-view, and obsession with death. The epidemiology (elements contributing to the disorder): 2:1 women to men ratio, learned helplessness theory, which is the giving up of a person who believes their effort has little effect on the outcome, negative cognitive schema is making mountains out of molehills, lack of serotonin and norepinephrine and even sunlight. Lack of sunlight is linked to a mood disorder called seasonal affective disorder. This is caused by too little melatonin being secreted by the pineal gland.

Bipolar Disorder: Alternating mood swings from mania to depression. A manic episode looks like gradiosity, decreased need for sleep, flight of ideas, distractibility, increase in activity and excessive pleasure seeking without regard for consequences. This manic episode must persist for more than a week. There is strong evidence that bipolar and creativity are linked. Geniuses and artists not counted, the average prevalence is 1.6%. It seems to be passed down through genetics. The neurotransmitters that seem to be involved are serotonin and norepinephrine. Lithium seems to prevent these chemicals from being overexcited.

Sorrow by van Gogh, 1882

Anxiety Disorders

Known in the past as neurosis. Anxiety is characterized by unreasonable, often paralyzing, anxiety or fear. They feel the world is dangerous and hostile. There are five major anxiety disorders: generalized anxiety, panic disorder, phobia, obsessive-compulsive, and post-traumatic stress.

Generalized Anxiety: Is twice as common in women. It is long-lasting anxiety that seems to persist without any observable cause. They feel afraid and have trouble controlling their worries.

Panic Disorder: a person suffers sudden but brief attacks of intense apprehension that causes trembling, dizziness and difficulty breathing.

Phobic Disorder: A phobia is a persistent fear reaction to some specific object or situation. There are three types of phobias: agoraphobia, social phobia and simple phobia. The Ultimate Phobia List

Post-Traumatic Stress Disorder: This anxiety grows out of stress. It is the attempt to adjust to some catastrophic event, such as war, death, divorce, or rape.

Obsessive-compulsive: It is the preoccupation of unwanted thoughts and repetitive, irresistible and undesired behavior.

anonymous artist

Somatoform Disorders

It is suspected when a series of physical complaints cannot be explained simply as a matter of stress, or as symptoms of some other psychiatric disorder-major depression or anxiety. Two major types exist: hypochondria and conversion disorder.

Hypochondria is a preoccupation with a hidden disease. They will notice various abnormal sensations, or even pains that seem incomprehensible to others. Many believe it involves an unusual sensitivity to slight body sensations such as mild headaches, and pains.

Conversion disorder patients display bizaar sensory and motor deficiencies . These symptoms are both cognitive and neurolagical, which makes them very controversial. They seem to be mental when they are self-serving.

Dissociative Disorders

The dissociative disorders: psychogenic amnesia, psychogenic fugue and dissociative identity disorder all have in common an attempt by the individual to escape from a significant personal problem or responsibility by severing, forgetting or distancing themselves from the core personality.

Psychogenic Amnesia: inability to recall or identify one's past experiences. It may result from a brain injury or living through a traumatic experience, such as an earthquake or death. There are four different patterns: localized amnesia, selective amnesia, generalized amnesia and contimuous amnesia. Psychogenic Fugue is similar to amnesia, but differs in that fugue adds a flight response as well.

Dissociative Identity Disorder: Little is known of this disorder and some even question if it truly exists. It is characterized as two or more distinct personalities coexisting and controlling behavior. Evidence suggests it to be real. Somatophysiological features, such as allergies and sensitivities to food are apparent with people of DID. Known as Multiple Personality Disorder.

Multiple Pencils by Barbara Norris

Organic Disorders

There are three symptoms that suggest the presence of organic disease: defects in basic mental activities, impairment in higher intellectual functioning, and certain types of affective disorders. An affective disorder is characterized as a sudden shift from inappropriately from one emotion to another. Organic disorders stem from brain damage. Many agents cause brain damage, thus categorizing the causes is generally broad. I can only guess that the AP Exam would only ask for the well-known organic disorders, such as Alzheimer's, Huntington's, Parkinson's diseases, epilepsy, and maybe Korsakoff's Syndrome.

Alzheimer's: various mental skills are lost, mainly memory, disorientation, and judgement. Degeneration of the acetylcoholine producing neurons in the brain is one cause, along with theories of genetics and aluminum levels in the blood.

Parkinson's: results from degeneration of parts ot the basal ganglia. There is an absence of dopamine. Symptoms include muscular rigidity, tremors, and masked facial expression.

Karsakoff's: Direct result of inadequate diet from chronic alcoholism. Vitamin B and thiamine dificiency. Irreversible!

Ronald Reagan with Alzheimer's Disease
The Pope with Parkinson's
Psychotic Disorders

Schizophrenia

A disorder characterized by major disturbances in perception, language, thought, emotion, and behavior. It is considered the most serious and severe of the mental disorders. The "split personality" is not what it appears. It refers to the fragmentation of the thought processes and emotions found within this illness.

There are five symptoms of schizophrenia. Delusions: false ideas they believe to be true. There are delusions of persecution, grandeur, and being controlled. Hallucinations: perceive visual, auditory and tactile senasations without external stimulus. Auditory hallucinations are the most common. Disorganized Speech: language variations such as word salad (phrases and words strung together) and neologisms (made up words like smever, which is smart and clever). Disorganized thinking: a tendency to have a flight of ideas that jump from place to place. Disorganized behavior: behavior innappropriate for the situation. Disorganized emotion is innappropriate display of emotions (laughing at a funeral).

The repetetive behavior seen in schizophrenia, such as rubbing ones head over and over is to clear out unwanted thoughts.

Martin V. mental health patient

Causes of Schizophrenia

Biological: 1) genetics: by most account genetics is around 50% responsible. One study of identical twins found the heritability to be 83% (Bailer, 2000). 2) neurotransmitters: according to the dopamine hypotheses, an overactivity of certain dopamine neurons in the brain cause schizophrenia. Chlorpromazine blocks the effects of dopamine in the brain. 3) brain function: brain damage. larger cerebral ventricles and lower levels of activity in the frontal and temporal lobes. (Pearlson, 1998)

Psychosocial : 1) Stress: According to the diathesis-stress model of schizophrenia, a person inherits a predispostion biologically and when they experience high levels of stress the schizophrenic episode may trigger. 2) Family communication: hostility and criticism aimed at a family member can set the stage for schizophrenia. (Hooley, &Miller, 200)

Harold, P. mental health patient