Chapter 10: Abnormal Psychology

What does ‘Abnormal’ mean

When we come to describe what is abnormal behavior, people basically says that an abnormal person will behave oddly or strangely, he or she doesn’t think the way ordinary people does. However all of these are just touching the surface and they are only considered as reasonable answers but not that exactly.

We cannot just simply judge or diagnose a person with behaviors that are not people used to do so. The concept of abnormality is always lacking accuracy and hard to define. Examples of abnormality can be happening in different ways and involve different features. Hence, even it seems to be quite reasonable to define the abnormality at first sight, however, it turns out to be quite problematical.

To define abnormal behavior in a practical way, it is necessary to ask whether the behavior causes impairment in the person’s life.

There are some different ways in which it is possible to define ‘abnormal’ as against to what we think is ‘normal’.

Statistical deviation

- A person would be classified as abnormal if his/her behavior, ability or experience is rare or statistically unusual from average.

Strength:    - helps to address what is meant by normal in a statistical context.
                  
- helps people to make cut-off points in terms of diagnosis.

Limitation: -does not specify how unusual the behavior must be before it is
                    said to be abnormal

                   -does not distinguish between desirable and undesirable
                   behavior

e.g.: High IQ people are considered as statistically abnormal, but people regarded it as highly desirable

Dysfunction

- A person would be classified as abnormal if his/her mental mechanism is not performing as well as the others.

- However, some of the things that we define it as a disorder might actually be adaptive reactions.

Personal Discomfort

- A person would be classified as abnormal if he/she experiences a sense of distress or anxiety within him/herself.

Limitation: - is a person who abuses drugs or believes they are receiving messages from outer-space – without experiencing distress?

Maladaptive behavior

- A person would be classified as abnormal if he/she they are not able to cope with the demands of everyday life.

- Cannot perform the natural behaviors for day-to-day living e.g. self-care, going to work, interact meaningfully with others, make themselves understood etc.

Norm or value violation

- A person would be classified as abnormal if he/she have the inconsistent behaviors as compare with the norms and values of society.

e.g.:    1. Behavior that is harmful to oneself or others

           2. Poor reality contact

           3. Inappropriate emotional reactions

           4. Erratic behavior

Limitation: - One must be careful when using these criteria because the fact that normal from one culture to the next can be totally different.

--by Zhi Zhong 

Mental Disorders

• causes of abnormal thinking & behavior can be found in 4 major research perspectives:
  • biological
  • behavioral
  • cognitive
  • sociocultural
• biopsychological approach to explaining abnormality examines interaction between above factors

3 Major Categories

• Anxiety disorders – specific phobia, social phobia & agoraphobia, panic disorder, generalized anxiety disorder, obsessive-compulsive disorders
• Mood disorders – major depressive disorder, bipolar disorder
• Schizophrenic disorders – schizophrenia (paranoid, disorganized, catatonic, undifferentiated, residual subtypes)

i. Anxiety Disorders

1. Specific phobia

• indicated by a marked & persistent fear of specific objects/situations that is excessive/unreasonable
• anxiety & fear of specific stimulus may be rational to an extent but in this case both are in excess of what is typical
• causes:
  • classical conditioning: Watson & Rayner conditioned Little Albert to fear white rats by pairing together a loud noise (UCS) + white rat (CS)
  • biological predispositions: certain associations (taste + sickness) are easy to learn while others (taste + electric shock) are much more difficult

2. Social phobia

• marked & persistent fear of one/more social performance situations in which there is exposure to unfamiliar people/scrutiny by others (fear eating in public, etc)

3. Agoraphobia

• fear of being in places/situations – which escape might be difficult/embarrassing
  • being in a crowd, standing in line, traveling in heavy traffic
  • to avoid such situations a person won't leave the security of their homes

4. Panic disorder

• person experiences recurrent panic attacks (sudden onsets of intense fear)
  • some panic attacks occur when a person is faced with something he dreads (giving a speech etc) but other attacks occur without apparent reason
  • can occur with/without agoraphobia
• fear-of-fear hypothesis:
  • (agoraphobia = fear of having panic attack in public)
  • agoraphobia: case of classical conditioning, fear & avoidance response = CR to initial panic attack

5. Generalized Anxiety Disorder

• person has excessive, global anxiety & worry that they can't control for a period/at least 6 months
  [anxiety not tied to any specific object/situation – as if in phobic disorder]
• might be related to biochemical dysfunction in brain – involves GABA (major inhibitory neurotransmitter)
  [activation problems of GABA – allowing more & more neurons to get excited]

6. Obsessive-Compulsive Disorder (OCD)

• person experiences recurrent obsessions/compulsions that are perceived by the person as excessive/unreasonable – causes significant distress & disruption in daily life
  • obsession: persistent intrusive thought, idea, image that causes anxiety
  • compulsion: repetitive, rigid behavior that person feels compelled to perform to reduce anxiety
• recent researches suggests neurotransmitter imbalance involving serotonin may be involved
  • antidepressants (Prozac, Anafranil etc – increase serotonin activity) help many obsessive-compulsive patients
• orbital region of frontal cortex (area just above eyes) & caudate nucleus (area in basal ganglia) have significantly higher than normal activity in obsessive-compulsive people
  (filter out irrelevant information & disengaging attention – 2 central aspects of OCD)

ii. Mood disorders

(involve dramatic changes in person's emotional mood – excessive & unwanted)

1. Major Depressive Disorder

• person must have experienced one/more major depressive episodes
• women suffer from this twice as often as men
• symptoms
  • intense hopelessness, low self esteem & worthlessness, extreme fatigue
  • dramatic changes – eating & sleeping behavior
  • inability to concentrate
  • greatly diminished interest in family, friends & activities for 2 weeks/more
• causes
  • neurotransmitter imbalance
  • biological predisposition
  • non-genetic factor – pessimistic explanatory style

2. Bipolar disorder

• person's mood takes dramatic swings between depression & mania with recurrent cycles of depressive & manic episodes
• symptoms: (... at least 1 week)
  • abnormally elevated mood
  • inflated self-esteem + grandiose delusions
  • decreased need for sleep
  • constant talking
  • distractibility
  • restlessness
  • poor judgment

3. Schizophrenic disorder

• characterized by loss of contact with reality
  • schizophrenia = “split mind” as mental functions become split from each other, detach from reality
• technically defined as presence (most of the time during one-month period, at least 2 of the following symptoms)
  • hallucinations
  • delusions
  • disorganized speech
  • disorganized/catatonic behavior
  • any negative symptoms (loss of emotion etc)
• symptoms:
  1. positive symptoms: more active symptoms that reflects excess distortion of normal thinking/behavior
  • hallucinations: tend to be auditory – hearing voices that are not real
  • delusions:
    • delusions of persecutions: thoughts of conspiracy against you
    • delusions of grandeur: believing that you are person of great importance, such as Jesus Christ
    [hallucinations & delusions are positive symptoms because they refer to things that have been added]
  2. negative symptoms: things that have been removed

• deficits/losses in emotion, speech, energy level, social activity and even basic drives such as hunger
3. disorganized symptoms: disorganized speech, disorganized behavior, inappropriate emotion

Subtype	Symptoms
Disorganized	Disorganized speech, behavior/inappropriate emotion
Catatonic	Extreme movement symptoms from excessive motor activity to posturing
Paranoid	Organized cognition & emotion + hallucinations & delusions that are usually concerned with persecution
Undifferentiated	Symptoms fit criteria of more than one of above 3 types/none of them
Residual	Been past schizophrenic episode but presently only negative symptoms & no positive ones

Causes of Schizophrenia

• possibility that different genes might be involved in different types of schizophrenia
• prenatal viral infections
  • increased risk if there was a flu epidemic during the middle of their fetal development
• neurotransmitters
  • schizophrenics have elevated levels of dopamine activities in certain areas of their brains
• brain abnormalities
  • shrunken cerebral tissue & enlarged fluid-filled areas
  • thalamus seems to be smaller & frontal lobes less active
• vulnerability-stress-model: genetic, prenatal, postnatal biological factors render a person vulnerable to schizophrenia but environmental stress determines whether it develops
• person's level of vulnerability interacts with the stressful social-cognitive events in their life to determine the likelihood of schizophrenia
• tend to strike in late adolescence & early adulthood, periods of unusually high stress levels

-- by Qi Qi (qxchxn)