Psychopathology the thin line that separates sanity from madness To study the abnormal is the best way of knowing the normal W James Fun to hear about uncommon disorders Limbic psychotic trigger reactions Sudden brain seizure triggered by harmless sight or sound causes some men to fly into violent rage 18 cases 14 murders quiet unassuming loners suddenly erupt into violence only to just as suddenly recoil in horror at their actions gripped by remorse BUT Historical Roots Caused Need by evil spirits an opening to escape Witchcraft demonic possession full moon supernatural forces Exorcism torture primitive surgery bloodletting bitter poisons starvation noise making Today Medical perspective Psychological perspective Debate Biological conditions vs Past present life experiences natural disasters to abuse divorce illness etc Psychoanalytic Parental influences unconscious defense mechanisms Behaviorial Reward beliefs CB punishment perceptions expectations AND Diathesis Stress Model Pibloktoq Intense coma Tear excitement seizures then off clothing break furniture shout obscenities eat feces later forget Diagnosis A Necessary Step DSM IV Disorders we ll discuss Anxiety GAD Panic phobias OCD PTSD Somatoform Hypochondriasis conversion Dissociative Amnesia fugue DID Mood Depression mania bipolar Schizophrenic Paranoid Disorganized Catatonic Undifferentiated Residual Personality borderline antisocial Who s crazy here anyway However much we may be personally convinced that we can tell the normal from the abnormal the evidence is simply not compelling Rosenhan 1973 On being Sane in Insane Places Hollow Empty Thud Described true life histories relationships etc Ceased any symptoms tried to convince staff of sanity to be discharged BY THEIR OWN DEVICES How many were identified as SANE How long did it take had a close relationship with his mother but was rather remote from his father during his early childhood During adolescence and beyond however his father became a close friend while his relationship with his mother cooled His relationship with his wife was characteristically close and warm Apart from occasional angry exchanges friction was minimal the children had rarely been spanked This white 39 year old male manifests a long history of considerable ambivalence in close relationships which begins in early childhood A warm relationship with his mother cools during adolescence A distant relationship to his father is described as becoming very intense Affective stability is absent His attempts to control emotionality with his wife and children are punctuated by angry outbursts and in the case of the children spankings And while he says that he has several good friends one senses considerable ambivalence embedded in those relationships also Role of Expectations 7 Schizophrenic diagnoses 1 bipolar I m fine no longer experiencing any symptoms Pseudopatients behavior caused by situation e g boredom hunger Interpreted by staff as reflecting psychopathology Length of stay 7 52 days No one detected EXCEPT Diagnoses are often not reliable or useful Sane needlessly stigmatized feigned insanity Line between Mental health professionals determine judge where on the continuum behavior lies Which criteria to use Bizarreness of Behavior Persistence of Behavior Social Deviance Subjective Distress Psychological Handicap Effect on Functioning Normal Abnormal Beware Medical Students Disorder is prevalent among psych students Psychological disorders are just exaggerations of tendencies that all of us have Being sad anxious or proud does not mean we are suffering from depression narcissism anxiety disorder or schizophrenia Detailed Examples 1 Anxiety OCD 2 Somatoform Hypochondriasis 3 Dissociative DID 4 Mood Depression 5 Schizophrenic Schizophrenia 6 Personality borderline antisocial 1 OCD Recurrent intrusive unwanted thoughts and compulsive actions One boy washed hands so much they became raw bloodied One boy ran up and down the stairs 63 times day Woman determined to keep eyebrows symmetric plucked them all out Woman spent 8hrs day bathing Man couldn t leave subway without picking up all litter Man s apartment stacked to ceiling with dishes dirty clothes collected objects he couldn t throw away MENTALLY NEUTRALIZE unacceptable thoughts and behaviors Treatment refocusing to unlock the area stuck in its pattern Label refocus to constructive activity Obsessions Compulsions Dirt germs contamination 55 Aggressive impulses 50 Need for symmetry 37 Bodily concerns 35 Forbidden sexual impulses 32 Checking Washing Counting 79 58 21 2 Hypochondriasis Guess who Complained of dizzy spells numbness in fingertips nausea indigestion chest pains and other assorted ailments Chronic unwarranted preoccupation w one s physical health Highly sensitive to NORMAL bodily sensations The whole day was planned out to suit him to be ready for reading aloud to him to go on his walks with him and to be constantly at hand to alleviate his daily discomforts Place your foot in this ice water Until can t tolerate it Heart rate Temperature Rate unpleasantness Heightened Sensitivity Hypochondriacs Removed their foot sooner Rated cold as more unpleasant Showed more physiological reactivity to stimulation 3 Dissociative Identity Disorder Learn to cope with trauma by mentally divorcing part of self from pain suffering Construct live 9X more prevalent in women 88 Ea alternative identities in which to victims of sexual abuse May have own voice speech pattern habits memories sexual orientation clothing handwriting brain wave BP eyeglass prescription rxns Skeptical 1817 1970 200 cases Faking for personal gain Undetected Therapists now more sensitive Therapists overdiagnose OR suggest reinforce Billy Milligan 4 Depression The common cold Universal 2x women 12 21 will experience Emotional Cognitive Motivational and Somatic symptoms without discernible cause 2 wks Profound sadness Diminished interest in food sex social banter Intense worthlessness guilt self blame Restlessness agitation Depleted energy Recurring thoughts of suicide death A cause Power control Action consequence Imagine feeling unable to have an effect on life events If expect bad things to happen over which you have little control Feel life hopeless about making positive changes in your Learned Helplessness in Humans More likely to become depressed if attribute failure to INTERNAL It s my fault STABLE It won t change GLOBAL It affects my whole life Expectation one cannot control important
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