Abnormal Behavior and Therapy I Defining Abnormality WHAT IS A MENTAL DISORDER Mental disorder a variety of cognitive emotional and behavioral Tori Olker symptoms that Deviate from the norm uncommon abnormal o Cultural determined Or the APA s definition Creates significant stress Or leads to significant risk of harm danger Impairs functioning disability o Distress disability danger WHAT IS CONSIDERED ABNORMAL It s hard to draw the line between normal and abnormal Based on cultural practices which change with time Based on what is determined by various health care organizations IT S ALL ABOUT CONTEXT Individuals with mental disorders are different from others in degree not in kind WHAT CAUSES MENTAL DISORDERS Demonic model o evil spirits in the body Medical model o mental illness is a physical disorder requiring medical treatment Insane asylums surgeries drugs Diathesis stress model must have both a biological predisposition to a certain disorder diathesis and significant environmental stressors BIOPSYCHOSOCIAL MODEL Abnormal behavior has 3 major aspects Biological o Genes anatomy neurotransmitters Psychological o Learning history stress Social o Cultural context society DSM IV DSM IV Diagnostic and Statistical Manual of Mental Disorders 4th edition Axis I o clinical disorders Represent a deterioration of functioning Axis II Axis III Axis IV Axis V o Personality Disorders and Mental Retardation Lifelong o Medical Conditions Diabetes head trauma o Psychosocial environmental stressors o Level of functioning within the past year GAF Global Assessment of Functioning 1 100 GAF is not very accurate DSM IV CONTINUED Designates lists of observable symptoms needed to warrant a particular disorder Prevalence course onset Adopts a categorical present absent model Does not explain causes of disorders besides PTSD Criticized for classifying so many human behaviors as disorders COMORBIDITY Presence of more than one psychological disorder Why does this occur Criteria for various disorders overlap Having one disorder increases vulnerability for another Common diathesis for different disorders Common stressors for different disorders o If you have one disorder there is a very good chance that you have another Abnormal Behavior and Therapy II Overview of Psychotherapy HISTORY OF TREATMENT IN AMERICA Tori Olker 1700 1800s Patients wandered streets and were sometimes put in jail Mental asylums 1773 Mani and melancholia o Patients chose to be irrational Poor living conditions confinement little activity Terrible treatments sedating drugs bloodletting restraining devices ETC electric convulsion therapy Mid 1800s Moral management and custodial care Hospitals custodians of people who could not be cured OTHER DEVELOPMENTS Phrenology Brain shape personality Lobotomies defective nerves would reform as normal nerves after being cut mid 1900s Dr Walter Freeman s lobotombile He performed 50 000 lobotomies Today treatments have improved considerably They are more humane and based on scientific research MODERN PSYCHOLOGICAL TREATMENTS WHAT IS REQUIRED FOR PATIENTS TO CHANGE Two Major Groups 1 Insight Oriented Therapies psychodynamic and person centered a Psychological problems are caused by emotional forces b Gaining insight into the forces is necessary 2 Action Oriented Therapies cognitive and behavioral a Psychological problems are caused by maladaptive thinking or behavior patterns PSYCHODYNAMIC THERAPY Sigmund Freud Psychodynamic and Psychoanalytic longer Problems arise because of unconscious conflicts Goal achieve insight into unconscious motivations Techniques free association dream analysis identifying defense mechanisms analyzing transference o Transference relationship between the therapist and the patient PERSON CENTERED THERAPY AKA Humanistic Therapy Carl Rogers Problems arise because of incongruence between real self and ideal self Goal decrease this incongruence Techniques unconditional positive regard genuineness empathy ACTION ORIENTED APPROACHES Thoughts feelings actions BEHAVIOR THERPY Joseph Wolpe B F Skinner Problems caused by maladaptive behavior patterns Goal change behaviors by learning new ones changing behaviors changes thoughts and feelings Techniques exposure therapies relaxation skills training modeling assertiveness training social skills training role plays token economies homework COGNITIVE THERAPY Albert Ellis Aaron Beck Problems are a function of maladaptive thinking patterns Goal replace maladaptive thoughts with more rational ones changing thoughts changes behaviors and feelings Techniques identify cognitive distortions cognitive restructuring changing maladaptive thoughts thought records CBT CBT cognitive behavioral therapy Combining cognitive and behavioral approaches CBT is the most widely researched treatment for most psychological disorders Better than or equal to medication for many disorders o Smitherman only likes this one CORE ELEMENTS OF ALL THERAPIES The Dodo Bird Verdict Some argue that all therapies are effective because they share 4 common factors and not because of any specific technique Relationship Locale is place of healing where you go to get treated Therapeutic rationale why they treat you the way they do Task or procedure prescribed by the theory how they treat you Smitherman doesn t believe this Therapists are NOT Paid Friends Therapists are highly trained professionals who treat disorders Treatment is confidential relationship is one way Much more than just talking Strong evidence backs its effectiveness Patients in therapy do better than 75 of those not in therapy EMPIRICALLY SUPPORTED TREATMENTS ESTs are treatments for specific disorders that are backed by high quality scientific evidence The same way new medications are tested Most are cognitive behavioral therapies Equal to or better than medication Without side effects With longer maintenance of gains http www apa org divisions div12 cppi html Some therapies don t work or are harmful DARE Scared Straight CISD Be skeptical of extraordinary claims and treatments not backed by research evidence Psychological Disorders and Their Treatment ANXIETY DISORDERS Tori Olker Most common class of disorders 29 Most anxiety disorders involve Fear of an object situation or event Avoidance of the feared stimulus Almost twice as common in women Often have early age of onset 11 years ORIGINS OF ANXIETY DISORDERS Classical conditioning Environment cues from CSs for fear o Claustrophobia elevator CS then trapped US fear