Psychology 1B - Abnormality, Mood, Anxiety, and Personality Disorders

Overview of Psychopathology and Abnormality

• Psychopathology Defined: The study of abnormal behavior and psychological dysfunction.

  • Etymology:

    • Psycho: Mind.

    • Pathos: Illness.

    • Ology: Study.

• Criteria for Abnormality: To determine if behavior or psychological functioning is abnormal, at least two of the following five criteria must be met:

  • Unusualness: The behavior is rare or deviates from statistical norms.

  • Social Norm Deviance: The behavior goes against current social standards or cultural expectations.

  • Subjective Discomfort/Distress: The behavior causes significant emotional pain or discomfort to the individual.

  • Maladaptive/Inability to Function: The behavior makes it difficult for the person to function in daily life or adapt to the demands of society.

  • Danger to Self or Others: The behavior poses a risk of harm to the individual or those around them.

• Formal Definition of a Psychological Disorder: Any pattern of behavior or psychological functioning that causes significant distress, leads to self-harm or harm to others, or significantly impairs daily functioning.

Models of Abnormality

• Biological Model: Attributes psychological disorders to medical causes. These can be diagnosed, treated, and cured. Primary causes include:

  • Faulty neurotransmitter systems.

  • Genetic predispositions.

  • Brain damage or dysfunction.

• Psychological Models: Propose that disorders result from emotional, behavioral, or thought-related malfunctioning.

  • Psychodynamic Perspective: Based on the work of Freud; focuses on repressed urges and childhood conflicts.

  • Behavioral Perspective: Focuses on learned behaviors through conditioning.

  • Cognitive Perspective: Focuses on illogical or irrational thought patterns.

• Socio-cultural Perspective: Argues that behavior and thinking are products of family, social, and cultural influences. What is considered "normal" is relative to the specific culture.

• Biopsychosocial Perspective: An integrative approach assuming biological, psychological, and sociocultural factors interact to cause disorders.

  • Biological Influences: Individual genes, evolution, brain structure, and chemistry.

  • Psychological Influences: Stress, trauma, learned helplessness, and mood-related perceptions/memories.

  • Social-Cultural Influences: Roles, expectations, and cultural definitions of normality.

Classification and Diagnosis

• Diagnostic and Statistical Manual of Mental Disorders (DSM): First published in 1952.

• Current Version: DSM-$5$-TR (Text Revision), revised in $2022$.

• Research Domain Criteria (RDoC) Project: A potential new system that incorporates behavior, genetics, and cognitive neuroscience for classification.

Mood Disorders

• Definition: Disorders characterized by disturbances in affect or emotion, reaching extremes of the human emotional range.

• Major Depressive Disorder (MDD):

  • Symptoms: Deeply depressed state, sudden onset, little to no pleasure in activities, fatigue, sleep disturbances (too much or too little), weight/appetite changes, feelings of worthlessness, and excessive guilt.

  • Prevalence: $1.5$ to $3.0$ times more likely in women, potentially due to gender roles and social factors.

  • Suicide: While more common in women, men commit suicide more frequently.

• Seasonal Affective Disorder (SAD): Depression with a seasonal pattern, typically worsening in winter due to low light levels.

• Bipolar Disorders: Involve cycles of depression and manic episodes.

  • Manic Episodes: Periods of excessive excitement, energy, elation, racing thoughts, and setting impossible goals.

  • Bipolar I: Characterized by normal moods alternating with full manic episodes (with or without depression).

  • Bipolar II: Normal moods alternating with major depression and hypomania.

  • Hypomania: An elevated mood that is less severe than full mania.

• Explanations for Mood Disorders:

  • Behavioral: Linked to learned helplessness.

  • Cognitive: Linked to distorted, self-defeating thoughts.

  • Biological: Linked to variations in neurotransmitter systems ($serotonin$, $norepinephrine$, and $dopamine$), specific genes, and brain activity.

Anxiety, Trauma, and Stress Disorders

• General Definition: Anxiety is considered a disorder when it is excessive, unrealistic, or persists long after a stressor is gone.

• Types of Anxiety Disorders:

  • Free-Floating Anxiety: Anxiety unrelated to any specific, known factor.

  • Social Anxiety Disorder: Fear of interacting with others or being negatively evaluated, leading to self-consciousness and avoidance (e.g., stage fright).

  • Specific Phobias: Irrational, persistent fear of specific objects (e.g., $claustrophobia$ for enclosed spaces, $acrophobia$ for heights, $cynophobia$ for dogs, $arachnophobia$ for spiders).

  • Agoraphobia: Fear of being in situations where escape is difficult, such as public transport, open spaces, or crowds (requires anxiety in $2$ out of $5$ specific situations).

  • Panic Disorder: Recurrent panic attacks causing persistent worry.

    • Panic Attack Symptoms: Racing heart, rapid breathing, sweating, dry mouth, out-of-body sensations, and fear of dying.

  • Generalized Anxiety Disorder (GAD): Chronic feelings of dread and impending doom with physical symptoms (tension, irritability, muscle aches) lasting at least $6$ months.

• Obsessive-Compulsive Disorder (OCD):

  • Obsessions: Intruding, recurring thoughts that create anxiety.

  • Compulsions: Repetitive, ritualistic behaviors performed to reduce that anxiety (e.g., hand-washing).

• Post-traumatic Stress Disorder (PTSD):

  • Results from exposure to a major stressor.

  • Symptoms: Anxiety, dissociation, nightmares, reliving the event, and concentration issues.

  • Duration: Lasts more than $1$ month; symptoms may appear $6$ months or later after the event.

  • Acute Stress Disorder (ASD): Diagnosed if symptoms last for only one month immediately following the trauma.

Causes and Perspectives on Anxiety

• Psychodynamic: Anxiety is a signal of repressed urges threatening to surface; phobias are displacements of unconscious fears.

• Behavioral: Anxiety is learned through classical or operant conditioning.

• Cognitive: Result of illogical thought processes, including:

  • Magnification: Interpreting situations as far more dangerous than they are.

  • All-or-nothing thinking: Believing performance must be perfect or it is a total failure.

  • Overgeneralization: Drawing sweeping conclusions from a single event.

  • Minimization: Giving little importance to successes.

• Biological: Genetic basis (runs in families); imbalances in $GABA$, $serotonin$, and $norepinephrine$; increased amygdala activity; and structural brain changes (reduced gray matter).

• Sociocultural: Different cultures experience anxiety differently (e.g., ataque de nervios in Latin American cultures).

Eating Disorders

• Anorexia Nervosa:

  • Characteristics: Significant weight loss (Adult BMI < $18.5$), intense fear of weight gain, and distorted body image.

  • Behaviors: Severe food restriction, excessive exercise, and sometimes purging.

  • Effects: Osteoporosis, heart damage, low blood pressure, and organ failure.

• Bulimia Nervosa:

  • Characteristics: Cycles of binging (large amounts of food) and purging (vomiting, laxatives, fasting).

  • Weight: Individuals usually maintain a normal weight or are slightly overweight.

  • Effects: Severe tooth decay, esophageal erosion, electrolyte imbalances, and seizures.

• Binge-Eating Disorder (BED):

  • Characteristics: Frequent binging without purging.

  • Experience: Feeling a lack of control and distress (guilt/shame) after eating.

• Risk Factors: Adolescent/young adult female, genetics ($40\% - 60\%$ risk), history of trauma, and exposure to Western beauty standards.

Sexual Dysfunctions

• Definition: Problems with sexual interest, arousal, or the physical work of the sex act.

• Categories:

  • Physical Act: Erectile Disorder, Genito-Pelvic Pain/Penetration Disorder.

  • Orgasmic Disorders: Premature Ejaculation, Female Orgasmic Disorder, Delayed Ejaculation.

  • Interest/Arousal: Female Sexual Interest/Arousal Disorder, Male Hypoactive Sexual Desire Disorder.

• Causes:

  • Organic: Chronic illness (diabetes, cancer), medications, and substance use.

  • Sociocultural: Cultural attitudes, religious guilt, and societal stereotypes.

  • Psychological: Performance anxiety, low self-esteem, depression, and history of trauma.

Personality Disorders

• Definition: Rigid, maladaptive patterns of behavior that interfere with normal social relationships.

• Clusters:

  • Cluster A (Odd/Eccentric): Paranoid, Schizoid, Schizotypal.

  • Cluster B (Dramatic/Erratic): Antisocial, Borderline, Histrionic, Narcissistic.

  • Cluster C (Anxious/Fearful): Avoidant, Dependent, Obsessive-Compulsive.

• Antisocial Personality Disorder (ASPD): Habitually breaking laws, disregarding others' rights, impulsivity, irresponsibility, and lack of remorse. More common in men.

• Borderline Personality Disorder (BPD): Intense, unstable relationships, unstable sense of self, fear of abandonment, and impulsive self-harm. More common in women.

• Causes: Genetic components (family history), lower stress hormone levels (in ASPD), disturbances in family dynamics (neglect/abuse), and maladaptive learning.

Schizophrenia

• Definition: A severe psychotic disorder involving a break from reality. Affects cognition, emotion, and behavior. Usually arises in late teens or early $20$s.

• Symptom Categories:

  • Positive Symptoms (Excess/Distortion): Hallucinations (false sensory perceptions, usually auditory) and Delusions (false beliefs).

    • Delusion Types: Persecution, Reference, Influence, Grandeur.

  • Negative Symptoms (Deficit): Flat affect (no emotion), Alogia (reduced speech), and poor attention.

• Disorganized Symptoms:

  • Speech: Clanging (stringing words by sound) or "word salad."

  • Behavior: Catatonia (ranging from statue-like immobility to frantic movement).

• Diagnosis: At least $2$ symptoms frequently for $1$ month; one must be delusions, hallucinations, or disorganized speech.

• Causes:

  • Neurodevelopmental Model: Combination of genes and environment.

  • Biological: Dopamine imbalances, brain structural defects (frontal lobe), and prenatal viral infections.

  • Genetics: Identical twins have a $50\%$ risk; fraternal twins have a $17\%$ risk.

  • Stress-Vulnerability Model: Genetic markers create a vulnerability that is triggered by environmental stress.

Questions & Discussion

• What is the difference between a panic attack and panic disorder? A panic attack is an isolated, sudden onset of extreme panic. Panic disorder occurs when these attacks happen repeatedly and lead to persistent worry or behavioral changes.

• Schizophrenia Empathy Exercise: Mentioned as a video/activity to understand the lived experience of the disorder.

• Common Cultural Misconceptions: Schizophrenia is often confused with Dissociative Identity Disorder ("split personality"), but it is actually a "split mind" between thoughts and feelings.