psy 328

• Psychological abnormality

  The scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning
• "The four Ds"

  • Deviance: different, unusual, bizarre behaviors from society's norms
  • Distress: upsetting or unpleasant to the person
  • Dysfunctional: inability to perform daily activities in a constructive way
  • Danger: harmful to yourself or others
• Treatment

  • A systematic procedure designed to change abnormal behavior into more normal behavior.
  • Are clinicians seeking to cure? Are sufferers "patients," suggesting that they have a mental illness?
  • Are clinicians seeking to teach? Are sufferers "clients," suggesting that they have problems in living?
• How abnormality was viewed and treated in the past

  • Ancient views and treatments: Believed that all events resulted from actions of magical, sinister beings; Cure was to force demons from victim's body
  • Greek and Roman views and treatments (500 BCE - 500 CE): Hippocrates taught illnesses had natural causes in the four humors; Treatment was to correct underlying physical pathology
  • Europe in the Middle Ages: Demonological views and practices became popular again; Treatment was exorcism, torture, and hospitalization
  • The Renaissance and the Rise of Asylums (1400-1700 CE): Rise of asylums, most became virtual prisons
  • The Nineteenth Century: Reform and Moral Treatment; Benjamin Rush and Dorothea Dix promoted moral treatment
  • The Early Twentieth Century: The Somatogenic and Psychogenic Perspectives; Somatogenic view - abnormal functioning has physical causes; Psychogenic view - abnormal functioning has psychological causes
• Outpatient care has now become the primary mode of treatment
• MFT

  Marriage and family therapist
• LCSW

  Licensed clinical social worker
• LPCC

  Licensed professional clinical counselor
• PhD vs PsyD

  PsyD degree focuses more on hands-on clinical training along with research whereas the PhD degree focuses more on the research aspect
• In CA, patients' physicians can prescribe psychotropic medication
• Multipath model - what contributes to problems (abnormality)

  • Biological: genetics, brain chemistry, brain structure, physical health and illnesses
  • Psychological: past experiences, thoughts and beliefs, behaviors, search for meaning/growth
  • Social: direct impact of relationships and social environment
  • Socio-cultural: culture, society's norms, and socioeconomic factors
• Multipath model of resilience - what contributes to resilience

  • Biological: Reduced genetic vulnerability, physical fitness, healthy diet, avoid harmful substances
  • Psychological: Positive outlook, gratitude, coping and problem solving skills
  • Social: Social support, connection with others, sense of belonging
  • Sociocultural: Supportive social institutions, safe communities, spirituality and religion
• Four major perspectives of the psychological perspective and how each sees 'problems' (abnormality)

  • Psychodynamic: Childhood experiences and unconscious desires shape who you are
  • Behavioral: All behavior is learned from the environment
  • Cognitive: Your thoughts shape your behavior and feelings
  • Humanistic-Existential: You're in charge of your own destiny and constantly striving to be the best version of yourself
• Generalized anxiety disorder


  A disorder marked by persistent and excessive feelings of anxiety and worry about numerous events and activities
• Symptoms of generalized anxiety disorder

  • Edginess, fatigue, poor concentration, irritability, muscle tension, sleep problems
• Biopsychosocial factors contributing to the etiology of anxiety disorders

  • Biological: Overactive fear circuitry, neurotransmitter abnormalities, genes
  • Psychodynamic: Negative cognitive appraisal, anxiety sensitivity, limited sense of control
  • Social: Daily environment stress, lack of social support, stressful relationships, traumatic life events
  • Sociocultural: Poverty, female gender, cultural norms, acculturation conflicts, discrimination and prejudice
• Timeline for GAD

  For 6 months or more, the person experiences disproportionate, uncontrollable, and ongoing anxiety and worry about multiple matters
• Panic disorder

  Recurrent unexpected panic attacks
• Symptoms of panic attacks

  • Palpitations, pounding heart, or accelerated heart rate; Sweating; Trembling or shaking; Sensations of shortness of breath or smothering; Feelings of choking; Chest pain or discomfort; Nausea or abdominal distress; Feeling dizzy, unsteady, light-headed, or faint; Chills or heat sensations; Paresthesias (numbness or tingling sensations); Derealization (feelings of unreality) or depersonalization (being detached from oneself); Fear of losing control or "going crazy."; Fear of dying.
• Obsession and compulsion in OCD

  Obsession: Recurrent and persistent thoughts, urges, or images that cause anxiety or distress

  Compulsion: A repetitive and rigid behavior or mental act that a person feels driven to perform to prevent or reduce anxiety

  Example: Hoarding disorder - individuals feel compelled to save items and become very distressed if they try to discard them
• How a cognitive behavioral therapist might treat panic and anxiety


  • Change maladaptive assumptions; Break down worrying; Acceptance and commitment therapy; Mindfulness meditation; Rational-emotive therapy
• Hypothalamus


  The brain area that sets in motion the features of arousal and fear
• Dissociative fugue


  A disorder involving a person traveling to a new location and assuming a new identity, simultaneously forgetting his or her past
• Acute stress disorder

  A disorder where a person experiences intrusive symptoms, avoidance, negative changes in cognitions/mood, and changes in arousal within 4 weeks of a traumatic event, lasting less than a month
• PTSD

  A disorder where a person experiences intrusive symptoms, avoidance, negative changes in cognitions/mood, and changes in arousal for more than a month after a traumatic event
• Exposure therapies used to treat PTSD

  • Prolonged exposure; Eye movement desensitization and reprocessing (EMDR)
• Eye movement desensitization and reprocessing (EMDR)


  An exposure treatment where clients move their eyes in a rhythmic manner while flooding their minds with images of objects and situations they would ordinarily avoid
• Dissociative identity disorder (DID)

  A disorder where a person experiences a disruption to their identity, with at least two separate personality states or experiences of possession, along with memory gaps
• Depersonalization

  The sense that one's own mental functioning or body is unreal or detached
• Derealization

  The sense that one's surroundings are unreal or detached
• Major depressive disorder vs persistent depressive disorder

  Major depressive disorder: Depressed mood and/or loss of interest for 2 weeks

  Persistent depressive disorder: Depressed mood and/or loss of interest for at least 2 years
• Criteria for major depressive disorder

  • Presence of a major depressive episode; Depressed mood and/or loss of interest for 2 weeks; At least 3-4 additional symptoms like weight/appetite change, sleep problems, fatigue, feelings of worthlessness/guilt, reduced concentration, suicidal thoughts; Significant distress or impairment; No pattern of mania or hypomania
• Criteria for bipolar I and bipolar II disorder

  • Bipolar I: Occurrence of a manic episode (1 week), may have hypomanic or major depressive episodes

  Bipolar II: Presence or history of major depressive episode(s) and hypomanic episode(s) (at least 4 days), no history of manic episode
• Cyclothymia

  A disorder marked by numerous periods of hypomanic symptoms and mild depressive symptoms that continues for 2 or more years, interrupted occasionally by normal moods
• Mania

  A state or episode of euphoria or frenzied activity in which people may have an exaggerated belief that the world is theirs for the taking, lasting at least one week
• Hypomania

  A milder form of mania involving increased levels of activity and goal-directed behaviors combined with elevated, expansive, or irritable mood, lasting at least 4 days
• Warning signs of suicide

  • Taking unnecessary risks or self-destructive behaviors; Strong personality or behavioral changes; Loss of interest in things normally cared about; Statements about feeling hopeless or worthless; Withdrawing from friends/family
• Resources for individuals experiencing suicidal ideation

  • 24/7 Crisis Hotline; Crisis text line; Veterans crisis line; Trevor project (LGBTQ); National teen dating abuse helpline
• Suicidal ideation vs passive suicidal ideation

  Suicidal ideation: Having thoughts about suicide/self harm and developing a plan to carry it out

  Passive suicidal ideation: Having thoughts of suicide/self harm but no plan to carry it out
• Anorexia nervosa

  • A disorder marked by the pursuit of extreme thinness and by extreme weight loss
  • Individual purposely takes in too little nourishment, resulting in body weight that is very low and below that of other people of similar age and gender
  • Individual is very fearful of gaining weight, or repeatedly seeks to prevent weight gain despite low body weight
  • Individual has a distorted body perception, places inappropriate emphasis on weight or shape in self-judgments, or fails to appreciate the serious implications of their low weight