Your Professor From Hell - Abnormal Psychology

Name: Animus Age: ? Hair: Reaches his shoulders in the back, red, kind of wolf-cut Eyes: Left eye is blue. Right eye does not exist, underneath his eyepatch is a dark void where he sends students who fail their exams. Features: Tall, Muscley, scarred face, stubble Personality: Strict, logical, the gruff mentor type that will kill you if you fail and let you suck his dick if you score well enough on your exam. Origin: No one knows where he came from, he appears only when he senses a college student who waisted their break sleeping instead of studying for their exam that IS FUCKING TOMORROW, YOU STUPID BITCH.

---

Animus is an ageless, timeless being who takes the shape of a middle-aged human man. He is in fact, the worst creature to walk the earth. A being who forces poor, pitiful students to study the night before their exams. Those students just wanted to enjoy their spring break and sleep in for once, but Animus demands perfection from these pathetic procrastinators.

---

Animus Teaches Abnormal Psychology.

What is Abnormal?

1. Culturally - What is normal to one person isn't always normal to others.

2. Statistically - Normal depends on the population being tested. Some rare behaviors are considered gifts and not abnormalities. That which is valued is not abnormal to the collective.

3. Legally - Insanity is a legal term. Do they understand right from wrong and can they control themselves (impulsivity)?

4. Psychologically - Is it harmful to themself or others and is it maladaptive?

~ Maladaptive: They have a hard time adapting or adapt in destructive ways. ~

Summary: Abnormal depends on when and where it is defined.

Elements of Abnormality

1. Suffering - The person doesn't always describe themself as suffering, this depends on the disorder.

2. Maladaptive - Context of how they do or don't adapt matters.

3. Irrationality & Incomprehensibility - Does the behavior seem rational to the person or those around them?

4. Unpredictability & Loss of Control - We expect people to be predictable as well as inhibit impulsive behaviors.

5. Vividness & Unconventionality - The behavior stands out.

6. Observer Discomfort - The behavior is painful or uncomfortable to watch.

7. Violation of Moral Standards - How society expects individuals to behave.

--

Models of Abnormality

1. Biomedical - Mental illness is like any other bodily illness.

a) Germs EX: General Paresis - Linked to syphilis. 1884, the first strong connection between the disorder and the STD. 1906, the first blood tests for syphilis. 1909, the first treatment, 605 people failed to be cured before it worked.

b) Genes

• The most evidence of genetic components are found with schizophrenia and bi-polar disorder.
• Huntington's chorea, if you have the mutation you will die from it. 50/50 chance of passing it down to your child.

c) Neuroanatomy - A part of the brain isn't functioning as it should.

• Too few or too many receptor sites (Can be blocked from drug use).
• Brain damage (In extreme alcoholics, they can develop Korsakoff's syndrome)

d) Biochemistry of Neurotransmitters EX: Serotonin, dopamine, epinephrine, norepinephrine.

• Production, too much or too little.
• Catabolism, an enzyme that breaks down transmitters in the synaptic cleft (can happed too fast or too slow).
• Reuptake, sucks up the neurotransmitter to release again later (Usually happens too quickly).

Treatments

a) Antipsychotics - Side effects are the main drawback (EX: Tardive dyskinesia, which can be permanent. Obesity).

b) Anti-Anxiety - Are not for long-term use.

c) Anti-Manic EX: Lithium

d) Anti-Depressants

• MAO Inhibitors (Drawbacks: dietary restrictions. Tyramine can be increased by MAO's, which spikes blood pressure).
• Tricyclics / TCA (Drawbacks: Can overdose, weight gain, etc..).
• SSRI & SSNRI (Drawbacks: Takes weeks-months to adjust, weird dreams, decreased libido, difficulty achieving orgasm, withdrawals), Near impossible to overdose on.

2. Psychoanalytic - Freud

The Psychosexual Stages - Fixations (oral, anal, phallic, latency, genital)

a) Oral Fixations - Eating, smoking...

b) Anal Fixations - Control, anxiety, OCD, anal retentive... ~ Anal retentive and anal expulsive are opposites ~

c) Phallic - Sexual disorders, kinks, Oedipus complex... ~ Oedipus Complex: Children are in love with their parent of the opposite sex, this is why children behave similarly to their same sex parent. (Daughters are in love with their fathers, so they mimic their mothers. Sons are in love with their mothers, so they mimic their fathers). ~

d) Latency - Homosexuality, same sex friends...

e) Genital - Marriage, having children... (Freud believed that when women reach this stage, they should stop having clitoral orgasms because vaginal orgasms are more mature).

The Personality Structure

a) ID - What we're all born with, the largest part of our personalities. Nearly all unconscious. Pleasure principle.

b) Ego - Develops to get the needs of the ID met in a socially appropriate way. Reality principle.

• Defense mechanisms: Sublimation, channel anxiety into something more constructive and socially appropriate. Repression, the person avoids by simply not allowing painful or dangerous thoughts to become conscious. Denial, the person refuses to acknowledge the existence of an external source of anxiety. Projection, the person attributes his or her own unacceptable impulses, motives, or desires onto others. Rationalization, a person creates a socially acceptable reason for an action that reflects an unacceptable motive. Displacement, the person displaces hostility away from a dangerous object and onto a safer substitute. Intellectualization, the person represses emotional reactions in favor of overly logical responses to a problem. Regression, the person retreats from an upsetting conflict to an early developmental stage in which no one is expected to behave maturely or responsibly.

c) Superego - Does things the most appropriate, moral way. The conscience.

Treatment - Psychotherapy

3. Behavioral

Classical Conditioning - Pavlov

• Unconditioned stimuli always leads to an unconditioned response. An unconditioned stimuli paired with a neutral stimuli will result in an unconditioned response. A conditioned stimuli leads to a conditioned response.
• This can explain a phobia

Operant Conditioning - Thorndike's law of effect

a) Actions followed by satisfying consequences are more likely to be repeated. What is satisfying depends on the person.

b) Reinforcers increase the frequency or likelihood or a behavior.

• Positive Reinforcer: Something is added to increase the likelihood of a behavior (Giving treats, gifts, something they want).
• Negative Reinforcer: Something aversive is removed to increase the likelihood of a behavior (Removing chores or other unpleasant activities/objects).

c) Punishment decreases the frequency or likelihood of a behavior.

• Positive Punishment: Something is added to the situation to decrease the likelihood of a behavior (Spanking).
• Negative Punishment: Something is taken from the situation to decrease the likelihood of a behavior (Time-out, taking things away).

Treatment

a) Flooding, immerse the subject in their fear until they calm down.

b) Systematic desensitization, three-step process.

• Learn relaxation response (required to move on), create a hierarchy of least to most threatening, exposure to feared object/situation paired with relaxation response.

c) Token economy, earn tokens for desired behavior, goal point to trade tokens for a reward.

4. Cognitive Behavioral

Cognitions: Behavior and Emotions, your interpretation of an experience is more important than the experience itself.

• Distorted thoughts "Stinkin Thinkin"
• Errors in reasoning

5. Existential - Universal aspects of the human experience

a) Fear of dying - Two ways of managing: A sense of specialness and fusion (major co-dependency).

b) Responsibility - You are responsible for you.

c) Will - The action in taking responsibility.

6. Humanistic - Rogers & Maslow

a) Societally imposed conditions. Only certain thoughts, feelings, behaviors, and attitudes are acceptable.

b) Incongruence between a person's self-concept and their inherent potential.

Treatment - Unconditional positive regard.

a) Family therapy approaches

• not residing in the "identified patient" but as a reflection of the family system.
• Treatment of the family as a whole.
• Goal depends on the family.
• Want a middle ground between enmeshed (They are too closely involved, no privacy) and disengaged (No one knows what's going on with each other).

7. Diathesis

• Stress model

• Predisposition

DSM-5-TR - American Psychiatric Association

Controversial

1. Medical model of mental illness

• It's yes or no, no middle ground.
• If you don't meet the symptom threshold, you can't be treated.

2. Labels can become self-fulfilling prophecies

3. Clinical judgments can be arbitrary and reflect bias

• Gender, wealth, race, appearance, etc...

4. Not standard outside of the USA.

• The rest of the world uses the ICD (International Classification of Disease, put out by the World Health Organization). The USA uses the 10th edition in the medical field but will not use it for mental health.

5. Controversial diagnosis

• Conditions are voted on EX: PMDD

6. No standardized training required to use it

Useful

1. Allows clinics to share information easily

2. Research

• We need labels to properly research abnormalities and the effects of medications.

3. Enables third-party payment

• HIPAA requires an ICD diagnosis.

~ Note: Federal agencies no longer use the DSM-5 ~

Factitious Disorder - Imposed on self. Imposed on another (Munchhausen's)

• The falsification of physical or psychological signs (faking bad), not always a conscious decision.

Malingering - Faking bad for a reward. Almost always for monetary gain.

Mood Disorders

Mood vs Affect

Mood - Your internal emotional state.

Affect - Your external expression of emotional content

Mood Episodes (Not a diagnosis) - Building blocks for mood disorders

1. Major depressive episode

• Key symptom is a depressed mood, most of the day, nearly every day, for at least 2 weeks (or anhedonia)
• With 4 additional symptoms: Fatigue or loss of energy, recurrent thoughts of death or suicidal ideation or a suicide attempt/plan, change in appetite (weight gain/loss), feelings of worthlessness or excessive inappropriate guilt, insomnia or hypersomnia, psychomotor agitation or psychomotor retardation, decreased ability to think or concentrate.
• Will resolve on its own if left alone, average of 6 months.

2. Manic episode

• Key symptom is abnormally and persistently elevated, expansive, or irritable mood. Only need to experience it for one week. With 3 additional symptoms: More talkative, excessive involvement in pleasurable activities that have a high potential for painful consequences, decreased need for sleep, inflated self-esteem (even to the point of grandiosity), distractibility, increase in goal-directed activity, flight of ideas.

3. Pre-existing mental illness

4. Female

• More likely to experience multiple traumas

• Dose-response curve

Dissociative Disorders

~ Dissociation: A mantal process(es), such as memory, identity, or consciousness is split off from the main stream of consciousness or behavior loses its relationship with the rest of the personality. ~

• Is a coping mechanism.

• Bask model (Behavior, affect, sensation, knowledge (amnesia)).

• Depersonalization, they feel like they're outside of their body or are watching themself from an outside point of view.

• Derealization, they feel like the world is detached, looking through a veil or fog.

DES - Dissociative Experience Scale

a) Dissociative Amnesia - cannot recall personal information, too extensive to be ordinary forgetting.

b) Depersonalization / Derealization Disorder

c) Dissociative Identity Disorder (DID) - Previously called Multiple Personality Disorder

• Has two or more distinct identities.
• Inability to recall personal information.
• One alter is usually in-charge, holds most of the memories, usually a strong male identity.
• Host (Executive), usually the original, not usually the one in-charge.
• Alters often have different names, genders, vocabulary, personalities, medical issues, eyesight, etc.
• The trigger between alters is usually a stressor.
• What the alters now varies a lot, some might not even know the others exist.

Associated Features in DID ~ Associated Features: Commonly seen but not apart of the diagnosis. ~

• Severe physical or sexual abuse as a child.
• Self-mutilation.
• Suicidal Ideation.
• Headaches.
• Reference to self as "we" or "us".

Etiology ~ Etiology: cause ~

Starts in childhood

1. Child is dissociation prone (high hypnotizable).

2. Harshly abused or neglected.

3. They couldn't escape.

4. They cope by dissociating.

~ Iatrogenic - Caused by the therapist ~

Treatment

• Average length of treatment is 4 years.

• Medication is not usually recommended.

• In-patient units are too stressful.

• Intensive psychotherapy.

• Stabilize the most functional or competent (rarely the host).

• Integrate the other personalities into one.

• At some point, the childhood trauma need to be addressed.

• They cannot use dissociation as a coping mechanism anymore.

Somatic Disorders

Anxiety Disorders

9-11 Video Notes

Eating Disorders

Schizophrenia and Related Disorders

Personality Disorders

Sexual Disorders and Gender Variations

Law, Society, and the Mental Health Professions