Abnormal Psychology

Defining Abnormal Behavior

Abnormal behavior is a mental illness
that affects or is manifested in a
persons brain and can affect the way
a person thinks, behaves, and
interacts with people.
Characteristics of
Abnormal Behavior
Statistical Infrequency: people who are
abnormal deviate much from the average in a
particular trait or behavior pattern
Violation of Norms: the behavior violates
social norms or threatens or makes anxious
those observing it
Personal Distress: the behavior creates great
distress and torment in the person
experiencing it
Disability or Dysfunction: the person is
impaired in some important area of life (e.g.,
work or personal relationships) because of the
abnormality
Classifying Abnormal Behavior
with the DSM-IV
Axis I: all diagnostic categories except
personality disorders and mental
retardation
Axis II: personality disorders and mental
retardation
Axis III: general medical health conditions
Axis IV: psychosocial and environmental
problems
Axis V: current level of functioning (GAF)
The Psychological Disorders
Childhood Disorders
Anxiety Disorders
Dissociative Identity Disorder
Schizophrenia
Mood Disorders
Personality Disorders
Childhood Disorders
Mental Retardation
Learning Disorders
Pervasive Developmental Disorders
(PDD)
Attention-Deficit/Hyperactivity
Disorder (AD/HD)
Mental Retardation
1. Significantly subaverage intellectual
functioning along with

2. Deficits in adaptive behavior and

3. Occurring prior to age 18

Learning Disorders
Inadequate devt in a specific area of
academic, language, speech or motor skills
not due to MR, autism, a demonstrable
physical disorder, or deficient educational
opportunities
Children w/ these disorders are usually of
average or above-average intelligence but
have difficulty learning some specific skill
and thus their progress in school is
impeded.
Learning Disorders
Reading disorder (dyslexia)

Disorder of written expression

Mathematics disorder
Famous People with Dyslexia
PDD, Autistic Disorder
characterized by impaired social interaction,
problems with verbal and nonverbal
communication, and unusual, repetitive, or
severely limited activities and interests.
AD/HD
A persistent pattern of inattention
and/or hyperactivity-impulsivity that
is more frequent or severe than is
typically observed in individuals at a
comparable level of development.
Symptoms must be present before
age 7 and interfere with functioning
in at least 2 settings.

Symptoms of AD/HD
Fidgets
Difficulty remaining
seated
Easily distracted
Difficulty waiting turn
Blurts out answers
Difficulty following
instructions
Difficulty sustaining
attention
Flits fr. 1 uncompleted
task to another
Difficulty playing
quietly
Talks excessively
Interrupts others
Doesnt seem to listen
Loses things needed
for tasks
Engages in physically
dangerous activities
Case # 1
Nine-year-old Cathy is described by
everyone as a handful. She
fidgets constantly in class,
drumming her fingers on the desk,
squirming around in her chair, and
getting up and down. She has
trouble waiting her turn at work or
at play, and she sometimes has
violent outbursts.
Case # 2
A young man in an undergraduate course
shows an unusual pattern of strengths
and difficulties. His oral comments in
class were exemplary, but his
handwriting and spelling were
sometimes indecipherable. The
undergraduate explained that it took
him longer to complete the weekly
reading assignments and to write
papers and exams.
The instructor decided to accord him
additional time for preparing written
work. The student was obviously of
superior intelligence and highly
motivated to excel. Excel he did,
earning an A in the seminar and on
graduation being admitted to a leading
law school.
Case # 3
Timmy was born with the umbilical cord
wrapped around his neck, so he had
been w/o oxygen for an unknown
period of time. Nonetheless, he
appeared to be a healthy little boy. He
was a very good baby who rarely cried,
although his mother was concerned
that he didnt like to be picked up and
cuddled. He wasnt talking at 2 years
old. He didnt play with other children;
he spent most of his time alone,
spinning plates on the floor, waving his
hands in front of his face, and lining up
blocks in a certain order. At age 3,
Timmys behavior persisted.
Neurological exams revealed nothing
unusual. Still, Timmy was delayed in
learning such basic skills as talking and
feeding himself. By age 7, Timmy still
didnt speak or play w/ other children,
and he was developing aggressive and
self-injurious behaviors.
Anxiety Disorders
have some form of irrational or
overblown fear as the central
disturbance
Some of the anxiety disorders:
Panic Disorder
Specific Phobia
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Panic Disorder
Anxiety marked by the sudden but brief
attacks of intense apprehension or terror
Panic attacks often cause severe
palpitations, chest pains, trouble in
breathing, trembling, sweating, dizziness,
and a feeling of helplessness.
May be accompanied by agoraphobia, the
fear of leaving familiar surroundings.
Generally, a stressful event precedes the
initial panic attack.
Phobic Disorders
An irrational, overwhelming, persistent fear
of a specific object or situation
Fear is so intense that people w/ phobic
disorder avoid it even though they know
that the fear is unwarranted & unreasonable
& disrupts their lives.
Examples: claustrophobia,
acrophobia, hydrophobia
Obsessive-Compulsive
Disorder
Anxiety-provoking thoughts (obsessions) are
followed by urges to engage in repetitive, ritualistic
behaviors (compulsions) to ward off an impending
feared situation
Most common compulsions:
cleaning, maintaining order thru elaborate
ceremonies
performing repetitive, magical, protective
practices like counting, saying certain numbers,
touching a talisman or a particular part of the
body
checking, going back 7-8 times to verify that
already performed acts were actually carried out
performing a particular act, such as eating
extremely slowly
Post-Traumatic Stress Disorder
Refers to anxiety symptoms that
develop through exposure to a
traumatic event
Symptoms include:
reexperiencing the traumatic event
avoidance of stimuli associated w/ the
event or numbing of responsiveness
symptoms of increased arousal
Case # 1
Bernice:
46-year-old female
her disorder began 12 years earlier shortly
after her dads death
had a fear of contamination, w/c she vaguely
linked to her fathers death of pneumonia
was afraid of everything: germs could be
anywhere
was upset by touching wood, scratchy objects,
mail, canned goods, and silver flecks (cant
state why these were sources of possible
contamination)
to reduce discomfort,
Bernice spends 3-4 hrs. in the CR washing and
rewashing herself, scraping outer layer of soap
During mealtime, she eats 3 bites of food at a
time, chewing each mouthful 300 times
Case # 2
The patient:
27-year-old singer referred by friend for
evaluation
8 months before, her boyfriend was stabbed to
death in a mugging, w/c she witnessed and
escaped unharmed
Began to have recurrent nightmares & vivid
memories of the night of the crime
Nightmares: saw blood, pursued by cloaked
figures
During the day: drifted off into daydreams,
startled easily, preoccupied
Other symptoms:
Left her change/groceries at the store
If she was waited on, she couldnt remember
what she came to buy
Slept restlessly
Work suffered because of poor concentration
Withdrew from friends and avoided work
Case # 3
Darlene has always refused to use
escalators. She knows they are quite
safe but she walks far out of her way
to find an elevator or stairs to avoid
the anxiety she feels when she
considers riding an escalator. Darlene
wishes she could overcome this fear
because she is a personal shopper and
does most of her work at department
stores in the mall.
Case # 4
The patient is a 46-year-old widow who
came for therapy. She reported
suddenly experiencing labored
breathing, heart palpitations, nausea,
chest pain, feelings of choking and
impending doom while driving the car,
w/c lasted for a few minutes.
Dissociative Identity Disorder
DID is characterized by two or more distinct
personalities or selves.
Each personality has its own memories,
behaviors, and relationships.
Shifts from one personality to another typically
occur under stress.
Most people with DID are female.
The disorder is generally the result of extreme
physical or sexual abuse in early childhood,
although the majority of individuals who have
been sexually abused do not develop
dissociative identity disorder.
Demon Alters VS Actual Demon
Possession
Persecutors, but
could be strong
allies

Initially appear to
be ego dystonic;
but in time, they
become ego
syntonic
Tend to be
arrogant; theres
no sense of
relating w/ them
Always remain ego
alien (forever
outside of person)
Demon Alters VS Actual Demon
Possession
Confusion & fear
subside w/
appropriate
therapy
Tend to conform to
surroundings &
culture
Have personalities
w/ accompanying
voices

Confusion & fear
persist despite
therapy, includes
lust
Force unwanted
behaviors & blame
the personality
Have a negative
voice w/o a
personality
Demon Alters VS Actual Demon
Possession
Irritation,
discontent, and
rivalry abound
Images remain
human in form
Hatred and
bitterness abound

Images could
become subhuman
Schizophrenia
A severe psychological disorder
characterized by distortions in thought,
perception, communication, emotion,
behavior, and social skills.
The symptoms include:
delusions
hallucinations
incoherent speech
loose associations
odd behaviors
social withdrawal
I: Have you been nervous or tense lately?
P: No. I got a head of lettuce.
I: You got a head of lettuce? I dont
understand.
P: Well, its just a head of lettuce.
I: Tell me about lettuce. What do you mean?
P: Welllettuce is a transformation of a dead
cougar that suffered a relapse on the lions
toe. And he swallowed the lion and
something happened. Thesee, theGloria
and Tommy, theyre two heads and theyre
not whales. But they escaped with herds of
vomit, and things like that.
I: Who are Tommy and Gloria?
P: Uhtheres Joe DiMaggio, Tommy
Henrich, Bill Dickey, Phil Rizzuto,
John Esclavera, Del Crandell, Ted
Williams, Mickey Mantle, Roy Mantle,
Ray Mantle, Bob Chance
I: Who are they? Who are those people?
P: Dead peoplethey want to be
fuckedby this outlaw.
I: What does all that mean?
P: Well, you see, I have to leave the hospital.
Im supposed to have an operation on my
legs, you know. And it comes to be pretty
sickly that I dont want to keep my legs.
Thats why I wish I could have an
operation.
I: You want to have your legs taken off?
P: Its possible, you know.
I: Why would you want to do that?
P: I didnt have any legs to begin with. So I
would imagine that if I was a fast runner,
Id be scared to be a wife, because I had a
splinter inside of my head of lettuce.
Mood Disorders
A group of disorders characterized by
a primary disturbance of mood, that
usually includes cognitive, behavioral,
and somatic symptoms as well as
interpersonal difficulties.
Disorders can represent one extreme
of emotion (depression) or both
extremes (bipolar disorders).
Major Depressive Disorder
An individual suffers from depression
without ever experiencing mania for
at least 2 weeks duration and with at
least five of nine symptoms present.
Symptoms of Depression
depressed mood
reduced interest or
pleasure in all or
most activities
significant weight
loss or decrease in
appetite
changes in sleep
patterns
psychomotor
agitation or
retardation
loss of energy
feelings of
worthlessness or
excessive guilt
difficulty
concentrating
suicidal ideation.
Bipolar Disorder
A disorder characterized by
extreme mood swings that
include episodes of mania alternating
with episodes of depression.
Mania is characterized by extreme
feelings of euphoria, energy, and
impulsivity.
Symptoms of Mania
Increase in activity
level at work, socially,
or sexually
Unusual talkativeness;
rapid speech
Flight of ideas or
subjective impression
that thoughts are
racing
Inflated self-esteem;
belief that one has
special talents,
powers, and abilities

Less than the usual
amount of sleep
Distractibility;
attention easily
diverted
Excessive involvement
in pleasurable
activities that are
likely to have
undesirable
consequences (e.g.,
reckless spending)
Case # 1
T: Well, you seem pretty happy today.
C: Happy! Happy! You certainly are a master
of understatement, you rogue! [Shouting,
literally jumping out of his seat.] Why, Im
ecstatic. Im leaving for the West Coast
today, on my daughters bicycle. Only
3,100 miles. Thats nothing, you know. I
could probably walk, but I want to get
there by next week. And along the way I
plan to contact a lot of people about
investing in my fish equipment. Ill get to
know more people that wayyou know,
Doc, know in the biblical sense [leering
at the therapist seductively]. Oh, God, how
good it feels. Its almost like a nonstop
orgasm.
Case # 2
Mrs. M, a 38-year-old factory worker was
a mother of four children. She had
returned to work three years earlier
when the worsening economy made it
impossible for her family to get by on
just by her husbands earnings. But
seven months before she visited the
psychologist, she was laid off, and the
familys financial situation
deteriorated. Ever-present worries
about money led to increased
arguments with her husband, not only
about their finances, but also about
the children.
She had begun to have difficulty sleeping
and lost her appetite, resulting in
weight loss. She had little energy and
no interest in activities that she
normally enjoyed. Even though she sat
for hours in front of the TV, she
couldnt get interested in any of the
programs that had been her favorites;
she didnt even pay attention most of
the time. Household chores became
impossible for her to do, and her
husband began to complain, leading to
further arguments. Finally, realizing
that something serious had happened
to his wife, Mr. M cajoled her into
making a first appointment with a
psychologist.

Personality Disorders
They are chronic, maladaptive
cognitive-behavioral patterns that are
thoroughly integrated into the
personality.
Some Personality Disorders:
Antisocial Personality Disorder
Borderline Personality Disorder
Passive-Aggressive Personality Disorder
Antisocial Personality Disorder
Characterized by a pattern of
exploitive behavior, lack of guilt, self-
indulgent behavior, and
interpersonally intrusive behavior.
The disorder generally begins before
the age of 15 and continues into
adulthood.
Borderline Personality Disorder
Borderline personalities are
emotionally unstable, impulsive,
unpredictable, irritable, and anxious.
Passive-Aggressive Personality
Disorder
Passive-aggressive personalities are
stubborn or are intentionally
inefficient in an effort to frustrate
others.
Case # 1
Alan is involved in drugs and has casual
sexual encounters. He feels empty
unless he does dangerous and
exciting things. He threatens to
commit suicide if his girlfriend
suggests getting help or if she talkjs
about leaving him. He alternates
between loving her and hating her.
He has low self-esteem and has
recently experienced high levels of
stress.
Case # 2
Matt is 19 and has been in trouble with
the law since he was 14. He lies to his
parents, vandalizes buildings in his
community and when caught, shows
no remorse. He frequently fights with
others and doesnt care whom he
injures.
Case # 3
Mike, male, 52 is attending therapy at
the request of his wife. She complains
that he is "emotionally absent" and
aloof. Mike shrugs: "We used to have a
great marriage, but good things don't
last. You can't sustain the same levels
of passion and interest throughout the
relationship." Isn't his family worth the
effort? Another shrug: "It doesn't pay
to be a good husband or a good father.
Look what my loving wife did to me. In
any case, at my age the future is
behind me. Carpe Diem is my motto.
Does he consider his wife's demands to
be unreasonable? He flares: "With all
due respect, that's between me and
my spouse." Then why is he wasting
his time and mine? "I didn't ask to be
here." Did he prepare a list of things
he would like to see improved in his
family life? He forgot. Can he compile
it for our next meeting? Only if nothing
more urgent pops up. It would be
difficult to continue to work together if
he doesn't keep his promises. He
understands and he will see what he
can do about it (without great
conviction).

The problem is, he says, that he regards
psychotherapy as a form of con-
artistry: "psychotherapists are snake
oil salesmen, latter-day witch doctors,
only less efficient." He hates to feel
cheated or deceived. Does he often
feel that way? He laughs dismissively:
he is too clever for run-of-the-mill
crooks. He is often underestimated by
them.

Do other people besides crooks
underestimate him? He admits to
being unappreciated and underpaid at
work. It bothers him. He deserves
more than that. Obsequious
intellectual midgets rise to the top in
every organization, he observes with
virulent envy. How does he cope with
this discrepancy between the way he
perceives himself and the way others,
evidently, evaluate him? He ignores
such fools. How can one ignore one's
co-workers and one's superiors? He
doesn't talk to them. In other words,
he sulks?

Not always. He sometimes tries to
"enlighten and educate" people he
deems "worthy". It often gets him into
arguments and he has acquired a
reputation as a cantankerous
curmudgeon but he doesn't care. Is he
an impatient or irritable person? "What
do you think?" - he counters - "During
this session did I ever lose my cool?"
Frequently. He half rises from his chair
then thinks better of it and settles
down. "Do your thing" - he says
sullenly and contemptuously - "Let's
get it over with."