Introduction to Psychology

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Introduction to Psychology

• Abnormal Psychology

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Recap Social Psychology

• Last week we talked about social psychology,
  which is
• The study of how social conditions (i.e. other
  people) affect human thought and behaviour.
• Specifically, we talked about conformity, and how
  human behaviour is a result of an interaction
  between both the individual and the individuals
  environment.

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Recap Social Psychology

• We learned how extraordinary situations can cause
  ordinary people to commit horrific acts of
  cruelty.
• We looked at studies by Asch and Milgram which
  examined the causes for the Holocaust and other
  atrocities through history.

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Recap Social Psychology

• Last weeks session was a little heavy, and the
  focus was mainly on how people can be influenced
  to do unexpectedly bad things.
• However, it also works the other way around!
• Although perhaps not as dramatic, we can also
  influence people for the better.
• This is actually what my research concerns.
• For a readable and insightful example of how
  social norms can do this, please see Cialdini
  (2003) available online.

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Recap Cognition and Social

• All four of my presentations (Intro, Cognition,
  Social, and Abnormal) are now available online
  at http//people.ex.ac.uk/ccd203
• Ive added many resources at the end of the
  presentations, most available on the web.
• Feel free to share the link above or the
  presentations with friends and family.

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Structure of the Session

• 1) Overview of Abnormal Psychology
• 2) Depression
• 3) Schizophrenia
• 4) Critiques of Abnormal Psychology
• 5) Conclusion

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Todays Session Abnormal

• Today we will be talking about Abnormal
  Psychology.
• What does Abnormal Psychology mean?
• It is actually quite tricky to define.
• Although not perfect, we define Abnormal
  Psychology as the mental processes that manifest
  themselves as Abnormal Behaviour.
• But what is Abnormal Behaviour?

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What Makes Behaviour Abnormal?

• There is no concrete definition, but abnormal
  behaviour generally meets most or all of these
  criteria
• 1) Statistical infrequency
• 2) Violation of norms
• 3) Personal distress
• 4) Disability or dysfunction
• 5) Unexpectedness

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Overview of Abnormal

• There are many psychological disorders.
• However, many are poorly understood, and there is
  widespread recognition that some may need to be
  redefined/reclassified.
• In fact, what is officially a disorder is a
  very thorny issue, and is somewhat political.
• By current definitions, mental illness is common
  about 20 of all people at any one time.
• Many people with disorders lead fulfilling lives

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Abnormal Psychology is actually common

• There is a stigma around mental illness, but it
  is actually quite common, and most people who
  have an illness are not crazy.
• In fact, most great and famous people in the
  world probably qualify for one or more mental
  illnesses.
• Mental illness is something that touches all of
  us, whether it be ourselves or someone we care
  about.
• You can always speak to your school counsellor if
  you have questions or concerns about yourself or
  a friend.

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Some Disorders (DSM-IV-TR)

• Specific phobias
• ADHD
• Pica
• Autism
• Substance-abuse related disorders
• Schizophrenia
• Depression
• Bipolar disorder
• Eating disorders

• Anxiety disorders
• Dissociative amnesia
• Dissociative fugue
• Dissociative personality disorder
• Frotteurism
• PTSD
• Borderline personality
• Antisocial personality
• Obsessive-Compulsive

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Pica

• A disorder you probably have not heard of
• It is the compulsion to eat inedible objects.
• Frequently includes dirt, clay, coins, and any
  number of other things.
• This image shows nearly a full stone of coins,
  jewellery, and needles swallowed over many years
  by a 62 year old man who ultimately died as a
  result of his pica.
• Note that it is believed that this man passed
  about 85 of the objects he swallowed.

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Depression

• What is depression?
• The word depression means many things,
  depending on who is using it.
• Today, we are talking about clinical depression
  or major depressive disorder.
• Clinical depression actually has a very exact
  definition.
• Though most clinicians acknowledge that people
  can still be depressed even if they do not meet
  the definition exactly.

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Clinical Definition of Depression

• According to the DSM-IV-TR, a depressed person
  must experience five of these symptoms for two
  consecutive weeks to officially be depressed
• 1) Feelings of overwhelming sadness and/or fear,
  or the seeming inability to feel emotion
  (emptiness).
• 2) A decrease in the amount of interest or
  pleasure in all, or almost all, daily activities.
• 3) Changing appetite and marked weight gain or
  loss.
• 4) Disturbed sleep patterns, such as insomnia,
  loss of REM sleep, or excessive sleep
  (hypersomnia).
• 5) Psychomotor agitation or retardation nearly
  every day.
• 6) Fatigue, mental or physical, also loss of
  energy.
• 7) Intense feelings of guilt, nervousness,
  helplessness, hopelessness, worthlessness,
  isolation/loneliness and/or anxiety.
• 8) Trouble concentrating, keeping focus or making
  decisions or a generalized slowing and obtunding
  of cognition, including memory.
• 9) Recurrent thoughts of death (not just fear of
  dying), desire to just "lie down and die" or
  "stop breathing", recurrent suicidal ideation
  without a specific plan, or a suicide attempt or
  a specific plan for committing suicide.
• 10) Feeling and/or fear of being abandoned by
  those close to one.

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Describing Depression

• In common terms, a depressed person seems down
  or blue for no apparent reason for weeks at a
  time.
• They will often feel tired and unmotivated.
• Changes in sleeping and eating habits are common.
• Importantly, these changes do not have a clear
  reason (e.g. grief) and are not within the
  conscious control of the depressed person.

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Prevalence of Depression

• Depression has been described as the common cold
  of mental health.
• In fact, it is highly likely that everyone in
  this room knows someone who is depressed.
• About 16 of people are clinically depressed at
  some point in their lives.
• Depression is the number one cause of disability
  in the developed world even more than heart
  disease.
• Many times depression is clearly evident in a
  person but often it is not clear, even to close
  friends of the depressed person.

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Causes of Depression

• The exact cause of depression is not known.
• Like most psychological disorders, the cause
  appears to be very complex.
• Most proposed causes are either biological or
  psychological.
• Proposed biological causes include chemical
  imbalances in the brain, genetics, poor diet,
  etc.
• Proposed psychological causes include low
  self-esteem, prior traumatic events, coping
  methods, etc.
• It is almost certainly an interaction of many
  causes.

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Depression and Gender

• Women report clinical depression about twice as
  often as men do, particularly in early and
  mid-adulthood.
• The reason is unknown, but several theories have
  been suggested
• Women experience more stress than men.
• Hormonal changes after childbirth often leads to
  postpartum depression.
• Men are more likely to mask their depression with
  substance abuse or express it as anger.

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Depression and Creativity

• Many people who have been depressed have been
  great historic or artistic characters.
• In fact, many researchers have speculated that
  there is a link between mood disorders
  (depression and bipolar disorder) and artistic
  creativity.

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Famous people who have had Depression

• Woody Allen
• Buzz Aldrin
• David Bohm
• Jim Carrey
• Winston Churchill
• Charles Darwin
• Princess Diana
• Paul Getty

• Julian Huxley
• King David of Israel
• Søren Kierkegaard
• Meriwether Lewis
• Abraham Lincoln
• Martin Luther
• Isaac Newton
• Boris Yeltsin

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Musicians/Artists who have had Depression

• Kurt Cobain (Nirvana)
• Billy Corgan (Smashing Pumpkins)
• Sheryl Crow
• Nick Drake
• Vincent Van Gogh
• Francisco de Goya
• Paul Gauguin
• Janet Jackson

• Morrissey
• Michelangelo
• Wolfgang Motzart
• Edvard Munch
• Friedrich Nietzsche
• Mark Rothko
• James Taylor
• Pyotr Tchaikovsky
• Robbie Williams

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Writers/Philosophers who have had Depression

• William Blake
• Albert Camus
• Charles Dickens
• Fyodor Dostoevsky
• T.S. Eliot
• Michael Foucault
• Ernest Hemingway
• Franz Kafka
• John Keats

• Herman Melville
• Sylvia Plath
• Edgar Allan Poe
• Amy Tan
• Leo Tolstoy
• Mark Twain
• Kurt Vonnegut
• Walt Whitman
• Tennessee Williams

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Treatment for Depression

• Depressive episodes typically disappear on their
  own after a few months, but they can last longer.
  Treatments include
• A wide variety of therapies, cognitive
  behavioural therapy (CBT) being one of the most
  effective.
• Medications Tricyclics, Monoamine Oxidase
  Inhibitors (MAOIs), Selective Serotonin Reuptake
  Inhibitors (SSRIs).
• Electroconvulsive Therapy (ECT).

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• Questions about depression?

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Schizophrenia

• What is schizophrenia?
• Literally means shattered mind.
• This should not be confused with split
  personality disorder (Dissociative Identity
  Disorder.)
• More accurately termed schizophrenias.
• Although it is one of the most studied disorders,
  the causes are still poorly understood, and it is
  likely to be a complex cluster of similar
  disorders.
• Officially, to be schizophrenic, symptoms must
  last for at least 6 months, 1 of which must be
  active.

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Art by Schizophrenic Patients
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Art by Schizophrenic Patients
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Art by Schizophrenic Patients
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Art by Schizophrenic Patients
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Art by Schizophrenic Patients
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Art by Schizophrenic Patients
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Positive Symptoms

• Positive symptoms are excess or distorted
  behaviours, including
• Disorganized speech and thought
• Delusions (grand and paranoid)
• Hallucinations (usually auditory, but can include
  visual and tactile hallucinations)
• Lets watch a short video of these symptoms.

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An Example of Disorganized Speech

• Interviewer Have you been nervous or tense
  lately?
• Patient No, I got a head of lettuce.
• Interviewer You got a head of lettuce? I dont
  understand.
• Patient Well, its just a head of lettuce.
• Interviewer Tell me about lettuce. What do you
  mean?
• Patient Well, lettuce 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.
• Interviewer Who are Tommy and Gloria?
• Patient Uh, theres Joe DiMaggio, Tommy
  Henrich, Bill Dickey, Phil Rizzuto, John
  Esclavera, Del Crandell, Ted Williams, Mickey
  Mantle, Roy Mantle, Ray Mantle, Bob Chance..

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An Example of Disorganized Speech

• Interviewer Who are they? Who are those people?
• Patient Dead people they want to be fxxxed by
  this outlaw.
• Interviewer What does all that mean?
• Patient 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.
• Interviewer You want to have your legs taken
  off?
• Patient Its possible, you know.
• Interviewer Why would you want to do that?
• Patient 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.
• (Neale Oltmanns, 1980, pp. 103-104)

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Negative Symptoms

• Negative symptoms are behavioural deficits
• Avolition (lack of energy)
• Alogia (low-content speech)
• Anhedonia (lack of pleasure)
• Flat Affect (no visible emotions)
• Asociality (poor social relationships)

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Other Symptoms

• Some symptoms of schizophrenia are not clearly
  positive or negative
• Inappropriate Affect (unexpected or out of
  context emotional responses)
• Catatonia (repeated gesturing)
• Catatonic Immobility (remaining motionless in
  unusual positions for hours or day)
• Waxy Flexibility (like catatonic immobility,
  except the person will hold whatever position
  their limbs are moved to)

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Catatonic Immobility and Waxy Flexibility
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Prevalence of Schizophrenia

• Schizophrenia is found in all cultures throughout
  the world.
• Onset most often begins in early adulthood.
• Prevalence is typically 0.5 to 1, although this
  does vary extensively by region.
• Frequency can vary over time, becoming more or
  less common in particular areas.
• Occurs roughly equally in men and women.

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Causes of Schizophrenia

• The truth is we do not know what really causes
  schizophrenia.
• It appears it is a very complex process, with
  both biological and environmental elements.
• One of the leading theories (for most mental
  illness) is the diathesis-stress theory.
• This means some people are biologically
  vulnerable to schizophrenia, but it only develops
  when some kind of stress triggers it.

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Genetics and Schizophrenia

• Identical twins share 100 of their genes, but if
  one has schizophrenia, the other only has a 48
  chance.
• The chance is increased, even if they are
  separated at birth.
• Genetics clearly plays a role in schizophrenia.
• But only part of the role.

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Environmental Factors

• Environmental stressors increase the chance of
  schizophrenia. Known triggers include
• Personal stress (abuse, persecution, etc.)
• Living in densely urban areas.
• Substance abuse.
• Poverty.
• The mother having the flu during pregnancy.
• The mother undergoing severe psychological trauma
  during pregnancy.

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Schizophrenia and the Brain

• Schizophrenics have decreased brain mass (about
  5 to 10 less) compared to non-schizophrenics.
• This is particularly evident in the ventricles.
• This image below is of two identical twins, one
  schizophrenic (right) and one non-schizophrenic
  (left)

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Treatment of Schizophrenia

• Institutionalization
• Anti-psychotic medication
• Reduction of environmental stressors
• Therapy
• Skills training
• Schizophrenia rarely goes away entirely, but
  symptoms do tend to decrease over time.

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• Questions about schizophrenia?

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Critique of Abnormal Psychology

• There are many critiques of abnormal psychology,
  particularly psychiatry.
• Critics claim that many disorders are poorly
  defined, and diagnosis can be subjective, and
  that the difference between mental illness and
  mental health is not concrete.
• Other criticisms include the reliance on
  medication instead of fixing the problems that
  cause the disorders (i.e. covering up the
  symptoms instead of relieving them.)

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Critique of Abnormal Psychology

• It seems unlikely that schizophrenia is totally a
  social construction.
• But there are obvious problems in its definition
  and diagnosis.
• This is true of many disorders.
• Most psychologists believe that abnormal
  psychology does need some kind of restructuring,
  and treatment needs to be approached more
  holistically, but that it is a valuable field
  that will continue to develop.

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• Final questions?

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Resources

• Note Much of what is online about abnormal
  psychology is not factual! People are often
  selling a treatment, have an axe to grind, or
  just have no idea what they are talking about. In
  contrast, Wikipedia is surprisingly accurate
  about most aspects of abnormal psychology (I have
  checked the articles below for accuracy myself.)
• Wiki on Clinical Psychology http//en.wikipedia.o
  rg/wiki/Clinical_psychology
• Wiki on Scientific Paradigms http//en.wikipedia.
  org/wiki/Paradigms
• Wiki on Depression http//en.wikipedia.org/wiki/C
  linical_depression
• Wiki on Cognitive Behavioural Theory (CBT)
• http//en.wikipedia.org/wiki/Cognitive_behavioral_
  therapy
• Wiki on Electroconvulsive Therapy (ECT)
  http//en.wikipedia.org/wiki/Electroconvulsive_the
  rapy
• Hell and Back - one mans experience with
  depression http//www.nola.com/news/t-p/frontpage
  /index2.ssf?/base/living-0/116149796856910.xmlcol
  l1
• Famous Depression Suffers http//en.wikipedia.org
  /wiki/Famous_Depression_Sufferers
• Wiki on Schizophrenia http//en.wikipedia.org/wik
  i/Schizophrenia
• Wiki on Causes of Schizophrenia
  http//en.wikipedia.org/wiki/Causes_of_schizophren
  ia
• Wiki on the Dissociative Identity Disorder
  http//en.wikipedia.org/wiki/Dissociative_identity
  _disorder
• Wiki on the Rosenhan Experiment
  http//en.wikipedia.org/wiki/Rosenhan_experiment
• Video about the Rosenhan experiment
  http//www.youtube.com/watch?vhqaptRYjhq4
• Rosenhan, D. (1973) On being sane in insane
  places. Science, 179, 250-8. Full-text PDF.