What Is Insanity?
Five ways to define abnormality:
1. Condition is considered abnormal in the person’s culture
2. Condition causes personal distress to the subject
3. Condition prevents functional living in society
4. Condition makes the person a danger to self or others
5. Condition calls into question a person’s legal responsibility for actions
2. Rosenhan sanity study: Showed difficulty diagnosing insanity; Rosenhan and associates (all sane) reported hallucinations to gain admittance to psychiatric ward. Once admitted, “plants” were treated as insane patients.
TYPES OF DISORDERS:
Psychological disorders are defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)
1. Anxiety disorders
A. Phobias: Intense, irrational fears of specific items or situations; include agoraphobia (fear of open, public spaces) and social phobia (fear of embarrassing social situations)
B. Generalized anxiety disorder (GAD): Chronic, pervasive low-level anxiety
C. Panic disorder: Intermittent anxiety, characterized by panic attacks (episodes of frightening mental and physical symptoms)
D. Obsessive-compulsive disorder (OCD): Includes obsessions (uncontrollable, repetitive internal thoughts that cause anxiety) and compulsions (behaviors performed to counteract obsessive thoughts)
2. Mood disorders
A. Major depression: Characterized by unhappiness, fatigue, loss of appetite, low self-esteem
B. Bipolar disorder (manic depression): Periods of depression followed by periods of mania (high energy, lack of inhibition)
C. Seasonal affective disorders: mood affected by time of year, and/or lack of sunlight
3. Dissociative disorders: Includes amnesia (person loses memory for personal identity) and identity (two or more distinct personalities in one person)
4. Somatoform disorders: Disorders that take bodily form (e.g., hypochondriasis, conversion)
5. Schizophrenia
A. Positive symptoms: Hallucinations, disorganized thought and speech, delusions (false beliefs)
B. Negative symptoms: Lack of speech and emotional expression, social withdrawal
C. Types of schizophrenia
i. Catatonic: Motionlessness, sudden frenziedness, and holding of contorted postures
ii. Disorganized: Incoherence, inappropriate emotional reactions
iii. Paranoid: Delusions of persecution and grandeur
6. Personality disorders: Stable patterns of experience and behavior that differ noticeably from patterns that are considered normal by a person’s culture. Disorders include antisocial personality disorder and narcissistic personality disorder.
TREATMENT OF PSYCHOPATHOLOGY
PSYCHOTHEREPY
Five main psychological therapies are used to treat psychopathology.
1. Classical psychoanalysis (Freud): Helps clients (patients) uncover and resolve repressed, unconscious childhood conflicts; involves four main techniques
A. Free association: Client says whatever comes to mind; technique uncovers unconscious meanings and preoccupations
B. Transference: Client transfers conflicts and emotions onto psychoanalyst; shows client how they feel about important people
C. Resistance: Focuses on what client refuses to talk about; helps client recall repressed memories
D. Dream analysis: Involves interpretation of dream imagery, because unconscious conflicts manifest as symbols in dreams
2. Psychodynamic therapy: Modified version of psychoanalysis that explores unconscious conflicts based on cultural or interpersonal factors, not childhood
3. Humanistic therapies: Treats the whole person; involves two main techniques
a. Person-centered therapy (Rogers): Based on belief in fundamental goodness of humans; therapist encourages client to achieve self-actualization via three techniques:
i. Unconditional positive regard: Person is valued no matter what
ii. Authenticity: Therapist is always honest
iii. Empathy: Therapist must feel what the patient is feeling
b. Existential therapy: Tries to imbue meaning in client’s life. Helps client take responsibility and exercise free choice. Goal is to make client feel life is authentic.
4. Behavior therapies: Treatments that involve changing behavior with little or no attention to the causes of the behavior. Effective for phobias. Involves three main techniques.
a. Exposure techniques: Breaks connection between stimuli and the resulting fears
i. Extinction: Therapist presents a stimulus without the threatening response, so that the associated fear will eventually disappear
ii. Systematic desensitization: Therapist teaches client to replace feelings of fear with relaxation; exposes client to hierarchy of stimuli called anxiety hierarchy
b. Aversion therapy: Pairing client’s habit with an unpleasant stimulus so client breaks the habit
c. Operant conditioning: The control of behavior through reinforcement; enforces the connection between behavior and consequences. Involves two main techniques:
i. Token economy: Provides rewards for desired behaviors
ii. Contingency management: Client learns that behaviors have strict consequences
5. Cognitive therapies: Treatments that change the client’s thought patterns
A. Rational-emotive therapy (Ellis): Confronts and changes client’s irrational beliefs
B. Cognitive therapy (Beck): Replaces negative thoughts with positive thoughts
Biological/Medical Treatment
Three main medical therapies are used to treat psychopathology.
1. Drug therapy (psychopharmacology): Drugs can be effective but can also have negative side effects. There are three main categories of drugs:
a. Antidepressants: Used to treat depression. Two main types:
i. SSRIs: Allow serotonin to stay in synapses; increase activity of serotonin (e.g., Prozac)
ii. MAO inhibitors: Prevent breakdown of monoamines such as serotonin (e.g., Nardil)
b. Anxiolytics: Used to treat anxiety
i. Benzodiazepines: Tranquilizers (e.g., Valium)
Antipsychotics: Used to treat symptoms of schizophrenia, such as delusions and agitation (e.g., Clozapine)
Electroconvulsive therapy (ECT): Treatment for major depression. Doctor uses electric shocks through brain hemisphere(s) to induce seizures. Side effects include muscle aches and memory loss.
Surgery: Treatment that physically changes the brain (such as prefrontal lobotomy)
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