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Abnormal Psychology (PSY 9)
Pamantasan ng Lungsod ng Valenzuela
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LESSON 1: OVERVIEW AND HISTORICAL AND
CONTEMPORARY VIEWS OF ABNORMAL
PSYCHOLOGY
Definition and Examples of Abnormal Behavior The definitions of abnormal in psychology have certain features in common, often called “the four Ds”: deviance, distress, dysfunction, and danger o DEVIANCE - Behaviors, thoughts, and emotions are different from each societal norm and culture. o DISTRESS - Extreme anxiety, sorrow, or pain o DYSFUNCTION - Interferes with daily life function o DANGER - Causes harm to self/others Historical and Contemporary Views of Abnormal Psychology GREEKS AND ROMANS Abnormal behavior was caused by an imbalance of the four bodily fluids, or humors: black bile (spleen), yellow bile (liver), blood, and phlegm. Treatment consisted of correcting the underlying physical pathology through diet and lifestyle. THE MIDDLE AGES Mental disorders were the work of the devil. Treatment by priest = exorcism As the Middle Ages drew to a close, such explanations and treatments began to decline, and people with mental disorders were increasingly treated in hospitals instead of by the clergy. THE RENAISSANCE Religious shrines became dedicated to the humane treatment of such individuals. By the middle of the sixteenth century, persons with mental disorders were being placed in asylums. THE NINETEENTH CENTURY Moral treatment was brought by Philippe Pinel and William Tuke. Dorothea Dix led development to ensure legal rights and protection for people with mental disorders and to establish state hospitals for their care. Unfortunately, some mental hospital patients received minimal care. THE EARLY TWENTIETH CENTURY Emil Kraepelin in the late 1800s discovered that general paresis was caused by the organic disease syphilis. The same period saw the rise of the psychogenic perspective, which posits that the chief cause of abnormal functioning is psychological, and the use of hypnotism is in treating patients with hysterical disorders was recognized. Sigmund Freud’s psychogenic approach, psychoanalysis, eventually gained wide acceptance and influenced future generations of clinicians. Jean Charcot - inspired freud Anton Franz Mesmer - introduce hypnotism = animal magnetism Definition and Examples of Abnormal Behavior Mental Disorders are defined in terms of typical signs (from others/doctors, objective) and symptoms (from the patient, subjective) rather than identifiable causal factors. Syndrome Group of Symptoms that appear together and are assumed to represent a specific type of disorder. There are no definitive psychological or biological tests that can be used to confirm the presence of psychopathology. Nowadays, the diagnosis of mental disorders depends on observations of the person’s behavior and descriptions of personal experience. Overview of Abnormal Psychology CULTURE The values, beliefs & practices that are shared by a specific community or group of people. It has a profound influence on opinions regarding the difference between normal and abnormal behavior. Epidemiology- the scientific study of the frequency and distribution of disorders with a population (Gordis, 2006). ✓ It is concerned with questions such as whether the frequency of disorder has increased or decrease during a particular period. Incidence- The number of new cases of a disorder that appear in a population during a specific period of time. Prevalence- Total number of active cases, both oldand new, that are present in a population during a specific period of time (Susser et al., 2006). Lifetime prevalence- The total proportion of people in a given population who have been affected by the disorder at some point during their lives. Comorbidity- the presence of more than one condition within the same period of time.
The Greek Tradition in Medicine HIPPOCRATES
- Greek physician who ridiculed demonological accounts of illness and insanity.
- Hypothesized that abnormal behavior, like other forms of disease, had natural causes.
- According to him, health depended on a balance of four body fluids (blood, phlegm, black bile (release by spleen) and yellow bile (release by liver)
- For Hippocrates, all problems were considered to be the result of an imbalance of body fluids, and treatment procedures were designed in an attempt to restore the ideal balance.
- These were often called “heroic” treatments because they were drastic and painful attempts to reverse the course of an illness. They involved bloodletting and purging as well as the use of heat and cold (LEECH). Trephination
- A surgical procedure in which a disk of bone is removed from the skull with a circular instrument (a trephine) having a saw-like edge.
- On the basis of evidence found in skulls of Neolithic humans, trephining is believed to be one of the oldest types of surgery.
- Among the numerous conjectural reasons given for the practice is that it was a treatment for headaches, infections, skull fractures, convulsions, mental disorders, or supposed demonic possession. Also called trepanation.
- Base when the cerebrospinal fluid is released The Creation of Asylum
- In Europe during the Middle Ages “lunatics” and “idiots” as the mentally ill and intellectually disabled were commonly called aroused little interest and were given marginal care.
- Lunatics from the word luna= moon. Illness is said to be influenced by environment specifically the moon (e werewolf, vampires)
- Disturbed behavior was considered to be the responsibility of the family rather than the community or state.
- In the1600’s and 1700’s “insane asylums” were established to house the mentally disturbed. Lunatic asylums
- The original mental hospitals
- Were created to serve heavily populated cities and to assume responsibilities that had previously been performed by individual families. Somatic Treatments Introduced and Widely Employed in the 1920’s & 1930’s
- Fever Therapy
- Blood from people with malaria was injected into psychiatric patients so that they would develop a fever.
- (Original Rationale) is Observation that symptoms sometimes disappear in patients who became ill with typhoid fever
- when there is no available blood, the patient is soaked in water to get a fever
- Insulin Coma Therapy
- Insulin was injected into psychiatric patients to lower the sugar content of the blood and induce a hypoglycemic state and deep coma.
- (Original Rationale) Observed mental changes among some diabetic drug addicts who were treated with insulin.
- Lobotomy
A sharp knife “leucotome” was inserted through a hole that was bored in the patient’s skull (e eyes), severing nerve fibers connecting the frontal lobes to the rest of the brain.
(Original Rationale) Observation that the same surgical procedure with chimpanzees led to a reduction in the display of negative emotion during stress.
Conversion Disorder
Functional Neurological Symptom Disorder (FNSD) o Freud observed that hysterical patients did not fake their symptoms. They also did not consciously associate the symptoms with emotional distress. Freud suggested instead that their psychological conflicts were unconsciously “converted” into physical symptoms. o Psychoanalytic theory divides the mind into three parts: the id, ego and the superego. o Id = pleasure, in unconscious mind o Ego = reality, in conscious & preconscious mind o Super-ego = idealistic, all parts o Alter-ego = alternative ego due to severe stress o Aggressive o fighter = need someone to face the trauma o Childish = regress to not face or have no idea to the trauma. Conflict in structures → moral anxiety
- COGNITIVE-BEHAVIORAL PARADIGM o Cognitive-behavioral viewpoints focus on observable, learned behavior. o 2 prominent early scientists who made testing substantive contributions to learning theory and research were the Russian physiologist Ivan Pavlov and the US psychologist B. Skinner. These psychological scientists articulated the principles of classical conditioning and operant conditioning. Classical Conditioning o is learning through association, and it involves four key components. o There is an unconditioned stimulus (the meat powder), the stimulus that that automatically produces the unconditioned response (salivation). A conditioned stimulus (the bell) is a neutral stimulus that, when repeatedly paired with an unconditioned stimulus, comes to produce a conditioned response (salivation). o Finally, extinction gradually occurs once a conditioned stimulus no longer is paired with an unconditioned stimulus. Eventually, the conditioned stimulus no longer elicits the conditioned response. Operant Conditioning
- Skinner’s operant conditioning asserts that behavior is a function of its consequences. Specifically, behavior increases if it is rewarded, and it decreases if it is punished. - In his numerous studies of rats and pigeons in his famous “Skinner box”, Skinner identified four different, crucial consequences. o Positive reinforcement is when the onset of a stimulus increases the frequency of behavior (eg. You get paid for your work). o Negative reinforcement is when the cessation of a stimulus increases the frequency of behavior (eg. You get up turn off your alarm clock). o Punishment is when the onset of a stimulus decreases the frequency of behavior (eg. You spend less money after your parents scold you); and response cost us when the cessation of a stimulus decreases the frequency of behavior (eg. You come home on time after getting grounded). o Extinction results from ending the association between a behavior and its consequences as in classical conditioning. o Spontaneous recovery is the reemergence of conditioned responding to an extinguished conditioned stimulus (CS) with the passage of time since extinction.
o Development of abnormal behavior is due o Cognitive paradigm, because of maladaptive cognitive process which may result to disorder o Behavioral Paradigm o Rest largely on the assumption that the symptoms of mental illnesses are developed because of learned behaviors; environmental effect o Learned behavior can be unlearned (due to environmental changes). We can learn abnormal behavior o Environment affect behavior, which helps us to be more motivated o No source of reward (mababa behavior, could develop abnormal behavior) 4. HUMANISTIC PARADIGM o The humanistic paradigm argues that behavior is a product of free will, the view that we control, choose and are responsible for our actions in many respects, this stance is a reaction against determinism, the scientific assumption that human behavior is caused by potentially knowable factors (a position held by the other paradigms e psychoanalytic is caused by experience and behavioral approach is caused by the environment) o Because free will, by definition, is not predictable, it is impossible to determine the causes of abnormal behavior according to the humanistic paradigm. o The humanistic paradigm is also distinguished by its explicitly positive view of human nature. Humanistic psychologist blames abnormal behavior on society, not on the individual, whom they see as inherently good Emotional Immaturity:
- Inappropriately guilty
- Inability to understand other people’s behavior or emotion o Development of abnormal behavior is due to interrupted/fault developmental process
BIOPSYCHOSOCIAL MODEL
Abnormal behavior is best understood in terms of the biopsychosocial model, the combination of different biological, psychological and social factors. Systems theory – a way of integrating different contributions to abnormal behavior its central principle is holism, the idea that the whole is more than the sum of its parts.
Eclectic approach - using more than one approach to explain the development of the behavior (e Carl Jung) Biological Schizophrenia = have something to do with brain mass, can be inherited = patients has family with abnormal behavior or parents "father" is too old compare to the mother Psychology Personality can be a root cause of abnormal behavior (e perfectionist, overthinker, high neuroticism, too much use of defense mechanism) Social context more social network, the healthier the self "mental health" when you have someone to talk to, it gives the sense of importance "not lonely" BIOLOGICAL FACTORS
Biological factors in abnormal behavior began with the neuron, or nerve cell. Communication between neurons occurs when the axon terminals release chemical substances called neurotransmitters into synapse between nerve cells.
Disrupted communication among neurons, particularly disruptions in the functioning of various neurotransmitters is involved in several types of abnormal behavior, although you should be cautioned against mind-body dualism.
The brain is divided into three subdivisions: the hindbrain, the midbrain, and the forebrain. Because of the rudimentary state of our knowledge about the brain, only the most severe mental disorders have been clearly linked with abnormalities in neuroanatomy. (Depression can cause brain shrinkage)
The analyst’s main tool for promoting insight is Interpretation.
In offering an interpretation, the analyst suggests hidden meanings to patients accounts of their life. Typically, interpretations relate to past experiences especially experiences with loved ones.
Hypnotherapy - works by inducing a hypnotic state marked by waking awareness that allows people to experience detached external attention and to focus on inner experiences.
- Anton Mesmer - introduced the idea of hypnotizing. (animal magnetism)
- Jean Charcot - influence Freud in hypnotherapy. COGNITIVE BEHAVIORAL TREATMENT
The approach contrasts sharply with psychodynamic therapy. CBT encourages collaborative therapist-client relationships, a focus on the present direct efforts to change problems, and the use of different, empirically supported treatments.
The beginnings of CBT can be traced to John B Watsons’s behaviorism, the view that the appropriate focus of psychological study is observable behavior. Watson viewed the therapist as a teacher and the goal of treatment as providing new, more appropriate learning experiences.
Unlike psychoanalysis, CBT is not based on an elaborate theory about human personality. Rather, CBT is a practical approach oriented to changing behavior rather than trying to understand the dynamics of personality
short term, with later “booster” sessions
HUMANISTIC TREATMENT
- To be human is to be responsible for your own life and for finding meaning in it. From this perspective, therapy cannot solve problems for you. Therapy can only help you to solve your own problems to make better choices in your life (Rogers, 1951).
- The key to making better choices is increased emotional awareness. Humanistic therapists encourage people to recognize and experience their true feelings.
- Humanists view the therapist-client relationship as the method for encouraging change. In humanistic therapy the relationship is the treatment. Classification of Mental Disorders
- Formal classification systems for mental disorders have been developed in order to facilitate communication research, and treatment planning.
- Clinicians assign a diagnosis if the person’s behavior meets the specific criteria for a particular type of disorder, such as schizophrenia or major depressive disorder.
- Currently, 2 diagnosis systems for mental disorders are widely recognized: ✓ Diagnostic and Statistical Method (DSM) - is published by the American Psychiatric Association. ✓ International Classification of Disease (ICD) – published by the World Health Organization.
LESSON 3: CLINICAL ASSESSMENT AND
DIAGNOSIS
Assessing Psychological Disorders Clinical assessment is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder. Diagnosis is the process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder, as set forth in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. Key Concepts in Assessment Assessment techniques are subject to a number of strict requirements, not the least of which is some evidence (research) that they actually do what they are designed to do. o Reliability is the degree to which a measurement is consistent. ● Test Retest - coefficient of stability ● Parallel Forms ● Split Half - Pearson R, internal consistency ● Inter Rater ● Kuder Richardson - right or wrong o One-way psychologists improve their reliability is by carefully designing their assessment devices and then conducting research on them to ensure that two or more raters will get the same answers. o Validity is whether something measures what it is designed to measure—in this case, whether a technique assesses what it is supposed to. ● Face ● Content ● Criterion > Concurrent > Predictive ● Construct > Convergent > Divergent o Comparing the results of an assessment measure under consideration with the results of others that are better known allows you to begin to determine the validity of the first measure. o Standardization is the process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements. o Lahat ng test na valid ay reliable, hindi lahat ng reliable ay valid. Clinical Interview
- gathers information on current and past. o Clinicians determine when the specific problem started and identify other events (for example, life stress, trauma, or physical illness) that might have occurred about the same time. o In addition, most clinicians gather at least some information on the patient’s current and past interpersonal and social history, including family makeup (for example, marital status, number of children, or college student currently living with parents). o Information on sexual development, religious attitudes (current and past), relevant cultural concerns (such as stress induced by discrimination), and educational history are also routinely collected. Mental Status Examination o In essence, the mental status exam involves the systematic observation of an individual’s behavior. This type of observation occurs when any one person interacts with another. o The exam covers five categories
- Appearance and behavior ▪︎ The clinician notes any overt physical behaviors as well as the individual’s dress, general appearance, posture, and facial expression
▪︎ Thematic Perception - making stories of pic before, during and after. ▪︎ The theory here is that people project their own personality and unconscious fears onto other people and things—in this case, the ambiguous stimuli—and, without realizing it, reveal their unconscious thoughts to the therapist. 1. Personality inventories ▪︎ Minnesota Multiphasic Personality Inventory or (MMPI) was developed in 1937 by clinical psychologist Starke R. Hathaway and neuropsychiatrist J. Charnley McKinley at the University of Michigan. ● 10 Clinical Scales of MMPI > Scale 1—Hypochondriasis ▪︎ This scale was designed to assess a neurotic concern over bodily functioning. ▪︎ The items on this scale concern physical symptoms and well-being. ▪︎ It was originally developed to identify people displaying the symptoms of hypochondria, or a tendency to believe that one has an undiagnosed medical condition. (Illness Anxiety Disorder- onting sakit lang tingin ay malala na) > Scale 2—Depression ▪︎ This scale was originally designed to identify depression, characterized by poor morale, lack of hope in the future, and general dissatisfaction with one's own life situation. ▪︎ Very high scores may indicate depression, while moderate scores tend to reveal a general dissatisfaction with one’s life. > Scale 3—Hysteria ▪︎ The third scale was originally designed to identify those who display hysteria or physical complaints in stressful situations. ▪︎ Those who are well-educated and of a high social class tend to score higher on this scale. Women also tend to score higher than men on this scale. > Scale 4—Psychopathic Deviate ▪︎ Originally developed to identify psychopathic individuals, this scale measures social deviation, lack of acceptance of authority, and amorality (a disregard for morality). ▪︎ This scale can be thought of as a measure of disobedience and antisocial behavior > Scale 5—Masculinity-Femininity ▪︎ This scale was designed by the original authors to identify what they referred to as "homosexual tendencies," for which it was largely ineffective. ▪︎ Today, it is used to assess how much or how little a person identifies how rigidly an individual identifies with stereotypical male and female gender roles. > Scale 6—Paranoia ▪︎ This scale was originally developed to identify individuals with paranoid symptoms such as suspiciousness, feelings of persecution, grandiose self-concepts, excessive sensitivity, and rigid attitudes. ▪︎ Those who score high on this scale tend to have paranoid or psychotic symptoms. > Scale 7—Psychasthenia ▪︎ This diagnostic label is no longer used today and the symptoms described on this scale are more reflective of anxiety, depression, and obsessive- compulsive disorder. ▪︎ This scale was originally used to measure excessive doubts, compulsions, obsessions, and unreasonable fears. > Scale 8—Schizophrenia ▪︎ This scale was originally developed to identify individuals with schizophrenia. ▪︎ It reflects a wide variety of areas including bizarre thought processes and peculiar perceptions, social alienation, poor familial relationships, difficulties in concentration and impulse control, lack of deep interests, disturbing questions of self-worth and self-identity, and sexual difficulties.
> Scale 9—Hypomania ▪︎ This scale was developed to identify characteristics of hypomania such as elevated mood, hallucinations, delusions of grandeur, accelerated speech and motor activity, irritability, flight of ideas, and brief periods of depression. > Scale 0—Social Introversion ▪︎ This scale was developed later than the other nine scales. ▪︎ It's designed to assess a person’s shyness and tendency to withdraw from social contacts and responsibilities. TESTS OF INTELLIGENCE
- Stanford-Binet Intelligence Scale
- Alfred Binet and Theodore Simon
- Binet-Simon: to detect and support children with special needs; classification
- Purely IQ Test
- Revised by Lewis Terman
- First published intelligence test to provide detailel administration and scoring instructions
- It creates a test composite: test score or index derived from the combination of and/or a mathematical transformation of one or more subtest scores
- 5th edition can be administered to examinees as young as 2 and as old as 85
- Theory: CHC Theory of Intelligence
- Mean: 100 SD: 16 Stanford-Binet Intelligence Scale
- Alfred Binet and Theodore Simon
- Binet-Simon: to detect and support children with special needs; classification
- Purely IQ Test
- Revised by Lewis Terman
- First published intelligence test to provide detailed administration and scoring instructions
- It creates a test composite: test score or index derived from the combination of and/or a mathematical transformation of one or more subtest scores
- 5 th edition can be administered to examinees as young as 2 and as old as 85
- Theory: CHC Theory of Intelligence
- Mean: 100 SD: 16
- Wechsler Tests - David Weschler
- Individually administered intelligence tests to assess the intellectual abilities of people from preschool to adulthood.
- Items may be presented orally
- The Weschsler Tests are all point scales that yield deviation IQs with a mean of 100 (interpreted as average) and a standard deviation of 15. 3 Wechsler Intelligence Tests:
- Wechsler Adult Intelligence Scale – Fourth Edition (WAIS – IV) for ages 16 to 90 years 11 months.
- Wechsler Intelligence Scale for Children – Fifth Edition (WISC – V) for ages 6 through 16 years 11 months.
- Wechsler Preschool and Primary Scale of Intelligence – Third Edition (WPPSI- III) for ages 3 years to 7 years 3 months. Neuropsychological Tests
- Brain damage is a general reference to any physical or functional impairment that results in sensory, motor, and cognitive, emotional, and/or related deficit.
- Organicity came from the research of German neurologist Kurt Goldstein of brain-injured soldiers he diagnosed as having organic brain syndrome or organicity for short. (Organic Problem) Signs signaling the need for a more thorough neuropsychological work-up can be classified as being hard or soft.
type of stress to change their lifestyle, as they accept stress as a part of life. 3. Chronic stress
- Persistent, pervasive, consistent, lasts for a very long period. •This is the most harmful type of stress and grinds away over a long period.
- Ongoing poverty, a dysfunctional family, or an unhappy marriage can cause chronic stress.
- It occurs when a person never sees an escape from the cause of stress and stops seeking solutions. Sometimes, it can be caused by a traumatic experience early in life.
- Cause physical disorders Kinds of Trauma- and Stressor-Related Disorders Acute Stress Disorder (ASD)
- ASD is a relatively new psychological diagnosis. The American Psychiatric Association first introduced it to the fourth edition of the Diagnostic and Statistical Manual of Mental Health Disorders in 1994.
- Although it shares many of the same symptoms as PTSD, ASD is a distinct diagnosis.
- A person with ASD experiences psychological distress immediately following a traumatic event. Unlike PTSD, ASD is a temporary condition, and symptoms typically persist for at least 2 to 4 weeks after the traumatic event.
- If a person experiences symptoms for longer than a month, a doctor will usually assess them for PTSD. Symptoms
- People who have ASD experience symptoms similar to
those of PTSD and other stress disorders, except that ASD
explicitly includes dissociative symptoms and last no
longer than four weeks.
- ASD symptoms fall under five broad categories: 1 symptoms - These occur when a person is unable to stop revisiting a traumatic event through flashbacks, memories, or dreams. Repetition Compulsion - napanaginipan Ang mga bagay na nagbigay trauma. 2 mood - A person may experience negative thoughts, sadness, and low mood. 3 symptoms - These can include an altered sense of reality, a lack of awareness of the surroundings, and an inability to remember parts of the traumatic event. Causes
- A person must be exposed to a traumatic event to be at risk for acute stress disorder.
- It is not clear why only a small proportion of people exposed to develop a stress disorder.
- Individuals may be at greater risk for developing stress disorder if they have previously been diagnosed with a mental disorder, perceive the traumatic event to be very severe, have an avoidant coping style when experiencing distress, or have a history of previous trauma.
- Women are more likely to develop acute stress disorder than men
- Men are more successful in their suicidal attempts/method. (Gun kasi gamit) Treatment
- Cognitive behavioral therapy
- Is the treatment that has met with the most success in combating acute stress disorder. CBT has two main components.
- First, it aims to change cognitions or patterns of thought surrounding the traumatic incident.
- Second, it tries to alter behaviors in anxiety-provoking situations.
- Cognitive behavioral therapy not only ameliorates the symptoms of acute stress disorder but also attempts to prevent the development of post-traumatic stress disorder.
- Aayusin ang paraan ng pag iisip, information processing para maayos ang behavior.
- Psychological debriefing and anxiety management groups have also been examined for the treatment of acute stress disorder.
- Psychological debriefing involves an intense therapeutic intervention immediately after the trauma so that traumatized individuals can "talk it all out." While some
people have found such intervention to be helpful, others have been re-traumatized by speaking about the situation that originally caused them distress.
- Psychological First Aid - how will you process yung shinare ng tao. (Make eye contact, relax dapat, empathetic listening)
- Psychotropic medication any medication capable of affecting the mind, emotions, and behavior. Some medications such as lithium, which may be used to treat depression, are psychotropic. Lithium - nagststabilize ng mood ng manic ep at suicidal na tao. E. Antidepressant, Selective Serotonin Reuptake Inhibitors (SSRIs), Benzodiazepines, Propranolol Posttraumatic Stress Disorder (PTSD)
Characterized by the re-experiencing of an extremely traumatic event, avoidance of stimuli associated with the event, numbing of responsiveness, and persistent increase of arousal it usually begins 3 months to a year after the event and may last a few months or years.
Not every traumatized person develops ongoing (chronic) or even short-term (acute) or PTSD.
Not everyone with PTSD has been through a dangerous event.
Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD.
Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward.
Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD.
The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic. Sign and Symptoms
- To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms Re-experiencing symptoms include:
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Frightening thoughts
- Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings.
- Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms. Avoidance symptoms include: ✓Staying away from places, events, or objects that are reminders of the traumatic experience ✓Avoiding thoughts or feelings related to the traumatic event ✓In PTSD , the avoidance also manifest itself as a general numbing of responsiveness – emotions are dampened or even nonexistent. This symptoms may be referred to as “emotional amnesia” a term that manifests captures its essence. (Loss if memory due to traumatic event) ✓Emotional numbing can cause sufferers to withdraw from others, particularly from close relationships.
- Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car. Arousal and Reactivity symptoms include:
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping (less sleep at least 3 and too much sleep, 10 hrs and above); insomnia & hypersomnia
Initiate conscious, voluntary behavior
Determine the meaning and emotional significance of events
Regulate emotions
Inhibit or correct dysfunctional reactions
Higher thinker oder skill
- Hippocampus is essential for memory formation when traumatic events occur the hippocampus:
- Create and store memory
- Retrieves the memory
- Calm the amygdala alarm circuit Signs and symptoms of PTSD associated with Prefrontal Cortex and Hippocampus;
- Confusion
- Disorientation
- Disturbing thoughts , nightmares and or flashback
- Difficulty of sleep
- Reduce the size of the hippocampus ADJUSTMENT DISORDER Adjustment disorders are stress-related conditions.
- You experience more stress than would normally be expected in response to a stressful or unexpected event, and the stress causes significant problems in your relationships, at work or at school.
- Most of the time, people adjust to such changes within a few months. But if you have an adjustment disorder, you continue to have emotional or behavioral reactions that can contribute to feeling anxious or depressed. Symptoms
- The mental and physical symptoms associated with adjustment disorder usually occur during or immediately after you experience a stressful event.
- While the disorder lasts no longer than six months, your symptoms may continue if the stressor isn’t removed. Some people have just one symptom. Others may experience many symptoms. Mental symptoms: rebellious/impulsive actions, anxiousness, feelings of sadness, hopelessness, crying, withdrawn attitude, lack of concentration, loss of self- esteem, suicidal thoughts Physical symptoms: Insomnia, muscle twitches or trembling, body pain or soreness, indigestion TYPES OF ADJUSTMENT DISORDER
Adjustment disorder with depressed mood ✓people diagnosed with this type of adjustment disorder tend to experience feelings of sadness and hopelessness. It’s also associated with crying. You may also find that you no longer enjoy activities that you did formerly.
Adjustment disorder with anxiety ✓Symptoms associated with adjustment disorder with anxiety include feeling overwhelmed, anxious, and worried. People with this disorder may also have problems with concentration and memory. For children, this diagnosis is usually associated with separation anxiety from parents and loved ones.
Adjustment disorder with mixed anxiety and depressed mood ✓People with this kind of adjustment disorder experience both depression and anxiety.
Adjustment disorder with disturbance of conduct ✓Symptoms of this type of adjustment disorder mainly involve behavioral issues like driving recklessly or starting fights. Teens with this disorder may steal or vandalize property. They might also start missing school.
Adjustment disorder with mixed disturbance of emotions and conduct ✓Symptoms linked to this type of adjustment disorder include depression, anxiety, and behavioral problems.
Adjustment disorder unspecified ✓Those diagnosed with adjustment disorder unspecified have symptoms that aren’t associated with the other types of adjustment disorder. These often include physical symptoms or problems with friends, family, work, or school. How is adjustment disorder diagnosed?
- In order to be diagnosed with an adjustment disorder, a person must meet the following criteria: ✓experiencing psychological or behavioral symptoms within three months of an identifiable stressor or stressors occurring in your life ✓having more stress than would be ordinary in response to a specific stressor, or stress that causes issues with relationships, in school or at work, or experiencing both of these criteria ✓the improvement of symptoms within six months after the stressor or stressors are removed ✓symptoms that aren’t the result of another diagnosis Treatment
- Adjustment disorder is primarily treated with psychotherapy, although in some cases medication may also be prescribed to alleviate symptoms Psychotherapeutic:
- Talk therapy is extremely effective in treating adjustment disorder.
- A therapist might encourage the patient to express emotions in a supportive environment and in a constructive fashion, or suggest that a typical reaction to stress has gotten out of hand but is within his power to control.
- Another goal of the therapy is to teach him healthier ways of dealing with future stressful situations.
- Since adjustment disorders often affect the whole family, some sessions might include the parents or other caregivers. Group therapy can also be helpful. A few sessions are usually sufficient for treatment, though occasionally it might take months.
- Even neuroleptic medication to help with anxiety and
behavior problems.
- Antidepressants may also be prescribed to treat depressive or suicidal thoughts. In most cases pharmacological treatment is short-lived. Reactive Attachment Disorder (RAD)
- Reactive attachment disorder (RAD) is a condition where a child doesn’t form healthy emotional bonds with their caretakers (parental figures), often because of emotional neglect or abuse at an early age.
- Children with RAD have trouble managing their emotions.
- Reactive attachment disorder is most common among children who experience physical or emotional neglect or abuse.
- Parang Erikson Psychosocial Theory - Trust Vs Mistrust Children may be more likely to develop RAD if they:
- Have many different parent figures, like multiple foster care situations.
- Were taken away from their primary caretakers after bonding with them emotionally.
- Experienced several traumatic losses early in life.
- Have parental figures who didn’t try to become emotionally close to them.
- Spent time in an institution, like an orphanage, where they didn’t have a loving parent figure. Symptoms of reactive attachment disorder?
- Symptoms of reactive attachment disorder are unique to each child. Common symptoms among toddlers and young children with RAD include: ✓Not showing positive emotions, like comfort, love or joy when interacting with others. ✓Avoiding eye contact and physical touch. ✓ Expressing fear or anger by throwing tantrums or frequently showing unhappiness or sadness. Disinhibited Social Engagement Disorder
- Disinhibited social engagement disorder (DSED) is a relatively rare mental health condition that typically stems from early childhood neglect or inconsistent caregivers.
- A child with DSED will appear fearless around new adults, seek attention or comfort from strangers, and often wander off with unfamiliar people.
- Therapeutic interventions can help, but having consistent, caring adults in the child’s life is the best way to reduce DSED symptoms.
Lesson 1 TO 4 Reviewer
Course: Abnormal Psychology (PSY 9)
University: Pamantasan ng Lungsod ng Valenzuela
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