Abnormal Psychology Lecture Notes

3/1/99

From 1965-1990, there were over 50,000 articles on depression.

Prof. learned as a grad student that depression was self-curing.

• there is a risk for suicide among depressed people
• counseling and treatment is advisable

recent studies show women have twice the occurrence rate of depression; even higher among women in milder forms and seasonal affective disorder

Seasonal Affective Disorder:

• more depression around the holidays = look at the amount of light a person is exposed to
• women’s sleeping patterns are more fragile and more sensitive to light
• hormonal component
• more common in people involved in the arts (4-10x greater risk for major depression; 3-18x greater risk of suicide; 10-20x greater risk for bipolar disorder)

Clinical Depression:

• helplessness and hopelessness
• anhedonia à absence of capacity to feel pleasure
• disturbance of appetite
• disturbance of sleep
• psychomotor retardation
• agitation
• loss of energy
• express worthlessness and guilt
• preoccupation with death and degenerative diseases
• slowed thinking

Mania:

• intense driven bubbliness
• irritable
• aggressive
• mood is elevated (euphoria)
• opposite of hopelessness
• sleeplessness
• may go several days without food
• talkative
• flight of ideas
• distractable
• hyperactivity and reckless behavior

Bipolar – depressed or manic = episodic

Various forms of cycling

• slow cycle schedules
• in deep depression, suspicion of a hormonal basis

2 forms of bipolar disorder

1. 1 major depression, 1 manic (Bipolar I)
2. 1 major depression, never becomes fully manic (Bipolar II)

dimensions:

1. suicidal vs. non-suicidal
2. endogenous vs. reactive
3. early vs late onset
4. comorbidity = strong with alcoholism, use of caffeine, anxiety

Professor read 2 suicide notes:

1. attempted suicide – sometimes considered to be just a cry for help
2. suicide took place – "I want to die"

women à less likely to be physically unappealing; less likely for women to actually go through with it

men à more violent

differs with culture; more prevalent in some than others

• on lithium, still predominantly elevated mood
• shows the therapist how he would protect himself
• exaggerates and out and out lies
• reports leaving the military because of too many laws and women problems
• reports that wife was a perfectionist and she attacked him and he hit back
• "I hate to go into the past" miseries
• "I’m on vacation now"
• trust fund caretaker is not doing a good job; needs every cent of his checks
• episodic à been on lithium before à side effect of impotence
• "self educated," pianist, 8 years of college, 8^th grade education, but took GED in military
• Holy Ghost came down and firs came down à started having problems after that
• attempted suicide because so much power came into him – speaks in tongues
• "God is love and God is cleanliness"
• recognizes conspiracy à can hear their thoughts, they have mind troubles – others know his thoughts
• tartive dyskenesia à uncontrollable mouth movements due to extensive use of psychiatric medications

3/3/99

Lyme disease à disorientation, loss of memory, mood swings, depression

Nightterrors à occur in Phase IV sleep

Nightmares à occur in REM sleep

• chronic disorder, psychosis, serious illness
• great amount of research done
• 1-2% in lifetime
• men exceed women
• 1 million current patients
• 10-13% of homeless are people release from hospital for schizophrenia
• ½ will be admitted within 2 years
• total cost of treatment is equal to the total cost spent on cancer research
• impaired ability to take care of self, earn living, carry on conversation
• mortality occurs early than in non-schizophrenics
• lower fecundity rate than non-schizophrenics

schizophrenic patient has trouble in human relations – some disorders do not interfere with relationships, but more common in schizophrenics

• Kraeplin à first to divide psychosis into mood disorder, paranoia, dementia praecox
• Blueler à attributed disorder to split mind, denied that it was multiple personality disorder

1. autism
2. affect
3. association
4. ambivalence
5. accessory symptoms: hallucinations and delusions

today’s list includes some of Blueler’s: anhedonia; drawn away from reality

Current symptoms for diagnosis:

1. delusions or hallucinations
2. disorganized speech
3. disorganized or catatonic behavior
4. negative symptoms – lacks ambitions and goals
5. 2 or more signs (6+ months and disturbances in normal functioning – work, school, family, home social)

one of the big problems is which symptoms is primary for the disorder

Professor: developmental disorder: failure to develop along a normal course – no typical goals, failure of early promise

consentual validation à I talk to you and you listen; social consent of thoughts; absent in schizophrenics

6. loose association
7. poverty of content à new words, rhyming words, selective attention
8. hallucinations
9. disruption of motor processes
10. social withdrawal
11. lack of volition and will

earlier DSMs had 4 categories of schizophrenia

1. simple
2. catatonic
3. hebephrenic
4. paranoia

• prognosis was poorest for hebephrenic and simple

1. Female Patient

• attempted once; "get rid of myself and problems", took pills, sister caught her
• didn’t care about how her family would feel
• reports that it was a serious attempt
• couldn’t handle anything, best thing was to commit suicide

1. Male Patient

• several attempts over the years
• 2 overdoses, 3 stepped in front of a car, 1 methodical attempt with a gas stove
• episodic depression that is devastating; minor problem at the office that keeps nagging at him to the point of distraction
• never made a decision to end it all; only one attempt was planned

1. Looseness of Association

• train of thought is disrupted
• "control…freedom…evolution…life generally survives…code of ethics"

1. Neologism

• "kedok" – think it means "My child did not want expensive things"

1. Poverty of Content

• patient making philosophical statements, but is not able to explain what he means
• did not understand the meaning behind "You can lead a horse to water, but you can’t make him drink" no figurative understanding

1. Blocking

• interrupted speech, periods of inactivity in the middle of a sentence and had to ask was the question was

1. Delusions

1. Being Controlled

• thoughts being controlled by aliens on Mars
• dreams regulated by doctor or nurse on duty
• makes him think perverted thoughts

1. Thought Broadcasting

• thought name of cousin and roommate said the name a few minutes later
• broadcasted through transmitters in teeth to be picked up by others

1. Grandiose and persecutory delusions

• had millions and billions of children
• man saying they gave him an abortion pill; several pregnancies
• mistreatment by hospital, doctor wanted to experiment on him
• made friends with Russians, FBI is holing him here because he looks like Jesus and is a Russian queen

1. Nihilistic and Somatic Delusions

• foot is not educated so he can’t walk straight
• old many says he is a boy growing up
• heavy lead balls in her body put in by Kruschev