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ABNORMALITAS

RATNA WIDIASTUTI
ANOREKSIA NERVOSA
UMUR 16-24 TH
5% REMAJA
KELG STATUS SOSIAL MENENGAH KE ATAS
PREDISPOSISI :
FK BIOLOGIS & GENETIK DISFUNGSI
HIPOTALAMUS,
INTRAPERSONAL CEMAS, DEPRESI,
INTROVERT, PERFEKSIONIS, PERFEKSIONIS,
KELUARGA kaku, overprotekstif, penuh konflik, ibu
tll berperan & ayah tidak,
SOSBUD tuntuan budaya/TV, ekskul balet,
penyakit kronik diabetes melitus

Ratna Widiastuti, S.Psi.,M.A.,Psi. 2


MANIFESTASI
MERASA DIRINYA GEMUK
SUDAH KURUS PUN MASIH MERASA GEMUK
KEPRIBADIAN: PENGKRITIK DIRI SENDIRI,
PERFEKSIONIS, CERDAS & POPULER DI
SEKOLAH
APATIS, TIDAK MAMPU MENGEKSPRESIKAN
KEBAHAGIAAN, TERTEKAN, TIDAK
BERGAIRAH, LEKAS MARAH, MALAS
BERGAUL
DR KELG DG STRES KRONIS BERCERAI
ATAU BERPINDAH TEMPAT
Ratna Widiastuti, S.Psi.,M.A.,Psi. 3
MANIFESTASI
TINGKAH LAKU MAKAN
MEMBATASI MAKANAN
BERKALORI TINGGI, DIBAGI-
BAGI DLM PORSI KECIL,
DIBUMBUI/DIBUBUHI SST
SHG TIDAK MENARIK,
CAMPURAN YG TIDAK
WAJAR
MENGGAMBARKAN DIRINYA
20-80% LEBIH BESAR DR
UKURAN SSGHNYA
MODEL DI MEDIA ADALAH
YG MENARIK YG KURUS,
SEMAKIN KURUS SEMAKIN
TINGGI STATUS SOSIAL

Ratna Widiastuti, S.Psi.,M.A.,Psi. 4


DIAGNOSIS
MEMBIARKAN DIRI KELAPARAN
TAKUT GEMUK; MENGHINDARI MAKAN
GANGG FISIOLOGIS FS HORMON REPRODUKSI TDK
MENS
DSM III:
TAKUT GEMUK BERLEBIHAN SHG TJD PENURUNAN BB
DRASTIS
GANGGUAN PENAMPILAN TUBUH TAKUT GEMUK
SHG TDK MAKAN
PENURUNAN BB 25% DR BB SEMULA\MENOLAK
MEMPERTAHANKAN BB NORMAL
TIDAK PENYAKIT FISIK LAIN YG MENGAKIBATKAN BB
TRN

Ratna Widiastuti, S.Psi.,M.A.,Psi. 5


TATALAKSANA
REHABILITASI NUTRISI
GASTROINTESTINAL (KALORI
3500/HARI) & EDEMA PERIFER
(KURANGI GARAM), OBAT ANTICEMAS
PSIKOTERAPI REGULASI EMOSI
KRN CEMAS & TAKUT
PEMELIHARAAN & TINDAK LANJUT
BERAT BADAN NORMAL, TINGKAH
LAKU MAKAN NORMAL, KEMATANGAN
SOS. EMOSI,Ratna
MENS NORMAL,
Widiastuti, S.Psi.,M.A.,Psi. 6
BULIMIA NERVOSA
EPISODE BINGE EATING
MERANGSANG MUNTAH, GERAK
BERLEBIHAN, PUASA
BERKEPANJANGAN,
PENYALAHGUNAAN LAKSAN ATAU
DIURETIK
TJD DI USIA 13-58
3% DI MASYARAKAT
SEMUA KELAS MASYARAKAT
Ratna Widiastuti, S.Psi.,M.A.,Psi. 7
ETIOLOGI
ADIKSI MAKANAN & PERILAKU
KELUARGA DISFUNGSI ATAU
KEKERASA NFISIK & SEKSUAL
SOSBUD MEDIA MASSA
KOGNITIF & TINGKAH LAKU
IRASIONAL BENTUK TUBUH, BERAT
BADAN, DIET, KEPERCAYAAN DIRI
PSIKODINAMIKA MENGENDALIKAN
& MENGHINDARI RASA TERTEKAN,
Ratna Widiastuti, S.Psi.,M.A.,Psi. 8
IMPULSIF, CEMAS
MANIFESTASI
BINGE EATING 3000-7000KAL
PURGING MEMUNTAHKAN DG
MERANGSANG FARING, LAKSAN,
DIURETIK, ENEMA, GERAK
BERLEBIHAN
BODY IMAGE KELIRU
DEPRESI, RASA BERSALAH,
MENYESAL YG MENDALAM
Ratna Widiastuti, S.Psi.,M.A.,Psi. 9
GEJALA KLINIS
PEMBENGKAKAN TANGAN /KAKI
LEMAH, LELAH
SAKIT KEPALA
PERUT TERASA PENUH
MUAL
HAID TDK TERATUR
KRAM OTOT
NYERI DADA & RASA TERBAKAR
MUDAH PENDARAHAN
Ratna Widiastuti, S.Psi.,M.A.,Psi. 10
PSIKOPATOLOGI
ANOREKSIA BULIMIA
NERVOSA NERVOSA
TAKUT GEMUK SAMA
MENGURANGI SAMA
MAKAN SAMA (HRS ADA)
BINGE EATING &
PURGING (TDK
HRS ADA)
SAMA
RAHASIA TINGKAH
LAKU INGIN ORLA
Ratna Widiastuti, S.Psi.,M.A.,Psi. 11
MENGHENTIKAN
TATALAKSANA
MENURUNKAN POLA MAKAN BULIMIK
HINDARI MAKANAN BINGE SPT ES
KRIM
OBAT ANTI DEPRESAN
PSIKOTERAPI
OR RINGAN SEDANG
TERAPI KELOMPOK
DIET RENDAH GARAM U/ YG MEMAKAI
DIURETIK Ratna Widiastuti, S.Psi.,M.A.,Psi. 12
DEPRESI
SEDIH
GANGGUAN SOMATIK, MUDAH LELAH,
KURANG ENERGI
GANGGUAN PSIKOMOTOR, LAMBAT,
KURANG ANTUSIAS, RAGU2
MUDAH TERSINGGUNG
GAGAL MENAIKKAN BERAT BADAN
NORMAL
WAKTU: SATU TAHUN
Ratna Widiastuti, S.Psi.,M.A.,Psi. 13
PENYEBAB
PSIKODINAMIKA PUTUS CINTA &
INTROYEKSI
KOGNITIF BEHAVIORAL: PANDANGAN
NEGATIF TTG DIRI SENDIRI,
INTERPRETASI NEGATIF TTG
HIDUPNYA, HARAPAN NEGATIF TTG
DIRINYA, RASA TAK BERHARGA,
HELPLESS, HOPELESS
LEARNED HELPLESSNESS MODEL
Ratna Widiastuti, S.Psi.,M.A.,Psi. 14
KETIDAKMAMPUAN ORTU
KLASIFIKASI
AFEKTIF BIPOLAR (satu atau lebih
episode energi peningkatan kadar
normal, kognisi , dan mood dengan atau
tanpa satu atau lebih episode
depresi. Suasana hati meningkat secara
klinis disebut sebagai mania atau, jika
ringan, hypomania . Episode ini biasanya
dipisahkan oleh periode "normal" suasana
hati)
HIPOMANIA (lht atas)
DISTIMIA (gangguan mood yang ditandai 15
Ratna Widiastuti, S.Psi.,M.A.,Psi.
TERAPI
PSIKOTERAPI
KELUARGA
OBAT ANTI
DEPRESAN
TERAPI CBT

Ratna Widiastuti, S.Psi.,M.A.,Psi. 16


SUICIDE/BUNUH DIRI
USIA: 15-24 TH,
POPULASI: 9%

Ratna Widiastuti, S.Psi.,M.A.,Psi. 17


FAKTOR RISIKO
BIOLOGIS
SEROTONIN
GANGGUAN MENTAL
ADHD, DEPRESI,
IMSONIA
PENYALAHGUNAAN
ZAT
MINORITAS, GAY,
LESBI,BISEKS
MASALAH KELUARGA
MASALAH SOSIAL
KDRT, MISKIN,
SEXUAL ABUSE
MASALAH SEKOLAH
TEKANAN
PELAJARAN, TEMAN
SEBAYA
CINTA Ratna Widiastuti, S.Psi.,M.A.,Psi. 18
TERAPI
CBT (COCNITIVE BEHAVIORAL
THERAPY)
PELATIHAN SOFT SKILL
FARMAKOLOGI ANTIDEPRESAN

Ratna Widiastuti, S.Psi.,M.A.,Psi. 19


PENYALAHGUNAAN ZAT
akibat:
Distress
Hubungan dengan
orang lain terganggu
Gangguan
perkembangan
kognitif, emosi, sosial
Kriminalitas
Masalah kompetensi
disekolah
Ratna Widiastuti, S.Psi.,M.A.,Psi. 20
PENYALAHGUNAAN ZAT
akibat:
Gangguan psikiatrik
Conduct disorder
Depresi
ADHD
Anxiety
Kehamilan usia dini
Penyakit seksual
Sakit fisik (jantung,
saraf, seksual)

Ratna Widiastuti, S.Psi.,M.A.,Psi. 21


ADHD
Tanda: tidak
perhatian, hiperaktif,
impulsif
Terjadi pd 3-7% anak
dan masih berlanjut
hingga remaja (50-
80%)
Social incompetence,
behavior

Ratna Widiastuti, S.Psi.,M.A.,Psi. 22


Treatments for ADHD
Classroom-based interventions YAITU
DENGAN strategi pendidikan (di kelas),
kelompok sebaya (tutoring), dan
manajemen diri.

Ratna Widiastuti, S.Psi.,M.A.,Psi. 23


Treatments for ADHD
Manajemen perilaku memfokuskan pada penugasan,
perilaku yang dituju, mengendalikan impuls,
ketrampilan sosial. Tujuan dari manajemen perilaku
untuk mengurangi hiperaktivitas, perilaku btidak
mengikuti perintah, menganggu, dan agresi. Teknik yg
banyak digunakan adalah hadiah, hukuman, token
ekonomy (Fiore, Becker, & Nero, 1993).
Cognitive-behavioral therapy mengkombinasikan
strategi kognitif untuk mengendalikan impuls,
pemecahan masalah, dan regulasi diri agar impuls
terkendali, hiperaktivitas menurun, dan konsep diri positif
(Fiore, Becker, & Nero, 1993).

Ratna Widiastuti, S.Psi.,M.A.,Psi. 24


SKIZOFRENIA
Schizophrenia adalah
gangguan mental yg
melibatkan disfungsi
kognitif dan emosional
termasuk persepsi,
berpikir, bahasa dan
komunikasi, perilaku,
perasaan, produksi dan
ketepatan pikiran dan
perkataan, kapasitas
hedonik, perhatian,
dorongan.

Ratna Widiastuti, S.Psi.,M.A.,Psi. 25


SKIZOFRENIA
Criterion A: two or more of the following symptoms must be present for a
significant portion of time during a one-month period (if the condition has
been treated successfully, then the period may be less).
Delusions
Hallucinations
Disorganized speech, such as frequent derailment or incoherence
Grossly disorganized or catatonic behavior
Negative symptoms, such as affective flattening, alogia, or avolition
If there are delusions, and they are bizarre; or if there are hallucinations and
they comprise a voice that keeps up a running commentary on the persons
behavior or thoughts, or there are two or more voices that are conversing
with each other then only these sole symptoms are necessary and
sufficient for diagnosis; a second symptom is not required. The presence of
this relatively severe constellation of signs and symptoms is referred to as
the active phase.

Ratna Widiastuti, S.Psi.,M.A.,Psi. 26


SKIZOFRENIA
Criterion B: a major area of function such as work,
interpersonal relations or self-care is severely
impacted for a significant portion of the time since
the onset of the disturbance.
Criterion C: the disturbance persists continuously
for at least six months. These six months must
include at least one month of symptoms that meet
criterion A. The period may also exhibit prodromal
or residual symptoms, during which the signs of
the disturbance may be manifested by only
negative symptoms. It is also possible that during
the six-month period, two or more symptoms listed
in Criterion A present in an attenuated form.
Ratna Widiastuti, S.Psi.,M.A.,Psi. 27
SKIZOFRENIA
Criterion D: during the period of six months described under
Criterion C, there have been no major Depressive, Manic or
Mixed Episodes occurring concurrently with the symptoms of
Criterion A. Further, if at all any mood disorder episodes have
occurred during the six-month period, these episodes have
been of a duration that is much less than the period when the
Criterion A symptoms were active.
Criterion E: the disturbance is not an outcome of the
physiological effects of a substance or a general medical
condition.
Criterion F: in case there is a history of autistic disorder or any
other pervasive developmental disorder, then there must also
be the presence of prominent delusions or hallucinations, for
at least one month, in order for the individual to be diagnosed
for schizophrenia.

Ratna Widiastuti, S.Psi.,M.A.,Psi. 28


The characteristic symptoms outlined in Criterion
A may be conceptualized as falling into two broad
categories:
Positive Symptoms: These symptoms appear to
reflect an excess or distortion of normal functions.
Listed in Criterion A1 to A4, the positive symptoms
further comprise two distinct dimensions, each
related to its own underlying neural mechanism
and clinical correlates:
Psychotic Dimension: The following two positive
symptoms form part of the psychotic dimension:
Delusions: distortions in thought content
Hallucinations: distortions in perception

Ratna Widiastuti, S.Psi.,M.A.,Psi. 29


Disorganization Dimension: The following two positive
symptoms form part of the the disorganization
dimension
Disorganized speech: distortions in language and thought
processes
Grossly disorganized or catatonic behavior: deficiency in
self-monitoring of behavior
Negative Symptoms: Listed in Criterion A5, negative
symptoms include restrictions in the range and
intensity of emotions, and take on the following forms:
Affective flattening: restriction in emotional
expressions
Alogia: deficit in fluency of thought and productivity of
thought and speech
Avolition: shortfall in initiating goal-directed behavior
Ratna Widiastuti, S.Psi.,M.A.,Psi. 30
Illness management skills
patients can learn to prevent relapses. Patients can
also use coping skills to deal with persistent
symptoms.
IntRehabilitation. Rehabilitation emphasizes social
and vocational training to help people with
schizophrenia function better in their communities.
Because schizophrenia usually develops in people
during the critical career-forming years of life (ages 18
to 35), and because the disease makes normal
thinking and functioning difficult, most patients do not
receive training in the skills needed for a job.
Rehabilitation programs can include job counseling
and training, money management counseling, help in
learning to use public transportation, and opportunities
to practice communication skills.
Ratna Widiastuti, S.Psi.,M.A.,Psi. 31
Illness management skills
Family education. People with schizophrenia are often discharged
from the hospital into the care of their families. So it is important that
family members know as much as possible about the disease. family
members can learn coping strategies and problem-solving skills. In
this way the family can help make sure their loved one sticks with
treatment and stays on his or her medication.
Cognitive behavioral therapy that focuses on thinking and
behavior. The therapist teaches people with schizophrenia how to
test the reality of their thoughts and perceptions, how to "not listen"
to their voices, and how to manage their symptoms overall. CBT can
help reduce the severity of symptoms and reduce the risk of relapse.
Self-help groups. With members support and comfort each other
which can help everyone feel less isolated, with families to work
together to advocate for research and more hospital and community
treatment programs, to draw public attention to the discrimination
many people with mental illnesses face.

Ratna Widiastuti, S.Psi.,M.A.,Psi. 32


Gangguan lain
kecemasan / anxiety stres/distres
Learning disorder disleksia, diskalkulia,
disgrafia, clumsy/ motor disorganized disorder
Bipolar

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