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Psychological Disorders Chapter 16
[object Object],[object Object]
[object Object]
Psychological Disorders ,[object Object],Marc, diagnosed with obsessive-compulsive disorder (from Summers, 1996)
Psychological Disorders ,[object Object],[object Object],[object Object]
Psychological Disorders ,[object Object],[object Object],[object Object],William James (1842-1910)
Defining Psychological Disorders ,[object Object],When behavior is  deviant, distressful, and dysfunctional  psychiatrists and psychologists label it as disordered (Comer, 2004).
Deviant, Distressful & Dysfunctional ,[object Object],[object Object],[object Object],In the Wodaabe tribe men wear costumes to attract women. In Western society this would be considered abnormal. Carol Beckwith
Historical Perspective ,[object Object],[object Object],[object Object],[object Object]
Understanding Psychological Disorders ,[object Object],Trephination (boring holes in the skull to remove evil forces) John W. Verano
Exorcism/Mental Hospital
Medical Perspective ,[object Object],Dance in the madhouse. George Wesley Bellows,  Dancer in a Madhouse , 1907. © 1997 The Art Institute of Chicago
Medical Model ,[object Object],[object Object],[object Object],[object Object],[object Object]
Biopsychosocial Perspective ,[object Object]
Exercise 16 p8 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classifying Psychological Disorders ,[object Object],The most recent edition, DSM-IV-TR (Text Revision, 2000), describes 400 psychological disorders compared to 60 in the 1950s.
Multiaxial Classification Are  Psychosocial  or  Environmental Problems  (school or housing issues) also present? Axis IV What is the  Global Assessment  of the person’s functioning? Axis V Is a  General Medical Condition  (diabetes, hypertension or arthritis etc) also present ? Axis III Is a  Personality Disorder  or  Mental Retardation  present? Axis II Is a  Clinical Syndrome  (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis I
 
Multiaxial Classification Note 16 syndromes in Axis I
Multiaxial Classification Note Global Assessment for Axis V
Goals of DSM ,[object Object],[object Object],Disorders outlined by DSM-IV are reliable. Therefore, diagnoses by different professionals are similar. Others criticize DSM-IV for “putting any kind of behavior within the compass of psychiatry.”
Labeling Psychological Disorders ,[object Object],Asylum baseball team (labeling) Elizabeth Eckert, Middletown, NY. From L. Gamwell and  N. Tomes,  Madness in America,  1995. Cornell University Press.
Labeling Psychological Disorders ,[object Object]
Labeling Psychological Disorders ,[object Object],Theodore Kaczynski (Unabomber)  Elaine Thompson/ AP Photo
Anxiety Disorders ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anxiety ,[object Object],[object Object]
Generalized Anxiety Disorder ,[object Object],2. Autonomic arousal. 3. Inability to identify or avoid the cause of certain feelings. Symptoms
[object Object]
Panic Disorder ,[object Object],Anxiety is a component of both disorders. It occurs more in the panic disorder, making people avoid situations that cause it. Symptoms
Phobia ,[object Object]
Kinds of Phobias Phobia of blood. Hemophobia Phobia of closed spaces. Claustrophobia Phobia of heights. Acrophobia Phobia of open places. Agoraphobia
Phobia Survey ,[object Object]
Top 10 Phobia’s ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fears of women and men ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Obsessive-Compulsive Disorder ,[object Object]
[object Object],Brain Imaging Brain image of an OCD
[object Object]
Post-Traumatic Stress Disorder ,[object Object],[object Object],2. Nightmares 3. Social withdrawal 4. Jumpy anxiety 5. Sleep problems Bettmann/ Corbis
Resilience to PTSD ,[object Object],Holocaust survivors show remarkable resilience against traumatic situations.  All major religions of the world suggest that surviving a trauma leads to the growth of an individual.
[object Object]
Exercise ,[object Object]
Explaining Anxiety Disorders Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.
The Learning Perspective Learning theorists suggest that  fear conditioning  leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced. John Coletti/ Stock, Boston
The Learning Perspective Investigators believe that fear responses are inculcated through  observational learning . Young monkeys develop fear when they watch other monkeys who are afraid of snakes.
The Biological Perspective Natural Selection  has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species. Twin studies suggest that our  genes  may be partly responsible for developing fears and anxiety. Twins are more likely to share  phobias.
The Biological Perspective Generalized anxiety, panic attacks, and even OCD are linked with  brain  circuits like the  anterior cingulate cortex. Anterior Cingulate Cortex of an OCD patient. S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action  monitoring in obsessive-compulsive disorder.  Psychological Science, 14,  347-353.
Dissociative Disorder ,[object Object],Symptoms ,[object Object],2. Being separated from the body. 3. Watching yourself as if in a movie.
Dissociative Identity Disorder (DID) ,[object Object],Chris Sizemore (DID) Lois Bernstein/ Gamma Liason
DID Critics ,[object Object],Critics’ Arguments ,[object Object],2. Learned response that reinforces reductions in anxiety.
Mood Disorders ,[object Object],[object Object],[object Object]
Major Depressive Disorder Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002). Chronic shortness of breath Gasping for air after a  hard run Major Depressive Disorder Blue mood
Major Depressive Disorder ,[object Object],[object Object],[object Object],[object Object],[object Object],Signs include:
Dysthymic Disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Major Depressive Disorder Blue  Mood Dysthymic Disorder
Bipolar Disorder ,[object Object],Multiple ideas Hyperactive Desire for action Euphoria Elation Manic Symptoms Slowness of thought Tired Inability to make decisions Withdrawn Gloomy Depressive Symptoms
Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library Whitman Wolfe Clemens Hemingway
[object Object]
Explaining Mood Disorders Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it.  Lewinsohn et al., (1985, 1995) note that a theory of depression should explain the following: ,[object Object],[object Object]
Theory of Depression ,[object Object]
Theory of Depression ,[object Object],[object Object],Post-partum depression Desiree Navarro/ Getty Images
Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide. ,[object Object],[object Object],[object Object],[object Object],[object Object],Suicide Statistics
Biological Perspective Genetic Influences:  Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Linkage analysis  and  association studies  link possible genes and dispositions for depression. Jerry Irwin Photography
Neurotransmitters & Depression Post-synaptic Neuron Pre-synaptic Neuron Norepinephrine Serotonin A reduction of  norepinephrine  and  serotonin  has been found in depression. Drugs that alleviate mania reduce norepinephrine.
The Depressed Brain ,[object Object],Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine
Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from  self-defeating beliefs  and  negative explanatory styles .
Depression Cycle ,[object Object],[object Object],[object Object],[object Object]
Example Explanatory style plays a major role in becoming depressed.
Schizophrenia ,[object Object],Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease (WHO, 2002). Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women.
Symptoms of Schizophrenia ,[object Object],[object Object],[object Object],[object Object]
Disorganized & Delusional Thinking Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”). This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” (Sheehan, 1982) This monologue illustrates fragmented, bizarre thinking with distorted beliefs called  delusions  (“I’m Mary Poppins”).
Disorganized & Delusional Thinking ,[object Object]
Disturbed Perceptions ,[object Object],L. Berthold,  Untitled.  The Prinzhorn Collection, University of Heidelberg August Natter,  Witches Head.  The Prinzhorn Collection, University of Heidelberg Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign
Inappropriate Emotions & Actions ,[object Object],Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours ( catatonia ).
Subtypes of Schizophrenia ,[object Object]
Positive and Negative Symptoms ,[object Object],Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals ( negative symptoms ).
Chronic and Acute Schizophrenia ,[object Object],When schizophrenia rapidly develops ( acute/reactive ) recovery is better. Such schizophrenics usually show positive symptoms.
Subtypes
Understanding Schizophrenia ,[object Object],Dopamine Overactivity:  Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Brain Abnormalities
Abnormal Brain Activity ,[object Object],Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro  Imaging and Judith L. Rapport, National Institute of Mental Health
Abnormal Brain Morphology ,[object Object],Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC
Viral Infection ,[object Object]
Genetic Factors ,[object Object],0  10  20  30  40  50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated
Genetic Factors ,[object Object]
Psychological Factors ,[object Object],Genain Sisters The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. Courtesy of Genain Family
Warning Signs ,[object Object],Birth complications, oxygen deprivation and low-birth weight.  2. Short attention span and poor muscle coordination. 3. Poor peer relations and solo play. 6. Emotional unpredictability. 5. Disruptive and withdrawn behavior. 4. A mother’s long lasting schizophrenia. 1.
Personality Disorders ,[object Object]
Antisocial Personality Disorder ,[object Object]
Understanding Antisocial Personality Disorder ,[object Object]
Understanding Antisocial Personality Disorder ,[object Object],Normal Murderer Courtesy of Adrian Raine,  University of Southern California
Understanding Antisocial Personality Disorder ,[object Object]
Rates of Psychological Disorders
Rates of Psychological Disorders The prevalence of psychological disorders during the previous year is shown below (WHO, 2004).
Risk and Protective Factors Risk and protective factors for mental disorders (WHO, 2004).
Risk and Protective Factors

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  • 17. Multiaxial Classification Are Psychosocial or Environmental Problems (school or housing issues) also present? Axis IV What is the Global Assessment of the person’s functioning? Axis V Is a General Medical Condition (diabetes, hypertension or arthritis etc) also present ? Axis III Is a Personality Disorder or Mental Retardation present? Axis II Is a Clinical Syndrome (cognitive, anxiety, mood disorders [16 syndromes]) present? Axis I
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  • 19. Multiaxial Classification Note 16 syndromes in Axis I
  • 20. Multiaxial Classification Note Global Assessment for Axis V
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  • 31. Kinds of Phobias Phobia of blood. Hemophobia Phobia of closed spaces. Claustrophobia Phobia of heights. Acrophobia Phobia of open places. Agoraphobia
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  • 43. Explaining Anxiety Disorders Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.
  • 44. The Learning Perspective Learning theorists suggest that fear conditioning leads to anxiety. This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced. John Coletti/ Stock, Boston
  • 45. The Learning Perspective Investigators believe that fear responses are inculcated through observational learning . Young monkeys develop fear when they watch other monkeys who are afraid of snakes.
  • 46. The Biological Perspective Natural Selection has led our ancestors to learn to fear snakes, spiders, and other animals. Therefore, fear preserves the species. Twin studies suggest that our genes may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias.
  • 47. The Biological Perspective Generalized anxiety, panic attacks, and even OCD are linked with brain circuits like the anterior cingulate cortex. Anterior Cingulate Cortex of an OCD patient. S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action monitoring in obsessive-compulsive disorder. Psychological Science, 14, 347-353.
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  • 52. Major Depressive Disorder Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002). Chronic shortness of breath Gasping for air after a hard run Major Depressive Disorder Blue mood
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  • 54. Dysthymic Disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Major Depressive Disorder Blue Mood Dysthymic Disorder
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  • 56. Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library Whitman Wolfe Clemens Hemingway
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  • 62. Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Linkage analysis and association studies link possible genes and dispositions for depression. Jerry Irwin Photography
  • 63. Neurotransmitters & Depression Post-synaptic Neuron Pre-synaptic Neuron Norepinephrine Serotonin A reduction of norepinephrine and serotonin has been found in depression. Drugs that alleviate mania reduce norepinephrine.
  • 64.
  • 65. Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles .
  • 66.
  • 67. Example Explanatory style plays a major role in becoming depressed.
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  • 69.
  • 70. Disorganized & Delusional Thinking Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”). This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” (Sheehan, 1982) This monologue illustrates fragmented, bizarre thinking with distorted beliefs called delusions (“I’m Mary Poppins”).
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  • 92. Rates of Psychological Disorders The prevalence of psychological disorders during the previous year is shown below (WHO, 2004).
  • 93. Risk and Protective Factors Risk and protective factors for mental disorders (WHO, 2004).

Notas do Editor

  1. OBJECTIVE 1 | Identify criteria for judging whether behavior is psychologically disordered.
  2. OBJECTIVE 2 | Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior.
  3. OBJECTIVE 3 | Describe the goals and content of the DSM-IV.
  4. OBJECTIVE 4 | Discuss the potential dangers and benefits of using diagnostic labels.
  5. OBJECTIVE 5 | Define anxiety disorder , and explain how this condition differs from normal feelings of stress, tension, or uneasiness.
  6. OBJECTIVE 6 | Contrast the symptoms of generalized anxiety disorder and panic disorder.
  7. OBJECTIVE 7 | Explain how a phobia differs from fears we all experience.
  8. OBJECTIVE 8 | Describe the symptoms of obsessive-compulsive disorder.
  9. OBJECTIVE 9 | Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.
  10. OBJECTIVE 10 | Discuss the contributions of the learning and biological perspectives to our understanding of the development of anxiety disorders.
  11. OBJECTIVE 11 | Describe the symptoms of dissociative disorders, and explain why some critics are skeptical about dissociative identity disorder.
  12. OBJECTIVE 12 | Define mood disorders , and contrast major depressive disorder and bipolar disorder.
  13. OBJECTIVE 13 | Discuss the facts that an acceptable theory of depression must explain.
  14. OBJECTIVE 14 | Summarize the contribution of the biological perspective to the study of depression, and discuss the link between suicide and depression.
  15. OBJECTIVE 15 | Summarize the contribution of the social-cognitive perspective to the study of depression, and describe the events in the cycle of depression.
  16. OBJECTIVE 16 | Describe the symptoms of schizophrenia, and differentiate delusion and hallucinations.
  17. OBJECTIVE 17 | Distinguish the five subtypes of schizophrenia, and contrast chronic and reactive schizophrenia.
  18. OBJECTIVE 18 | Outline some abnormal brain functions and structures associated with schizophrenia, and discuss the possible link between prenatal viral infections and schizophrenia.
  19. OBJECTIVE 19 | Discuss the evidence for a genetic contribution to the development of schizophrenia.
  20. OBJECTIVE 20 | Describe some psychological factors that may be early signs of schizophrenia in children.
  21. OBJECTIVE 21 | Contrast the three clusters of personality disorders, and describe the behaviors and brain activity associated with antisocial personality disorders.
  22. OBJECTIVE 22 | Discuss the prevalence of psychological disorders, and summarize the findings on the link between poverty and serious psychological disorders.