Psychological Disorders Lecture 15 Chapter 14

2 Defining Abnormality To study the abnormal is the best way of understanding the normal. William James ( )

Defining Abnormality

4 Defining Psychological Disorders Is being abnormal enough to call something a disorder?

5 Defining Psychological Disorders 1.deviant behavior 2.distress 3.dysfunctional

6 The Medical Model Philippe Pinel ( ) from France, insisted that madness was not due to demonic possession, but an ailment of the mind. Dance in the madhouse. George Wesley Bellows, Dancer in a Madhouse, © 1997 The Art Institute of Chicago

7 Medical Model physicians discovered that syphilis led to mental disorders 1.Etiology 2.Diagnosis 3.Treatment 4.Prognosis

8 The Biopsychosocial Approach

9 Classifying Psychological Disorders

10 Multiaxial Classification Note 16 syndromes in Axis I

11 Goals of DSM 1.Describe (400) disorders. 2.Determine how prevalent the disorder is. Disorders outlined by DSM-IV are reliable.

12 Labeling Psychological Disorders 1.Critics of the DSM-IV argue that labels may stigmatize individuals. Asylum baseball team (labeling) Elizabeth Eckert, Middletown, NY. From L. Gamwell and N. Tomes, Madness in America, Cornell University Press.

13 Labeling Psychological Disorders 2.Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.

14 Labeling Psychological Disorders 3.How should the label affect responsibility? g/2010/jun/28/ Theodore Kaczynski (Unabomber) Elaine Thompson/ AP Photo

15 Anxiety Disorders Feelings of excessive apprehension and anxiety. Often includes the symptom of panic attacks. 1.Generalized anxiety disorder 2.Panic disorder 3.Phobias 4.Obsessive-compulsive disorder 5.Post-traumatic stress disorder

16 Generalized Anxiety Disorder Symptoms

17 Panic Disorder Symptoms

18 Phobias

19 Obsessive-Compulsive Disorder

20 A PET scan of the brain of a person with Obsessive-Compulsive Disorder (OCD). High metabolic activity (red) in the frontal lobe areas are involved with directing attention. Brain Imaging Brain image of an OCD

21 Post-Traumatic Stress Disorder Four or more weeks of the following symptoms 1.Haunting memories 2.Nightmares 3.Social withdrawal 4.Jumpy anxiety 5.Sleep problems Bettmann/ Corbis

22 Resilience to PTSD Only about 10% of women and 20% of men react to traumatic situations and develop PTSD.

23 Explaining Anxiety Disorders Freud suggested that we repress our painful and intolerable ideas, feelings, and thoughts, resulting in anxiety.

24 The Learning Perspective fear conditioning observational learning John Coletti/ Stock, Boston

25 The Biological Perspective Natural Selection Genetic inheritance

26 The Biological Perspective Generalized anxiety, panic attacks, and even OCD are linked with brain circuits like the anterior cingulate cortex.

27 Dissociative Disorders Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings. Symptoms 1.Having a sense of being unreal. 2.Being separated from the body. 3.Watching yourself as if in a movie.

28 Dissociative Identity Disorder (DID) Chris Sizemore (DID) Lois Bernstein/ Gamma Liason 4/real-sybil-admits-multiple-personalities- were-fake

29 DID Critics

30 Mood Disorders 1.Major depressive disorder 2.Bipolar disorder

31 Major Depressive Disorder Symptoms:

32 Bipolar Disorder Multiple ideas Hyperactive Desire for action Euphoria Elation Manic Symptoms Slowness of thought Tired Inability to make decisions Withdrawn Gloomy Depressive Symptoms

33 Bipolar Disorder Whitman WolfeClemensHemingway Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library

34 Explaining Mood Disorders Lewinsohn et al., (1985, 1998) note that a theory of depression should explain the following: 1.Behavioral and cognitive changes 2.Common causes of depression

35 Theory of Depression 3.Gender differences

36 Theory of Depression 4.Depressive episodes self-terminate. 5.Stressful events often precede depression. 6.Depression is increasing, especially in the teens. Post-partum depression Desiree Navarro/ Getty Images

37 Suicide

38 Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%).

39 The Depressed Brain PET scans Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

40 Social-Cognitive Perspective

41 Negative Thoughts and Moods

42 Depression Cycle

43 Schizophrenia 1.Disorganized and delusional thinking. 2.Disturbed perceptions. 3.Inappropriate emotions and actions.

Types of Schizophrenia

45 Symptoms of Schizophrenia Positive symptoms versus Negative symptoms

46 Disorganized & Delusional Thinking Does selective attention failure play a part?

47 Hallucinations L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg

48 Inappropriate Emotions & Actions

49 Onset and Development of Schizophrenia Nearly 1 in a 100 suffer from schizophrenia (WHO, 2002). Usually diagnosed between age 18-24

50 Chronic and Acute Schizophrenia When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms. When schizophrenia rapidly develops (acute/reactive) recovery is better. Such schizophrenics usually show positive symptoms.

51 Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Dopamine Overactivity Brain Abnormalities

52 Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health

53 Abnormal Brain Morphology Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

54 Viral Infection individuals who contracted a viral infection (flu) during the middle of their fetal development

55 Genetic Factors Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated

56 Genetic Factors

57 Personality Disorders inflexible and enduring behavior patterns that impair social functioning. Antisocial Personality Disorder Borderline Personality Disorder Narcissistic Personality Disorder

Symptoms – Trouble regulating emotions – Quick to anger – Fear of abandonment – Impulsiveness – Rocky relationships – Suicidal thoughts and attempts Understanding Borderline Personality Disorder

Risk Factors – Genetics Twin studies – Environmental Unstable family Understanding Borderline Personality Disorder

Understanding Antisocial Personality Disorder Psychopath org/radio- archives/episode/436/the- psychopath-test Take notes on symptoms and risk factors

61 Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study, repeat offenders had 11% less frontal lobe activity (Raine et al., 1999; 2000). Normal Murderer Courtesy of Adrian Raine, University of Southern California