C hapter Fourteen Psychological Disorders © 2012 John Wiley & Sons, Inc. All rights reserved.

Five Common Myths About Mental Illness 1.People with psychological disorders act in bizarre ways and are very different from normal people 2.Mental disorders are a sign of personal weakness 3.Mentally ill people are often dangerous and unpredictable 4.A person who has been mentally ill never fully recovers 5.Most mentally ill individuals can work at only low- level jobs © 2012 John Wiley & Sons, Inc. All rights reserved.

STUDYING PSYCHOLOGICAL DISORDERS © 2012 John Wiley & Sons, Inc. All rights reserved.

Abnormal Behavior Patterns of behaviors, thoughts, or emotions considered pathological (diseased or disordered) for one or more of four reasons: Deviance Dysfunction Distress Danger © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO Dying to be Thin

Initial Understanding of Abnormal Behavior Evil spirits and witchcraft Asylums—initially good intentions, but many resulted in inhumane conditions © 2012 John Wiley & Sons, Inc. All rights reserved.

Initial Understanding of Abnormal Behavior Medical model—perspective that assumes diseases (including mental illness) have physical causes that can be diagnosed, treated, and possibly cured Psychiatry—branch of medicine dealing with the diagnosis, treatment, and prevention of mental disorders “Mentally ill” label can have drawbacks What might be some drawbacks? © 2012 John Wiley & Sons, Inc. All rights reserved.

Seven Psychological Perspectives on Abnormal Behavior © 2012 John Wiley & Sons, Inc. All rights reserved.

Diagnostic and Statistical Manual IV-TR Classification system developed by the American Psychiatric Association used to name and describe abnormal behaviors Neurosis—outmoded term for disorders characterized by unrealistic anxiety and other associated problems; less severe disruptions than psychosis Psychosis—serious mental disorders characterized by extreme mental disruption and defective or lost contact with reality Insanity—legal term applied when people cannot be held responsible for their actions, or are judged incompetent to manage their own affairs, because of mental illness © 2012 John Wiley & Sons, Inc. All rights reserved.

Diagnostic and Statistical Manual IV-TR Approximately 400 disorders 17 categories © 2012 John Wiley & Sons, Inc. All rights reserved.

Main Categories in DSM-IV-TR © 2012 John Wiley & Sons, Inc. All rights reserved.

Main Categories in DSM-IV-TR © 2012 John Wiley & Sons, Inc. All rights reserved.

Most Common DSM-IV-TR Diagnoses © 2012 John Wiley & Sons, Inc. All rights reserved.

Diagnostic and Statistical Manual IV-TR Organizes diagnostic information into five dimensions/axes: 1.Clinical disorders 2.Personality disorders and mental retardation 3.General medical condition 4.Psychosocial and environmental problems 5.Global assessment of functioning © 2012 John Wiley & Sons, Inc. All rights reserved.

Five Axes of DSM-IV-TR © 2012 John Wiley & Sons, Inc. All rights reserved.

DSM-IV-TR Criticisms and Limitations Overdiagnosing Cultural bias Problem of labels © 2012 John Wiley & Sons, Inc. All rights reserved.

ANXIETY DISORDERS © 2012 John Wiley & Sons, Inc. All rights reserved.

Anxiety Disorders Definition Overwhelming apprehension and fear accompanied by autonomic nervous system arousal Five Major Types Generalized anxiety disorder (GAD) Panic disorder Phobias Obsessive-compulsive disorder (OCD) Posttraumatic stress disorder (PTSD) © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO Panic Disorder

Anxiety Disorders © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO 9/11 PTSD Therapy

Explaining Anxiety Disorders © 2012 John Wiley & Sons, Inc. All rights reserved.

Explaining Anxiety Disorders © 2012 John Wiley & Sons, Inc. All rights reserved.

Explaining Anxiety Disorde rs © 2012 John Wiley & Sons, Inc. All rights reserved.

MOOD DISORDERS © 2012 John Wiley & Sons, Inc. All rights reserved.

Mood Disorders Definition Extreme disturbances in emotional states Two Major Types Major Depressive Disorder —long-lasting depressed mood that interferes with the ability to function, feel pleasure, or maintain interest in life Bipolar Disorder—repeated episodes of mania (unreasonable elation, often with hyperactivity) alternating with depression © 2012 John Wiley & Sons, Inc. All rights reserved.

Depressive Explanatory Style © 2012 John Wiley & Sons, Inc. All rights reserved.

Suicide What are some common misconceptions and stereotypes about suicide? © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO Troubled Teens WILEY VIDEO Antidepressant Suicide Genes

Talking to the Depressed Some General Tips Don’t trivialize the disease Don’t be a cheerleader or a Mr. or Mrs. Fix-it Don’t equate normal, everyday “down times” with clinical depression Educate yourself Be Rogerian Get help (1-800-SUICIDE) © 2012 John Wiley & Sons, Inc. All rights reserved.

Explaining Mood Disorde rs Biological Factors Structural brain changes Neurotransmitter imbalances Genetics Generally adaptive response (evolutionary perspective) Psychosocial Factors Learned helplessness Attribution Environmental stressors Relationship disturbances Thought disturbances © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO Imaging Antidepressant Accuracy WILEY VIDEO Blues to Brains WILEY VIDEO Exercise and Depression

SCHIZOPHRENIA © 2012 John Wiley & Sons, Inc. All rights reserved.

Schizophrenia Group of severe disorders involving major disturbances in perception, language, thought, emotion, and behavior A more devastating disorder Affects about 1% of the population Emerges between late teens and mid-thirties © 2012 John Wiley & Sons, Inc. All rights reserved. ANIMATION Schizophrenia

Schizophrenia: Areas of Disturbance Perception Senses may be enhanced or blunted Hallucinations—false, imaginary sensory perceptions that occur without external stimuli (most common is auditory) Language and Thought Disorganized and bizarre thoughts and logic Word salad, neologisms Delusions—mistaken beliefs based on misrepresentations of reality © 2012 John Wiley & Sons, Inc. All rights reserved.

Schizophrenia: Areas of Disturbance Emotion Exaggerated and fluctuate rapidly Blunted and decreased intensity Flattened affect Behavior Social withdrawal Unusual actions with a special meaning Cataleptic Waxy flexibility © 2012 John Wiley & Sons, Inc. All rights reserved.

Subtypes of Schizophrenia © 2012 John Wiley & Sons, Inc. All rights reserved.

Schizophrenia: Methods of Classification Positive Symptoms Additions or exaggerations Delusions Hallucinations Disorganization of Behavior Negative Symptoms Loss or absence Impaired attention Limited or toneless speech Flat or blunted affect Social withdrawal © 2012 John Wiley & Sons, Inc. All rights reserved.

Explaining Schizophrenia Biological Factors Genetics Neurotransmitters Dopamine hypothesis— overactivity of dopamine neurons may contribute to some forms of schizophrenia Brain abnormalities Larger cerebral ventricles Psychosocial Factors Diathesis-stress model— people inherit a predisposition that increases their risk for mental disorders if exposed to certain extremely stressful life experiences Critical and hostile families Families with communication disorders © 2012 John Wiley & Sons, Inc. All rights reserved.

Genetics and Schizophrenia © 2012 John Wiley & Sons, Inc. All rights reserved.

Biopsychosocial Model of Schizophr enia © 2012 John Wiley & Sons, Inc. All rights reserved.

OTHER DISORDERS © 2012 John Wiley & Sons, Inc. All rights reserved.

Substance-Related Disorders Abuse of, or dependence on, a mood- or behavior-altering drug Comorbidity—co-occurrence of two or more disorders in the same person at the same time, as when a person suffers from both depression and alcoholism, possible self-medication © 2012 John Wiley & Sons, Inc. All rights reserved. WILEY VIDEO Buzzed Brain WILEY VIDEO Maternal Separation WILEY VIDEO Teen Brains on Alcohol

Substance Abuse and Dependence © 2012 John Wiley & Sons, Inc. All rights reserved.

Dissociative Disorders Dissociative Disorder Amnesia, fugue, or multiple personalities resulting from a splitting apart of experience from memory or consciousness Need to escape from anxiety Environmental variables are primary cause Dissociative Identity Disorder (DID) Presence of two or more distinct personality systems in the same individual at different times; previously known as multiple personality disorder © 2012 John Wiley & Sons, Inc. All rights reserved.

Personality Disorders Inflexible, maladaptive personality traits that cause significant impairment of social and occupational functioning Antisocial Personality Disorder Extreme disregard for and violation of the rights of others; guiltless, exploitive, irresponsible, intrusive, and self-indulgent Ego-centrism, lack of conscience, impulsive behavior, superficial charm Potential environmental and biological causes © 2012 John Wiley & Sons, Inc. All rights reserved.

Personality Disorders Borderline Personality Disorder (BPD) Severe instability in emotion and self-concept, along with impulsive and self-destructive behavior See the world in black and white Relationship problems Possible environmental and biological causes © 2012 John Wiley & Sons, Inc. All rights reserved.

Gender and Psychological Disorders More women are diagnosed with depression around the world Why might this be? © 2012 John Wiley & Sons, Inc. All rights reserved.

Culture and Psychological Disorders Differences in schizophrenia rates around the world Most research conducted in Western cultures Culture-general and culture-bound symptoms © 2012 John Wiley & Sons, Inc. All rights reserved.

Culture and Psychological Disorders © 2012 John Wiley & Sons, Inc. All rights reserved.

Culture and Psychological Disorders © 2012 John Wiley & Sons, Inc. All rights reserved.