1. Some current theories about depression

2. Biological Perspective on mood disorders 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

3. 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.

4. fMRI scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

5. Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.

6. Oppression Cycle 1.Negative stressful events. 2.Pessimistic explanatory style. 3.Hopeless depressed state. 4.These hamper the way the individual thinks and acts, fueling personal rejection.

7. Example Explanatory style plays a major role in becoming depressed.

8. Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide.

9. Suicide Suicide threats should always be taken seriously even if you think the threat is a bid for attention Things that increase suicide risk: –Drug and alcohol use –Other chronic physical diseases –Brain abnormalities

10. Somatoform Symptom and Related Disorders Somatoform Symptom Disorders- psychological disorders appearing in the form of bodily symptoms or physical complaints, such as weakness or excessive worry about disease –These do NOT include PSYCHOSOMATIC disorders in which stress leads to actual physical disease Specific Somatoform Symptom & Related Disorders: –1. Somatoform Symptom Disorder –2. Conversion Disorder –3. Factitious Disorder

11. Somatic Symptom Disorder Symptoms: –Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following: Disproportionate and persistent thoughts about the seriousness of one’s symptoms Persistently high levels of anxiety about health or symptoms Excessive time and energy devoted to these symptoms or health concerns Used to be Called: Hypochondriasis

12. Somatoform Disorders Conversion Disorder- a type of somatoform disorder marked by paralysis, weakness, or loss of sensation but no discernible physical cause –Used to be called “hysteria” –Has declined in modern times

13. Somatoform and Related Disorders Factitious Disorder –Symptoms: Falsification of physical or psychological signs or symptoms or induction of injury or disease Individual presents himself or herself to others as ill, impaired, or injured The deceptive behavior is evident even in the absence of obvious external rewards Or the individual presents another individual (victim) to others as ill, impaired, or injured

14. Eating & Feeding Disorders Def: Disorders that include extreme emotions, attitudes, and behaviors surrounding weight and food issues. –Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males. Specific disorders: –Pica –Anorexia nervosa –Bulimia nervosa –Bing eating disorder

15. Eating & Feeding Disorders Pica: Symptoms –Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month –The eating behavior is not part of culturally supported normative practice –The eating of nonfood substances is inappropriate to the developmental level of the individual

16. Eating & Feeding Disorders Anorexia Nervosa: A condition in which a normal-weight person continuously loses weight but still feels overweight. Symptoms –Restriction of energy intake relative to requirements, leading to a significantly low body weight given age, sex, and development –Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain –Weight loss is accomplished primarily through dieting, fasting, and excessive exercise

17. Eating Disorders Bulimia Nervosa: A disorder characterized by episodes of overeating, usually high-calorie foods, followed by vomiting, using laxatives, fasting, or excessive exercise. Symptoms: –Binge Eating –Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self- induced vomiting, misuse of laxatives or medications, fasting, or excessive exercise –Binge eating and inappropriate behaviors at least once a week for three weeks

18. Eating Disorders Binge Eating Disorder: Symptoms: –Recurrent episodes of binge eating –Binge eating episodes are associated with three or more of the following: Eating more rapidly Eating until feeling uncomfortably full Eating large amounts of food when not hungry Eating alone because of embarrassment about how much one is eating Feeling disgusted, depressed, and guilty afterwards –Binge eating occurs on average at least once a week for 3 months

19. Schizophrenia Spectrum & Related Disorders If depression is the common cold of psychological disorders, schizophrenia is the cancer. 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. Nearly 1/3 of patients with schizophrenia will never recover even with all of the newest treatments.

20. Schizophrenia The literal translation is “split mind.” Not a split or fragmentation of personality it instead involves distortions of reality psychosis.

21. Schizophrenia Symptoms: –A. 2+ of the following for at least 1 month Delusions Hallucinations Disorganized speech Catatonic behavior Negative symptoms: diminished emotional expression –B. Level of functioning in one or more major areas is decreased: work, interpersonal relations, or self-care –C. Continuous signs of the disturbance for at least 6 months with at least 1 month of full symptoms

22. Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Mary 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”).

23. Delusions Other forms of delusions include: –Delusions of persecution (“someone is following me”) –Delusions of grandeur (“I am a king”). –Referential delusions (“I know that the song on the radio is about me and it is telling me what I am supposed to do”) –Erotomanic delusions- false belief that another person is in love with them –Nihilistic delusions- involve the conviction that a major catastrophe will occur All delusions indicate a loss of control over the mind or body

24. Why the delusion? Many psychologists believe disorganized thoughts occur because of selective attention failure (fragmented and bizarre thoughts).

25. Disturbed Perceptions A schizophrenic person may perceive things that are not there, hallucinations. Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory. 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

26. Inappropriate Emotions & Actions A person with schizophrenia may laugh at the news of someone dying, inappropriate affect, or show no emotion at all, flat affect/apathy. Patients with schizophrenia may also continually rub an arm, rock a chair, or remain motionless for hours, catatonia.

27. Positive and Negative Symptoms 1. Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (positive symptoms). Tend to respond to anti-psychotics drugs. 2. Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals (negative symptoms). Tend not to respond to anti-psychotics drugs. Missing something that people normally have or do. Adding a symptom/experience that people normally don’t have.

28. Chronic/Process and Acute/Reactive Schizophrenia When schizophrenia is slow to develop we call it chronic/process schizophrenia and recovery is doubtful. Such schizophrenics usually display negative symptoms. When schizophrenia rapidly develops we call it acute/reactive schizophrenia and changes of recovery are better. Such schizophrenics usually show positive symptoms.

29. Theories about why schizophrenia occurs? Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. 1. Brain Abnormalities

30. 2. Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions.

31. 3. Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

32. 4. Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.

33. 5. Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991). If a parent has schizophrenia then there is a 1:14 chance the child will develop it 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated

34. Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries.

35. 6. Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983). Genain Sisters The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. Courtesy of Genain Family

36. Diathesis Stress Hypothesis In reference to schizophrenia, the proposal that says that genetic factors place the individual at risk while environmental stress factors transform this potential into an actual disorder

37. Treatment of Schizophrenia 1. Antipsychotics 60 to 70% show improvements 30% are able to live on their own Side effects: dry mouth, constipation, sleepiness, Parkinsonism, acute akathesia, tardive dyskinesia 2. Atypical antipsychotic drugs Clozapine Acts strongly on D4 Dopamine receptors Less severe side effects

38. Treatment of Schizophrenia Results: 25% Completely recovered 25% Improved and living independently 25% Improved but support still needed 15% Hospitalized but unimproved 10% Deceased (mostly suicide)

39. Warning Signs of Schizophrenia Early warning signs of schizophrenia include: 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 parent’s long lasting schizophrenia.1.

40. Personality Disorders Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They usually occur without anxiety, depression, or delusions.

41. How the DSM-5 deals with Personality Disorders Currently the DSM-5 breaks down all personality disorders into 3 clusters –The categories are helpful for classifying/ seeing trends

42. Cluster A: Odd or Eccentric Paranoid Personality Disorder- unwarranted suspicion and mistrust of other people Schizoid Personality Disorder- lack of interest in people or social relationships Schizotypal Personality Disorder- social and interpersonal deficits marked by acute discomfort with close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior

43. Cluster B: Erratic or Emotional Borderline Personality Disorder- characterized by instability and impulsivity Histrionic Personality Disorder- characterized by a need for attention & shallow social relationships Narcissistic Personality Disorder- characterized by a preoccupation with oneself and exaggerated sense of importance Antisocial Personality Disorder- characterized by a long standing pattern of irresponsible behavior and diminished sense of responsibility towards others

44. Cluster C: Anxious or Fearful Avoidant Personality Disorder- hypersensitivity to social rejection Dependent Personality Disorder- excessive reliance on others & reluctance to make independent decisions

45. 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 compared to normals (Raine et al., 1999; 2000). Normal Murderer Courtesy of Adrian Raine, University of Southern California

46. Understanding Antisocial Personality Disorder The likelihood that one will commit a crime doubles when childhood poverty is compounded with obstetrical complications (Raine et al., 1999; 2000).

47. Neurodevelopmental Disorders Intellectual Disability Autism Spectrum Disorder ADHD

48. Intellectual Disability Intellectual disability- is characterized by deficits in mental abilities such as reasoning, problem solving, planning, abstract thinking, academic learning, and learning from experience IQ of below 70 –Mild –Moderate –Severe –Profound

49. Autism Spectrum Disorder Persistent deficits in social communication and social interaction across the multiple contexts: –Deficits in social-emotional reciprocity –Deficits in nonverbal communicative behaviors –Deficits in developing, maintaining, and understanding relationships –Repetitive motor movements –Insistence on sameness, inflexible adherence to routines –Highly restricted, fixated interests that are abnormal in their intensity –Hyperactivity to sensory input –Symptoms must be present in childhood

50. Language Disorders –Individuals with ASD often have one of the following language delays: Loss or decrease in the number of words used General regression in use and language ability Use of non-normal language Behavioral Disorders –Common behavioral disturbances that are often associated with ASD are: Self-destructive behavior Aggression Temper tantrums Noncompliance Intense responses to sensory stimuli

51. Enhanced Knowledge on Limited Topics –In some cases of ASD: Some young children with ASDs, known often as 'little professors', accumulate a great wealth of knowledge about one particular specific topic. Often these 'little professors' shift conversation to their particular topic and can speak at great length about this topic to the point that it socially isolates the child. Trouble Inferring –In some cases individuals with ASD struggle to deal with inferential material: While many with ASDs develop sufficient literal comprehension skills they often are unable to deal with inferential material.

52. ADHD ADHD- Attention-deficit hyperactivity disorder is a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity Real neurobiological disorder whose existence is not up for debate anymore Drug therapies as well as behavioral therapies can be used to treat this disorder

53. Rates of Psychological Disorders

54. The prevalence of psychological disorders during the previous year is shown below (WHO, 2004).

55. Risk and Protective Factors Risk and protective factors for mental disorders (WHO, 2004).

56. Risk and Protective Factors