1. This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including extraction, in whole or in part, of any images; any rental, lease, or lending of the program. “ Copyright © Allyn & Bacon 2007 Psychological Disorders: More Than Everyday Problems

2. “ Copyright © Allyn & Bacon 2007 Today’s class What is Abnormal? What is Abnormal? Diagnostic system: DSM IV Diagnostic system: DSM IV Types of Disorders Types of Disorders Dissociative Dissociative Anxiety Anxiety Schizophrenia Schizophrenia Mood Mood Personality Personality Work on projects, review exam

3. “ Copyright © Allyn & Bacon 2007 Psychological Disorder The presence of a constellation of symptoms that create significant distress; impair work, school, family, relationships, or daily living; or lead to significant risk or harm Symptoms Symptoms Cognitive Cognitive Emotional Emotional Behavioral Behavioral

4. “ Copyright © Allyn & Bacon 2007 How do we decide what is abnormal Class exercise Class exercise

5. “ Copyright © Allyn & Bacon 2007 Defining Abnormality Distress Distress Impairment Impairment Danger Danger Cultural and social influences Cultural and social influences

6. “ Copyright © Allyn & Bacon 2007 Historical explanations of abnormality Ancient Greece – fluid imbalance Ancient Greece – fluid imbalance Middle ages – work of the devil Middle ages – work of the devil 1800’s to present – Sigmund Freud 1800’s to present – Sigmund Freud Present – Biopsychosocial model Present – Biopsychosocial model

7. “ Copyright © Allyn & Bacon 2007 Explaining Abnormality The Brain The Brain Genes Genes Neurotransmitters Neurotransmitters Brain Structure and Function Brain Structure and Function Diathesis (of the Diathesis-Stress Model) Diathesis (of the Diathesis-Stress Model)

8. “ Copyright © Allyn & Bacon 2007 Explaining Abnormality The Person The Person Classical and Operant Conditioning Classical and Operant Conditioning Cognitive Biases Cognitive Biases Emotions Emotions

9. “ Copyright © Allyn & Bacon 2007 Explaining Abnormality The Group The Group Culture  Conception of Disorders Culture  Conception of Disorders Social labeling creates disorders? Social labeling creates disorders? Social factors can lead to diagnostic bias Social factors can lead to diagnostic bias

10. “ Copyright © Allyn & Bacon 2007 Causation 1. Predisposition In place before onset of disorder In place before onset of disorder genetic characteristics, learned beliefs, sociocultural factors genetic characteristics, learned beliefs, sociocultural factors 2. Precipitating causes Immediate events that bring on the disorder Immediate events that bring on the disorder Stress, Negative or positive life changes Stress, Negative or positive life changes 3. Maintaining causes Effects of disorder that serve to perpetuate it Effects of disorder that serve to perpetuate it depressed person may withdraw from social interactions depressed person may withdraw from social interactions Schizophrenics are reacted to strangely or violently, enhancing their stress, which enhances the disorder Schizophrenics are reacted to strangely or violently, enhancing their stress, which enhances the disorder

11. “ Copyright © Allyn & Bacon 2007 Diagnosing Disorders Use diagnostic interview Use diagnostic interview Performance on Psychological Tests Performance on Psychological Tests e.g., MMPI, Projective tests e.g., MMPI, Projective tests Interviews with Family & Friends Interviews with Family & Friends Compare patient information to pre-established psychological disorders Compare patient information to pre-established psychological disorders Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Diagnostic and Statistical Manual of Mental Disorders Diagnostic and Statistical Manual of Mental Disorders DSM IV: Agreed-upon criteria for diagnosing psychological disorders DSM IV: Agreed-upon criteria for diagnosing psychological disorders

12. “ Copyright © Allyn & Bacon 2007 Diagnosis: The first step in treatment Someone came in with a rash? Someone came in with a rash? Someone came in with a cough? Someone came in with a cough? Someone came in who couldn’t move an arm? Someone came in who couldn’t move an arm? Someone came in who was hearing voices? Someone came in who was hearing voices?

13. “ Copyright © Allyn & Bacon 2007 Labels and Abnormality Rosenhan: “On being sane in insane places” Rosenhan: “On being sane in insane places” 8 pseudopatients claimed to hear voices 8 pseudopatients claimed to hear voices Admitted to psychiatric hospitals Admitted to psychiatric hospitals Stopped reporting symptoms Stopped reporting symptoms Normal behaviors were interpreted as pathological Normal behaviors were interpreted as pathological Doctors rarely responded to questions Doctors rarely responded to questions Many real patients were not fooled Many real patients were not fooled

14. “ Copyright © Allyn & Bacon 2007 Categorizing Disorders Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV) Diagnostic and Statistical Manual of Mental Disorders, 4 th edition (DSM-IV) Axis I: clinical disorders Axis I: clinical disorders Axis II: personality disorders and mental retardation Axis II: personality disorders and mental retardation Axis III: general medical conditions Axis III: general medical conditions Axis IV: psychosocial and environmental problems Axis IV: psychosocial and environmental problems Axis V: global assessment of functioning Axis V: global assessment of functioning

15. “ Copyright © Allyn & Bacon 2007 Classification Systems & Labeling: Advantages Advantages: grouping of similar symptoms may help to identify underlying causes grouping of similar symptoms may help to identify underlying causes facilitates communication facilitates communication

16. “ Copyright © Allyn & Bacon 2007 May seem dehumanizing for patients May seem dehumanizing for patients Better to apply diagnostic labels to the disorder and NOT to the people themselves Better to apply diagnostic labels to the disorder and NOT to the people themselves May lead clinicians to overlook unique aspects of each case May lead clinicians to overlook unique aspects of each case Label becomes a lens through which we see and evaluate a person’s behavior Label becomes a lens through which we see and evaluate a person’s behavior Is a label the same as a diagnosis? Is a label the same as a diagnosis? Classification Systems & Labeling: Disadvantages

17. “ Copyright © Allyn & Bacon 2007 Mood Disorders Persistent or episodic disturbances in emotion that interfere with normal functioning in at least one realm of life Major depressive disorder Major depressive disorder Affect Affect Behavior Behavior Cognition Cognition More common in women More common in women Most common psychological disorder in the United States Most common psychological disorder in the United States

18. “ Copyright © Allyn & Bacon 2007 Mood Disorders Dysthymia Dysthymia Lifetime prevalence 6% Lifetime prevalence 6% Suicide Suicide Attempted by 30% of depressed people Attempted by 30% of depressed people

19. “ Copyright © Allyn & Bacon 2007 Mood Disorders Bipolar disorder Bipolar disorder Mania Mania Hypomania Hypomania Manic episode Manic episode Prodromal phase Prodromal phase Often cycles with depression Often cycles with depression Formerly called manic depression Formerly called manic depression Lifetime prevalence 1% Lifetime prevalence 1%

20. “ Copyright © Allyn & Bacon 2007 Explaining Mood Disorders The brain The brain Hereditary factors Hereditary factors Frontal lobe Frontal lobe Amygdala Amygdala The person The person Beck’s negative triad Beck’s negative triad Learned helplessness Learned helplessness Attributional style Attributional style The group The group Life stressors Life stressors Lack of social reinforcement Lack of social reinforcement

21. “ Copyright © Allyn & Bacon 2007 Anxiety Disorders Generalized anxiety disorder Generalized anxiety disorder Panic disorder Panic disorder Panic attacks Panic attacks Agoraphobia Agoraphobia Locus coeruleus Locus coeruleus Anxiety sensitivity Anxiety sensitivity Lifetime prevalence 3% Lifetime prevalence 3%

22. “ Copyright © Allyn & Bacon 2007 Anxiety Disorders Phobias Phobias Social phobia Social phobia Lifetime prevalence 13% Lifetime prevalence 13% Specific phobia Specific phobia Animal fears Animal fears Blood-injection-injury fears Blood-injection-injury fears Natural environment fears Natural environment fears Situation fears Situation fears Miscellaneous fears Miscellaneous fears Lifetime prevalence 10% Lifetime prevalence 10%

23. “ Copyright © Allyn & Bacon 2007 Anxiety Disorders Obsessive-compulsive disorder (OCD) Obsessive-compulsive disorder (OCD) Obsession Obsession Compulsion Compulsion Checking Checking Washing Washing Ordering Ordering Lifetime prevalence 2-3% Lifetime prevalence 2-3% Caudate nucleus Caudate nucleus

24. “ Copyright © Allyn & Bacon 2007 Anxiety Disorders Posttraumatic stress disorder (PTSD) Posttraumatic stress disorder (PTSD) Traumatic event Traumatic event Fear and helplessness Fear and helplessness Symptoms Symptoms Re-experience event Re-experience event Avoidance and emotional numbing Avoidance and emotional numbing Heightened arousal Heightened arousal Lifetime prevalence 8% (among Americans) Lifetime prevalence 8% (among Americans) Genetic predisposition Genetic predisposition

25. “ Copyright © Allyn & Bacon 2007 Schizophrenia Positive symptoms Positive symptoms Delusions Delusions Hallucinations Hallucinations Disordered behavior Disordered behavior Disorganized speech Disorganized speech Negative symptoms Negative symptoms Flat affect Alogia Avolition Lifetime prevalence 1%

26. “ Copyright © Allyn & Bacon 2007 Schizophrenia Four subtypes Four subtypes Paranoid Paranoid Disorganized Disorganized Catatonic Catatonic Undifferentiated Undifferentiated

27. “ Copyright © Allyn & Bacon 2007

28. Explaining Schizophrenia The brain The brain Hereditary Hereditary Ventricle size Ventricle size Stress-related hormones Stress-related hormones The dopamine hypothesis The dopamine hypothesis The person The person Emotional dampening Emotional dampening The group The group High expressed emotion High expressed emotion Social selection and social causation Social selection and social causation

29. “ Copyright © Allyn & Bacon 2007 Testing yourself Name that disorder Name that disorder