2. Myers’ PSYCHOLOGY (6th Ed) Chapter 15 Psychological Disorders James A. McCubbin, PhD Clemson University Worth Publishers

3. NUMBERS z1.7 MILLION INPATIENTS PER YEAR. z2.4 MILLION PUTPATIENTS PER YEAR. z400 MILLION WORLD WIDE WITH A MENTAL DISORDER. zMANY ARE HOMELESS

4. Psychological Disorders zPsychological Disorder ya “harmful dysfunction” in which behavior is judged to be: xatypical- not enough in itself xdisturbing- varies with time & culture xmaladaptive- harmful xunjustifiable- sometimes there’s a good reason

5. Historical Perspective zPerceived Causes ymovements of sun or moon xlunacy- full moon yevil spirits zAncient Treatments yexorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood, teeth pulled, boiled alive, extremities torn off. yPinel: the first to treat patients humanely.

6. Psychological Disorders zMedical Model yconcept that diseases have physical causes ycan be diagnosed, treated, and in most cases, cured yassumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital

7. Psychological Disorders zBio-psycho-social Perspective yassumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders Biological (Evolution, individual genes, brain structures and chemistry) Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Sociocultural (Roles, expectations, definition of normality and disorder)

8. Psychological Disorders- Etiology zDSM-IV yAmerican Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) ya widely used system for classifying psychological disorders yDescribe, predict, imply

9. Psychological Disorders- Etiology zNeurotic disorder (term seldom used now) yusually distressing but that allows one to think rationally and function socially yFreud saw the neurotic disorders as ways of dealing with anxiety zPsychotic disorder yperson loses contact with reality yexperiences irrational ideas and distorted perceptions

10. Anxiety Disorders zAnxiety Disorders ydistressing, persistent anxiety or maladaptive behaviors that reduce anxiety zGeneralized Anxiety Disorder yperson is tense, apprehensive, and in a state of autonomic nervous system arousal zPhobia ypersistent, irrational fear of a specific object or situation

11. Anxiety Disorders zCommon and uncommon fears Afraid of itBothers slightlyNot at all afraid of it Being closed in, in a small place Being alone In a house at night Percentage of people surveyed 100 90 80 70 60 50 40 30 20 10 0 SnakesBeing in high, exposed places MiceFlying on an airplane Spiders and insects Thunder and lightning DogsDriving a car Being In a crowd of people Cats

12. Anxiety Disorders zObsessive-Compulsive Disorder ycharacterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) zPanic Disorder ymarked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation

13. Anxiety Disorders Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder Thought or BehaviorPercentage* Reporting Symptom Obsessions (repetitive thoughts) Concern with dirt, germs, or toxins 40 Something terrible happening (fire, death, illness) 40 Symmetry order, or exactness 24 Excessive hand washing, bathing, tooth brushing, 85 or grooming Compulsions (repetitive behaviors) Repeating rituals (in/out of a door, 51 up/down from a chair) Checking doors, locks, appliances, 46 car brake, homework

14. Anxiety Disorders zPET Scan of brain of person with Obsessive/ Compulsive disorder zHigh metabolic activity (red) in frontal lobe areas involved with directing attention

15. Mood Disorders zMood Disorders ycharacterized by emotional extremes zMajor Depressive Disorder ya mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities

16. Mood Disorders zManic Episode ya mood disorder marked by a hyperactive, wildly optimistic state zBipolar Disorder ya mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania yformerly called manic-depressive disorder

17. Mood Disorders- Depression Percentage of population aged 18-84 experiencing major depression at some point In life 20 15 10 5 0 USA Edmonton Puerto Paris West Florence Beirut Taiwan Korea New Rico Germany Zealand Around the world women are more susceptible to depression

18. Mood Disorders- Depression 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+ Age in Years 10% 8 6 4 2 0 Percentage depressed Females Males

19. Mood Disorders- Suicide 15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+ Suicides per 100,000 people 70 60 50 40 30 20 10 0 Males Females The higher suicide rate among men greatly increases in late adulthood

20. Mood Disorders- Suicide zIncreasing rates of teen suicide 1960 1970 1980 1990 2000 Year 12% 10 8 6 4 2 0 Suicide rate, ages 15 to 19 (per 100,000)

21. Mood Disorders- Bipolar zPET scans show that brain energy consumption rises and falls with emotional swings Depressed stateManic stateDepressed state

22. Mood Disorders- Depression zAltering any one component of the chemistry- cognition-mood circuit can alter the others Brain chemistry Cognition Mood

23. Mood Disorders- Depression zA happy or depressed mood strongly influences people’s ratings of their own behavior Negative Positive behaviors Self-ratings 35% 30 25 20 15 Percentage of observations

24. Mood Disorders- Depression zThe vicious cycle of depression can be broken at any point 1 Stressful experiences 4 Cognitive and behavioral changes 2 Negative explanatory style 3 Depressed mood

25. SOMATOFORM DISORDERS zDistressing symptoms take a somatic (bodily) form, without any apparent physical cause. zEmotional Distress zConversion disorder: anxiety is converted into a physical symptom. Hysterical blindness zAmnesia – psychogenic zFugue: amnesia with travel & identity replacement zHypochondrias – keep going to doctors

26. Dissociative Disorders zDissociative Disorders yconscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings zDissociative Identity Disorder yrare dissociative disorder in which a person exhibits two or more distinct and alternating personalities yformerly called multiple personality disorder/Sybil – not a true DID. Eve – Chris Sizemore – 3 personalities. ySpano’s studies indicates it varies by therapist and by countries. U.S. vs. the rest of the world.

27. Schizophrenia zSchizophrenia yliteral translation “split mind” ya group of severe disorders characterized by: xdisorganized and delusional thinking xdisturbed perceptions xinappropriate emotions and actions xDisorganized speech – word salad. xDisorganized behavior. xDisturbance for 6 months or more.

28. CAUSES??? zPrenatal viral infection? zPrenatal malnutrition zOBGyn complications during delivery zOther brain insults zDiathesis – Stress Model: proposes that some persons develop schizophrenia because of an underlying vulnerability (diathesis) that is compounded by stress. zGenetic and environment conditions needed to cross the threshold.

29. Schizophrenia zPOSITIVE SYMTOMS: zDelusions yfalse beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Bizarre bhavior. zHallucinations yfalse sensory experiences such as seeing something without any external visual stimulus. 63% are auditory.

30. SCHIZOPHRENIA zNegative symptoms: zApathy, flattened affect, social withdrawal, inattentive, slowed or no speech.

31. Schizophrenia Subtypes of Schizophrenia Paranoid: Preoccupation with delusions or hallucinations Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements Undifferentiated Schizophrenia symptoms without fitting one of the or residual: above types

32. schizophrenia zEnlarged cerebral ventricles zMRI shows damage to frontal and temporal areas. zDopamine hypothesis: elevated levels of dopamine. zThalamus appears smaller and there seems less metabolic activity.

33. Schizophrenia Lifetime risk of developing schizophrenia for relatives of a schizophrenic 40 30 20 10 0 General population SiblingsChildrenFraternal twin Children of two schizophrenia victims Identical twin

34. schizophrenia 10 years after diagnosis…. z25% complete recovery z25% improved, extensive support is needed z15% hospitalized, no imporvement z10% died ( often by suicide) z25% improved, moderately independent.

35. Personality Disorders zPersonality Disorders ydisorders characterized by inflexible and enduring behavior patterns that impair social functioning yusually without anxiety, depression, or delusions

36. Personality Disorders zAntisocial Personality Disorder ydisorder in which the person (usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members ymay be aggressive and ruthless or a clever con artist ySchizoid: detachment from social relationships.

37. PERSONALITY DISORDER zBlatantly disregards and violates the rights of others. zBorderline: erratic, unstable relationships, feeling of emptiness, self-destructive. zHistrionic: exaggerated, overly dramatic, attention seeking behavior, provocative. zNarcissistic: grandiose sense of self importance, exaggerates abilities, need for admiration, pretentions.

38. PERSONAILITY DISORDERS zAvoidant personality disorder: social inhibition die to feelings of inadequacy; hypersensitive to criticism. zDependent/co-dependent: needs to be taken care of. Clingy. zOCD personality disorder: orderliness, personal control, rules, tasks

39. Personality Disorders zPET scans illustrate reduced activation in a murderer’s frontal cortex Normal Murderer

40. Personality Disorders Percentage of criminal offenders 35 30 25 20 15 10 5 0 Total crimeThieveryViolence Childhood poverty Obstetrical complications Both poverty and obstetrical complications

41. Rates of Psychological Disorders Percentage of Americans Who Have Ever Experienced Psychological Disorders Disorder White Black Hispanic Men Women Totals Ethnicity Gender Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8% Generalized anxiety 3.4 6.1 3.7 2.4 5.0 3.8 Phobia 9.7 23.4 12.2 10.4 17.7 14.3 Obsessive-compulsive disorder 2.6 2.3 1.8 2.0 3.0 2.6 Mood disorder 8.0 6.3 7.8 5.2 10.2 7.8 Schizophrenic disorder 1.4 2.1 0.8 1.2 1.7 1.5 Antisocial personality disorder 2.6 2.3 3.4 4.5 0.8 2.6