Myers’ PSYCHOLOGY

(6th Ed)

Chapter 15

Psychological Disorders

James A. McCubbin, PhDClemson University

Worth Publishers

NUMBERS

1.7 MILLION INPATIENTS PER YEAR.2.4 MILLION PUTPATIENTS PER YEAR.400 MILLION WORLD WIDE WITH A

MENTAL DISORDER.

MANY ARE HOMELESS

Psychological Disorders

Psychological Disorder a “harmful dysfunction” in which

behavior is judged to be:atypical- not enough in itselfdisturbing- varies with time & culturemaladaptive- harmfulunjustifiable- sometimes there’s a

good reason

Historical Perspective

Perceived Causes movements of sun or moon

lunacy- full moon evil spirits

Ancient Treatments exorcism, caged like animals, beaten, burned, castrated,

mutilated, blood replaced with animal’s blood, teeth pulled, boiled alive, extremities torn off.

Pinel: the first to treat patients humanely.

Psychological Disorders

Medical Model concept that diseases have physical causes can be diagnosed, treated, and in most

cases, cured assumes 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

Psychological Disorders

Bio-psycho-social Perspective assumes 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)

Psychological Disorders- Etiology

DSM-IV American Psychiatric Association’s

Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)

a widely used system for classifying psychological disorders

Describe, predict, imply

Psychological Disorders- Etiology

Neurotic disorder (term seldom used now) usually distressing but that allows one to think

rationally and function socially Freud saw the neurotic disorders as ways of

dealing with anxietyPsychotic disorder

person loses contact with reality experiences irrational ideas and distorted

perceptions

Anxiety DisordersAnxiety Disorders

distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Generalized Anxiety Disorder person is tense, apprehensive, and in a state

of autonomic nervous system arousalPhobia

persistent, irrational fear of a specific object or situation

Anxiety DisordersCommon and uncommon fears

Afraid of it Bothers slightly Not at all afraid of it

Beingclosed in,

in a smallplace

Being alone

In a house

at night

Percentageof peoplesurveyed

100

90

80

70

60

50

40

30

20

10

0Snakes Being

in high,exposedplaces

Mice Flyingon an

airplane

Spidersand

insects

Thunderand

lightning

Dogs Drivinga car

Being In a

crowdof people

Cats

Anxiety Disorders

Obsessive-Compulsive Disorder characterized by unwanted repetitive

thoughts (obsessions) and/or actions (compulsions)

Panic Disorder marked by a minutes-long episode of intense

dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation

Anxiety DisordersCommon Obsessions and Compulsions AmongPeople With Obsessive-Compulsive Disorder

Thought or Behavior Percentage*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, 85or grooming

Compulsions (repetitive behaviors)

Repeating rituals (in/out of a door, 51up/down from a chair)Checking doors, locks, appliances, 46car brake, homework

Anxiety Disorders

PET Scan of brain of person with Obsessive/ Compulsive disorder

High metabolic activity (red) in frontal lobe areas involved with directing attention

Mood Disorders

Mood Disorders characterized by emotional extremes

Major Depressive Disorder a 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

Mood DisordersManic Episode

a mood disorder marked by a hyperactive, wildly optimistic state

Bipolar Disorder a mood disorder in which the person

alternates between the hopelessness and lethargy of depression and the overexcited state of mania

formerly called manic-depressive disorder

Mood Disorders-Depression

Percentageof population

aged 18-84experiencing

majordepression

at somepoint In life

20

15

10

5

0 USA Edmonton Puerto Paris West Florence Beirut Taiwan Korea New Rico Germany Zealand

Around the worldwomen are more

susceptible todepression

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

Percentagedepressed

Females

Males

Mood Disorders- Suicide

15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+

Suicides per100,000 people

70

60

50

40

30

20

10

0

Males Females

The higher suicide rateamong men greatly increases in late adulthood

Mood Disorders-SuicideIncreasing rates of teen suicide

1960 1970 1980 1990 2000Year

12%

10

8

6

4

2

0

Suicide rate,ages 15 to 19(per 100,000)

Mood Disorders-Bipolar

PET scans show that brain energy consumption rises and falls with emotional swings

Depressed state Manic state Depressed state

Mood Disorders-Depression

Altering any one component of the chemistry-cognition-mood circuit can alter the others

Brainchemistry

Cognition

Mood

Mood Disorders-Depression

A happy or depressed mood strongly influences people’s ratings of their own behavior

Negative Positivebehaviors behaviors

Self-ratings

35%

30

25

20

15

Percentage ofobservations

Mood Disorders-Depression

The vicious cycle of depression can be broken at any point

1Stressful

experiences

4Cognitive and

behavioral changes

2Negative

explanatory style

3Depressed

mood

SOMATOFORM DISORDERS

Distressing symptoms take a somatic (bodily) form, without any apparent physical cause.

Emotional DistressConversion disorder: anxiety is converted

into a physical symptom.Hysterical blindness

Amnesia – psychogenic Fugue: amnesia with travel & identity

replacementHypochondrias – keep going to doctors

Dissociative Disorders

Dissociative Disorders conscious awareness becomes separated

(dissociated) from previous memories, thoughts, and feelings

Dissociative Identity Disorder rare dissociative disorder in which a person

exhibits two or more distinct and alternating personalities

formerly called multiple personality disorder/Sybil – not a true DID. Eve – Chris Sizemore – 3 personalities.

Spano’s studies indicates it varies by therapist and by countries. U.S. vs. the rest of the world.

Schizophrenia

Schizophrenia literal translation “split mind” a group of severe disorders characterized by:

disorganized and delusional thinkingdisturbed perceptionsinappropriate emotions and actionsDisorganized speech – word salad.Disorganized behavior. Disturbance for 6 months or more.

CAUSES???

Prenatal viral infection? Prenatal malnutrition OBGyn complications during delivery Other brain insults Diathesis – Stress Model: proposes that some

persons develop schizophrenia because of an underlying vulnerability (diathesis) that is compounded by stress.

Genetic and environment conditions needed to cross the threshold.

Schizophrenia

POSITIVE SYMTOMS: Delusions

false beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Bizarre bhavior.

Hallucinations false sensory experiences such as seeing

something without any external visual stimulus. 63% are auditory.

SCHIZOPHRENIA

Negative symptoms:Apathy, flattened affect,

social withdrawal, inattentive, slowed or no speech.

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

schizophrenia

Enlarged cerebral ventricles MRI shows damage to frontal and

temporal areas.Dopamine hypothesis: elevated

levels of dopamine.Thalamus appears smaller and there

seems less metabolic activity.

Schizophrenia

Lifetime riskof developingschizophrenia

for relatives of a schizophrenic

40

30

20

10

0 Generalpopulation

Siblings Children Fraternaltwin

Childrenof two

schizophrenia victims

Identicaltwin

schizophrenia

10 years after diagnosis….25% complete recovery25% improved, extensive support is

needed15% hospitalized, no imporvement10% died ( often by suicide)25% improved, moderately

independent.

Personality Disorders

Personality Disorders disorders characterized by

inflexible and enduring behavior patterns that impair social functioning

usually without anxiety, depression, or delusions

Personality Disorders

Antisocial Personality Disorder disorder in which the person

(usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members

may be aggressive and ruthless or a clever con artist

Schizoid: detachment from social relationships.

PERSONALITY DISORDER

Blatantly disregards and violates the rights of others.

Borderline: erratic, unstable relationships, feeling of emptiness, self-destructive.

Histrionic: exaggerated, overly dramatic, attention seeking behavior, provocative.

Narcissistic: grandiose sense of self importance, exaggerates abilities, need for admiration, pretentions.

PERSONAILITY DISORDERS

Avoidant personality disorder: social inhibition die to feelings of inadequacy; hypersensitive to criticism.

Dependent/co-dependent: needs to be taken care of. Clingy.

OCD personality disorder: orderliness, personal control, rules, tasks

Personality DisordersPET scans illustrate reduced activation in a

murderer’s frontal cortex

Normal Murderer

Personality Disorders

Percentageof criminaloffenders

35

30

25

20

15

10

5

0Total crime Thievery Violence

Childhoodpoverty

Obstetricalcomplications

Both poverty and obstetrical complications

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