psychological disorders psychology 12. what is normal? what are examples of “normal” adolescent...

Psychological DisordersPsychology 12

What is Normal?• What are examples of “normal” adolescent

behaviour?• Imagine the following four settings: 1) a rural village in India2) a formal dinner with the Queen3) a funeral4) a city courtyard in the city of Beijing, China• Defining “normal” is not simple. It depends

upon such variables as behavioural setting, cutural perspective, public expectation, and so on…

“Giraffe Women” of Thailand

• Have you heard of the “giraffe women” of the Kenyan tribe in Thailand who wear heavy copper coils around their necks to push their faces up and make their necks look longer? At the age of 5, the first coil is normally added, but some little girls are “coiled” at the age of 2. Year after year, new coils are added. Once fastened, the rings are worn for life because the neck muscles weaken and deteriorate to the point they can no longer support the weight of the head. These coils weigh up to 12 pounds and depress the clavicle and the ribs about 45 degrees from their normal position.

• Would you consider this behaviour abnormal? What about the following cases taken from our own culture…

Abnormal Behaviour?• “Mary’s troubles first began in adolescence. She

began to miss curfew, was frequently truant, and her grades declined sharply. Mary later became promiscuous and prostituted herself several times to get drug money…She also quickly fell in love and overly idealized new friends. But when they quickly (and inevitably) disappointed her, she would angrily cast them aside…Mary’s problems, coupled with a preoccupation with inflicting pain on herself (by cutting and burning) and persistent thoughts of suicide, eventually led to her admittance to a psychiatric hospital at age 26”

(Kring et. al., 2007, pp 386-387)

Abnormal Behaviour?

• “Rain or shine, day in and day out, 43-year-old Joshua occupies his “post” on a busy street corner wearing his standard outfit—a Red Sox baseball cap, yellow T-shirt, worn-out hiking shorts, and orange sneakers. Sometimes he can be seen, “conversing” with imaginary people. Without apparent cause, he also frequently explodes into shrieks of laughter or breaks down into miserable sobs. Police and social workers keep taking him to shelters for homeless, but Joshua manages to get back on the street before he can be treated. He has repeatedly insisted that these people have no right to keep bothering him.

• (Halgin & Whitbourne, 2008, p. 283)

Abnormal Behaviour?

Both Mary and Joshua have severe psychological problems, and both of their stories raise interesting questions.

What caused their difficulties? Was there something in their early backgrounds

to explain their later behaviours? Is their something medically wrong with them? What about the “giraffe women”? What is the

difference between being culturally different and being disordered?

Do you recognize these myths?

Myth #1•People with psychological disorders act in

bizarre ways and are very different from normal people.


Fact #1•This is true for only a small minority of

individuals and during a relatively small portion of their lives. In fact, sometimes even mental health professionals find it difficult to distinguish normal from abnormal individuals without formal screening.


Myth #2•Mental disorders are a sign of personal

weakness.


Fact #2•Psychological disorders are a function of

many factors, such as exposure to stress, genetic disposition, family background, and so on.

•Mentally disturbed individuals can’t be blamed for their illness any more than we blame people who develop Alzheimer’s or other physical illness


Myth #3•Mentally ill people are often dangerous

and unpredictable.


Fact #3•Only a few disorders, such as some

psychotic and antisocial personalities, are associated with violence.

•The stereotype that connects mental illness and violence persists because of prejudice and selective media attention


Myth #4•A person who has been mentally ill never

fully recovers.


Fact #4•With therapy, the vast majority of people

who are diagnosed as mentally ill eventually improve and lead normal productive lives.

•Moreover, mental disorders are generally only temporary. A person may have an episode that lasts for days, weeks or months. Afterwards, they may go for years—even a lifetime—without further difficulty.


Myth #5•Most mentally ill individuals can work at

only low-level jobs.


Fact #5• Mentally disturbed people are individuals. As such, their

career potentials depend on their particular talents, abilities and experience, and motivation, as well as their current state of physical and mental health. Many creative and successful people have suffered serious mental disorders. For example, John Forbes Nash Jr., a nobel prize winner has a lifetime history of schizophrenia (but he is doing well as has been documented in the book and movie—A Beautiful Mind

• British PM, Winston Churchill, comedian Stephen Fry, poet Edgar Allen Poe, Pink Floyd band member Syd Barrett, painter Vincent Van Gogh, billionaire Howard Hughes, former PM’s wife Margaret Trudeau are all believed to have suffered from a serious mental disorder

Uppy-Downy Mood-Swing Kind of Guyhttp://bigthink.com/ideas/17869

http://bigthink.com/ideas/17869

Normal or Not? The difficulty with drawing the line…

“A man living in the Ozark Mountains has a vision in which God speaks to him. He begins preaching to his relatives and neighbours, and soon he has the whole town in a state of religious fervor. People say he has a “calling.” His reputation as a prophet and healer spreads, and in time he is drawing large audiences everywhere he goes. However, when he ventures into St. Louis and attempts to hold a prayer meeting, blocking traffic on a main street at rush hour, and he is arrested. He tells the police officers about his conversations with God, and they hurry him off to the nearest mental hospital.”

--from Understanding Psychology, Richard A. Kasschau, 1995

How can a person be viewed as normal in one community and abnormal in the next?

Studying Psychological Disorders•Like personality, consciousness, and

intelligence, abnormal behaviour is difficult to define.

•Rather than being fixed categories (i.e., normal/abnormal), both “abnormal” and “normal” behaviours exist along a continuum (i.e., from “rare” to “common” or “low” to “high”…)

Abnormality can be viewed as an inability to adjust to getting along in the world—physically, emotionally, and socially.

Studying Psychological DisordersIdentifying Abnormal Behaviour: Four Basic Standards1. Statistical Infrequency2. Disability or Dysfunction3. Personal Distress4. Violation of Norms

Identifying Abnormal Behaviour: Standards

1. Statistical Infrequency (e.g., believing others are plotting against you)

A behaviour may be judged abnormal if it occurs infrequently in a given population.

Statistical infrequency alone does not determine what is normal. For example, no one would classify Albert Einstein’s great intelligence as abnormal

Rare (Normal) (Abnormal) Common


2. Disability or Dysfunction (e.g., being unable to go to work due to alcohol abuse)

• People who suffer from psychological disorders may be unable to get along with others, hold a job, eat properly, or clean themselves.

• Their ability to think clearly and make rational decisions also may be impaired

Low (Normal) (Abnormal) High


3. Personal Distress (e.g. having thoughts of suicide)

The personal distress criterion focuses on the individual’s judgment of his or her level of functioning.

Yet many people with psychological disorders (such as antisocial personality disorder) have little or no personal emotional discomfort.

The personal distress criterion by itself is not sufficient for identifying all forms of abnormal behaviourLow (Normal)

(Abnormal) High

Identifying Abnormal Behaviour: Standards4. Violation of Norms (e.g. shouting at

strangers)The fourth approach to identifying abnormal

behaviour is violation of social norms, or cultural rules that guide behaviour in particular situations.

A major problem with this criterion, however, is that cultural diversity can affect what people consider a violation of cultural norms

Rare (Normal) (Abnormal) Common

Cultural Diversity• Culture has a strong effect on mental disorders—studying

the similarities and differences can lead to better diagnosis and understanding

• Even strongly biological mental disorders, like schizophrenia, can differ greatly between cultures—fortunately, cross-cultural researchers have devised ways to identify disorders across cultures (culture-general symptoms and culture bound symptoms).

• Research shows that certain symptoms of depression seem to exist across all cultures: (1) frequent and intense sad affect (emotion), (2) decreased enjoyment, (3) anxiety, (4) difficulty in concentrating, and (5) lack of energy.

• Culture-bound symptoms—symptoms that only occur within a culture. For example—a headache: Chinese report a “fullness in my head,” Mexican respondents report a “problem with memory”

Cultural DiversityCulture Bound SymptomsLatin America: “attack of the nerves” Symptoms: trembling,

palpitations, and seizure-like episodesSoutheast Asia: “running amok” Symptoms: Wild, out-of-control,

aggressive, attempting to kill othersWest Africa: “brain tiredness” Symptoms: ‘brain tiredness’ a

mental and physical response to challenges of schoolingEthiopia: “possession by the zat” Symptoms: involuntary

movements, an incomprehensible languageSouth China: “koro” Symptoms: belief that the penis is retracting

into the abdomen and that when it is fully retracted, death will result; attempts to prevent retraction may lead to severe physical damage

Western Nations: “anorexia nervosa” Symptoms: severe loss of weight resulting from self-imposed starvation and obsessive fear of obesity

Gender & Cultural Diversity12 Culture-General Symptoms of Mental Health

Difficulties(1) Nervous(2) trouble sleeping(3) Low spirits(4) Weak, all over(5) Personal worries (6) Restlessness(7) feel apart, alone (8) can’t get along (9) Hot all over(10) worry all the time (11) can’t do anything worthwhile(12) nothing turns out right

Explaining Abnormality: Superstition to ScienceHow do we explain it?Historically, evil spirits and witchcraft have been the primary

suspects• Stone Age people, believed that abnormal behaviour stemmed

from demonic possession—the therapy was to bore a hole in the skull so that evil spirits could escape.

• Middle Ages: a troubled person was sometimes treated with exorcism; an effort to drive the Devil out through prayer, fasting, noise-making, beating, and drinking terrible-tasting brews.

• 15th Century: many believed that some individuals chose to consort with the Devil—many of these supposed witches were tortured, imprisoned for life, or executed.

• As the Middle Ages ended, special mental hospitals, called asylums, began to appear in Europe—they eventually became overcrowded and inhumane prisons.

An example of the “Historical Model” of Abnormal Behaviour

--An early Catch 22: (Catch 22: is a paradoxical situation in which an individual is

incapable of avoiding a problem because situations are such that solving one part of a problem only creates another problem)

In the Middle Ages, “dunking tests” were used to determine whether people who behaved abnormally were possessed by demons.

Individuals who did not drown while being dunked were believed to be guilty of possession and then punished (usually by hanging).

Those who did drown were judged as innocent.---the ultimate no-win situation!

Classifying Abnormal Behaviour

The Diagnostic and Statistical Manual IV-TR• This is a classification system developed by the

American Psychological Association used to describe abnormal behaviours; the “IV-TR” indicates it is the text revision (TR) of the fourth major revision (IV)

• Each revision of the DSM has expanded the list of disorders and changed the descriptions and categories to reflect both the latest advances in scientific research and changes in the way abnormal behaviours are viewed within our social context

Classifying Abnormal Behaviour

For example, take the terms “neurosis” and “psychosis”• In previous editions, neurosis reflected Freud’s belief that all

neurotic conditions arise from unconscious conflicts—now conditions that were previously grouped under the heading “neurosis” have been redistributed as anxiety disorders, somatoform disorders, and dissociative disorders

• Unlike “neurosis” the term “psychosis” is still listed in the DSM because it helps distinguish the most severe mental disorders, such as schizophrenia and some mood disorders.

• FYI: Psychosis is: serious mental disorder characterized by extreme mental disruption and defective or lost contact with reality

• Somatoform disorder, is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained

• Dissociative disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception

What about the term “insanity” where does it fit in?•Insanity is a legal term indicating that a

person cannot be held responsible for his/her actions, or is judged incompetent to manage his/her own affairs, because of a mental illness.

•In law, the definition of mental illness rests primarily on a person’s inability to tell right from wrong.

•For psychologists, insanity is not the same as abnormal behaviour---see the next example…

What about the term “insanity” where does it fit in?

• The insanity plea—guilty of a crime or mentally ill?• On the morning of June 20, 2001, Texas mother Andrea

Yates drowned her five children in the bathtub, then calmly called her husband to tell him he should come home. At Yates’s trail, both the defense and the prosecution agreed that Yates was mentally ill at the time of the murders, yet the jury still found her guilty and sentenced her to life in prison.

• In 2006, this was overturned and was found not guilty by reason of insanity. How could two courts come to such opposite conclusions?

• Insanity is a complicated legal term—despite cases like this one, it is important to keep in mind that the insanity plea is used in less than 1% of all cases that reach trial, and when used, it is rarely successful.

Understanding the DSM

The DSM is organized into five major dimensions, called axes, which serve as guidelines for making decisions about symptoms.

• Axis I describes clinical disorders that reflect a patient’s current condition. Depression and anxiety disorders are examples

• Axis II describes trait disorders, which are long-running personality disturbances (like antisocial personality disorder) and mental retardation

The other three axes are used to record important supplemental information.

• Axis III lists general medical conditions that may be important to a person’s psychopathology (such as diabetes or hypothyroidism, which can affect mood)

• Axis IV is reserved for psychosocial and environmental stressors that could be contributing to emotional problems (job or housing issues)

• Axis V evaluates a person’s overall level of functioning, on a scale from 1 (serious attempt at suicide or complete inability to take care of oneself) to 100 (happy, productive, with many interests)

Understanding the DSM

•The DSM offers a comprehensive, well-defined system intended for the diagnosis and classification of psychological disorders. It does not suggest therapies or treatment.

•The current DSM-IV-TR contains more than 200 diagnostic categories grouped into 17 subcategories.

•Also, note that the DSM classifies disorders, not people. Accordingly, we use the terms such as a persons with schizophrenia, rather than describing people as schizophrenic

Anxiety DisordersI was 9 years old and sitting alone in the back of a cab as it rumbled

over New York City’s 59th St. Bridge. I noticed the driver was watching me curiously. My feet began tapping and then shaking, and slowly my chest grew tight and I couldn’t get enough air in my lungs. I tried to disguise the little screams I made as throat clearings, but the noises began to rattle the driver. I knew a panic attack was coming on, but I had to hold on, get to the studio, and get through the audition. Still, if I kept riding in that car I was certain I was going to die. The black water was just a few hundred feet below. “Stop!” I screamed at the driver. “Stop right here, please! I have to get out!”

“Young miss, I can’t stop here.” “Stop!” I must have looked like I meant it because he squealed to a

halt in the middle of traffic. I got out and began to run. I ran the entire length of the bridge and kept going. Death would never catch me as long as my small legs kept propelling me forward.

◦ Adapted from Pearce & Scanlon, 2002, p. 69 (words of actress Patty Duke)

Anxiety DisordersThese are the words of actress Patty Duke describing an

episode around the time she was starring as Helen Keller, the deaf and blind child in “The Miracle Worker.”

• Patty’s flight from the cab and other cases of ANXIETY DISORDER share one central defining characteristic—unreasonable, often paralyzing, anxiety or fear.

• The person feels threatened, unable to cope, unhappy, insecure in a world that seems dangerous and hostile.

• Anxiety Disorders (diagnosed twice as often in women as in men) are the most frequently occurring category of mental disorders in the general population.

• They are also the easiest to treat and have one of the best chances of recovery.

Anxiety Disorders

Anxiety disorders are marked by excessive fear, caution, and avoidance.

5 Major Types: 1) Generalized Anxiety Disorder2) Panic Disorder3) Phobias4) Obsessive-Compulsive Disorder5) PTSD

Five Major Anxiety Disorders

Symptoms of anxiety such as rapid breathing and increased heart rate, plague most of us at different times in our lives (final exams, important job interviews, public speaking).

But some people experience unreasonable anxiety that is do intense and chronic it seriously disrupts their lives.

5 Major Anxiety Disorders: Generalized Anxiety Disorder

1) Generalized Anxiety Disorder• This disorder affects twice as many women as it does men• It is characterized with chronic, uncontrollable, and

excessive fear and worry that lasts at least six months and that is not focused on any particular object or situation.

• As the name implies, the anxiety is generalized and nonspecific or free-floating. Victims feel afraid of something, but are unable to identify and articulate the specific fear.

Because of specific muscle tension and autonomic fear reactions, people with this disorder may develop headaches, heart palpitations, dizziness, and insomnia, making it ever harder to cope with daily activities

5 Major Anxiety Disorders: Panic

2) Panic Disorder is marked by sudden, but brief, attacks of intense apprehension that causes trembling, dizziness, and difficulty breathing. (Patty Duke suffered from this)

•Panic attacks (in the DSM) are classified with or without agoraphobia

•Agoraphobia is an anxiety disorder characterized by anxiety in situations where the sufferer perceives the environment as being difficult to escape or get help.

5 Major Anxiety Disorders: Phobias

3) Phobias involve a strong, irrational fear and avoidance of objects or situations that are usually considered harmless (fear of elevators, fear of going to the dentist, for example).

• Although the person recognizes that the fear is irrational, the experience is still one of overwhelming anxiety, and a full-blown panic attack may follow.

• The DSM divides phobic disorders into three broad categories: agoraphobia, specific phobias, and social problems


A) Agoraphobia:•People with agoraphobia restrict their

normal activities because they fear having panic attacks in crowded, enclosed, or wide-open places where they would be unable to receive help in an emergency.

• In severe cases, people with agoraphobia may refuse to leave the safety of their homes.


B) Specific Phobias:• A specific phobia is a fear of a specific object or

situation, such as needles, heights, rats, spiders…• Claustrophobia (fear of closed spaces) and

acrophobia (fear of heights) are the specific phobias most often treated by therapists.

• People with specific phobias generally recognize that their fears are excessive and unreasonable, but they are unable to control their anxiety and will go to great lengths to avoid the feared stimulus.


C) Social Phobias:•People with social phobias are irrationally

fearful of embarrassing themselves in social situations.

•Fear of public speaking and of eating in public are the most common social phobias.

•The fear of public scrutiny and potential humiliation may become so pervasive that normal life is severely restricted.

5 Major Anxiety Disorders:

4) Obsessive-Compulsive Disorder Do you remember the movie The Aviator? The main

character, Howard Hughes, was endlessly counting, checking, and repeatedly washing his hands in a seemingly senseless, ritualistic pattern. What drives this behaviour? The answer is Obsessive-Compulsive Disorder (OCD)

• This disorder involves persistent, unwanted fearful thoughts (obsessions) or irresistible urges to perform an act or repeated ritual (compulsion), which help relieve the anxiety created by the obsession.

• Common examples of obsessions are fear of germs, of being hurt or of hurting others, and troubling religious or sexual thoughts.

OCD• Examples of compulsions are repeatedly

checking, counting, cleaning, washing the body or parts of it, or putting things in certain order.

• While everyone worries, and sometimes double-checks, people with OCD have these thoughts and do these rituals for at least an hour or more each day, often longer

• Most suffers of OCD realize that their actions are senseless, but when they try to stop the behaviour, they experience mounting anxiety, which is relieved only by giving in to the urges.

5) PTSD: anxiety disorder following exposure to a life-threatening or other extreme event that evoked great horror or helplessness; characterized by flashbacks, nightmares, and impaired functioning

•Children as well as adults may suffer

5 Major Anxiety Disorders: PTSD

Explaining Anxiety Disorders

Psychological: Faulty cognition and maladaptive learning

•Faulty Cognition: People with certain thinking, or cognitive habits that make them vulnerable or prone to fear. They tend to be hyper vigilant.

•They constantly scan their environment for danger and seem to ignore signs of safety.

•They also tend to magnify ordinary threats and failures.

Explaining Anxiety DisordersMaladaptive Learning: • They may have learned these behaviours. Through classical

conditioning, for example: a stimulus that is originally neutral (e.g. harmless spider) becomes paired with a frightening event (a sudden panic attack)so that it becomes a conditions stimulus and brings about anxiety. The person then begins to avoid spiders in order to reduce anxiety.

• Social learning theorists propose that some phobias are the result of modeling and imitation, or learned indirectly.

• Example of vicarious (indirect learning): Monkeys who watch artificially created videos of other monkeys being afraid of a toy snake, toy crocodile toy rabbit, or toy flower, will develop their own set of phobias. The fact that the “viewing” monkeys only develop fears of snakes and crocodiles, but not flowers or rabbits, demonstrates that phobias are both learned and biological


•Biological: •Phobias may develop from a genetic and

evolutionary predisposition to fear that was dangerous to our ancestors.

• In addition, studies show that anxiety disorders may be due to a disrupted biochemistry ,or unusual brain activity.


• Sociocultural: There has been a sharp rise in anxiety disorders in the past 50 years, particularly in Western culture.

• Can you see how our increasingly fast-paced lives—along with our increased mobility, decreased job security and decreased family support—might contribute to anxiety?

• Further support to this theory is that anxiety disorders have dramatically different forms in other cultures.

• For example, in a collectivist twist on anxiety, the Japanese have a type of social phobia call taijin kyofusho (TKS) which involves morbid dread of doing something to embarrass others.

Dissociative DisorderThere are several types of dissociative disorders, but all

involve splitting apart (a dis-association) of significant aspects of experience from memory or consciousness.

• Individuals dissociate from the core of their personality by failing to recall or identify past experiences (dissociative amnesia)

• Individuals may leave home and wander off (dissociative fugue)

• May lose the sense of reality and feeling estranged from self (depersonalization disorder)

• May develop completely different personalities (dissociative identity disorder, DID—recall Shutter Island)

Dissociative-Identity Disorder•Previously known as “multiple personality

disorder”•Two or more distinct personalities exist within

the same person at different times•Each personality has unique memories,

behaviours and social relationships.•Transition from one personality to the next

occurs suddenly and is often triggered by stress

•Usually, the other personality has no awareness of the other

Mood Disorders• Anne had been divorced for eight months when she called a

psychologist for an emergency appointment. Although her husband had verbally and physically abused her for years, she had mixed feelings about staying on in the marriage. She had anticipated feeling good after the divorce, but she became increasingly depressed. She had trouble sleeping, had little appetite, felt very fatigued, and showed no interest in her usual activities. She stayed home from work for two days because she “just didn’t feel like going in.” Late one afternoon, she went straight to bed, leaving her two small children to fend for themselves. Then, the night before calling for an emergency therapy appointment, she took five sleeping tablets and a couple of stiff drinks. As she said, “ I don’t think I wanted to kill myself; I just wanted to forget everything for awhile.” (Meyer & Salmon, 1988)

Mood Disorders

•Anne’s case is a good example of a mood disorder (also known as affective disorder).

• This category encompasses not only excessive sadness, like Anne’s, but also unreasonable elation and hyperactivity.

Mood Disorders

•Mood Disorders are characterized by extreme disturbances in emotional states that may include psychotic distortions of reality.

• There are two main types of mood disorders—major depressive disorder and bipolar disorder

Mood Disorders: Major Depressive Disorder

•Depression has been recorded as far back as ancient Egypt, when the condition was called melancholia and was treated by priests.

•We all feel “blue” sometimes, especially when we’ve suffered some kind of loss

Mood Disorders: Major Depressive Disorder•People suffering from major depressive

disorder, however, may experience a lasting and continuously depressed mood without a clear trigger or precipitating event.

• In addition, their sadness is far more intense, interfering with their basic ability to function, feel pleasure or maintain interest in life.

•When depression is unipolar, the depressive episode eventually ends and people return to a “normal” emotional level.

Mood Disorders: Major Depressive DisorderSigns of Clinical Depression: • trouble sleeping• lose (or gain) weight• may feel so fatigued that they cannot go to work or

school or even comb their hair and brush their teeth.

• may sleep both day and night• have problems concentrating• feel so profoundly sand and guilty that they

consider suicide. These feelings have no apparent cause and may

be so severe that the individual loses contact with reality.

Mood Disorders: Bipolar Disorderer

With bipolar disorder, the person experiences periods of depression as well as mania (an excessive and unreasonable state of overexcitement and impulsive behaviour)

Mood Disorders: Bipolar DisorderDuring a manic episode:• person is overly excited• extremely active• easily distracted• the person exhibits unrealistically high self-esteem • an inflated sense of importance or even delusions of

grandeur (He/she often makes elaborate plans for becoming rich and famous. )

• this individual is hyperactive and may not sleep for days at a time, yet does not become fatigued.

• thinking is speeded up and can change abruptly to new topics, showing “rapid flight of ideas.”

• speech is also rapid (“pressured speech”), and it is difficult for others to get a word in edgewise.

• poor judgment is common: a person may give away valuable possessions or go on wild spending sprees.

Mood Disorders: Bipolar DisorderCycle of Behaviour: Manic episodes may last a few days to a few

months and generally end abruptly. The person’s previous manic mood, rapid thinking

and speaking style, and hyperactivity are reversed.

The following depressive episode generally lasts three times as long as the manic disorder.

Risk: The lifetime risk for developing bipolar disorder is

low, between 0.5 and 1.6 %, unfortunately, it can be one of the most debilitating and lethal disorders, with a high suicide rate.

Mood Disorders: An Explanation

Biological Factors:•Biological factors play a significant role

in both major depression and bipolar disorder.

•Evidence suggest that major depressive disorders and bipolar disorder may be inherited.

•For example, when one identical twin has a mood disorder, there is a 50% chance that the other will also develop the illness.

Mood Disorders: An Explanation•Research shows that some patients with bipolar disorder and depression show decreased grey matter and decreased overall functioning in the frontal lobes.

•These areas of the brain are associated with memory and coordination.

• This suggests structural brain changes may contribute (or cause) these mood disorders.

• http://www.nature.com/news/2007/070720/full/news070716-16.html

http://www.nature.com/news/2007/070720/full/news070716-16.html

http://www.nature.com/news/2007/070720/full/news070716-16.html

Mood Disorders: An Explanation•Other research points to an imbalance of

several neurotransmitters, including serotonin, norepinephrine, and dopamine. ▫these same neurotransmitters are involved in the

capacity to be aroused or energized and in the control of other functions affected by depression, (i.e., sleep cycles and hunger)

▫drugs that alter the activity of these neurotransmitters also decrease symptoms of depression (antidepressants).

▫The drug lithium reduces or prevents manic episodes by preventing norepinephrine and serotonin-sensitive neurons from being over-stimulated

Mood Disorders: An Explanation

Psychosocial Theories:•These theories focus on environmental

stressors and disturbances in the person’s interpersonal relationships, thought processes, self-concept, and learning history.

•The psychoanalytic explanation of depression is anger turned inward against oneself when an important relationship or attachment is lost.

Mood Disorders: An ExplanationtionPsychosocial Theories:• Another important contributor may be explained

by the “learned helplessness” theory of depression (Martin Seligman).

• Seligman demonstrated that when humans are repeatedly subjected to pain that they cannot escape, they develop such as strong sense of helplessness or resignation that they do not attempt to escape future painful experiences.

• In other words, when people learn they are unable to change things for the better, they’re more likely to give up—this may explain why people stay in abusive relationships.

Postpartum Depression

• Postpartum depression is a relatively common depressive disorder that occurs among new mothers within three to four weeks after birth of a child.

• Symptoms: similar to other depressive disorders, plus it often includes anxiety about harming the baby.

• One possible explanation is the wide hormonal swings that occur as the mother’s body readjusts to its non-pregnant state.

• Episodes of postpartum depression increase the risk for developing other types of depressive disorders

• http://www.globalnews.ca/health/fact+file/6442639858/story.html

http://www.globalnews.ca/health/fact+file/6442639858/story.html

http://www.globalnews.ca/health/fact+file/6442639858/story.html

SAD—Seasonal Affective Disorder•As a result of the dull, dreary, short and

often rainy days of winter, some people may develop a deep depression

•It is suggested that the hormone melatonin plays a significant role. The less light available the more melatonin is secreted by the brain’s pineal gland

Stephen Fry: The Secret Life of a Manic Depressive•http://topdocumentaryfilms.com/stephen-f

ry-the-secret-life-of-the-manic-depressive/

http://topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/

http://topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/

Schizophrenia

Schizophrenia: The Jerusalem SyndromeEvery year, dozens of tourists to Jerusalem are

hospitalized with symptoms of “Jerusalem Syndrome,” a psychological disorder in which a person becomes obsessed with the significance of Jerusalem and engages in bizarre, deluded behaviour while visiting the city.

For example, the person might come to believe that he is Jesus Christ or some biblical character

Although scholars disagree with the explanation for “religious psychosis,” the symptoms themselves provide a classic example of delusional thought disturbances

Schizophrenia: Mental illness in public view• What could be more terrifying than performing

at a final audition for American Idol? How about doing so just moments before announcing—to Simon Cowell, the celebrity judge—that you have a mental illness?

• Singer/songwriter Tracey Moore, who was diagnosed with schizophrenia at 21, felt it was important to say. Even as she combats paranoid and delusional thoughts, Moore has worked to raise awareness and develop support groups for people with schizophrenia.

Schizophrenia

•Imagine for the moment that your friend has just left for college and you hear voices inside your head shouting, “You’ll never see her again! You have been a bad friend! She’ll die.” Or what if you saw dinosaurs on the street and live animals in your refrigerator? These are actual experiences that have plagued Mrs. T for almost 30 yrs.

Schizophrenia• Mrs. T suffers from schizophrenia, a disorder

characterized by major disturbances in perception, language, thought, emotion, and behaviour.

• Mental disorders exist on a continuum and many people suffering from schizophrenia can still function in daily life.

• For some people however, schizophrenia is so severe that it is considered a “psychosis,” meaning that the person is out of touch with reality.

Schizophrenia

•People with schizophrenia often have difficulty with:

•Caring for themselves•Relating to others•Holding a jobIn extreme cases—the individual may

withdraw from others and reality, often into a fantasy life of delusions and hallucinations—this is when they may require custodial/institutional care

Schizophrenia: Facts• It is one of the most widespread and devastating of

all mental disorders• Approx. 1/100 persons will develop schizophrenia

in his/her lifetime• Approx. half of those admitted to mental hospitals

are diagnosed with this disorder• Usually emerges between late teens and mid-

thirties and only rarely prior to adolescence or after age 45

• Equally prevalent in both men and women• Generally more severe and strikes earlier in men

than women

Schizophrenia: Same as multiple personalities?•No. Schizophrenia means “split mind.”

Referring to the fragmented thought processes and emotions found in schizophrenia

•Multiple personality disorder (known as dissociative identity disorder) is the rare condition of having more than one distinct personality

Symptoms of Schizophrenia: Five Areas of Disturbance• All people with anxiety disorders have anxiety.

All people with mood disorders have depression, and/or mania.

• People who suffer from schizophrenia can have significantly different symptoms, yet all are given the same general label. This is because schizophrenia is a group or class of disorders.

• Each case is identified according to some kind of basic disturbance in one or more of the following areas: perception, language, thought, emotions (affect), and behaviour

Symptoms of Schizophrenia: Five Areas of Disturbance—Perceptual SymptomsPerceptual Symptoms• The senses may be either enhanced (Mrs. T) or

blunted. Sensory stimulation is jumbled and distorted. One patient reported:

“When people are talking, I just get scraps of it. If it is just one person who is speaking, that’s not so bad, but if others join in then I can’t pick it up at all. I just can’t get in tune with the conversation. It makes me feel all open—as if things are closing in on me and I have lost control.”

Symptoms of Schizophrenia: Five Areas of Disturbance—Perceptual SymptomsPerceptual Symptoms• These disruptions in sensations help explain why people with

schizophrenia experience hallucinations—imaginary sensory perceptions that occur without external stimuli.

• Hallucinations occur in all of the senses (visual, tactile, olfactory). But auditory hallucinations (hearing voices and sounds) are most common.

• They hear voices speaking their thoughts aloud, commenting on their behaviour, or telling them what to do. Voices may come from inside their heads or from external sources such as an animal, telephone wires, or a TV set.

• On rare occasions, people with schizophrenia will hurt others in response to distorted internal experiences or the voices they hear---in reality these people are more inclined to self-harm/suicide

Symptoms of Schizophrenia—Language & Thought DisturbancesLanguage & Thought Disturbances• “People who live in glass houses should not throw stones.”

When asked to explain its meaning, a patient with schizophrenia said, “People who live in glass houses shouldn’t forget people who live in stone houses and shouldn’t throw glass.”

• You can see how for people with schizophrenia their logic is sometimes impaired and their thoughts disorganized and bizarre.

• When language and thought disturbances are mild, an individual will jump from topic to topic.

• In severe disturbances, phrases and words are jumbled together (word salad). Or the person creates artificial words (neologisms)—the person might say, “splisters” for splinter and blisters, or “smever” for smart and clever.

Symptoms of Schizophrenia—Language & Thought DisturbancesLanguage & Thought Disturbances•The most common thought disturbance:

lack of contact with reality (psychosis). Think about seeing dinosaurs walking down the street--it would be frightening to no longer separate hallucinations and delusions from reality

•Another common thought disturbance: delusions, or mistaken beliefs based on misrepresentations of reality.

Symptoms of Schizophrenia—Language & Thought DisturbancesLanguage & Thought Disturbances

Delusions of persecution: They may believe others are stalking them or trying to kill them

Delusions of grandeur: believe they are someone very important (Jesus, queen of England)

Delusions of reference: unrelated events are given special significance—when a person believes a radio program or newspaper is giving him/her a special message

Symptoms of Schizophrenia—Emotional Disturbances“It must look queer to people when I laugh

about something that has got nothing to do with what I am talking about, but they don’t know what’s going on inside me and how much of it is running around in my head. You see, I might be talking about something quite serious to you and other things come into my head at the same time that are funny and this makes me laugh. If I could only concentrate on one thing at the same time, I wouldn’t look half so silly.”

Symptoms of Schizophrenia—Emotional Disturbances•As you can see from this quote, the

emotions of people suffering from schizophrenia are sometimes exaggerated and fluctuate rapidly in inappropriate ways. In other cases, emotions may become blunted or decreased in intensity.

•Some people have a flattened affect—meaning there is almost no emotional response of any kind

Symptoms of Schizophrenia—Behaviour Disturbances• Behavioural disturbances may take the form of

social withdrawal and/or unusual actions that have special meaning

• Examples: one patient shook his head rhythmically from side to side to try to shake the excess thoughts out of his mind. Another massaged his head repeatedly “to help clear it” of unwanted thoughts. Other cases, the affected person may grimace and display unusual mannerisms (may also be related to side effects from medication)

Symptoms of Schizophrenia—Behaviour Disturbances• People with schizophrenia may become cataleptic and

assume uncomfortable, nearly immobile stance for an extended period.

• A few people have symptoms called waxy flexibility, which is the tendency to maintain whatever posture is imposed on them

• These abnormal behaviours are often related to disturbances in perception, thoughts and feelings. For example, experiencing a flood of sensory stimuli or overwhelming confusion, a person with schizophrenia may hallucinate, experience delusions, and/or withdraw from social contacts and refuse to communicate.

Types of Schizophrenia: Methods of ClassificationTwo groups of symptoms :1. Positive Symptoms involve additions to

or exaggerations of normal thought, such as delusions and hallucinations. These symptoms are more common when schizophrenia develops rapid (acute). Positve symptoms are associated with better adjustment before the onset and better prognosis for recovery.

Types of Schizophrenia: Methods of ClassificationTwo groups of symptoms :1. Negative Symptoms: involve the loss or

absence of normal thought processes and behaviours. Examples include impaired attention, limited or toneless speech, flattened affect (emotions), and social withdrawal

Negative symptoms are more often found in slow-developing schizophrenia.

Subtypes of SchizophreniaParanoid Dominated by delusions (persecution

and grandeur) and hallucinations (hearing voices)

Catatonic Marked by motor disturbances (immobility or wild activity) and echo speech (repeating the speech of others)

Disorganized Characterized by incoherent speech, flat or exaggerated emotions, and social withdrawal

Undifferentiated Varied symptoms that meet the criteria for schizophrenia but is not any of the other subtypes

Residual No longer meets the full criteria for schizophrenia but still shows some symptoms

Explaining Schizophrenia

•Research supports possible biological factors in schizophrenia.

•Some research suggest prenatal virus infections, birth complications, immune responses, maternal malnutrition, and advanced paternal age

•Biological Theories focus on: genetics, neurotransmitters, and brain abnormalities

Biological Theories: Genetics

•Most genetic studies focus on twins and adoptions—research indicates that the risk for schizophrenia increases with genetic similarity; that is, people who share more genes with a person who has schizophrenia are more likely to develop the disorder

Biological Theories: Neurotransmitters

• It is not fully clear how neurotransmitters contribute.

•Dopamine hypothesis suggest that overactivity of certain dopamine neurons in the brain contribute to some forms of schizophrenia. This is based on (1) administering amphetamines increases the amount of dopamine and can produce (or worsen) some symptoms (2) drugs that reduce dopamine activity in the brain reduce or eliminate some symptoms

Biological Theories: Brain Abnormalities1) Abnormalities in brain function and structure

have been noted. Researchers have found larger cerebral ventricles (fluid-filled spaces in the brain) in some people with schizophrenia

2) Some people with chronic schizophrenia have a lower level of activity in their frontal and temporal lobes—areas that are involved in language, attention and memory. Damage to these areas may explain the thought and language disturbances that characterize schizophrenia

Psychosocial Theories

1) Diathesis-Stress Model: stress plays an essential role in triggering schizophrenic episodes in people with an inherited predisposition

2) Communication disorders in family members may be a predisposing factor—such disorders include unintelligible speech, fragmented communication, and parents frequently sending contradictory messages—this research is inconclusive.

Biosocial Model•Takes into account the biological,

psychological and social factors

• John Nash, the Nobel Prize winning mathematician demonstrated several classic symptoms of schizophrenia, including disturbances in perception, language, thought, behaviour, and emotion. For Nash, as well as others with schizophrenia, no single factor led to his illness.

Personality Disorders

Personality Disorders: Antisocial and Borderline

• Personality is defined as a unique and relatively stable pattern of thoughts, feelings, and actions. What would happen if these stable patterns, called personality , were so inflexible and maladaptive that they created significant impairment of someone’s ability to function socially and occupationally?

• This is what happens to personality disorders—people with PD generally do not feel upset or anxious about their behaviour and may not be motivated to change.

Personality Disorder: Types

Disorder Characteristics

Antisocial Displays pattern of disregarding and violating the rights of others without feeling and remorse

Dependent Displays pattern of submissiveness and excessive need to be taken care of

Histrionic Displays excessive emotions; excessively seeks attention

Obsessive compulsive Has an intense interest in being orderly, having control, and achieving perfection

Paranoid Distrust others; percieves others as having evil emotions

Schizotypal Feels intense discomfort in close relationships; has distorted thinking and eccentric behaviour

Personality Disorders

Media reports that Scott Peterson was more upset about burning chicken on the barbecue than about the disappearance of his wife, Laci, who at the time was eight months pregnant with their child.

Do you remember this case---listening to the audiotapes of Scott Peterson flirting and lying to his girlfriend while others were frantically searching for his “missing” wife?This is a good example of the traits and behaviours of an antisocial personality disorder

How Do You Recognize Antisocial PD?

•Often labeled psychopaths or sociopaths, people with this disorder function on an entirely different plane of existence than the rest of us.

•Official diagnosis in usually not determined until the affected individual reaches adulthood, however, there are several telltale signs that indicate the presence of this disturbing disorder.

Antisocial Personality Disorder

•Term is used interchangeably with terms sociopath and psychopath.

•These labels describe behaviour that is so far outside the ethical and legal standards of society that many consider it the most serious of all mental disorders.

•People with this diagnosis feel little personal distress (and may not be motivated to change). Yet their maladaptive traits generally bring considerable harm and suffering to others


Four hallmarks of antisocial personality disorder:

1. Egocentrism: preoccupation with oneself and insensitivity to the needs of others

2. Lack of conscience3. Impulsivity4. Superficial charm


• Unlike most adults, individuals with APD act impulsively, without giving thought to their consequences.

• They are usually poised when confronted with their destructive behaviour and feel contempt for anyone they are able to manipulate

• They often change jobs and relationships suddenly• They often have a history with truancy from school

and of being expelled for destructive behaviour• They may be charming and persuasive, and have

remarkably good insight into the needs and weaknesses of others


•Twin and adoption studies suggest a possible genetic predisposition to antisocial personality disorder

•Biological contributions are also suggested by studies that have found abnormally low autonomic activity during stress, right hemisphere abnormalities , reduced grey matter in the frontal lobes, smaller amygdala, and biochemical disturbances


• Evidence also exists for environmental or psychological causes.

• Antisocial personality disorder is highly correlated with neglectful and/or abusive parenting styles, and inappropriate modeling

• They often come from homes characterized by emotional deprivation, harsh, inconsistent disciplinary practices, and antisocial parental behaviour

• Other studies show a strong interaction between both heredity and environment

How To Recognize Someone with Borderline Personality Disorder

•People who act out by throwing tantrums, getting drunk all the time or frequently talking of or attempting suicide may be having more than a bad day. They could be suffering from borderline personality disorder. This mental disorder most frequently occurs in young adults, although it can hit at any age. The disorder can be successfully treated once it's recognized.

Profile of BPD

1. Abandonment Issues2. Unstable Personal Relationships3. Self Harm & Impulsivity4. Mood Swings5. Poor Self-Image

Borderline Personality Disorder

•BPD is among the most commonly diagnosed personality disorders.

•The core features are impulsivity and instability in mood, relationships, and self-image•Originally, the term implied that the person was on the borderline between neurosis and schizophrenia—the modern day take no longer has this connotation, but BPD remains one of the most complex and debilitating of all the personality disorders

Borderline Personality Disorders•People with borderline experience

extreme difficulties in relationships. •Subject to chronic feelings of depression,

emptiness, and intense fear of abandonment, they also engage in destructive, impulsive behaviour, such as sexual promiscuity, drinking, gambling, and eating sprees.

•In addition, they may attempt suicide and sometimes engage in self-mutilating behaviour.

Borderline Personality Disorders•People with BPD tend to see themselves

and everyone else in absolute terms—perfect or worthless

•They constantly seek reassurance from others and may quickly erupt in anger at the slightest sign of disapproval

•This disorder is typically marked by a long history of broken friendships, divorces, and lost jobs

Borderline Personality Disorders•People with BPD frequently have a

childhood history of neglect; emotional deprivation; and physical, sexual, or emotional abuse.

•The disorder tends to run in families, and some data suggests it is the result of impaired functioning of the brain’s frontal lobes and limbic system, areas that control impulsive behaviours

Borderline Personality Disorders•Some therapist have had success in treating

BPD with drug therapy and behaviour therapy, the prognosis is generally not favourable.

•People with BPD appear to have a deep well of intense loneliness and a chronic fear of abandonment.

•Given their troublesome personality traits, friends, lovers, even family members and therapists often do “abandon” them—thus creating a tragic self-fulfilling prophecy.

psychological disorders psychology 12. what is normal? what are examples of “normal” adolescent...

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