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C16:1
Myers’ PSYCHOLOGY
Psychological Disorders
C16:2
• Widespread and debilitating effects
• WHO (2001)
– Estimated 450 million people worldwide suffer
psychological disorders
– Account for 15.4% of years of life lost due to
death or disability, slightly below cardiovascular
and above cancer
Chapter 16
Psychological
Disorders
• USA
– 2.1 million per year admitted as inpatients
– Another 2.4 million outpatients
– 1 in 5 people need some help each year, twice that
at some time in their lives
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Outline
• Perspectives on
Psychological Disorders
–
–
–
–
–
–
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically:
Insanity and Responsibility
• Anxiety Disorders
– Generalized Anxiety Disorder
and Panic Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress Disorder
– Explaining Anxiety Disorders
– Thinking Critically: Dissociation
and Multiple Personality
• Mood Disorders
–
–
–
–
Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
– Symptoms
– Subtypes
– Understanding
• Personality Disorders
– Antisocial PD
– Understanding Antisocial PD
• Rates of Psychological
Disorders
Thinking Critically: ADHD
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• Attention Deficit Hyperactivity Disorder
(ADHD)
– More common today than in past
– CPA estimates about 4% of children
– Three key symptoms: Inattention, Hyperactivity,
Impulsivity
– 2 to 3 times more common in boys
– Rates vary across nations, regions, teachers, …
– Heritable, treatable by stimulants and
psychotherapy
– Questions about over-diagnosis, long-term effects
of medications, …
Perspectives: Defining
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• Psychological Disorder is a “harmful
dysfunction” in which behavior is judged to be:
– Atypical: not enough in itself, and sometimes disorders
widespread
– Disturbing: varies with time & culture
– Maladaptive: harmful
– Unjustifiable: occasionally justified
• Standards vary with History and Culture
– Sexual arousal and orgasm
– Homosexuality
– Hearing voices
Perspective:
Understanding (Etiology)
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• Historical Causes and
Treatments
– Supernatural events
Movements of sun or moon,
evil spirits, possession, …
• Lunacy: full moon
•
– Treatments
•
Exorcism, caged like
animals, beaten, burned,
castrated, mutilated, blood
replaced with animal’s blood
1
• Medical Model
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– Diseases have physical causes and can be diagnosed, treated, and often
cured
– “Mental” illnesses can be diagnosed on basis of symptoms and cured
through therapy, which may include treatment in psychiatric hospital
– Much attention at present to identify biochemical and genetic factors
that underlie mental disorders
• Bio-psychosocial
Perspective
– Grouping like elements (e.g.,
disorders) together
– Similar Symptoms, Etiology,
Treatment, …
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Perspectives:
Classifying
• DSM-IV-TR
– American Psychiatric
Association’s Diagnostic and
Statistical Manual of Mental
Disorders (Fourth Edition, Text
Revision)
– Widely used system for
classifying psychological
disorders
– Developed in coordination with
ICD-10: WHO’s International
Classification of Diseases
– Biological,
sociocultural,
and
psychological
factors
combine and
interact to
produce
psychological
disorders
(right)
• Earlier important distinction
• Taxonomy or Classification
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– Neurotic disorders (term seldom used now)
• Distressing but allow one to think rationally and function socially
Classifying Psychological Disorders:
Five Axes of the DSM IV
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• Freud: neurotic disorders are ways to deal with anxiety
– Psychotic disorder
Axis I
• Lose contact with reality
• Experience irrational ideas and distorted perceptions
(hallucinations)
Axis II
• 5 Axes (+1)
– 15+ major categories in Axis I (+2)
– 400 disorders, increased from 60 disorders in 1950s
• Reliability of Diagnosis
– Historically a weak area for psychiatric diagnosis
– Now better criteria, structured interviews more common
• 83% agreement in one recent study
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Is a Clinical Syndrome (cognitive, anxiety,
mood disorders [16 syndromes]) present?
Is a Personality Disorder or Mental
Retardation present?
Axis III
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis IV
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
What is the Global Assessment of the
Axis V person’s functioning? (100 point scale)
Perspectives: Labeling
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• Some concern about negative consequences of
labeling people with disorders
• Classic Rosenhan study
– Rosenhan and 7 other “normal” people admitted selves to
psychiatric hospital complaining of “hearing voices”
– Acted normally once admitted
– Normal behaviors seen as symptoms (e.g., taking notes)
– Possible “causes” found in people’s personal histories
– Average of 19 days before release
• Other studies show behavior interpreted differently
depending on label (e.g., Langer interview study)
• Stigma associated with mental illness (+1)
– 3/4 refused to rent room to someone allegedly being
released from mental hospital (same as for jail)
– Portrayed as dangerous and frightening in media
2
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• Insanity Defense
– Controversial
• Sent to jail, not hospital
Insanity and
Responsibility
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– Dahmer: murdered 15 young men and
ate parts
– Kacsynski: Unabomber killed 3 and
injured 23
– Kinkel: killed parents, 2 fellow students,
wounded 25
– Andrea Yates: drowned her 5 children
– Li: beheaded stranger on bus
• Mental Disorder and Justice system
– 16% US inmates have severe mental
disorders (283,000)
– Some were executed
• Difficult balance
– Compassion for those with mental
disorder, and
– Personal responsibility for our acts,
including bad ones
• Perspectives on
Psychological Disorders
–
–
–
–
–
–
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically: Insanity
and Responsibility
• Anxiety Disorders
– Generalized Anxiety
Disorder and Panic
Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress
Disorder
– Explaining Anxiety
Disorders
– Thinking Critically:
Dissociation and Multiple
Personality
• Phobia
Outline
• Mood Disorders
–
–
–
–
• Anxiety Disorders
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Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
– Symptoms
– Subtypes
– Understanding
• Personality Disorders
– Antisocial PD
– Understanding Antisocial PD
• Rates of Psychological
Disorders
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Anxiety
Disorders
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– Distressing, persistent anxiety
– Or maladaptive behaviors that reduce
anxiety
• Generalized Anxiety Disorder
– Person is tense, apprehensive, and in
a state of autonomic nervous system
arousal
– Unable to identify cause, “free
floating”
• Panic Disorder
– Minutes-long episode of intense
dread in which person experiences
terror and accompanying chest pain,
choking, or other frightening
sensation
– Perceived as heart-attack, come to
fear fear itself
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– Persistent, irrational fear of a specific object or situation
– Some common and uncommon fears (below +1)
3
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• Obsessive-Compulsive Disorder
– Unwanted repetitive thoughts (obsessions)
and/or actions (compulsions)
An Example of
OCD: Howard
Hughes (The
Aviator)
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• Leonardo DiCaprio’s characterization of OCD in movie
is reportedly quite good
– Repetitive phrases: striving to “get things right”
– Awareness at some level that behavior is not appropriate:
covering mouth to avoid repetition
– Compulsive hand-washing: cleaning rituals to alleviate fear
of germs, infection, and disease
• Hughes’ wealth allowed him to develop elaborate
rituals carried out by his staff
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•
Four or more weeks of
following symptoms
–
–
–
–
–
•
Explaining
Anxiety
Disorders
PostTraumatic
Stress
Disorder
• Learning Perspective
Associated with
–
–
•
Haunting memories
Nightmares
Social withdrawal
Jumpy anxiety
Sleep problems
– Fear Conditioning: 58% of people with social
phobia experienced disorder after traumatic event
More intense trauma
Closer proximity (e.g., 9/11)
•
Concerns about PTSD
–
–
–
– Natural Selection: predispositions to
fear certain kinds of objects and
events (snakes, confinement) and
engage in certain ritual behaviors
(hand-washing)
– Genes: higher prevalence of anxiety
in identical twins
– Reduced GABA levels: GABA is
inhibitory neurotransmitter
– Physiology: over-arousal of frontal
lobe areas involved in directing
attention and impulse control, as in
PET Scan of brain of person with
Obsessive/ Compulsive disorder
(top); high metabolic activity (red)
in frontal lobe areas; or overactivity of brain region involved in
error checking (bottom)
Horley et al (2004): Social Phobics avoid looking at eyes
of angry faces (above, early experiences?)
– Stimulus Generalization
– Avoidance or Escape behaviors: Negative
Reinforcement
– Observational Learning
Overdiagnosed?
Trauma counseling ineffective
or harmful in some cases
Resilience of survivors
• Biological Perspective
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• Cognitive Perspective
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– Attentional and other cognitive processes play role
in anxiety (and other psychological disorders)
– Emotional Stroop task: name ink color of words
that are either Threatening or Non-Threatening
– Study with Adolescents who also completed Beck
Anxiety Inventory (BAI). Measured time (sec) to
read Stroop card.
Words
Low BAI High BAI
Non-threatening
63.2
68.3
Threatening
65.3
76.6
Difference
2.1
8.3*
– Interference index calculated by subtracting time
to read colors of threat words from time to read
colors of neutral words: r with BAI = +.42
4
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Thinking Critically: Dissociation and Multiple Personalities
Outline
• Dissociative experiences (mild forms common)
• Perspectives on
Psychological Disorders
– Lack of awareness of activities, feeling different or unreal,
viewing self from external perspective, …
• Dissociative Identity Disorder
– 2+ distinct identities without awareness of one another
• Controversial
– “Strong evidence” according to 11% psychiatrists: e.g.,
some evidence for distinct brain states
– Skeptics
• Explosion in diagnosis
• Marked increase in # personalities (mean 3 prior to Sybil, 16 after)
• Incidence varies across therapists and nations
• Use of hypnosis (Iatrogenic)
• Fantasy-prone personalities
• …
Mood Disorders
– Generalized Anxiety Disorder
and Panic Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress Disorder
– Explaining Anxiety Disorders
– Thinking Critically: Dissociation
and Multiple Personality
• Mood Disorders
–
–
–
–
Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
– Symptoms
– Subtypes
– Understanding
• Personality Disorders
– Antisocial PD
– Understanding Antisocial PD
• Rates of Psychological
Disorders
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• Depression: Five (or more) of following symptoms
present during same 2-week period
–
–
–
–
–
–
–
–
Depressed mood most of day, nearly every day
Markedly diminished interest in most activities most of day
Significant weight loss when not dieting or weight gain
Insomnia or Hypersomnia nearly every day
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy nearly every day
Feel worthless or excessive guilt nearly every day
Diminished ability to think or concentrate, or
indecisiveness, nearly every day
– Recurrent thoughts of death (not just fear of dying),
recurrent suicidal ideation without specific plan, or suicide
attempt or specific plan for committing suicide
– Characterized by emotional extremes
– Two variants: Major Depressive
Disorder and Bipolar Disorder
• Major Depressive Disorder
– Mood disorder in which person, for no
apparent reason, experiences two or
more weeks of depressed moods,
feelings of worthlessness, and
diminished interest or pleasure in most
activities
– Symptoms (+1)
C16:29
• Bipolar Disorder
– Mood disorder in which person alternates
between hopelessness and lethargy of
depression and overexcited state of mania
– Formerly called manic-depressive disorder
• Manic Episode
– Mood disorder marked by hyperactive, wildly
optimistic state
– Symptoms (+1)
– Poets, Artists, Actors, …
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically: Insanity
and Responsibility
• Anxiety Disorders
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• Mood Disorders
• May be associated with creativity
–
–
–
–
–
–
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• Manic Episode: Three (or more) of following
symptoms present during same 1-week period
– Inflated self-esteem or grandiosity
– Decreased need for sleep (feels rested after three
hours sleep)
– More talkative than usual or pressure to keep
talking
– Flight of ideas or subjective experience that
thoughts are racing
– Distractibility
– Increase in goal-directed activity or psychomotor
agitation
– Excessive involvement in pleasurable activities that
have high potential for painful consequences
(sexual indiscretions, foolish business investments)
5
Characterization of Major Depressive C16:31
Disorder (left) and Bipolar Disorder (right)
Explaining Mood Disorders
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• Facts to be explained by theory
– Many associated behaviors and cognitions: lack motivation,
recall negative events, negative expectations, …
– Stressful events often precede depression: Incidence of 1%
if 0 stressful events, 24% for 3 or more
– Major Depressive Episodes often Self-Terminate
– Increase in rates of depression (and other disorders), and
also earlier onset (+1)
– Widespread (+2)
– More common in women (+2 +3), but suicides (later)
– Affects all ages, but especially young (+3)
– Also suicide facts (later slides)
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• Suicide Facts
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– Higher rates for Rich,
Nonreligious, Non-married
– Cultural (National & Ethnic)
differences (right)
• Relative to Canada, Australia,
and USA (CAU)
England, Italy, Spain: 1/2
Austria, Finnish: 2x
Lithuanians: 15x Portuguese
White Americans 2x Black
(+1)
• Aboriginals in Canada (+1)
•
•
•
•
– Gender
• Women more likely to try
• Men 2x to 4x more likely to
succeed (not China) because
of lethal means (6/10 bullet to
head in USA) (+2)
– Age differences (+1 +2)
– Trends across time (+2 +3)
6
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• Assessing risk of suicide attempt and success
• Increasing rates of teen suicide
Suicide rate,
ages 15 to 19
(per 100,000)
– Emotions and Thoughts: Feelings of depression.
Think and talk of suicide.
– Seriousness of intent: Plan for suicide, Lethality of
plan, Means to carry out plan
– Plans for future
– History: Previous attempts
– Depression + Anger motivated by cry for help
– Depression + Hopelessness motivated by death
12
10
8
6
4
2
0
1960
1970
1980
Year
1990
2000
Explanation: Biological Perspectives
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Pet Scan for serotonin
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• Genetic Influences
– Higher incidence with higher degrees of genetic
relatedness. Concordance of 57% in identical twins
and 14% in fraternal twins
– Linkage studies to identify relevant genes
• Depressed Brain
– Neurotransmitters
Norepinephrine, Serotonin low during Depressed state
(+1)
• Norepinephrine high during Manic state
•
– Brain activity (+2)
Person in depressive episode
Healthy Person
7
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• Biological Rhythm Dysfunction
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– Sleep disturbances
– Seasonal Affective Disorder: latitude? (below)
Have you cried today?
% Yes
Men
Women
August
4%
7%
December
8%
21%
• PET scans show that brain energy consumption
rises and falls with emotional swings
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C16:46
Explanation: Social-Cognitive Perspective
• Historical psychological models
– Psychodynamic Perspective: Intrapsychic conflict
• Current psychological model(s) more integrated
– Models emphasize role of Cognition and Emotion (i.e.,
psychological states and processes), as well as biology
– Reciprocal relations among various elements (+1)
– Stressful Life Events
• Discussed in earlier chapter
– Specifically, Social-Cognitive model hypothesizes cyclic
relations among various psychological processes (+2)
• 1. Stressful experiences
• 2. Negative explanatory style (+3)
• 3. Depressed mood
• 4. Cognitive and Behavioral changes
C16:47
• The vicious
cycle of
depression
can be
broken at
any point
Negative
Explanatory Style
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• Learned Helplessness /
Hopelessness (Seligman)
(+1)
• Attributional Style
– Can lead to feelings of
Hopelessness (+1)
– Explain bad events in terms
that are Stable, Global, and
Internal (+2)
• Beck
– Pessimistic view of self,
world, and future; Irrational
beliefs (+3); and Errors in
Thinking
8
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Helplessness/Hopelessness Theory
C16:50
• Attributional style of depressives
•
Learned Helplessness
•
Bad things
happen
Why I failed my test.
– Internal
Sense of
Helplessness
I have taken too many classes
– Stable
Depression
•
I am a lousy student (not I did not study this time)
– Global
Hopelessness
Bad things
happen
Attribution
style
•
Sense of
Hopelessness
Depression
C16:51
Irrational Beliefs (Beck)
1.
2.
3.
4.
5.
6.
7.
Must have love and approval nearly all time from people
important to you.
Must be completely competent in all endeavors, or must
have real expertise or talent in something important.
Life must go way you want. Things are awful when you
don't get first choices.
Other people should treat everyone fairly. People who are
unfair or unethical are horrible and rotten, and are to be
punished or avoided.
People and things should turn out better than they do turn
out. It's awful and terrible when quick solutions to life's
hassles are not forthcoming.
Your past is strong influence on your behavior and must
continue to affect you and determine your behavior.
You can find happiness by inertia, inactivity, or passivity.
• More common in people who are alone
– Unmarried, unattached, young
Loneliness
C16:53
• Work-related moves
• Four types: Feel excluded, Feel unloved, Feel constricted
(unable to share), Feel alienated (different)
• Self-blame
– Tend to be shy, lack self-esteem, less socially competent (how to
introduce self, participate in groups), negative interpretations of social
acts, remember negative events
I am a failure (not I did not do well in one test)
• Such attributions lead to feelings of
hopelessness because causes can seem so
pervasive and unchangeable
C16:52
• Negative Mood Feeds
Negative Thoughts
– Judge same behavior
of self more negatively
when sad (blue) than
happy (red) (right)
35%
30
• Vicious Cycle
– People who ruminate
and catastrophize with
self-blaming thoughts
more at risk for
depression
– Women more likely to
ruminate on negative
events
25
20
15
Negative
behaviors
Positive
behaviors
Self-ratings
C16:54
Outline
• Perspectives on
Psychological Disorders
–
–
–
–
–
–
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically: Insanity
and Responsibility
• Anxiety Disorders
– Generalized Anxiety Disorder
and Panic Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress Disorder
– Explaining Anxiety Disorders
– Thinking Critically: Dissociation
and Multiple Personality
• Mood Disorders
–
–
–
–
Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
– Symptoms
– Subtypes
– Understanding
• Personality Disorders
– Antisocial PD
– Understanding Antisocial PD
• Rates of Psychological
Disorders
9
Schizophrenia
C16:55
– Delusions: False beliefs, often of persecution or grandeur,
that may accompany psychotic disorders
– “Word salad” speech: “I am fine…apple pie…no
sale…furniture store…take it slow…cellar door…”
– Break-down in selective attention, capacity to inhibit
irrelevant material
• Schizophrenia
– Literal translation “split mind”
– Psychotic Disorder
– Group of severe disorders
characterized by:
• Disturbed Perceptions
Disorganized and Delusional
thinking
• Disturbed Perceptions
• Inappropriate emotions and actions
•
– Hallucinations: False sensory experiences, such as seeing or
hearing something without any external physical stimulus
– Usually auditory
– Negative messages: bad, hurt self, …
• Symptoms very disruptive
• Inappropriate Emotions and Actions
– Live in private inner world
– Socially withdrawn and isolated much
of lives
Schizophrenia
Understanding
– Higher risk if maternal virus Schizophrenia
during midpregnancy
C16:56
• Disorganized Thinking
–
–
–
–
Inappropriate responses: e.g., laugh at sad event
Flat Affect: appears like apathy
Senseless, compulsive acts: e.g., rocking
Catatonia: motionless for hours, then agitated
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Schizophrenia
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Schizophrenia
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• Brain abnormalities
• Flu epidemic during midpregnancy
• Densely populated areas at greater risk of viral disease
• Born during winter and Spring months in Northern Hemisphere and
reverse in Southern Hemisphere
• Mother reported being sick with flu, especially 2nd trimester
• Higher levels of flu-related antibodies in mothers
– Neurotransmitters
• Dopamine overactivity and positive symptoms: hallucinations,
paranoia
• Glutamate underactivity and negative symptoms: withdrawal
– Brain Anatomy
• Low activity in frontal lobes
• Enlarged fluid-filled areas (+1) and shrinkage of cortex (+2)
• Low birth-weight, oxygen deprivation, prenatal under-nutrition
10
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Understanding Schizophrenia
C16:62
• Genetic factors
– Inherit predisposition
1/100 baseline incidence
1/10 in those with affected sibling or parent
• 1/2 with affected identical twin, whether reared together
or apart (+1 +2)
•
•
– 6/10 if shared single placenta
– 1/10 if twins had separate placentas
– Adopted higher if Biological parent affected, not
Adoptive parent
– Varying degrees of genetic relatedness (+3)
– Older father increases incidence: More mutated
DNA in sperm cells
– Multiple genes involved (polygenic)
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• Genain quadruplets
– All identical twins
– All affected with
Schizophrenia, two
more seriously
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Understanding Schizophrenia
C16:66
• Psychological Factors
– Disturbed communication with parents
•
Causal direction?
– Follow high risk children for years. More at risk if:
•
•
•
•
•
•
•
Birth complications: oxygen deprivation, low birthweight
Mother’s schizophrenia severe and long-lasting
Separation from parents
Short attention span and poor muscle coordination
Disruptive or withdrawn behavior
Emotional unpredictability
Poor peer relations and solo play
– Difficult to separate Environmental from Genetic
effects and from (Early) Symptoms
11
C16:67
Outline
• Perspectives on
Psychological Disorders
–
–
–
–
–
–
• Mood Disorders
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically: Insanity
and Responsibility
• Anxiety Disorders
– Generalized Anxiety Disorder
and Panic Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress Disorder
– Explaining Anxiety Disorders
– Thinking Critically: Dissociation
and Multiple Personality
–
–
–
–
Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
– Symptoms
– Subtypes
– Understanding
• Personality Disorders
– Antisocial PD
– Understanding Antisocial
PD
• Rates of Psychological
Disorders
• Antisocial Personality Disorder
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Personality Disorders
– Inflexible and enduring behavior patterns
that impair social functioning, usually
without anxiety, depression, or delusions
• Three “clusters”
– Sensitivity to Rejection: e.g., Avoidant PD
– Eccentric: e.g., Schizoid PD
– Dramatic or Impulsive
• Histrionic PD: shallow, attention-getting
emotions
• Narcissistic PD: exaggerate own importance
• Borderline PD: unstable identity and relations
• Antisocial PD: most troubling (next few slides)
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– Person (usually man) exhibits lack
of conscience for wrongdoing, even
toward friends and family (e.g.,
Bernardo, right)
– Aggressive and ruthless or clever
con artist
– Previously called Sociopath or
Psychopath
– More common in, but not majority
of criminals, nor limited to criminals
– Little regret
• Henry Lee Lucas: many murders;
“Once I’ve done a crime, I just forget
it.” Partner Toole “I think of killing like
smoking a cigarette, like another
habit.”
– Hare Psychopathy Check List (+1)
Antisocial Personality Disorder
• Biological
–
–
–
–
Low arousal (+1)
Weak frontal lobe functioning (+2)
Genetic influence shown in Twin and Adoption studies
Early temperament: impulsive, uninhibited, unconcerned
with social rewards, low in anxiety
• Environment also important
– Increased violence cannot be explained by change in genes
– Environmental/Biological risk factors (+3)
• 13 year-old
boys later
convicted of
crime
showed
relatively low
arousal
• Interaction between Genes and Environment
Gene
No
No
Yes
Yes
Maltreatment
No
Yes
No
Yes
+++
12
C16:73
• PET scans illustrate reduced activation in a
murderer’s frontal cortex
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Outline
–
–
–
–
–
–
Defining
Thinking Critically: ADHD
Understanding
Classifying
Labeling
Thinking Critically: Insanity
and Responsibility
• Anxiety Disorders
– Generalized Anxiety Disorder
and Panic Disorder
– Phobias
– Obsessive-Compulsive
Disorder
– Post-Traumatic Stress Disorder
– Explaining Anxiety Disorders
– Thinking Critically: Dissociation
and Multiple Personality
C16:74
Murderer
Normal
• Perspectives on
Psychological Disorders
Antisocial Personality Disorder
C16:76
– NIMH study of 20,000 people in 1980s
• Mood Disorders
–
–
–
–
• Psychological Disorders Widespread
Major Depressive Disorder
Bipolar Disorder
Explaining Mood Disorders
Close-up: Suicide
• Schizophrenia
•
1/6 Americans clinically significant mental disorders
– Britain’s Office of National Statistics (2002)
•
1/6 rate of active disorders
– Australian survey of 10,600 adults
– Symptoms
– Subtypes
– Understanding
•
In any year slightly less than 1/6 have mental disorder
– Australian survey 4,500 children and adolescents
• Personality Disorders
– Antisocial PD
– Understanding Antisocial PD
•
1/7 had mental health problems
• Rates of Psychological
Canadian Statistics (+1)
Disorders
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C16:78
• 1 in 5 Canadians will experience, during their lifetime,
mental illness serious enough to impair functioning
• 3% of those (nearly 1 million Canadians) suffer from
severe and persistent mental illness
• 1% of Canadians suffer from schizophrenia
• 4,000 people a year die prematurely by suicide
• Disability due to depression seriously affects 10 out
of 100 people at some point in their lives along with
their families and places of work, and is leading
cause of disease burden among women 15 - 44 years
of age in developed world
• Only 1 out of 5 children who need mental health
services receives them
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• Moderating Factors
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C16:80
C16:81
C16:82
– Age: 75% experience
first symptoms by age 24
– Doubly high among
those below poverty line
– Varies with Nationality
(right WHO 2004,
prevalence during
preceding year )
– Gender and Ethnicity
(+1)
– Variety of Risk and
Protective Factors (+2
+3, WHO, 2004)
Conclusions
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• Definition and measurement of psychological
disorders a challenge
– Identifying defining and characteristic features
– Overlapping symptoms across disorders
– Possible negative consequences of labeling
• Complex causal factors at multiple levels
– Diathesis – Stress models increasingly common:
i.e., interaction between predisposition to disorder
and some stressor
– Neurotransmitters and Brain Regions
– Bio-Psycho-Social Models
• Treatment similarly complex
– Chapter 17
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