Download Psychological

Myers’ PSYCHOLOGY
(6th Ed)
Chapter 15
Psychological Disorders
James A. McCubbin, PhD
Clemson 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 itself
disturbing- varies with time & culture
maladaptive- harmful
unjustifiable- 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
Biological
(Evolution,
individual
genes, brain
structures
and chemistry)
Sociocultural
(Roles, expectations,
definition of normality
and disorder)
Bio-psycho-social
Perspective
assumes that
biological,
sociocultural, and
Psychological
psychological factors
(Stress, trauma,
learned helplessness,
combine and
mood-related perceptions
interact to produce
and memories)
psychological
disorders
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 anxiety
Psychotic disorder
person loses contact with reality
experiences irrational ideas and distorted
perceptions
Anxiety Disorders
Anxiety 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 arousal
Phobia
persistent, irrational fear of a specific object
or situation
Anxiety Disorders
Common and uncommon fears
100
Percentage 90
of people 80
surveyed
70
60
50
40
30
20
10
0
Snakes
Being Mice Flying Being Spiders Thunder Being Dogs
in high,
on an closed in, and
and
alone
exposed
airplane in a
insects lightning In a
places
small
house
place
at night
Afraid of it
Bothers slightly
Not at all afraid of it
Driving Being
Cats
a car
In a
crowd
of people
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 Disorders
Common Obsessions and Compulsions Among
People 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
Compulsions (repetitive behaviors)
Excessive hand washing, bathing, tooth brushing,
or grooming
85
Repeating rituals (in/out of a door,
up/down from a chair)
Checking doors, locks, appliances,
car brake, homework
51
46
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 Disorders
Manic 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 DisordersDepression
25
Percentage
of population
aged 18-84
experiencing
major
depression
at some
point In life
Around the world
women are more
susceptible to
depression
20
20
15
15
10
10
5
5
0
0
USA Edmonton Puerto
Rico
Males
Females
Paris
West
Florence Beirut
Germany
Taiwan
Korea
New
Zealand
Mood DisordersDepression
10%
Percentage
depressed 8
Females
6
4
2
Males
0
12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+
Age in Years
Mood DisordersSuicide
Suicides per 70
100,000 people 60
50
The higher suicide rate
among men greatly
increases in late
adulthood
40
30
20
10
0
15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+
Males
Females
Mood DisordersSuicide
Increasing rates of teen suicide
12%
Suicide rate,
ages 15 to 19 10
(per 100,000)
8
6
4
2
0
1960
1970
1980
Year
1990
2000
Mood DisordersBipolar
PET scans show that brain energy consumption
rises and falls with emotional swings
Depressed state
Manic state
Depressed state
Mood DisordersDepression
Brain
chemistry
Cognition
Mood
Altering any one
component of
the chemistrycognition-mood
circuit can alter
the others
Mood DisordersDepression
Percentage of
observations
35%
30
25
20
15
Negative
behaviors
Positive
behaviors
Self-ratings
A happy or
depressed
mood
strongly
influences
people’s
ratings of
their own
behavior
Mood DisordersDepression
1
Stressful
experiences
4
Cognitive and
behavioral changes
3
Depressed
mood
The vicious
cycle of
depression
can be
2
broken at
Negative
explanatory style
any point
SOMATOFORM
DISORDERS
Distressing symptoms take a somatic (bodily)
form, without any apparent physical cause.
Emotional Distress
Conversion disorder: anxiety is converted into a
physical symptom.
Hysterical blindness
Amnesia – psychogenic
Fugue: amnesia with travel & identity
replacement
Hypochondrias – 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 thinking
disturbed perceptions
inappropriate emotions and actions
Disorganized 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
or residual:
Schizophrenia symptoms without fitting one of the
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 risk 40
of developing
schizophrenia 30
for relatives of
a schizophrenic
20
10
0
General
population
Siblings
Children
Fraternal Children
Identical
twin
of two
twin
schizophrenia
victims
schizophrenia
10 years after diagnosis….
25% complete recovery
25% improved, extensive support is
needed
15% hospitalized, no imporvement
10% 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 Disorders
PET scans illustrate reduced activation in
a murderer’s frontal cortex
Normal
Murderer
Personality Disorders
35
30
Percentage
of criminal
offenders
25
20
15
10
5
0
Total crime
Childhood
poverty
Thievery
Obstetrical
complications
Violence
Both poverty
and obstetrical
complications
Rates of Psychological
Disorders
Percentage of Americans Who Have Ever Experienced Psychological Disorders
Ethnicity
Gender
Disorder
White
Black
Hispanic
Men
Women
Totals
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