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SUMMER AT THE ACADEMY
Introduction to Psychology
Days 11 & 12: Psychological Disorders
Ms. Mary-Liz Fuhrman
TOPICS
Perspectives
 Anxiety Disorders
 Mood Disorders
 Schizophrenia
 Personality Disorders
 Rates of Psych. Disorders

WHAT DO YOU KNOW?
What Psychological disorders do you know?
 Why do you think it is important to study and
understand these disorders?
 Why do we tend to be fascinated by psychological
disorders?

“TO STUDY THE ABNORMAL IS THE BEST WAY
OF UNDERSTANDING THE NORMAL”- WILLIAM
JAMES

Common Disorders:
Depression
 Obsessive-Compulsive Disorder
 Schizophrenia
 ADD/ADHD


Our curiosity:
We exhibit some of characteristics at different points–
we relate to some of these disorders
 450 million people suffer from psychological disorders

PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS
Questions To Be Considered…
 How should we define psychological disorders?
 How should we understand disorders?


Sicknesses to be cured or reactions to environment?
How should we classify disorders? How do we help
people without adding labels?
PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS DEFINING PSYCHOLOGICAL
DISORDERS
Psychological Disorder: deviant, distressful, and
dysfunctional behavior patterns
 Persistently harmful thoughts, feelings, and actions
 Q: What is deviant behavior?


Standards for deviance vary by culture and context


What are our standards for behavior in the US? How might
these be different in other countries?
Vary over time

Homosexuality
 What are some common diagnoses today that may be
controversial?
PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS DEFINING PSYCHOLOGICAL
DISORDERS CONT’D

Distress


Problematic, stressful, worrisome
Dysfunctional
When thoughts and behaviors interfere in daily activities
 KEY in defining disorders

PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS UNDERSTANDING
PSYCHOLOGICAL DISORDERS
Medical Model
 1800’s
 Diseases have physical
causes that can be
diagnosed, treated and
cured.
 Diagnosed based on
symptoms and treated
with therapy



Hospitalization
Depression &
Schizophrenia



Biopsychosocial
Approach
Nature and nurture
Cultural Influences
Depression and
Schizophrenia are found
worldwide
 Anorexia Nervosa is
western
 Different causes of
anxiety in different
cultures


Takes into account
Biological: genetics,
evolution
 Psychological: stress,
mood
 Social-Cultural: roles,
expectations

PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS CLASSIFYING PSYCHOLOGICAL
DISORDERS
Classification based on symptoms
 Diagnostic classification describes and predicts
 DSM-IV: the APA Diagnostic and Statistical Manual
of Mental Disorders (Fourth Edition)
 Pros and Cons of Diagnosing


-Pro: $$ insurance
-Con: illness = stigma
Describes various disorders and prevalence
 Offers standards, consistency, and organization for
subjective symptoms

PERSPECTIVES ON PSYCHOLOGICAL
DISORDERS LABELING PSYCHOLOGICAL
DISORDERS

Labels affect how we perceive people


Normal v. Different
Movies/Media
Accurate: A Beautiful Mind
 “Freaks”- Silence of the Lambs


Changes “reality”
Students are “slow”
 Someone is “hostile”

ANXIETY DISORDERS
What are some anxiety provoking situations?
 What is anxiety?



A feeling of apprehension, often characterized by
feelings of stress. (WebMD)
Anxiety Disorder: psychological disorder
characterized by distressing, persistent, anxiety or
maladaptive behaviors that reduce anxiety
ANXIETY DISORDERS
GENERALIZED ANXIETY DISORDER
Person is continually tense, apprehensive, and in a
state of autonomic nervous system arousal
 Symptoms are common; persistence is key in
diagnosing


Symptoms: dizziness, heart palpitations, sweating,
edgy, shaky
2/3 women
 Tense, jittery, worried, sleepless


Twitching, sweating, trembling, fidgeting
Concentration is difficult
 Hard to find one cause
 Often linked with depression

ANXIETY DISORDERS
PANIC DISORDER
Disorder marked by unpredictable minutes-long
episodes (attacks) of intense dread n which a
person experiences terror and accompanying chest
pain, choking, or other frightening sensations
 1 in 75 people
 Panic Attacks affect social interactions and daily life
 Withdrawal and avoidance of social situations/
interactions that cause attacks

ANXIETY DISORDERS
PHOBIAS
Persistent, irrational fear and avoidance of a
specific object, activity, or situation
 Disrupts behavior and daily life



Social Phobia
Common Phobias:
Being alone
 close spaces

-storms-water -height
-flying
-blood -animals
ANXIETY DISORDERS
OBSESSIVE-COMPULSIVE DISORDER
Unwanted repetitive thoughts (obsessions) and/or
actions (compulsions)
 Interfere with everyday life and cause distress

Check to see if the door is closed- normal
 Checking the door 10 times everyday- abnormal


Late teens, early twenties
ANXIETY DISORDERS
OBSESSIVE-COMPULSIVE DISORDER:
COMMON OBSESSIONS AND COMPULSIONS
Obsessions
 Dirt, germs, toxins


Fire, death, illness

Symmetry, order, or
exactness
Compulsions
 Excessive handwashing, bathing,
tooth-brushing, or
grooming
 Repeating rituals


Checking doors, locks,
appliances, homework
ANXIETY DISORDERS
POST- TRAUMATIC STRESS DISORDER

Haunting memories, nightmares, social withdrawal,
anxiety, and/or insomnia that lingers for 4 weeks+
after a traumatic experience
Veterans
 Accident and Disaster Survivors
 Sexual Assault Victims

Trauma: direct exposure to serious threats
 Controversial

ANXIETY DISORDERS
EXPLAINING ANXIETY DISORDERS
Anxiety includes feelings and thoughts
 Freud said we repress these feelings from
childhood
 Two contemporary Perspectives

Learning Perspective
 Biological Perspective

ANXIETY DISORDERS
EXPLAINING ANXIETY DISORDERS: LEARNING
PERSPECTIVE
Fear Conditioning
 Classical conditioning—associate anxiety with
certain cues



People, places, environments
Stimulus Generalization

Fear heights—begin to fear flying
Reinforcement maintains
 Observational Learning
 Observing others’ fears


If your mom is afraid of heights, you may also develop
that fear
ANXIETY DISORDERS
EXPLAINING ANXIETY DISORDERS: BIOLOGICAL
PERSPECTIVE

Natural Selection
Fears faced by our ancestors—way to protect ourselves
 What do we learn NOT to fear?


Genes
Temperament: sensitive, high strung
 Family esp. twins


Brain
Over arousal of brain areas for impulse control
 Fear-learning experiences can traumatize the brain

DISSOCIATION AND MULTIPLE PERSONALITIES

Dissociative Disorders: conscious awareness
becomes seperated from previous memories,
thoughts, and feelings


Stressful situations—dissociate self from them
Dissociative Identity Disorder: person exhibits 2 or
more distinct and alternating personalities

A.k.a. multiple personality disorder
Is this a more exaggerated version of our ability to vary
ourselves? Are we playing roles?
 Support: Brain and body states; memories fail to transfer
 Skeptics: only few cases reported before 1960 when it was
first noted in the DSM; less in North America—cultural
phenomenon

Seen as a way to cope w/ anxiety and protect
selves
 WHAT DO YOU THINK?

TREATMENT OPTIONS (ADAA)





Behavior Therapy
The goal of Behavior Therapy is to modify and gain control over unwanted
behavior. The individual learns to cope with difficult situations, often through
controlled exposure to them. This kind of therapy gives the individual a sense of
having control over their life.
Cognitive Therapy
The goal of Cognitive Therapy is to change unproductive or harmful thought
patterns. The individual examines his feelings and learns to separate realistic from
unrealistic thoughts. As with Behavior Therapy, the individual is actively involved in
his own recovery and has a sense of control.
Cognitive-Behavior Therapy (CBT)
Many therapists use a combination of Cognitive and Behavior Therapies, this is
often referred to as CBT. One of the benefits of these types therapies is that the
patient learns recovery skills that are useful for a lifetime.
Relaxation Techniques
Relaxation Techniques help individuals develop the ability to more effectively cope
with the stresses that contribute to anxiety, as well as with some of the physical
symptoms of anxiety. The techniques taught include breathing re-training and
exercise.
Medication
Medication can be very useful in the treatment of anxiety disorders, and it is often
used in conjunction with one or more of the therapies mentioned above.
Sometimes anti-depressants or anxiolytics (anti-anxiety medications) are used to
alleviate severe symptoms so that other forms of therapy can go forward.
Medication is effective for many people and can be either a short-term or long-term
treatment option, depending on the individual.
TAKING SIDES:
ISSUE 11: DOES ADHD EXIST?
What is ADHD? Why is it so controversial?
 Class Survey: Does ADHD Exist?
 Questions

3) Medication v. Other treatments?
 4) Side effects for medications; pros & cons

YES
 Scientists and scholars
agree that it exists
 Neuro-imaging studies
show brain
irregularities
 Meets scientific criteria
for valid psychological
disorder
 Twin studies—heritable

NO
 No stable definition
 Neuro-imaging studies
do not adequately
show that it is a
biochemical disorder
 Prevalence is due to
unrealistic cultural
expectations
 Heritability is debatable

WHAT DO THESE FAMOUS NAMES HAVE IN
COMMON?







Walt Whitman
Ernest Hemingway
Ludwig von Beethoven
Kurt Cobain
Isaac Newton
Edgar Allen Poe
Vincent Van Gough







Kurt Vonnegut
Billy Joel
Brooke Shields
Jim Carrey
Abraham Lincoln
Rodney Dangerfield
Tim Burton
All suffered from Mood Disorders
MOOD DISORDERS

What is mood?

relatively lasting emotional or affective state
What are mood disorders?
 Mood Disorders: psychological disorders
characterized by emotional extremes
 2 Principal forms:

1) Major Depressive Disorder
 2) Bipolar Disorder

MOOD DISORDERS
MAJOR DEPRESSIVE DISORDER

What are some common symptoms of depression?


What are some common causes of depression?


Discouraged, dissatisfied, isolated, lethargic, changes in
sleeping and eating patterns, suicidal thoughts
Academic successes/failures, social stresses,
relationships, family stressors
Depression is the “common cold” of psychological
disorders

#1 reason people seek psychological help
MOOD DISORDERS
MAJOR DEPRESSIVE DISORDER (CONT’D)
Anxiety is a response to the threat of the future
loss; Depression is a response to the past and
current loss.
 Q: When do these responses become
maladaptive?
 Major Depressive Disorder: a mood disorder in
which a person experiences, in the absence of
drugs or a medical condition, two or more weeks of
significantly depressed moods, feelings of
worthlessness, and diminished interest or pleasure
in most activities.


Grasping for breath for a few minutes after a run v.
chronic short breath
MOOD DISORDERS
BIPOLAR DISORDER



Major depression usually ends and people often return
back to previous state…sometimes, they rebound with
the opposite emotional extreme
Mania: mood disorder marked by a hyperactive, wildly
optimistic state
Alternating between mania and depression signals
Bipolar disorder






Formerly known as Manic-Depressive Disorder
Manic Phase: talkative, overactive, elated, little sleep
Maladaptive Symptoms: grandiose optimism and selfesteem
Less common than Major Depression
Affects men and women equally
Mild forms of bipolar may fuel creativity
MOOD DISORDERS
BIPOLAR DISORDER (CONT’D)

Mild forms of bipolar may fuel creativity








Walt Whitman
Ernest Hemingway
Ludwig von Beethoven
Kurt Cobain
Isaac Newton
Edgar Allen Poe
Vincent Van Gough
Kurt Vonnegut
MOOD DISORDERS
EXPLAINING MOOD DISORDERS
Theories of depression must explain:
 Behavioral and cognitive changes accompany
depression
 Depression is widespread
 Women are nearly twice as vulnerable to major
depression
 Most major depressive episodes self-terminate
 Stressful events related to work, marriage, and
close relationships often precede depression
 The rate of depression is increasing and striking
earlier with each generation

GENDER AND DEPRESSION: WORLDWIDE
Why are females consistently more depressed?
MOOD DISORDERS
THE BIOLOGICAL PERSPECTIVE
Genetic predispositions, biochemical imbalances,
negative thoughts, and melancholy mood
 GENETIC INFLUENCES

Increase in vulnerability if parent/sibling is diagnosed
 Adopted children with mood disorders have biological
links

Genes alone have small effects– when they
combine with other genes and nongenetic factors
risk rises
 DEPRESSED BRAIN
 Norepinephrine and Serotonin- scarce in
depression
 Omega-3 fatty acids low- support brain and mental

MOOD DISORDERS
THE SOCIAL-COGNITIVE PERSPECTIVE
Self-defeating beliefs and negative explanatory
style feed cycle of depression
 Negative Thoughts and Negative Moods Interact
 Self-defeating beliefs – learned helplessness



“I’ll never be able to do this”
Who do we blame?
Blame self: depressed
 Blame others: anger

MOOD DISORDERS
THE SOCIAL-COGNITIVE PERSPECTIVE
EXPLANATORY STYLE AND DEPRESSION: ROMANTIC
BREAK-UP




Stable
“I’ll never get over this”
Global
“Without him, I can’t do
anything”






Internal
“It’s all my fault”

RESULT: Depression



Temporary
“This is tough but I’ll get
through this”
Specific
“I miss him but I still have
my friends and family”
External
“Yes I made mistakes,
but so did he and it was
not working”
RESULT: Successful
Coping
MOOD DISORDERS
THE SOCIAL-COGNITIVE PERSPECTIVE
EXPLANATORY STYLE AND DEPRESSION:
_____________

Stable

Temporary

Global

Specific

External

RESULT: Successful
Coping

Internal

RESULT: Depression
Stressful Events
Negative Explanatory Style
Cognitive and Behavioral
Changes
Depressed Mood
SCHIZOPHRENIA
1
in 100 people suffer from Schizophrenia
 Who is likely to develop it?



Adolescents into young adulthood
No cultural influences
Equal for males and females

Men develop earlier, more severely, more often
 Schizophrenia:
group of severe disorders
characterized by disorganized and delusional
thinking, disturbed perceptions, and
inappropriate actions and emotions.

“Split Mind”—Split from reality
SCHIZOPHRENIA
SYMPTOMS OF SCHIZOPHRENIA
Disorganized Thinking

Delusions: false beliefs that may accompany psychotic disorders
 Often of grandeur or persecution *Paranoid tendencies are more
prone

Possibly due to a breakdown in selective attention/sensory processing
Disturbed Perceptions

hallucinations
Inappropriate Emotions and Actions
 Angry for no reason; laughing at sad events
 Flat affect: “zombie”
 Behaviors: senseless and compulsive

Catatonia: motionless for hours
SCHIZOPHRENIA
SUBTYPES OF SCHIZOPHRENIA
Cluster of disorders that share common features but
distinguishing symptoms:
 Positive
Symptoms: hallucinations, talk is
disorganized and deluded, inappropriate laughter,
tears, or rage
 Negative Symptoms: toneless voices,
expressionless faces, mute or rigid bodies
 Positive symptoms = inappropriate behaviors
 Negative Symptoms = absence of behaviors
SCHIZOPHRENIA
TYPES OF SCHIZOPHRENIA
Chronic or Process Schizophrenia

Develops slowly, gradually, from a long history of social
inadequacy

Exhibit negative symptom of withdrawal

Recovery is unlikely
Acute or Reactive Schizophrenia

Develops quickly, as a reaction to stress

Recovery is likely
-Men more often exhibit negative symptoms and chronic
schizophrenia
-Outlook is better for those with positive symptoms—
reactive condition responds to drug therapy
SCHIZOPHRENIA
5 SUBTYPES OF SCHIZOPHRENIA
Paranoid

Preoccupation with delusions or hallucinations, often with
themes of persecution or grandiosity
Disorganized

Disorganized speech or behavior or flat or inappropriate
emotion
Catatonic

Immobility, extreme negativism, and/or parrot-like
repetition of another’s speech or movements
Undifferentiated

many and varied symptoms
Residual

withdrawal, after hallucinations and delusions have
disappeared
SCHIZOPHRENIA
UNDERSTANDING SCHIZOPHRENIA
Brain Abnormalities
 Dopamine overactivity– high levels may increase
positive symptoms

Drugs to decrease dopamine

Little effect on negative symptoms
Abnormal Brain Activity and Anatomy
 Frontal lobes (reasoning and problem solving)
 Decline in brain waves
 Fluid-filled areas and shrinking cerebral tissue
 Possibly due to problems in prenatal development
and/or delivery
SCHIZOPHRENIA
UNDERSTANDING SCHIZOPHRENIA
Psychological Factors
 Environmental causes
 Warning Signs
 Mother with severe and long-lasting schizophrenia
 Birth complications
 Separation from parents
 Short attention span and poor muscle coordination
 Disruptive/withdrawn behavior
 Emotional unpredictability
 Poor peer relations and solo play
 We
have difficulty relating to schizophrenia
PERSONALITY DISORDERS
 Some
maladaptive behavior patterns impair
people’s social functioning without anxiety,
depression, or delusions
REMEMBER…
(Personality: Enduring pattern of thinking, feeling and
acting)
 Personality
Disorders: characterized by inflexible
and enduring behavior patterns that impair social
functioning
 Grouped into 3 Clusters in the DSM-IV
PERSONALITY DISORDERS: CLUSTERS
Cluster A- Odd/Eccentric Cluster
Paranoid
Suspicious of others, secretive, looking for signs
of trickery and abuse
Schizoid
Eccentric behaviors, emotionless
disengagement-no desire for social
relationships
Schizotypal
Interpersonal difficulties of the schizoid and
excessive social anxiety; some symptoms of
residual phase of schizophrenia
PERSONALITY DISORDERS: CLUSTERS
Cluster B- Dramatic/Erratic Cluster
Antisocial
Borderline Personality Disorder
Unstable identity, unstable relationships, unstable
or impulsive emotions; unstable sense of self
Histrionic
Dramatic or impulsive behaviors; use features of
physical appearance to draw attention to selves
(clothes, makeup, hair color)
Narcissistic Personality Disorder
Self-focused, exaggerating own importance and
success; require constant attention and excessive
admiration
PERSONALITY DISORDERS: CLUSTERS
Cluster C- Anxious/Fearful Cluster
Avoidant
Anxiety, fearful sensitivity to rejection and criticism
causing withdrawal
Dependent
Lacking self-confidence and sense of autonomy;
view selves as weak; passive and agreeable
Obsessive-Compulsive
Perfectionist, preoccupied with details, rules, schedules,
etc.; pay attention to details so much that they may never
finish a project
PERSONALITY DISORDERS
ANTISOCIAL PERSONALITY DISORDER
Antisocial Personality Disorder: person exhibits
a lack of conscience for wrong doing, even
toward friends and family. May be aggressive and
ruthless or a clever con artist
 Formerly called sociopath or psychopath
 Usually males
 Often begins before age 15
 Stealing, fighting, displays unrestrained sexual
behaviors
 How

does this affect adult life?
Jobs, relationships (spouse and parent),
assaultive or otherwise criminal
PERSONALITY DISORDERS
ANTISOCIAL PERSONALITY DISORDER
Antisocial Personality Disorder and Criminals
 Most criminals do not fit the description


Many show responsibility and remorse for their actions
(concern for family and friends)
Antisocial Personalities feel and fear little,
express little regret over violating others’ rights
PERSONALITY DISORDERS
UNDERSTANDING ANTISOCIAL PERSONALITY
DISORDER
Biological and psychological
 Relatives of those w/ antisocial tendencies are
at an increased risk for antisocial behavior
 Reduced activity in the Frontal Lobes
 Antisocial behavior has been detected as early as
ages 3-6
 Boys who become aggressive or antisocial
adolescents may have been impulsive,
uninhibited, low in anxiety as young children
 Environment/Society


1960s to 1990s
RATES OF PSYCHOLOGICAL DISORDERS
How prevalent are the various disorders? Who is most vulnerable to them? At
what times of life?
 1 in 7 Americans
 Britain: 1 in 6
 Australia: 1 in 6 to 1 in 7
 World Health Organization study in 2004
Lowest Rate: Shanghai
 Highest Rate: United States


When people immigrate to the US their mental health declines over time
PERCENTAGE
OF
AMERICANS WHO HAVE EXPERIENCED
SELECTED
PSYCHOLOGICAL DISORDERS IN THE PRIOR YEAR
(U.S. NATIONAL INSTITUTE OF MENTAL HEALTH IN 2002)
Disorder
Percentage
Alcohol Abuse
5.2
Generalized Anxiety
4.0
Phobias
7.8
OCD
2.1
Mood Disorder
5.1
Schizophrenia
1.0
Antisocial Personality
1.5
RATES OF PSYCHOLOGICAL DISORDERS
 Predictor:


Poverty
Does poverty cause disorders or do disorders cause
poverty?
Varies with disorder
Schizophrenia leads to poverty
 Stress and demoralization of poverty can cause depression and
substance abuse

 Risk



Factors and Protective Factors
Usually experience by early adulthood (by age 24)
Antisocial personality (age 8) and phobias (age 10) are
among the earliest to appear
Alcohol Abuse, OCD, Bipolar, and Schizophrenia by
age 20
RISK AND PROTECTIVE FACTORS FOR MENTAL DISORDERS
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Academic Failure
Birth Complications
Caring for chronically ill patients
Child abuse/neglect
Chronic insomnia
Chronic pain
Family disorganization/conflict
Low Birth Weight
Low Socioeconomic Status
Medical Illness
Neurochemical Imbalance
Parental Mental Illness
Parental Substance abuse
Personal loss/bereavement
Poor work skills and habits
Reading disabilities
Sensory Disabilities
Social incompetence
Stressful life events
Substance Abuse
Trauma experiences
•
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Aerobic Exercise
Community offering empowerment,
opportunity, and security
Economic independence
Feelings of security
Feelings of master and control
Good parenting
Literacy
Positive attachment and early bonding
Problem-solving skills
Resilient coping with stress and
adversity
Self-esteem
Social and work skills
Social support from family and friends