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Psychological Disorders Book authors: R. H. Ettinger Chapter 15 This multimedia product and its contents are protected under copyright law. The following are prohibited by law: Slide authors: Larry D. Thomas Landon O. Thomas •Any public performance or display, including transmission of any image over a network; •Preparation of any derivative work, including the extraction, in whole or in part, of any images; •Any rental, lease, or lending of the program Copyright 2003 Allyn & Bacon What Is Abnormal? Defining mental disorders – Several questions can help determine what behavior is abnormal: Is the behavior considered strange within the person’s own culture Does the behavior cause personal distress Is the behavior maladaptive Is the person a danger to self of others Is the person legally responsible for his or her acts Copyright © 2007 Horizon Textbook Publishing All rights reserved What Is Abnormal? Prevalence of psychological disorders – Mental disorders have a lifetime prevalence rate of nearly 50% – Mental disorders represent a significant source of personal misery for individuals and lost productivity for society Explaining psychological disorders – Biological perspective Views abnormal behavior as arising from a physical cause, such as genetic inheritance, biochemical abnormalities or imbalances, structural abnormalities within the brain, and/or infections Copyright © 2007 Horizon Textbook Publishing All rights reserved What Is Abnormal? Explaining psychological disorders (continued) – Biopsychosocial perspective Agrees that physical causes are of central importance but also recognizes the influence of biological, psychological, and social factors in the study, identification, and treatment of psychological disorders – Psychodynamic perspective Originally proposed by Feud Maintains that psychological disorders stem from early childhood experiences and unresolved, unconscious conflicts, usually of a sexual or aggressive nature Copyright © 2007 Horizon Textbook Publishing All rights reserved Psychological Disorders Biological (Evolution, individual genes, brain structures and chemistry) Sociocultural (Roles, expectations, definition of normality and disorder) Bio-psycho-social Perspective Psychological (Stress, trauma, learned helplessness, mood-related perceptions and memories) Copyright © 2007 Horizon Textbook Publishing All rights reserved – assumes that biological, sociocultural, and psychological factors combine and interact to produce psychological disorders What Is Abnormal? Explaining psychological disorders (continued) – Learning perspective Psychological disorders are thought to be learned and sustained in the same way as any other behavior – Cognitive perspective suggests that faulty thinking or distorted perceptions can contribute to some types of psychological disorders – Irrespective of theoretical perspective, all clinicians and researchers use the same set of criteria to classify psychological disorders – The American Psychiatric Association publishes a manual (DSM-IV-TR) listing these criteria Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Generalized anxiety disorder – An anxiety disorder in which people experience excessive anxiety or worry that they find difficult to control – These people expect the worst – Their excessive anxiety may cause them to feel tense, tired, and irritable, and to have difficulty concentrating and sleeping – This disorder affects twice as many women as men and leads to considerable distress and impairment Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Panic disorder – An anxiety disorder in which a person experiences recurrent unpredictable attacks of overwhelming anxiety, fear, or terror – Panic attacks An attack of overwhelming anxiety, fear, or terror – Panic-disorder patients tend to overuse the health care system and are at increased risk for abuse of alcohol and other drugs Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Phobias – An intense fear of being in a situation form which immediate escape is not possible or in which help is not immediately available in case of incapacitating anxiety – Agoraphobia A persistent, irrational fear of an object, situation, or activity that the person feels compelled to avoid An agoraphobic often will not leave home unless accompanied by a friend or family member and, in severe cases, not even then Women are four times more likely than men to be diagnosed with agoraphobia Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Phobias (continued) – Social phobia An irrational fear and avoidance of social situations in which one might embarrass or humiliate oneself by appearing clumsy, foolish, or incompetent About one-third of social phobics fear only speaking in public In its extreme form, it can seriously affect people’s performance at work, prevent them from advancing in their careers or pursuing an education, and severely restrict their social lives Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Phobias (continued) – Specific phobia A marked fear of a specific object or situation The categories of specific phobias, in order of frequency of occurrence, are (1) situational phobias (2) fear of the natural environment (3) animal phobias and (4) bloodinjection-injury phobia – A person has three times the risk of developing a phobia if a close relative suffers form one – A therapist my use classical conditioning principles to teach patients to associate pleasant emotions with feared objects or situations Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Common and uncommon fears 100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 Snakes Being Mice Flying Being SpidersThunder Being Dogs Driving Being Cats in high, on an closed in, and and alone a car In a 0 exposed places Afraid of it airplane in a insectslightning In a small house place at night Bothers slightly Copyright © 2007 Horizon Textbook Publishing All rights reserved Not at all afraid of it crowd of people Anxiety Disorders Obsessive compulsive disorder (OCD) – An anxiety disorder in which a person suffers form obsessions and/or compulsions – Obsessions A persistent, recurring, involuntary though, image, or impulse that invades consciousness and causes great distress – People with obsessions might worry about contamination or about whether they performed a a certain act, such as turning off the stove or locking the door Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Obsessive compulsive disorder (continued) – Compulsion A persistent, irresistible, irrational urge to perform an act or ritual repeatedly – The individual knows such acts are irrational and senseless but cannot resist performing them without experiencing an intolerable buildup of anxietyanxiety that can be relieved only by yielding to the compulsion – People with OCD realize their behavior is not normal; but they simply cannot help themselves Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders PET Scan of brain of person with Obsessive/ Compulsive disorder High metabolic activity (red) in frontal lobe areas involved with directing attention Copyright © 2007 Horizon Textbook Publishing All rights reserved Anxiety Disorders Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder Thought or Behavior Obsessions (repetitive thoughts) Percentage* Reporting Symptom 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 Repeating rituals (in/out of a door, up/down from a chair) Checking doors, locks, appliances, car brake, homework Copyright © 2007 Horizon Textbook Publishing All rights reserved 85 51 46 Identifying Anxiety Disorders Read each of the four descriptions below and place a checkmark beside each description that sounds like you or someone you know. 1. You are always worried about things, even when there are Generalized no signs of trouble. You have frequent aches and pains Anxiety that can’t be traced to physical illness or injury. You tire Disorder easily, and yet you have trouble sleeping. Your body is constantly tense. Panic 2. Out of the blue, your heart starts pounding. You feel dizzy. Disorder You can’t breathe. You feel like you are about to die. You’ve had these symptoms over and over again. Agoraphobia 3. Every day you fear you will do something embarrassing. You’ve stopped going to parties because you’re afraid to meet new people. When other people look at you, you break out in a sweat and shake uncontrollably. You stay home from work because you’re terrified of being called on in a staff meeting Obsessive/ 4. You are so afraid of germs that you wash you hands Compulsive repeatedly until they are raw and sore. You can’t leave the Disorder house until you check the locks on every window and door over and over again. You are terrified that you will harm someone you care about. You just can’t get those thoughts (From NIMH, out of your head 1999.) Copyright © 2004 2007 Allyn Horizon & Bacon Textbook All rights Publishing reserved All rights reserved Mood Disorders Disorders characterized by extreme and unwarranted disturbances in feeling or mood Depressive disorders – Major depressive disorder A mood disorder marked by feelings of great sadness, despair, guilt, worthlessness, and hopelessness Key symptoms of major depressive disorder are psychomotor disturbances – Depression can be so severe tat its victims suffer form delusions or hallucinations, which are symptoms of psychotic depression Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Culture, gender, and depression – One large study involving participants form ten countries revealed that the lifetime risk for developing depression varied greatly around the world – Before boys reach puberty, they are more likely than girls to be depressed, but at adolescence a dramatic reversal in the gender-related depression rates takes place – Not only are women more likely to suffer form depression, they are also more likely to be affected by negative consequences as a result Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders-Depression 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 USA Edmonton Puerto Rico 0 Males Paris West Florence Beirut Germany Females Copyright © 2007 Horizon Textbook Publishing All rights reserved Taiwan Korea New Zealand Mood Disorders-Depression 10% Percentage depressed 8 Females 6 4 Males 2 0 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+ Age in Years Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Bipolar disorder – A mood disorder in which manic episodes alternate with periods of depression, usually with relatively normal periods in between – Manic episode A period of extreme elation, euphoria, and hyperactivity, often accompanied by delusions of grandeur and by hostility if activity is blocked Such episodes are marked by excessive euphoria, inflated self-esteem, wild optimism, and hyperactivity People in a manic state have temporarily lost touch with reality and frequently have delusions of grandeur along with their euphoric highs Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Bipolar disorder (continued) – Bipolar disorder is much less common than major depressive disorder – Bipolar disorder tends to appear in late adolescence or early childhood, and, unfortunately, about 90% of those with the disorder have recurrences, and half experiences another episode within a year of recovering form a previous one Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders-Bipolar PET scans show that brain energy consumption rises and falls with emotional swings Depressed state Manic state Copyright © 2007 Horizon Textbook Publishing All rights reserved Depressed state Mood Disorders Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders-Depression Brain chemistry Cognition Mood Copyright © 2007 Horizon Textbook Publishing All rights reserved Altering any one component of the chemistrycognitionmood circuit can alter the others Mood Disorders-Depression 1 Stressful experiences 4 Cognitive and behavioral changes The vicious cycle of depression can be broken at any point 2 Negative explanatory style 3 Depressed mood Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders-Depression Percentage 35% of observations 30 25 20 15 Negative behaviors A happy or depressed mood strongly influences people’s ratings of their own Positive behavior behaviors Self-ratings Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Causes of mood disorders – Biological factors such as genetic inheritance and abnormal brain chemistry play a major role in bipolar disorder and major depressive disorder – Drevets and others Located a brain area that may trigger both the sadness of major depression and the mania of bipolar disorder A small, thimble-size patch of brain tissue in the lower prefrontal cortex hereditary depression – Researchers have found that patterns of dopamine, GABA, and norepinephrine production, transport, and reuptake in people suffering from mood disorders differ from those of normal individuals Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Causes of mood disorders (continued) – In one twin study, researchers found that 50% of the identical twins of bipolar sufferers had also been diagnosed with a mood disorder, compared to only 7% of fraternal twins – Depressed individuals view themselves, their world, and their future all in negative ways – Depressed persons believe they are deficient, unworthy, and inadequate, and they attribute their perceived failures to their own physical, mental, or moral inadequancies Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Causes of mood disorders (continued) – The vast majority of first episodes of depression strike after major life stress – Cui and Vaillant Found that negative life events as well as family history played significant roles in the development of mood disorders Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Suicide and race, gender, and age – Whites are more likely to commit suicide than African Americans – Native American suicide rates are similar to those of whites; rates for Hispanic Americans are similar to those of African Americans – Suicide rates are far lower for both White and African American women than for men – Older Americans are at far greater risk for suicide than younger people Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders Suicide and race, gender, and age (continued) – Poor general health, serious illness, loneliness, and decline in social and economic status are conditions that may push many older Americans, especially those aged 75 and over, to commit suicide Copyright © 2007 Horizon Textbook Publishing All rights reserved Mood Disorders- Suicide 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 Copyright © 2007 Horizon Textbook Publishing All rights reserved Females Mood Disorders-Suicide Increasing rates of teen suicide 12% Suicide rate, ages 15 to 19 (per 100,000) 10 8 6 4 2 0 1960 1970 Copyright © 2007 Horizon Textbook Publishing All rights reserved 1980 Year 1990 2000 Schizophrenia A severe psychological disorder characterized by loss of contact with reality, hallucinations, delusions, inappropriate or flat affect, some disturbance in thinking, social withdrawal, and/or other bizarre behavior Positive symptoms of schizophrenia – Positive symptoms are the abnormal behaviors that are present in people with schizophrenia – Hallucinations A sensory perception in the absence of any external sensory stimulus; an imaginary sensation Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Positive symptoms of schizophrenia (continued) – Schizophrenic patients may see, hear, feel, taste, or smell strange things in the absence of any stimulus in the environment, but hearing voices is the most common type of hallucinations – Delusions A false believe, not generally shared by other in the culture, that cannot be changed despite strong evidence to the contrary – Delusions of grandeur A false belief that one is a famous person or a person who has some great knowledge, ability, or authority Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Positive symptoms of schizophrenia (continued) – Delusions of persecutions A false belief that a person or group is trying in some way to harm one – Another positive symptom is the loosening of associations, or derailment, when a schizophrenic does not follow one line of though to completion, but on the basis of vague connections shifts from one subject to another in conversation or writing – Schizophrenics may also display inappropriate affect; that is, their facial expressions, tone of voice, and gestures ma not reflect the emotion that would be expected under the circumstances Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Negative symptoms of schizophrenia – A negative symptom of schizophrenia is a loss of or deficiency in thoughts and behaviors that are characteristic of normal functioning – Negative symptoms include social withdrawal, apathy, loss of motivation, lack of goal-directed activity, very limited speech, slowed movements, poor hygiene and grooming, poor problem-solving abilities, and a distorted sense of time – Flat affect Showing practically no emotional response at all, even though they often report feeling the emotion Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Brain abnormalities in schizophrenics – Many schizophrenics have defects in the neural circuitry of the cerebral cortex and limbic system – There is also evidence of reduced volume in the hippocampus, amygdala, thalamus, frontal lobe gray matter – Abnormal activity in the brain’s dopamine system is found in many schizophrenics Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Types of schizophrenia – Paranoid schizophrenia A type of schizophrenia characterized by delusions of grandeur or persecution Paranoid schizophrenics often show exaggerated anger and suspiciousness – Disorganized schizophrenia The most serious type of schizophrenia, marked by inappropriate affect, silliness, laughter, grotesque mannerisms, and bizarre behavior Tends to occur at an earlier age than the others types Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Types of schizophrenia (continued) – Catatonic schizophrenia A type of schizophrenia characterized by complete stillness or stupor and/or periods of great agitation and excitement; patients may assume an unusual posture and remain in it for long periods – Undifferentiated schizophrenia A catchall term for people who display symptoms of schizophrenia but who do not fit into other categories Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Subtypes of Schizophrenia Paranoid: Preoccupation with delusions or hallucinations Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion Catatonic: Undifferentiated or residual: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements Schizophrenia symptoms without fitting one of the above types Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia Risk factors in schizophrenia – Schizophrenia develops when there is both a genetic predisposition toward the disorder and more stress than a person can handle – Schizophrenia is more likely to strike men than women – The earlier age of onset of the disorder among males appears to be independent of culture and socioeconomic variables Copyright © 2007 Horizon Textbook Publishing All rights reserved Schizophrenia 40 Lifetime risk of developing schizophrenia for relatives of a schizophrenic 30 20 10 0 General Siblings population Children Copyright © 2007 Horizon Textbook Publishing All rights reserved Fraternal Children Identical twin of two twin schizophrenia victims Somatoform and Dissociative Disorders Somatoform disorders – Disorders in which physical symptoms are present that are due to psychological rather than physical causes – People with somatoform disorders are not consciously faking illness to avoid work or other activities – Hypochondriasis A somatoform disorder in which persons are preoccupied with their health and convinced they have some serious disorder despite reassurance from doctors to the contrary Copyright © 2007 Horizon Textbook Publishing All rights reserved Somatoform and Dissociative Disorders Somatoform disorders (continued) – Conversion disorder A somatoform disorder in which a person suffers a lost of motor or sensory functioning in some part of the body; the loss has no physical cause but solves some psychological problem – A person may become blind, deaf, or unable to speak or may develop a paralysis in some part of the body Copyright © 2007 Horizon Textbook Publishing All rights reserved Somatoform and Dissociative Disorders Dissociative disorders – Dissociation The loss of one’s ability to integrate all the components of self into a coherent representation of one’s identity – Dissociative disorder Disorders in which, under stress, one loses the integration of consciousness, identity, and memories of important personal events – Dissociative amnesia A dissociative disorder in which there is a lost of memory of limited periods in one’s life or of one’s entire identity Copyright © 2007 Horizon Textbook Publishing All rights reserved Somatoform and Dissociative Disorders Dissociative disorders (continued) – Dissociative fugue A dissociative disorder in which one has a complete loss of memory of one’s entire identity, travels away from home,and may assume a new identity When people recover from the fugue, they often have no memory of events that occurred during the episode – Dissociative identity disorder (DID) A dissociative disorder in which tow or more distinct personalities occur in the same person, each taking over a t different times; also called multiple personality Copyright © 2007 Horizon Textbook Publishing All rights reserved Somatoform and Dissociative Disorders Dissociative disorders (continued) – Dissociative identity disorder (continued) The alternate personalities, or alter personalities, may differ radically in intelligence, speech, accent, vocabulary, posture, body language, hairstyle, taste in clothes, manners, and even handwriting and sexual orientation There is the common complaint of “lot time”-periods for which a given personality has no memory because he or she was not in control of the body Copyright © 2007 Horizon Textbook Publishing All rights reserved Sexual Disorders Sexual disorders – Disorders that are destructive, guilt- or anxietyproducing, compulsive, or cause of discomfort or harm to one or both parties involved – Perhaps the most common of all of the sexual disorders are the sexual dysfunctions – Drug treatment for sexual dysfunctions in both men and women have proved successful – Depression is both a cause and an effect of sexual dysfunctions Copyright © 2007 Horizon Textbook Publishing All rights reserved Sexual Disorders Sexual disorders (continued) – Paraphilias Disorders in which recurrent sexual urges, fantasies, and behaviors involve nonhuman objects, children, other nonconsenting persons, or the suffering or humiliation of the individual or his/her partner – Gender identity disorders Disorders characterized by a problem accepting one’s identity as male or female An individual may feel so strongly that she or he is psychologically of the other gender that sex-reassignment surgery is sought Copyright © 2007 Horizon Textbook Publishing All rights reserved Sexual Motivation Sex is a physiologically based motive, like hunger, but it is more affected by learning and values Copyright © 2007 Horizon Textbook Publishing All rights reserved Sexual Motivation Androgens – A sex hormone, secreted in greater amounts by males than by females Estrogen – a sex hormone, secreted in greater amounts by females than by males Copyright © 2007 Horizon Textbook Publishing All rights reserved Sexual Motivation Sexual Response Cycle – the four stages of sexual responding described by Masters and Johnson Excitement Plateau Orgasm Resolution Refractory Period – resting period after orgasm, during which a man cannot achieve another orgasm Copyright © 2007 Horizon Textbook Publishing All rights reserved The Sexual Response Cycle Orgasm Plateau Resolution Excitement Resolution with orgasm Males Copyright © 2007 Horizon Textbook Publishing All rights reserved Females Sexual Motivation Same drives, different attitudes “Do you think it is, or is not, wrong for a couple to have a baby if they are not married?” 100% Percent 90 answering 80 wrong 70 60 50 40 30 20 10 0 Iceland Germany Great Canada Mexico United India Britan States Copyright © 2007 Horizon Textbook Publishing All rights reserved Country Taiwan Singapore Sexual Motivation Changing attitudes 100% Extramarital sex is “always wrong” 80 60 Homosexual sex is “always wrong” 40 20 1987 1998 Year 0 Copyright © 2007 Horizon Textbook Publishing All rights reserved Source: National Opinion Research Center (University of Chicago) General Social Survey Forces Affecting Sexual Motivation Physiological readiness Imaginative stimuli Sexual motivation Copyright © 2007 Horizon Textbook Publishing All rights reserved External stimuli Sexual Motivation Births to unwed parents 40% Percentage of births to unwed mothers 35 30 United States 25 20 Canada 15 10 Britain 5 Japan 0 1960 1970 Copyright © 2007 Horizon Textbook Publishing All rights reserved 1980 Year 1990 2000 Sexual Motivation Sexual Orientation – an enduring sexual attraction toward members of either one’s own gender (homosexual orientation) or the other gender (heterosexual orientation) Copyright © 2007 Horizon Textbook Publishing All rights reserved Personality Disorders Personality disorders – A continuing, inflexible, maladaptive pattern of inner experience and behavior that causes great distress or impaired functioning and differs significantly form the patterns expected in the person’s culture – Characteristics of personality disorders People who suffer form other disorders, especially the mood disorders, are often diagnosed with personality disorders as well People with personality disorders are extremely difficult to get along with Copyright © 2007 Horizon Textbook Publishing All rights reserved Personality Disorders Personality disorders (continued) – Types of personality disorders Those who suffer from paranoid personality disorder display extreme suspiciousness, while those with schizoid personality disorder isolate themselves from others and appear to be unable to form emotional bonds Individuals diagnosed with schizotypal personality disorder are often mistakenly classified as schizophrenic because their odd appearances, magical thinking, and lack of social skills are also often seen in schizophrenics A pervasive desire to be the center of others’ attention is characteristic of both narcissistic personality disorder and histrionic personality disorder, as is a lack of concern for others Copyright © 2007 Horizon Textbook Publishing All rights reserved Personality Disorders Personality disorders (continued) – Types of personality disorders (continued) People with borderline personality disorder are highly unstable and fear of abandonment is the primary theme of their social relationships A significant proportion of borderline personality disorder patients have histories of abuse or other disturbances in childhood attachment relationships People who suffer from antisocial personality disorder have a “pervasive pattern of disregard for, and violation of, the rights of other that begins in childhood or early adolescence and continues into adulthood” Copyright © 2007 Horizon Textbook Publishing All rights reserved Personality Disorders Personality disorders (continued) – Types of personality disorders (continued) Individuals diagnosed with obsessive-compulsive personality fear falling short of perfectionistic standards Avoidant personality disorder and dependent personality disorder, represent opposite approaches to social relationships The avoidant personality shuns relationships because of excessive sensitivity to criticism and rejection The dependent personality relies on others to an inappropriate degree Copyright © 2007 Horizon Textbook Publishing All rights reserved Personality Disorders PET scans illustrate reduced activation in a murderer’s frontal cortex Normal Copyright © 2007 Horizon Textbook Publishing All rights reserved Murderer Personality Disorders 35 30 Percentage 25 of criminal offenders 20 15 10 5 0 Total crime Childhood poverty Thievery Obstetrical complications Copyright © 2007 Horizon Textbook Publishing All rights reserved 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 Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 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 Copyright © 2007 Horizon Textbook Publishing All rights reserved Totals 13.8%