Download Abnormal Behavior: Myths and Realities Anxiety Disorders

Abnormal Behavior: Myths and Realities
Anxiety Disorders
Somatoform Disorders
Dissociative Disorders
Mood Disorders
Schizophrenic Disorders
Eating Disorders
Chapter 13: Psychological
Disorders
―No Great Genius has ever
existed without some touch of
madness‖ (Aristotle)
Psychological Disorders
• Psychopathology—scientific study of
the origins, symptoms, and development
of psychological disorders
• Psychological disorder or mental
disorder--A pattern of behavioral and
psychological symptoms that causes
significant personal distress, impairs the
ability to function in one or more
important areas of daily life, or both
Abnormal Behavior
• The medical model
• What is abnormal behavior?
– Deviant
– Maladaptive
– Causing personal distress
Normal
Personal Distress
Abnormal
Deviance
Maladaptive Behavior
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Hollywood Versus Reality In The Dark Knight, the Joker takes the image of the insane killer to
new heights. As a plot device, the deranged, evil killer on the loose is standard fare in television
dramas like CSI and film thrillers like the Halloween and the Friday the 13th movies. Such media
depictions foster the stereotype that people with a mental illness are evil, threatening, and prone
to violence—an image that is not supported by psychological research.
Diagnosis
Diagnostic and Statistical Manual of Mental
Disorders 4th ed., Text Revision (DSM-IV-TR,
2000)—describes specific symptoms and
diagnostic guidelines for psychological
disorders
– Provides a common language to label
mental disorders
– Comprehensive guidelines to help
diagnose mental disorders
Axis I
Axis II
Clinical Syndromes
Personality Disorders or Mental Retardation
Axis III
Axis IV
General Medical Conditions
Psychosocial and Environmental Problems
Axis V
Global Assessment of Functioning (GAF) Scale
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Axis I
Axis II
Clinical Syndromes
Personality Disorders or Mental Retardation
1. Anxiety
6.
Disorders
disorders
usually first diagnosed in infancy, childhood, or adolescence
This category
includes
disorders that
before adolescence,
such(for
asexample,
attention palpitations)
deficit disorders,
These
disorders
are characterized
by arise
physiological
signs of anxiety
and autism,
enuresis, and
stuttering.
subjective
feelings
of tension, apprehension, or fear. Anxiety may be acute and focused (panic disorder)
or continual
and diffuse
(generalized anxiety disorder).
2. Organic
mental
disorders
7. Somatoform
disorders
These disorders
are temporary or permanent dysfunctions of brain tissue caused by diseases or chemicals.
Examples
are
delirium,
dementia,
amnesia.
These disorders are dominated
byand
somatic
symptoms that resemble physical illnesses. These symptoms
cannot
be
fully
accounted
for
by
organic
damage.
This category includes somatization and conversion
3. Substance-related disorders
disorders
and
bypochondriasis.
This category refers to the maladaptive use of drugs and alcohol. This category requires an abnormal
8. Dissociative
pattern of use,disorders
as with alcohol abuse and cocaine dependence.
These
disorders
all feature
a sudden, temporary
4. Schizophrenia and
other psychotic
disorders alteration or dysfunction of memory, consciousness, and
identity,
as
in
dissociative
amnesia
and
identity disorder.
The schizophrenias are characterized bydissociative
psychotic symptoms
(for example, grossly disorganized behavior,
9. Sexual
andand
gender
identity disorders
delusions,
hallucinations)
and by over six months of behavioral deterioration. This category also
includes
disorder
and
schizoaffective
disorder.gender identity disorders (discomfort with identity
There
aredelusional
three basic
types of
disorders
in this category:
as male
or female), paraphilias (preference for unusual acts to achieve sexual arousal), and sexual
5. Mood
disorders
dysfunctions
(impairments
in sexual
functioning).
The cardinal feature
is emotional
disturbance.
These disorders include major depression, bipolar disorder,
10. Eating
Disorders
dysthymic
disorder, and cyclothymic disorder.
Eating disorders are severe disturbances in eating behavior characterized by preoccupation with weight
concerns and unhealthy efforts to control weight. Examples include anorexia nervosa and bulimia nervosa.
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Some DSM-IV-TR (2000) Axis I Categories
Category
Features
Examples
Infancy,Childhood, or
adolescent
Symptoms usually
diagnosed in
childhood
Autistic Disorder
Tourette’s Disorder
ADHD
Substance-related
Effects of seeking
or using drugs
Substance abuse
Substance Dep.
Eating disorders
Disturbances in
body image,
eating
Anorexia nervosa
Bulimia nervosa
Impulse-control
disorders
Inability to resist
actions that may
be harmful
Kleptomania,
pyromania
Prevalence of Psychological
Disorders
• Approximately 50% of adults experienced symptoms
at least once in their lives (Kessler research)
• Approximately 80% who experienced symptoms in
the last year did NOT seek treatment
• Most people seem to deal with symptoms without
complete debilitation
• Women have a higher prevalence of depression and
anxiety disorders
• Men have a higher prevalence of substance abuse
disorders and antisocial personality disorder
Anxiety Disorders
• Primary disturbance is
distressing, persistent anxiety or
maladaptive behaviors that reduce
anxiety
• Anxiety—diffuse, vague feelings
of fear and apprehension
Portion of population meeting criteria for disorder (%)
0
5
10
15
20
25
30
35
40
45
50
Category
Any Disorder
Substance Use
Disorders (Including
Alcoholism)
Anxiety Disorders
Mood Disorders
Schizophrenic
Disorders
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Anxiety Disorders
• Generalized anxiety disorder
– ―free-floating anxiety‖
• Phobic disorder
– Specific focus of fear
• Panic disorder and agoraphobia
• Obsessive compulsive disorder (OCD)
– Obsessions
– Compulsions
• Posttraumatic Stress Disorder (PTSD)
Generalized Anxiety Disorder (GAD)
• More or less constant worry about
many issues
• The worry seriously interferes with
functioning
• Physical symptoms
–
–
–
–
headaches
stomach aches
muscle tension
irritability
Generalized Anxiety Disorder
Chronic, High Level of Anxiety
Dizziness
Sweating
Heart palpitations
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Model of Development
of GAD
• GAD has some genetic component
• Related genetically to major depression
• Childhood trauma also related to GAD
Genetic predisposition
or childhood trauma
Hypervigilance
GAD following life
change or major event
Panic Disorder
• Panic attacks—sudden episode of helpless
terror with high physiological arousal (the
fight or flight syndrome kicks in)
• Very frightening—sufferers live in fear
of having more attacks
• Agoraphobia often develops as a result
Cognitive-behavioral Theory of Panic
Disorder
• Sufferers tend to misinterpret the physical
signs of arousal as catastrophic and
dangerous
• This interpretation leads to further physical
arousal, tending toward a vicious cycle
• After the attack the person is very
apprehensive of another attack
ABC Video: Panic Disorder
http://abcnews.go.com/Health/video?id=44
31806/
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Phobias
Intense, irrational fears that may focus on:
• Natural environment—heights, water, lightening
• Situation—flying, tunnels, crowds, social
gathering
• Injury—needles, blood, dentist, doctor
• Animals or insects—insects, snakes, bats, dogs
Agoraphobia
• Fear of panic attacks in public places
• Avoid situations that might provoke a panic
attack or where there may be no escape or
help if a panic attack were to come
• Not everyone with panic disorder develops
agoraphobia
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Going out by
oneself
Being alone
Crowds
Social Phobias
Tunnels or bridges
Public transport
Eating in public
Speaking to new
acquaintances
Simple Phobias
Speaking in public
Animals
Closed places
Storms
Water
Heights
Bugs, mice,
snakes, bats
Portion of population
reporting each phobia (%)
Type of Phobias
Agoraphobias
25
20
15
10
5
0
Eating
Disorders
Some Unusual Phobias
• Anemophobia: fear of wind
• Aphephobia: fear of being touched by
another person
• Catotrophobia: fear of breaking a
mirror
• Gamophobia: fear of marriage
• Phonophobia: fear of the sound of
your own voice
Social Phobias
• Social phobias—fear of social situations. Also called
social anxiety disorder. Stems from irrational fear of
being embarrassed or judged by others in public
– public speaking (stage fright)
– fear of crowds, strangers
– meeting new people
– eating in public
• Considered phobic if these fears interfere with
normal behavior
• More prevalent among women than men
Development of Phobias
• Classical conditioning model
– problems:
• often no memory of a traumatic experience
• traumatic experience may not produce phobia
• Preparedness theory—phobia serves to
enhance survival
Obsessive-Compulsive
Disorder (OCD)
• Obsessions—irrational, disturbing thoughts that
intrude into consciousness
• Compulsions—repetitive actions performed to
alleviate obsessions
• Often accompanied by an irrational belief that
failure to perform ritual action will lead to
catastrophe
• Checking and washing most common compulsions
• Deficiency in serotonin implicated and heightened
neural activity in caudate nucleus
Obsessive-compulsive
Disorder (OCD)
Example of OCD – the beginning of the
movie ―As Good as it Gets‖
http://www.youtube.com/watch?v=44DC
WslbsNM/
Posttraumatic Stress Disorder
(PTSD)
• Follows events that produce intense horror or
helplessness (traumatic episodes)
• Core symptoms include:
– Frequent recollection of traumatic event, often
intrusive and interfering with normal thoughts
– Avoidance of situations that trigger recall of the
event
– Increased physical arousal associated with stress
ABC Video: Post-traumatic Stress Disorder: A Rape Victim (14:01)
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Etiology of Anxiety Disorders
• Biological factors
– Genetic predisposition
– GABA circuits in the brain
• Conditioning and learning
– Acquired through classical conditioning
– Maintained through operant conditioning
• Cognitive factors
– Judgments of perceived threat
• Stress—a precipitator
Genetic
Relatedness
Relationship
Identical
Twins
100%
Fraternal
Twins
50%
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Concordance Rate (%)
(Lifetime Risk)
0
10
Dissociative
Disorders
20
Mood
Disorders
30
40
Schizophrenic
Disorders
Eating
Disorders
CS
Elevator
CR
Fear
UCR
UCS
Elevator Fall
2 Feet
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
GABA Synapse
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Conditioned
Fear
Response
Take stairs to avoid elevator
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Aversive Stimulus Removed
Conditioned fear brought to end
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
0
10
20
30
40
50
60
Anxious
Subjects
Non-anxious
Subjects
Threatening Interpretations Endorsed (%)
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Somatoform Disorders
Somatoform disorders are physical ailments
that can‘t be explained by organic diseases
•
•
•
•
Somatization Disorder
Conversion Disorder
Hypochondriasis
Etiology of somatoform disorders
– Cognitive factors
– Personality factors
– The sick role
Somatoform Disorders
Physical ailments that cannot be explained
by organic conditions
Psychosomatic Diseases
Real physical ailments caused in part by
psychological factors
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Somatization Disorder
History of Diverse Physical Complaints
Occur Mostly in Women
Often Co-exists with Depression/Anxiety
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Nerve
Loss of Feeling
Distribution
Complaint
of Arm
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Am I having
a stroke?
Do I have
a brain tumor?
I think I have
heart disease
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Dissociative Disorders
• What is dissociation?
– literally a dis-association of memory
– person suddenly becomes unaware of some
aspect of their identity or history
– unable to recall except under special
circumstances (e.g., hypnosis)
• Three types are recognized
– dissociative amnesia
– dissociative fugue
– dissociative identity disorder (DID)
Dissociative Amnesia
Dissociative Fugue
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Dissociative Amnesia
• Also known as psychogenic amnesia
• Memory loss the only symptom
• Often selective loss surrounding traumatic
events
– person still knows identity and most of their past
• Can also be global
– loss of identity without replacement with a new
one
Dissociative Amnesia
• Margie and her brother were
recently victims of a robbery.
Margie was not injured, but her
brother was killed when he resisted
the robbers. Margie was unable to
recall any details from the time of
the incident until four days later.
Dissociative Fugue
• Also known as psychogenic fugue
• Global amnesia with identity replacement
– leaves home
– develops a new identity
– apparently no recollection of former life
– called a ‗fugue state‘
• If fugue wears off
– old identity recovers
– new identity is totally forgotten
Dissociative Fugue
Jay, a high school physics teacher in New
York City, disappeared three days after his
wife unexpectedly left him for another man.
Six months later, he was discovered tending
bar in Miami Beach. Calling himself Martin,
he claimed to have no recollection of his past
life and insisted that he had never been
married.
Dissociative Identity Disorder
(DID)
• Originally known as “multiple personality
disorder”
• 2 or more distinct personalities manifested by
the same person at different times
• VERY rare and controversial disorder
• Examples include Sybil, Trudy Chase, Chris
Sizemore (―Eve‖)
• Has been tried as a criminal defense
*Dissociative Identity
Disorder* (DID)
Norma has frequent memory gaps and cannot
account for her whereabouts during certain
periods of time. While being interviewed by a
clinical psychologist, she began speaking in a
childlike voice. She claimed that her name was
Donna and that she was only six years old.
Moments later, she seemed to revert to her adult
voice and had no recollection of speaking in a
childlike voice or claiming that her name was
Donna.
Dissociative Identity Disorder
(DID)
• Pattern typically starts prior to age 10
(childhood)
• Most people with disorder are women
• Most report recall of torture or sexual abuse
as children and show symptoms of PTSD
• Becomes a pathological defense
mechanism to cope with intense feelings of
rage and anger
The DID Controversy
• Some curious statistics
– 1930–60: 2 cases per decade in USA
– 1980s: 20,000 cases reported
– many more cases in US than elsewhere
– varies by therapist—some see none, others
see a lot
• Is DID the result of suggestion by therapist
and acting by patient?
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Mood Disorders
• ―Men have called me mad! But the
question is not yet settled, whether
madness is or is not the loftiest
intelligence – whether much that is
glorious – whether all that is profound –
does not spring from disease of thought- .‖
. . (Edgar Allen Poe)
Mood Disorders
A category of mental disorders in which
significant and chronic disruption in
mood is the predominant symptom,
causing impaired cognitive, behavioral,
and physical functioning
– Major depression
– Dysthymic disorder
– Bipolar I and II disorders
– Cyclothymic disorder
Major Depression
A mood disorder characterized by extreme
and persistent feelings of despondency,
worthlessness, and hopelessness
– Prolonged, very severe symptoms
– Passes without remission for at least 2
weeks
– Global negativity and pessimism
– Very low self-esteem
Symptoms of Major Depression
• Emotional—sadness, hopelessness, guilt, turning away
from others
• Behavioral—tearfulness, dejected facial expression,
loss of interest in normal activities, slowed movements
and gestures, withdrawal from social activities
• Cognitive—difficulty thinking and concentrating, global
negativity, preoccupation with death/suicide
• Physical—appetite and weight changes, excess or
diminished sleep, loss of energy, global anxiety,
restlessness
Major depressive episode
Youtube link for major depression
http://www.youtube.com/watch?v=spE2BvE
FOyk/
Major Depression
Prevalence and Course of Major
Depression
• Most common of psychological disorders
• Women are twice as likely as men to be
diagnosed with major depression
• Untreated episodes can become recurring
and more serious
• Seasonal affective disorder (SAD)—onset
with changing seasons – not common here
Dysthymic Disorder
• Chronic, low-grade depressed feelings
that are not severe enough to be major
depression
• Depressed mood that occurs on most days
for at least 2 years (1 year in children)
• May develop in response to trauma, but
does not decrease with time
• Can have co-existing major depression
Bipolar Disorders
• Cyclic disorder (manic-depressive disorder)
• Mood levels swing from severe depression to
extreme euphoria (mania)
• No regular relationship to time of year (SAD)
• Must have at least one manic or hypomanic
(type II) episode
– Supreme self-confidence
– Grandiose ideas and movements
– Flight of ideas
(Examples- van Gogh, Edgar Allen Poe,
Hendrix, Kurt Cobain)
Manic
Normal
Depressed
Time (years)
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Portion of population meeting criteria for disorder (%)
0
5
10
15
20
25
30
35
40
45
50
Category
Any Disorder
Substance Use
Disorders (Including
Alcoholism)
Anxiety Disorders
Mood Disorders
Schizophrenic
Disorders
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Serotonin
Norepinephrine
Synapse
Reuptake
Inactive
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Learned Helplessness
Negative Events
Attribution to Personal Flaws
Sense of Hopelessness
Depression
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Acquire Fewer
Reinforcers
Such as Good
Friends, Top Jobs
Court Rejection
Because of
Irritability, Pessimism
Poor Social Skills
Increased Vulnerability
to Depression
Gravitate to People
Who Confirm
Negative Self-views
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
What is Schizophrenia?
• Comes from Greek meaning ―split‖ and ―mind‖
– ‗split‘ refers to loss of touch with reality
– not dissociative state
– not ‗split personality‘
• Trailer from the movie ―A Beautiful Mind‖
http://www.youtube.com/watch?v=aS_d0Ayjw4
o/
Subtyping of Schizophrenia
• Four subtypes
– Paranoid type
– Catatonic type
– Disorganized type
– Undifferentiated type
• New model for classification
– Positive vs. negative symptoms
Subtypes of Schizophrenia
• Paranoid type
– delusions of persecution
• believes others are spying and plotting
– delusions of grandeur
• believes others are jealous, inferior,
subservient
• Catatonic type—unresponsive to surroundings,
purposeless movement, parrot-like speech
• Disorganized type
– delusions and hallucinations with little meaning
– disorganized speech, behavior, and flat affect
Symptoms of Schizophrenia
• Positive symptoms
– hallucinations
– delusions
• Negative symptoms
– absence of normal cognition or affect (e.g., flat
affect, poverty of speech)
• Disorganized symptoms
– disorganized speech (e.g., word salad)
– disorganized behaviors
Symptoms of Schizophrenia
• Delusions of persecution
– ‗they‘re out to get me‘
– paranoia
• Delusions of grandeur
– ―God‖ complex
– megalomania
• Delusions of being controlled
– the CIA ( or ET) is controlling my brain with a
radio signal
Symptoms of Schizophrenia
• Hallucinations
– hearing or seeing things that aren‘t there
– contributes to delusions
– command hallucinations: voices giving orders
• Disorganized speech
– Over-inclusion—jumping from idea to idea without
the benefit of logical association
– Paralogic—on the surface, seems logical, but
seriously flawed
• e.g., Jesus was a man with a beard; I am a man
with a beard, therefore I am Jesus.
Symptoms of Schizophrenia
• Disorganized behavior and affect
– behavior is inappropriate for the situation
• e.g., wearing sweaters and overcoats on hot days
– affect is inappropriately expressed
• flat affect—no emotion at all in face or speech
• inappropriate affect—laughing at very serious things,
crying at funny things
– catatonic behavior
• unresponsiveness to environment, usually marked by
immobility for extended periods
Portion of Population Meeting Criteria for Disorder (%)
0
5
10
15
20
25
30
35
40
45
50
Category
Any Disorder
Substance Use
Disorders (Including
Alcoholism)
Anxiety Disorders
Mood Disorders
Schizophrenic
Disorders
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Etiology of Schizophrenia
•
•
•
•
•
•
Genetic vulnerability
Neurochemical factors
Structural abnormalities of the brain
The neurodevelopmental hypothesis
Expressed emotion
Precipitating stress
Norepinephrine
Synapse
Neurotransmitter Activity
at the Dopamine Synapse
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
The Dopamine Theory
• Drugs that reduce dopamine reduce
symptoms
• Drugs that increase dopamine produce
symptoms even in people without the
disorder (Amphetamine/Cocaine psychosis)
• Theory: Schizophrenia is caused by excess
dopamine
• Dopamine theory not enough; other
neurotransmitters involved as well
Figure 13.13 The dopamine hypothesis as an explanation for schizophrenia
Right Ventricle
Left Ventricle
Third Ventricle
Fourth Ventricle
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Biological Factors
• Brain structure and function
– enlarged cerebral ventricles and reduced neural
tissue around the ventricles
– PET scans show reduced frontal lobe activity
• Early warning signs
– nothing very reliable has been found yet
– certain attention deficits can be found in children
who are at risk for the disorder
• Father‘s age—older men are at higher risk for
fathering a child with schizophrenia
Prenatal Viral Infection
Prenatal Malnutrition
Obstetrical Complications
Other Brain Insults
Disruption
of Normal
Maturational
Process
Before or
at Birth
Subtle
Neurological
Damage
Increased
Vulnerability
Schizophrenia
Minor Physical Anomalies
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Figure 13.15 The neurodevelopmental hypothesis of schizophrenia
Parental Communication Deviance
Poor Sense of Reality
Withdrawal
Sense ofInto
Hopelessness
Personal World
Schizophrenic Thinking
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Expressed Emotion in Patient’s Family
0
20
40
60
80
High
Low
Two-year Relapse Rate (%)
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Environmental
Factors
in Present
Stress
Intersection of
High Stress and
High Vulnerability
Psychological
Factors
in Personal History
Vulnerability
Onset of
Schizophrenic
Disorder
Biological Factors
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Culture-bound Disorders
Koro
Windigo
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Summary of Schizophrenia
• Many biological factors seem involved
– heredity
– neurotransmitters
– brain structure abnormalities
• Family and cultural factors also important
• Combined model of schizophrenia
– biological predisposition combined with
psychosocial stressors leads to disorder
(Remember Biopsychosocial Disorder)
– Is schizophrenia the maladaptive coping behavior
of a biologically vulnerable person?
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Eating Disorders
• Involve serious and maladaptive
disturbances in eating behavior,
including reducing food intake, severe
overeating, obsessive concerns about
body shape or weight
Two Main Types
• Anorexia Nervosa-characterized by
excessive weight loss, irrational fear of
gaining weight, and distorted body selfperception
• Bulimia Nervosa-characterized by binges
of extreme overeating followed by selfinduced vomiting, misuse of laxatives, or
other methods to purge
45
40
Cases (%)
35
30
25
20
15
10
5
0
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45+
Age of Onset
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Causes of Eating Disorders
• Perfectionism, rigid thinking, poor peer
relations, social isolation, low self-esteem
associated with anorexia
• Genetic factors implicated in both
• Both involve decrease in serotonin
Cultural Factors
Thinness
Abnormal
Behavior: Myths
and Realities
Anxiety
Disorders
Attractiveness
Somatoform
Disorders
Dissociative
Disorders
Mood
Disorders
Schizophrenic
Disorders
Eating
Disorders
Personality Disorders
Inflexible, maladaptive pattern of
thoughts, emotions, behaviors, and
interpersonal functioning that are stable
over time and across situations, and
deviate from the expectations of the
individual‘s culture
Personality Disorders
• Four Main Types
– Paranoid personality disorder
– Antisocial personality disorder
– Borderline personality disorder
– Histrionic personality disorder