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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