Download Mood Disorders

Myers’ PSYCHOLOGY
(7th Ed)
Chapter 16
Psychological Disorders
James A. McCubbin, PhD
Clemson University
Worth Publishers
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http://www.appsychology.net/flash/index.shtml
Good AP Psy website for review!
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Ch. 16: Psy Disorders: “harmful dysfunction”
in which behavior is judged to be…
A. Atypical (violates social-norms): goes against
accepted behaviors; but not enough by itself
to be a mental disorder…
---Varies w/ era & culture
B. Disturbing: causes distress to you or those
around you-C. Maladaptive—harmful; keeps you from
functioning well in your world
D. Unjustifiable: no apparent reason….sometimes
there’s a good reason
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Defining Psychological Disorders
Psychological disorders
Deviant behavior
Distressful behavior
Harmful dysfunctional behavior
Definition varies by context/culture
Attention deficit hyperactivity disorder
(ADHD)
Historical Perspective
 Formerly Perceived Causes
 movements of sun or moon
 lunacy--full moon
 evil spirits; demons ; witches
 Ancient Treatments
 exorcism, caged like animals, beaten, burned,
castrated, mutilated, blood replaced w/ animal’s
blood
 Lock into attics…chain them up
 Changing from “demons” to illness:
-Paris: Philippe Pinel: became head of a mental
hospital in 1700’s & saw horrid ways patients were
treated…unchained the people & demanded humane
treatment BEGAN the MEDICAL MODEL
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Psychological Disorders
 Medical Model
 concept that diseases have physical causes
 can be diagnosed, treated, (& in most cases) cured
 assumes “mental” illnesses can be diagnosed on
the basis of their symptoms & cured through
therapy…& may include treatment in a
psychiatric hospital
 Used to use psych. hospitals a lot but now most
is on out-patient basis
 Bio-Psycho-Social Perspective: assumes that
biological, socio-cultural, & psychological factors
combine & interact to produce psychological
disorders
--a combination of causes in a cycle

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Psychological Disorders
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Psychological Disorders--Etiology
 Etiology: the causes of a disorder or condition
(where it comes from…)
 DSM-IV: classifies a disorder…mainly the symptoms
that define that disorder
 American Psychiatric Association’s Diagnostic &
Statistical Manual of Mental Disorders (4th Edition)
= DSM-IV-TR (text revision...this is latest)
 a widely used system for classifying & defining
what constitutes a particular psychological
disorders
 It does NOT tell you how to treat a disorder
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Classifying Psychological Disorders
Labeling Psychological Disorders
Rosenhan’s study
Power of labels
Preconception can stigmatize
Insanity label
Stereotypes of the mentally ill
Self-fulfilling prophecy
Match the Famous ppl w/ mental disorder
http://health.discovery.com/tv/psych-week/articles/celebrities-mentaldisorders.html NOTE: Some may have more than 1 disorder,
some disorders have more than one person affected
ADHD
Agoraphobia
Bipolar Disorder
Bulimia
Depression
DID (Dissociative identity disorder)
OCD (obsessive compulsive disorder)
Panic Attacks
Post-partum depression
Schizophrenia
Social Anxiety
Substance Abuse
(answers on LAST slide)
Joan Baez
Craig Ferguson
Paula Deen
Howard Hughes
Brooke Shields
Vincent van Gogh
Emma Thompson
Michael Phelps
Elton John
Herschel Walker
Carrie Fisher
John Nash
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Psychological Disorders-
Etiology
When Revisions are made in the DSM :
EX: used to classify homosexuality as a mental disorder but
when they did the last major revisions (late ’70’s) it was
changed & is no longer considered a disorder
Neurotic Disorder: usually distressing/upsetting but… allows
one to think rationally & function socially
(this term is seldom used now)
Psychotic disorder
Person loses contact w/ reality, experiencing irrational
ideas & distorted perceptions
Commonly seen in schizophrenia & more severe bipolar
disorders as well as others
Major divisions of mental disorders (there are others):
*anxiety disord. *schizophrenia *dissociative disord.
*mood disorders *personality disord. *somatoform 12
More clarification of psychosis vs. neurosis:
Psychosis: A loss of contact with reality, usually
including delusions & hallucinations.
Can be caused by drugs (using & withdrawal), brain
tumors, dementia & other brain diseases..plus certain
psychiatric disorders
Neurosis: a relatively mild mental illness that is not
caused by physical disease, involving symptoms of stress
(EX: depression, anxiety, obsessive behavior, hypochondria)
but not a radical loss of touch with reality.
This term was taken out of DSM in 1980 & is not used much
today in true diagnoses…used more as a descriptive term
if at all.
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Anxiety Disorders: distressing, persistent anxiety or
maladaptive behaviors that reduce anxiety for no
apparent or rational reason (these are not rare…)
 Panic Disorder (panic attacks): marked by a minuteslong episode of intense dread in which a person
experiences terror and accompanying chest pain,
choking, or other frightening sensation
 Often diagnosed in ER…why?
 Generalized Anxiety Disorder: person is tense,
apprehensive, and in a state of autonomic nervous
system arousal
 Phobia: persistent, irrational fear of a specific object or
situation
 Agoraphobia: fear of unfamiliar places…fear of being
away from home
 Obsessive-Compulsive Disorder: unwanted repetitive
thoughts (obsessions) and/or actions (compulsions)14
Obsessive-Compulsive Disorder
Obsessive-compulsive disorder
An obsession versus a compulsion
Checkers
Hand washers
PTSD: Post Traumatic
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 Anxiety Disorders: NOTE: There are many more than
just those most common ones on the previous slide…
 Common & uncommon fears: extremes = phobias
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Anxiety Disorders: OCD
obsessions & compulsions: Kids & adolescents
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Explaining anxiety disorders: etiology– cause?
 fear conditioning: bad uncontrollable events can
cause these (rape victim?)
EX: PTSD: post-traumatic stress disorder
 stimulus generalization: person falls…then fears
airplanes…
 reinforcement: becomes cyclic: anxiety, so do
something to relieve it (run away, stay home,
etc.), feel better, so you will do this the next time
 observational learning: parents, siblings, etc.
teach fears to the young
 genetic: thru natural selection (many are
heritable)
 physiological: folks w/ overactive limbic system
can be prone to these disorders…& antidepressants help them
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Anxiety Disorders
PET Scan of brain of
obsessive/
compulsive disorder
(OCD)
 High metabolic
activity (red) in
frontal lobe areas
involved with
directing attention
 Over-active amygdala
&/or limbic system
can affect this
 ** b/c it’s a stimulant,
nicotine increases
risk of a 1st episode
of anxiety disorders
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Mood Disorders: Emotional extremes (ups OR downs)
Mild or moderate Depression (aka dysthymic disor.):
“common cold” of mental disorders…
Related to lack of N-T’s serotonin & nor-epinephrine
(both affect mood)
Women more prone to depression…probably b/c of ...
**Hormones
**Lack of self-esteem
**Lack of a a sense of efficacy ( “I have control, etc.)
Major Depressive Disorder
For no apparent reason, person experiences 2 or more
wks of depressed moods, feelings of worthlessness, &
diminished interest or pleasure in most activities
 Possibility of suicide is major concern
 If drugs & cognitive/behavioral therapy don’t work, this
is 1 of few disorders Dr’s. may still use shock (ECTelectroconvulsive) therapy on b/c of fear of suicide
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Mood Disorders
Manic Episodes
(“Mania”)
Marked by a hyperactive, wildly optimistic state
 Biological influence seems to be excess of what 2
neurotransmitters? ( ___ & especially ___ )
EX’s of manic behaviors: Could be 1, some, or all (or
some other…) of the following:
-grandiose ideas
-euphoric optimism
-spending sprees
-reckless, aggressive
-long periods of no sleep
-speech becomes loud
-excessive self-esteem
-poor judgment, egocentric
-increased chances of unprotected sex
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Bipolar Disorder
 Mood disorder in
which the person
alternates betwn.
the hopelessness
& lethargy of
depression… & the
overexcited state
of mania
 way up…then way
down…& back
again…
 formerly called
manic-depressive
disorder
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Bipolar disorder:
a lifelong illness. Episodes of mania and
depression eventually can occur again, if you don't get treatment.
Many continue to have symptoms, even after getting treatment
Types of bipolar disorder:
Bipolar I disorder: involves periods of severe mood episodes
from mania to depression.
Bipolar II disorder: a milder form of mood elevation, involving milder
episodes of hypomania that alternate with periods of severe
depression.
Cyclothymic disorder: periods of hypomania with brief periods of
depression that are not as extensive or long-lasting as seen in full
depressive episodes.
Mixed bipolar: periods that simultaneously involve the full symptoms
of both a manic and a full depressive episode. It's marked by
grandiose feelings with racing thoughts. At the same time, the
person is irritable, angry, moody, and feeling bad.
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Rapid-cycling bipolar disorder:
Characterized by 4 or more mood episodes that occur within a 12month period. Episodes must last for some minimum number of
days in order to be considered distinct episodes.
MAY experience changes in polarity (high  low or vice-versa) within
a single week, or even within a single day -- the full symptom
profile that defines distinct, separate episodes may not be
present (EX: the person may not have a decreased need for sleep),
making such "ultra-rapid" cycling a more controversial
phenomenon.
Rapid cycling can occur at any time in the course of illness,
although some researchers believe that it may be more common
at later points in the lifetime duration of illness.
Women appear more likely than men to have rapid cycling. A rapidcycling pattern increases risk for severe depression and suicide
attempts. Antidepressants are thought to trigger and prolong
rapid cycling in bipolar disorder. However, that theory is
controversial and is still being studied.
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Mood Disorders-Bipolar
 PET scans show that brain energy consumption
rises and falls with emotional switches
 May 17
Depressed state
May 18
Manic state
May27
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Depressed state
Manic
Chocolate
deliveries..
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READ!!
P.638
Suicides & differing groups:
 National: see #’s: where’s US?
 Racial: Euro.-Amer.(W) more than Afr. Amer. (B)
 Gender: Which try? Which succeed? Why?
 Age: most = older men; increase in older male
teens
 Other groups:




religious vs. non-relig.
heterosexual/homosexual?
married, single, widowed, divorced?
drug usage?
The Depressed brain:
How do serotonin & norepinephrine affect depression vs.
mania??
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Mood Disorders - Depression &
Gender cross-culturally:
Females more susceptible
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Mood Disorders-Depression
 Canadian depression rates: M vs F in varying ages
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Mood DisordersSuicide
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Mood Disorders-Depression
Altering any one
component of the
chemistry-cognitionmood circuit can alter
the others
 Genetic: there is a
strong genetic link in
mood disorders
 Physiological (638)
brains differences:
lobes, NT’s, activity
levels
 Social-cognitive: selfdefeating beliefs;
negative thoughts
-”stable, global,
internal” (b-640)
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Mood DisordersDepression
 The vicious
cycle of
depression can
be broken at
any point
 Rumination:
dwelling on
something
 P. 643:
Loneliness:
“aloneness
often breeds
loneliness”:
-excluded
-unloved
-constricted
-alienated
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Major Depressive Disorder
Bipolar Disorder
Bipolar Disorder
Mania (manic)
Overtalkative, overactive, elated,
little need for sleep, etc.
Bipolar disorder and creativity
2 other Mood
disorders:
Post-Partum Depression:
“baby blues”…comes after
birth of a baby…linked to
hormonal changes
(Brooks Shield, Andrea Yates)
SAD: seasonal Affective
Disorder:
“Winter Blues”—lack of light
usually the trigger
-hormone melatonin linked
to this it also helps
w/ jetlag, shift work—
i.e., disruption of sleep cycles
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Understanding Mood Disorders
 Many behavioral and cognitive changes accompany
depression
 Depression is widespread
 Compared with men, 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
 With each new generation, depression is striking
earlier and affecting more people
Understanding Mood Disorders
The Biological Perspective
Genetic Influences
 Mood disorders run in families
 Heritability
 Linkage analysis
The depressed brain
 Biochemical influences
Norepinephrine and serotonin
Understanding Mood Disorders
The Social-Cognitive Perspective
Negative Thoughts & Moods Interact
Self-defeating beliefs
 Learned helplessness
 Overthinking
Explanatory style
 Stable, global, internal explanations
Cause versus indictor of depression?
Understanding
Mood
Disorders:
Explanatory
Styles
Understanding Mood Disorders
The Social-Cognitive Perspective
Depression’s Vicious Cycle
 Stressful experience
 Negative explanatory style
 Depressed mood
 Cognitive and behavioral changes
Understanding Mood Disorders
The Vicious Cycle of Depression
Biopsychosocial Approach to Depression
Dissociative Disorders (Read 644-5)
 conscious awareness becomes separated (dissociated)
from previous memories, thoughts, and feelings
 Dissociative amnesia: blocking of information regarding a
very stressful event; just go on w/ life like it never
happened (Freud’s repression)
 Dissociative Fugue: go to new place & take up new life
after some traumatic event
 Dissociative Identity Disorder (DID)
 rare dissociative disorder in which a person exhibits two
or more distinct and alternating personalities
 formerly called multiple personality disorder
 Some psychologists disbelieve this, say it’s role-playing
 It is NOT schizophrenia (though you’ll hear it called that)
 V. rare & disputed by most psychologists
 Virtually always related to long-term childhood sexual
abuse
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Dissociative Identity Disorder
Dissociative identity disorder (DID)
Multiple personality disorder
Understanding Dissociative Identity Disorder
 Genuine disorder or not?
 DID rates…v. small: .01%
 Therapist’s creation? Ppl do not come “with” the
disorder—often comes after therapist begins to
ask specifically about it
 Differences from culture to culture are too
great…it is NOT cross-cultural & seems specific
mainly to USA
 DID and other disorders
Schizophrenia
 Schizophrenia: This one IS real…& v. sad…
 literal translation “split mind” which is why may
hear schiz. called multi. personality
 a group of severe disorders characterized by:
 disorganized and delusional thinking
 disturbed perceptions
 inappropriate emotions and actions
 Delusions
 false beliefs, often of persecution or grandeur,
that may accompany psychotic disorders
 Hallucinations
 sensory experiences without sensory stimulation47
Schizophrenic Art:
also 
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5 subtypes of schizophrenia:
Also… Acute vs. chronic?
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Schizophrenia
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Schizophrenia in ID Twins: 1 w/ & 1 w/o
Indicates some other cause other than ____?
FLUID FILLED areas are “ventricles”…larger
ventricles associated w/ schizophrenia
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Positive vs. negative symptoms …
These do NOT relate to good or bad…
Positive: something added…
EX: hallucinations; delusions; excessive
emotion….etc.
Negative: something taken away…
EX: -flat affect (no emotion)
-no movement (catatonic)
Onset of schiz.: those predisposed to schiz.
have their 1st episode typically between about
ages 17 – 35
--some possible warning signs…
EX: poor selective attention
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Understanding Schizophrenia: Psychological Factors
Possible warning signs
 Mother severely schizophrenic
 Birth complications (low weight/oxygen
deprivation)
 Separation from parents
 Short attention span
 Poor muscle coordination
 Disruptive or withdrawn behavior
 Emotional unpredictability
 Poor peer relations and solo play
Clarification: Positive vs. Negative
Schiz. symptoms
Positive symptoms are things that are
present in schizophrenics which are
absent in normal people, such as
delusions, hallucinations, or word salad.
Negative symptoms are things which are
absent in schizophrenics which are
present in normal people, such as flat
affect, avolition (lack of motivation, etc.) or
catatonia.
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Etiology of schizophrenia:
Environment: Other disorders have effects from
from the environment, BUT schiz. very much
physiological
…BUT stress can bring on episodes in those who have
physiological tendencies already
EX: family interaction & communication can have an
effect (Hi-risk factors RE: schiz.: p. 652)
 Dopamine over-activity: too much dopamine in
brains of schiz. during autopsies
 Brain anatomy: low activity in frontal lobes;
enlarged brain cavities (ventricles)
 Maternal viruses during mid-pregnancy: is it
the virus, or the medications, etc.?
But only 2% of schiz. seem affected this way…
 Genetic factors: there is a genetic link …so if you
have a close family member w/ schiz., risk is up
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Personality Disorders: inflexible, long-lasting behavior
patterns that impair social functioning usually
without anxiety, depression, or delusions
(SOME below......BUT are others!)
 Borderline Personality Disorder: manipulative; can be
sexually promiscuous; defensive; high-risk; may
threaten suicide for attention
 Co-dependent Persn. Disor.: over-dependent on
another; will allow another to abuse verbally,
emotionally, etc., & tend to make excuses for him/her
-usually women; “passive-aggressive”
 Narcissistic Persn. Disor.: It’s ALL about MEEEE!!!
 Antisocial Persn. Disor. (aka “sociopaths”)
 person (usually male) exhibits a lack of conscience
for wrongdoing, even toward friends & family
 may be aggressive and ruthless or a clever con artist
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 Early signs? (See “ppl who abuse animals…”)
A personality disorder :
Enduring pattern of inner experience & behavior that deviates
markedly from the expectations of the individual’s culture, is
pervasive & inflexible, has an onset in adolescence or early
adulthood, is stable over time, and leads to distress or
impairment. From DSM-5
Dimensional Models for Personality Disorders
General Personality Disorder
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder
Other Specified Personality Disorder
Unspecified Personality Disorder
Personality Change Due to Another Medical Condition
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Anti-social personality disorder:
little guilt or effect
 Boys who
were later
convicted of
a crime
showed
relatively low
arousal
during stress
situations
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Antisocial-Personality Disorders
 PET scans illustrate reduced activation in a
murderer’s frontal cortex…lacks guilt, etc.
 Less related to genetics, more environ.
Normal
Murderer
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Personality Disorders:
Do seem to have an
environmental etiology...often abusive, poor,
neglectful parents are involved + birth
problems
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Rates of Psychological Disorders:
Highest? Lowest? Cultural /gender aspects?
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Rates of
Disorders
Mental
health
statistics
Influence
of poverty
Other
factors
Somatoform disorders:
(Not in bk!)
-Preoccupation w/ health…or showing physical
symptoms w/ NO true physical problems
Conversion disorder: used to be called
“hysterical ___”, i.e., hysterical blindness or
hysterical paralysis
Hypochodriasis: hypochondria…preoccupied
w/ your health, worried you have everything
Munchausen’s Syndrome or Munchausen
by proxy: actually poison or otherwise hurt
yourself (or another= proxy) in order to get
sympathetic attention (any movie you remember?)
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Answers to
Match the famous ppl w/ mental disorders
ADHD: Michael Phelps
Agoraphobia: Paula Deen
Bipolar Disorder: Carrie Fisher, Vincent van Gogh
Bulimia: Elton John
Depression: Emma Thompson
Dissociative identity disorder (DID): Herschel Walker
OCD: Howard Hughes
Panic Attacks: Paula Deen
Post-partum depression: Brooke Shields
Schizophrenia: John Nash
Social Anxiety: Joan Baez
Substance Abuse: Craig Ferguson, Elton John
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