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Myers’ PSYCHOLOGY (6th Ed) Chapter 15 Psychological Disorders James A. McCubbin, PhD Clemson University Worth Publishers NUMBERS 1.7 MILLION INPATIENTS PER YEAR. 2.4 MILLION PUTPATIENTS PER YEAR. 400 MILLION WORLD WIDE WITH A MENTAL DISORDER. MANY ARE HOMELESS Psychological Disorders Psychological Disorder a “harmful dysfunction” in which behavior is judged to be: atypical- not enough in itself disturbing- varies with time & culture maladaptive- harmful unjustifiable- sometimes there’s a good reason Historical Perspective Perceived Causes movements of sun or moon lunacy- full moon evil spirits Ancient Treatments exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced with animal’s blood, teeth pulled, boiled alive, extremities torn off. Pinel: the first to treat patients humanely. Psychological Disorders Medical Model concept that diseases have physical causes can be diagnosed, treated, and in most cases, cured assumes that these “mental” illnesses can be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital Psychological Disorders Biological (Evolution, individual genes, brain structures and chemistry) Sociocultural (Roles, expectations, definition of normality and disorder) Bio-psycho-social Perspective assumes that biological, sociocultural, and Psychological psychological factors (Stress, trauma, learned helplessness, combine and mood-related perceptions interact to produce and memories) psychological disorders Psychological Disorders- Etiology DSM-IV American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) a widely used system for classifying psychological disorders Describe, predict, imply Psychological Disorders- Etiology Neurotic disorder (term seldom used now) usually distressing but that allows one to think rationally and function socially Freud saw the neurotic disorders as ways of dealing with anxiety Psychotic disorder person loses contact with reality experiences irrational ideas and distorted perceptions Anxiety Disorders Anxiety Disorders distressing, persistent anxiety or maladaptive behaviors that reduce anxiety 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 Anxiety Disorders Common and uncommon fears 100 Percentage 90 of people 80 surveyed 70 60 50 40 30 20 10 0 Snakes Being Mice Flying Being Spiders Thunder Being Dogs in high, on an closed in, and and alone exposed airplane in a insects lightning In a places small house place at night Afraid of it Bothers slightly Not at all afraid of it Driving Being Cats a car In a crowd of people Anxiety Disorders Obsessive-Compulsive Disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Panic Disorder marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation Anxiety Disorders Common Obsessions and Compulsions Among People With Obsessive-Compulsive Disorder Thought or Behavior Percentage* Reporting Symptom Obsessions (repetitive thoughts) 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 85 Repeating rituals (in/out of a door, up/down from a chair) Checking doors, locks, appliances, car brake, homework 51 46 Anxiety Disorders PET Scan of brain of person with Obsessive/ Compulsive disorder High metabolic activity (red) in frontal lobe areas involved with directing attention Mood Disorders Mood Disorders characterized by emotional extremes Major Depressive Disorder a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities Mood Disorders Manic Episode a mood disorder marked by a hyperactive, wildly optimistic state Bipolar Disorder a mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania formerly called manic-depressive disorder Mood DisordersDepression 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 0 USA Edmonton Puerto Rico Males Females Paris West Florence Beirut Germany Taiwan Korea New Zealand Mood DisordersDepression 10% Percentage depressed 8 Females 6 4 2 Males 0 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+ Age in Years Mood DisordersSuicide 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 Females Mood DisordersSuicide Increasing rates of teen suicide 12% Suicide rate, ages 15 to 19 10 (per 100,000) 8 6 4 2 0 1960 1970 1980 Year 1990 2000 Mood DisordersBipolar PET scans show that brain energy consumption rises and falls with emotional swings Depressed state Manic state Depressed state Mood DisordersDepression Brain chemistry Cognition Mood Altering any one component of the chemistrycognition-mood circuit can alter the others Mood DisordersDepression Percentage of observations 35% 30 25 20 15 Negative behaviors Positive behaviors Self-ratings A happy or depressed mood strongly influences people’s ratings of their own behavior Mood DisordersDepression 1 Stressful experiences 4 Cognitive and behavioral changes 3 Depressed mood The vicious cycle of depression can be 2 broken at Negative explanatory style any point SOMATOFORM DISORDERS Distressing symptoms take a somatic (bodily) form, without any apparent physical cause. Emotional Distress Conversion disorder: anxiety is converted into a physical symptom. Hysterical blindness Amnesia – psychogenic Fugue: amnesia with travel & identity replacement Hypochondrias – keep going to doctors Dissociative Disorders Dissociative Disorders conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings Dissociative Identity Disorder rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities formerly called multiple personality disorder/Sybil – not a true DID. Eve – Chris Sizemore – 3 personalities. Spano’s studies indicates it varies by therapist and by countries. U.S. vs. the rest of the world. Schizophrenia Schizophrenia literal translation “split mind” a group of severe disorders characterized by: disorganized and delusional thinking disturbed perceptions inappropriate emotions and actions Disorganized speech – word salad. Disorganized behavior. Disturbance for 6 months or more. CAUSES??? Prenatal viral infection? Prenatal malnutrition OBGyn complications during delivery Other brain insults Diathesis – Stress Model: proposes that some persons develop schizophrenia because of an underlying vulnerability (diathesis) that is compounded by stress. Genetic and environment conditions needed to cross the threshold. Schizophrenia POSITIVE SYMTOMS: Delusions false beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Bizarre bhavior. Hallucinations false sensory experiences such as seeing something without any external visual stimulus. 63% are auditory. SCHIZOPHRENIA Negative symptoms: Apathy, flattened affect, social withdrawal, inattentive, slowed or no speech. Schizophrenia Subtypes of Schizophrenia Paranoid: Preoccupation with delusions or hallucinations Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of another’s speech or movements Undifferentiated or residual: Schizophrenia symptoms without fitting one of the above types schizophrenia Enlarged cerebral ventricles MRI shows damage to frontal and temporal areas. Dopamine hypothesis: elevated levels of dopamine. Thalamus appears smaller and there seems less metabolic activity. Schizophrenia Lifetime risk 40 of developing schizophrenia 30 for relatives of a schizophrenic 20 10 0 General population Siblings Children Fraternal Children Identical twin of two twin schizophrenia victims schizophrenia 10 years after diagnosis…. 25% complete recovery 25% improved, extensive support is needed 15% hospitalized, no imporvement 10% died ( often by suicide) 25% improved, moderately independent. Personality Disorders Personality Disorders disorders characterized by inflexible and enduring behavior patterns that impair social functioning usually without anxiety, depression, or delusions Personality Disorders Antisocial Personality Disorder disorder in which the person (usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members may be aggressive and ruthless or a clever con artist Schizoid: detachment from social relationships. PERSONALITY DISORDER Blatantly disregards and violates the rights of others. Borderline: erratic, unstable relationships, feeling of emptiness, self-destructive. Histrionic: exaggerated, overly dramatic, attention seeking behavior, provocative. Narcissistic: grandiose sense of self importance, exaggerates abilities, need for admiration, pretentions. PERSONAILITY DISORDERS Avoidant personality disorder: social inhibition die to feelings of inadequacy; hypersensitive to criticism. Dependent/co-dependent: needs to be taken care of. Clingy. OCD personality disorder: orderliness, personal control, rules, tasks Personality Disorders PET scans illustrate reduced activation in a murderer’s frontal cortex Normal Murderer Personality Disorders 35 30 Percentage of criminal offenders 25 20 15 10 5 0 Total crime Childhood poverty Thievery Obstetrical complications 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 Totals Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8% 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