Download anxiety disorders

Myers’ Psychology for AP*
Unit 12:
Abnormal
Psychology
David G. Myers
Some PowerPoint Presentation Slides
by Kent Korek
Germantown High School
Worth Publishers, © 2010
*AP is a trademark registered and/or owned by the College Board, which was not involved in the production of, and does not endorse, this product.
OBJECTIVES:
The student will know and understand
the Psychological Disorders investigates patterns of
behavior that are considered deviant or distressful in our
culture and includes how psychologists diagnose these
patterns. After completing their study of this chapter,
students should be able to:
1)identify the criteria for judging whether behavior is
psychologically disordered.
2) Describe the medical model of psychological
disorders, and discuss the bio-psycho-social perspective
offered by critics of this model
3) Describe the aims of DSM-IV, and discuss the potential
dangers associated with the use of diagnostic labels.
4) Describe the symptoms of generalized anxiety
disorder, phobias, and obsessive-compulsive
disorder.
5) Explain the development of anxiety disorders from
both a learning and a biological perspective.
6) Describe major depressive disorder and bipolar
disorder.
7) Explain the development of mood disorders, paying
special attention to the biological and social-cognitive
perspectives.
8)Describe the characteristics and possible cause of
dissociative identity disorder.
9) Describe the various symptoms and types of
schizophrenia, and discuss research on its causes.
10) Describe the nature of personality disorders, focusing
on the characteristics of the antisocial personality
disorder.
11) Describe the prevalence of various disorders and the
timing of their onset.
Unit 12:
Abnormal Psychology
Unit Overview
•
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Perspectives on Psychological Disorders
Anxiety Disorders
Somatoform Disorders
Dissociative Disorders
Mood Disorders
Schizophrenia
Personality Disorders
Rates of Disorder
Introduction
• How should we define
psychological disorders?
• How should we understand
disorders?
• How should we classify
psychological disorders?
Normal or Abnormal?
Not easy task:
*Is Robin Williams normal?
Anna Nicole Smith? Marilyn
Manson? Karl Rove?
*Is a soldier who risks his life
or her life in combat normal?
*Is a grief-stricken woman
unable to return to her
routine three months after
her husband died normal?
Is a man who climbs
mountains as a hobby
normal?
Some abnormalities are easy:
Hallucinations (false sensory experiences)
Delusions (extreme disorders of thinking)
Affective problems (emotion: depressed, anxious,
or lack of emotion)
CORE CONCEPT:
Medical model: takes a “disease” view
Psychology model: interaction of biological, mental, social,
and behavioral factors
According to a study conducted by the National Institute
of mental health:
*15.4% of the population suffers from diagnosable
mental health problems
*56 million Americans meet the criteria for a
diagnosable psychological disorder (Carson, 1996,
Regier 1993).
*Over the lifespan, +/- 32% of Americans will suffer
from some psychological disorder (Regier, 1988).
1 in 5 in the U. S. in a given year
(Allaboutdepression.com,1993).
1 in 4 n the world- 450 million people (WHO.int.com,
2001).
SHOW:
Psych in Film, Ver.2, #33, Patch Adams
Perspectives on Psychological
Disorders
Defining Psychological Disorders
• Psychological disorders
–Deviant behavior
–Distressful behavior
–Harmful dysfunctional behavior
• Definition varies by context/culture
• Attention deficit hyperactivity
disorder (ADHD)
Understanding Psychological Disorders
The Medical Model
• Philippe Pinel-French physician who was instrumental in
the development of a more humane psychological
approach to the custody and care of psychiatric patients,
referred to today as moral therapy.
• He also made notable contributions to the classification of
mental disorders and has been described by some as "the
father of modern psychiatry".
• An 1809 description of a case that Pinel recorded in the
second edition of a textbook on insanity is regarded as the
earliest evidence for the existence of the form of mental
disorder known as dementia praecox or schizophrenia
in the 20th century.
Historical Perspective
Perceived Causes
*movements of sun or moon
*lunacy- full moon
*demons & evil spirits
Ancient Treatments
*exorcism, caged like animals, beaten,
burned, castrated, mutilated, blood
replaced with animal’s blood
Historical Perspective
Hippocrates (400 bc)
*first step in scientific view of mental disturbance.
*imbalance (excess) among four body fluids called “humors”
Humors
Origin
Temperament
Blood
heart
sanguine (cheerful)
Choler (yellow bile) liver
choleric (angry)
Melancholer
spleenmelancholy (depressed) (black bile)
Phlegm
brain
phlegmatic (sluggish)
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
Understanding Psychological Disorders
The Biopsychosocial Approach
• Interaction of
nature and
nurture
• Influence of
culture on
disorders
The Biopsychosocial Approach to
Psychological Disorders
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 factors
combine and interact to
produce psychological
disorders
Psychological
(Stress, trauma,
learned helplessness,
mood-related perceptions
and memories)
Origins of the Diagnostic and Statistical
Manual: Mental Disorders
• United States was the recording of the frequency of
"idiocy/insanity" in the 1840 census. By the 1880
census, seven categories of mental health were
distinguished: mania, melancholia, monomania,
paresis, dementia, dipsomania, and epilepsy.
• The American Psychiatric Association Committee
on Nomenclature and Statistics developed a
variant of the ICD-6 that was published in 1952 as
the first edition of Diagnostic and Statistical
Manual: Mental Disorders (DSM-I).
Classifying Psychological Disorders
• Diagnostic and Statistical
Manual of Mental Disorders
(DSM)
–DSM-IV-TR
–DSM-5
• International Classification of
Diseases (ICD-10)
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Classifying Psychological Disorders
Psychological Disorders- Etiology
DSM-V
*American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders (Fifth Edition)
*a widely used system for classifying
psychological disorders
*Prior to last May we used the DSM-IV-TR
(text revision. Now we use the DSM V
*today used as “convenient shorthand”
to avoid labeling.
DSM-IV-TR organizes each psychiatric
diagnosis into five levels (axes) relating to
different aspects of the disorder or disability:
1) Axis 1 -- Clinical disorders including major
mental disorders, as well as developmental or
learning problems. Common disorders in this
category include depression, bipolar,
anxiety, ADHD, and schizophrenia.
2) Axis 2 -- Pervasive or personality disorders,
including mental retardation. Common
disorders in this category include borderline
PD, schizotypal PD, narcissistic PD,
antisocial PD, paranoid PD.
DSM-IV-TR continued:
3) Axis 3 -- Acute medical conditions and
physical disorders. Common disorders in this
category include brain trauma, brain injury,
brain disease..
4) Axis 4 -- Psychosocial and environmental
factors contributing to the disorder. Common
factors in this category include a man
suffering from depression after losing his
job, or his wife dying, et. al.
5) Axis 5 -- Global Assessment of Functioning or
Children’s Global Assessment Scale (under
18)
David Rosenhan suspected that terms such as sanity,
insanity, schizophrenia, mental illness, and abnormal might
have fuzzier boundaries that the psychiatric community
thought.
He also suspected that some strange behaviors seen in
mental patients might originate in the abnormal
atmosphere of the mental hospital, rather than the patients
themselves.
Education
･AB, Yeshiva College, 1951
･MA, Columbia University,
1953
･PhD (psychology),
Columbia University, 1958
Professor, Stanford
University
Dangers of Labeling
David
Rosenhan Being
Sane in Insane
Places
In 1973 sociologist
David Rosenhan
designed a clever
study to examine the
difficulty that people
have shedding the
"mentally ill" label. He
was particularly
interested in how
staffs in mental
institutions process
information about
patients.
Rosenhan & seven associates had themselves
committed to different mental hospitals
complaining of hearing voices. All but one were
diagnosed as schizophrenic.
•Once admitted, they acted totally normal.
•Remained hospitalized for average 19 days (9 to
52)
•Only the patients detected their sanity
•When discharged their chart read,
“schizophrenia in remission”
No professional staff member at
any of the hospitals ever realized
that any of Rosenhan’s
pseudopatients was a fraud.
Failure to detect sanity during the course of hospitalization may
be due to the fact that physicians operate with a strong bias
toward what statisticians call the Type 2 error [5].
This is to say that physicians are more inclined to call a healthy
person sick (a false positive, Type 2) than a sick person healthy
(a false negative, Type 1). The reasons for this are not hard to
find: it is clearly more dangerous to misdiagnose illness than
health. Better to err on the side of caution, to suspect illness
even among the healthy.
Power of labels
Preconception can stigmatize
Insanity label-mental illness of such a severe nature that a
person cannot distinguish fantasy from reality, cannot conduct
her/his affairs due to psychosis, or is subject to uncontrollable
impulsive behavior.
Insanity is a concept discussed in court to help distinguish guilt
from innocence
Stereotypes of the mentally ill
Self-fulfilling prophecy
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)
Show
THE WORLD OF AbNORMAL
BEHAVIOR:
#1 Looking at Abnormal Behavior
#2 The Nature of Stress
Carol D. Ryff argues that we must define mental illness in terms of
the positive. She names 6 core dimensions:
1) Self-acceptance:
positive attitude towards self
multiple aspects of self
positive about past life
2) Positive self relations with other people:
warm, trusting, satisfying interpersonal relationships
capable of empathy, affection, intimacy
3) Autonomy
independent, self-determined
able to resist social pressures
4) Environmental mastery:
sense of mastery and competence
makes good use of opportunities
creates contexts that support their personal needs
5) Purpose of Life:
has goals and directedness
feels there is meaning to past and present life
6) Personal Growth:
see oneself as growing and expanding
open to new experiences
change in ways that reflect self-knowledge and
effectiveness
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
PREPAREDNESS HYPOTHESIS:
Suggests that we have an innate biological
tendency, acquired through natural selection, to
respond quickly and automatically to stimulti
that posed a survival threat to our ancestors.
(Ohman & Mineka, 2001)
This explains why we
develop phobias for
snakes and lightening
more easily than others.
•ANXIETY DISORDERS
•MOOD DISORDERS
•DISSOCIATIVE DISORDERS
•SCHIZOPHRENIA
•PERSONALITY DISORDERS
•BIOPSYCHOSOCIAL DISORDERS
•SUBSTANCE ABUSE DISORDERS
•SEXUAL DISORDERS
•DEVELOPMENTAL (CHILDHOOD)
DISORDERS
Anxiety Disorders
1) PANIC DISORDER w/AGORAPHOBIA
2) GENERALIZED ANXIETY DISORDER
3) PHOBIAS
a) simple
b) social
c) agoraphobia
4) 5) POST TRAUMATIC STRESS DISORDER
(PTSD)
6) STOCKHOLM SYNDROME
7) SOMOTOFORM
a) hypochondria
b) conversion (hysteria)
Anxiety Disorders
• Anxiety disorders
–Generalized anxiety disorder
–Panic disorder
–Phobia
–Obsessive-compulsive disorder
–Post-traumatic stress disorder
Anxiety Disorders
Anxiety Disorders
*distressing, persistent
anxiety or maladaptive
behaviors that reduce
anxiety
Panic Disorder
• Panic disorder = an anxiety disorder
marked by unpredictable minutes-long
episodes of intense dread in which a person
experiences terror and accompanying chest
pain, choking, or other frightening sensations.
–Panic attacks
Anxiety Disorders
1) Panic Disorder
*marked by a minutes-long episode of intense dread in
which a person experiences terror and accompanying
chest pain, choking, racing heart, sweating, musclespasms, or other frightening sensations
*common thinking patterns include:
"I’m losing control.....”
"I feel like I’m going crazy.....”
"I must be having a heart attack.....”
"I’m smothering and I can’t breathe.....”
1a) Panic Disorder w/Agoraphobia
*fear of leaving home for fear of having a panic attack
Generalized Anxiety Disorder
• Generalized anxiety disorder =
an anxiety disorder in which a person is
continually tense, apprehensive, and in a
state of autonomic nervous system
arousal.
*2/3 women
*Free floating anxiety =
a generalized, persistent, pervasive
fear that is not attributable to any
specific object, event, or source.
2) Generalized Anxiety Disorder
person is tense, apprehensive, and in a state of
autonomic nervous system arousal
*Chronic (6 months) unrealistic or excessive worry
about 2 or more elements in one’s life.
SHOW:
Psych in Film, Ver 2, #24, Apollo 13
Phobias
• Phobias = an anxiety disorder marked by
a persistent, irrational fear and avoidance of a
specific object, activity, or situation.
–Specific phobia
–Social phobia
–Agoraphobia
3) Phobias
a) Simple
Excessive, irrational fear of objects or situations
b) Social
Persistent fear of scrutiny by others doing something humiliating
(stage fright or speech phobia)
c) Agoraphobia
Fear of being in a place or situation with no escape. (childhood
environments in which one did not feel safe)
Anxiety Disorders
Phobias
persistent, irrational fear of a specific object or situation
Ablutophobia: washing, bathing
Genophobia: sex
Acrophobia: heights
Gynephobia: women
Algophobia: pain
Ichthyophobia: fish
Arachibutyrophobia: peanut butter
sticking to roof of mouth
Lutraphobia: otters
Caligynephobia: beautiful women
Medorthophobia: erect penis
Cleptophobia: stealing
Parthenophobia: virgins
Demophobia: crowds
Pophyrophobia: color purple
Ecclesiophobia: church
Somniphobia: sleep
Ergophobia: work
Testophobia: taking a test
Macrophobia: long waits
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 SpidersThunderBeing Dogs Driving Being Cats
in high,
on anclosed in, and
and alone
a car In a
0
exposed
airplane in a insectslightning In a
crowd
places
Afraid of it
small
house
place
at night
Bothers slightly Not at all afraid of it
of people
Phobias
Phobias
Obsessive-Compulsive Disorder
• Obsessive-compulsive disorder
= an anxiety disorder characterized by
unwanted repetitive thoughts (obsessions)
and/or actions (compulsions).
–An obsession versus a
compulsion
–Checkers
–Hand washers
Obsessive Compulsive
Spectrum Disorders
Obsessive-Compulsive Disorder
*unwanted repetitive thoughts (obsessions) and/or actions
(compulsions)
*feel obsessed w/something they do not want to think about
and/or compelled to carry out some action, often pointlessly
ritualistic.
New DSM V Disorders
Hoarding Disorder, Excoriation (skin-picking) Disorder,
Substance or Medication Induced OCD, and OCD due to
another medical condition
Obsessive Compulsive
Disorders
*1 in 50 adults has OCD
*Exact pathophysiologic process that underlies
OCD has not been established.
*Research suggests that abnormalities in
serotonin (5-HT) transmission in the central
nervous system are central to this disorder.
*Supported by the efficacy of specific
serotonin reuptake inhibitors (SSRIs) in the
treatment of OCD.
OCD
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
Obsessive-Compulsive Disorder
OCD
• PET Scan of brain of person
with Obsessive/ Compulsive
disorder
• High metabolic activity (red) in
frontal lobe areas involved
with directing attention
Good examples of obsessions and their closely
related compulsions:
Obsession: A young
woman is continuously
terrified by the thought
that cars might careen
onto the sidewalk and
run over her.
Obsession: A mother tormented by
concern that she might inadvertently
contaminate food as she cooks dinner.
Compulsion: Every day she sterilizes all
cooking utensils in boiling water and
wears rubber gloves when handling food
Compulsion: She
always walks as far from
the street pavements as Obsession: A woman cannot rid herself
of the thought that she might
possible and wears red
accidentally leave her gas stove turned
clothes so that she will
on, causing her house to explode
be immediately visible
to an out-of-control car.
Compulsion: Every day she feels the
irresistible urge to check the stove
exactly 10 times before leaving for work.
Post-Traumatic Stress Disorder
• Post-traumatic stress disorder
characterized by haunting memories, nightmares,
social withdrawal, jumpy anxiety, and/or insomnia
that lingers for four weeks or more after a traumatic
experience.
– PTSD
– “shellshock” or “battle fatigue”
– Not just due to a war situation
• Post-traumatic growth = positive
psychological changes as a result of struggling with
extremely challenging circumstances and life crises.
Post Traumatic Stress Disorder (PTSD)
Follows a psychologically distressing event that is outside the
normal experience (rape, war, murder, beatings, torture,
natural disasters)
*1 in 12 adults in the U.S.
suffer from PTSD
*incessant reliving of event,
recurring dreams, intrusive
memories, flashbacks,
intensive fears, sleep
problems.
Perpetration-induced
traumatic stress (PITS)
*soldiers who had killed in combat
were found to suffer higher rates of
PTSD than other troops
*lasting biological effects:
causes the brain’s hormone- *other studies include grief, survivor’s
guilt, fear
regulating system to develop
hair-trigger responsiveness
p341 Zim
SHOW:
Psych in Film, Ver 2, #23, Deer Hunter
6) Stockholm Syndrome
*captor threatens to kill and is able to do so
*victim cannot escape or life depends on the
captor
*victim is isolated from outsiders
*captor is perceived as showing some degree
of kindness
*victim denies anger at abuser & focuses on
good qualities
Example of this
disorder would
be Francine
Hughes (The
Burning Bed)
Francine set fire to her
*”fight or flight” reactions are inhibited
husband while he was
asleep after years of
*victim fears interference by authorities--fears
repeated physical and
the captor will return from jail
mental abuse.
*victim is grateful to abuser for sparing her life
Somatoform Disorders
Somatoform disorders
• Mental illnesses that cause bodily
symptoms, including pain. The
symptoms can't be traced back to any
physical cause. And they are not the
result of substance abuse or another
mental illness.
• People with somatoform disorders are
not faking their symptoms. The pain and
other problems they experience are
real.
Somotoform Disorders
Disorders, involving physical complaints for
which no organic basis can be found.
1. Hypochondria
Fear of having serious disease where no evidence of illness can be
found.
2. Conversion disorder. This condition strikes when people have
neurological symptoms that can't be traced back to a medical
cause. For example, patients may have symptoms such as:
paralysis
blindness
hearing loss
SHOW:
Psych in Film, ver 2, #29, Freud (therapy)
Somatoform Disorders
• 3. Somatization disorder. This is also known as
Briquet's syndrome. Patients with this type have a
long history of medical problems that starts before
the age of 30.
• The symptoms involve several different organs and
body systems. The patient may report a
combination of:
• pain
• neurologic problems
• gastrointestinal complaints
• sexual symptoms
4. Body Dysmorphic
Disorder.
• People with this disorder are obsessed
with -- or may exaggerate -- a physical
flaw. Patients may also imagine a flaw
they don't have.
• The worry over this trait or flaw is
typically constant. It may involve any
part of the body. Patients can be
obsessed with things such as wrinkles,
hair, or the size or shape of the eyes,
nose, or breasts.
5. Pain Disorder
• People who have pain disorder typically
experience pain that started with a
psychological stress or trauma.
• Continue reading below...
• For example, they develop an
unexplained, chronic headache after a
stressful life event.
Understanding Anxiety Disorders
The Learning Perspective
• Fear conditioning
–Stimulus generalization
–Reinforcement
• Observational learning
Understanding Anxiety Disorders
The Biological Perspective
• Natural selection
• Genes
– Anxiety gene
– Glutamate
• The Brain
– Anterior cingulate cortex- resembles a "collar"
surrounding the frontal part of the corpus
callosum. It is also involved in rational
cognitive functions, such as reward
anticipation, decision-making, empathy,
impulse control, and emotion.
TREATMENTS:
*Medical model: antianxiety drugs (valium,
librium, xanax), SSRIs (OCD), Ritlin (ADHD)
*Psychoanalysis: observational learning,
childhood (mom/dad), free association, resistance
(transference), hypnosis
*Learning Theories: classical conditioning,
counterconditioning, systematic desensitization
(phobias)
*Behaviorists: principles of learning, aversive
conditioning, operant conditioning (token
economy)
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies,
responsibility, active-listening.
Show
THE WORLD OF AbNORMAL
BEHAVIOR:
#3 The Anxiety Disorders
MOVIES
The Burning Bed (Stockholm
Synd)
Ordinary People (PTSD)
The Aviator (OCDPD)
Mood Disorders
(Affective Disorders)
Mood Disorders
• Mood disorders = psychological disorders
characterized by emotional extremes.
– Major depressive disorder
– Persistent Depressive Disorder-chronic
major depressive disorder and the previous
dysthymic disorder.
– Premenstrual Dysphoric Disorder
– SEASONAL AFFECTIVE DISORDER (SAD)
– Bipolar disorder
– Disruptive Mood Dysregulation Disorderchildhood Bipolar
– Cyclothmia
Mood Disorders
Mood Disorders
characterized by emotional extremes
1) Depressive Disorders *most common disorders”
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
a) Major Depressive Disorder
Unhappy for 2 weeks without reason,
appetite changes, insomnia, inability to
concentrate, worthlessness, hallucinations
b) Persistent Depressive DisorderUnhappy for over 2 years
Major Depressive Disorder
• Major depressive disorder
–Lethargy
–Feelings of
worthlessness
–Loss of interest in
family and friends
–Loss of interest in
activities
Major Depressive Disorder
•
•
•
•
•
•
•
•
•
Persistent Depressive
Disorder
Formerly known as Dysthymic Disorder (also known
as dysthymia)
The essential feature of persistent depressive disorder
(dysthymia) is a depressed mood that occurs for most of the
day, for more days than not, for at least 2 years (at least 1 year
for children and adolescents).
Individuals with persistent depressive disorder describe their
mood as sad or “down in the dumps.” During periods of
depressed mood, at least two of the following six symptoms
from are present.
Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Seasonal Affective disorder
(SAD)
• A type of depression that's related to
changes in seasons — SAD begins and
ends at about the same times every
year. If you're like most people with
SAD, your symptoms start in the fall
and continue into the winter months,
sapping your energy and making you
feel moody.
• Treatment for SAD may include light
therapy (phototherapy),
psychotherapy and medications.
Symptoms of major depression may be part of SAD, such as:
• Feeling depressed most of the day, nearly every day
• Feeling hopeless or worthless
• Having low energy
• Losing interest in activities you once enjoyed
• Having problems with sleeping
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Having frequent thoughts of death or suicide
• Fall and winter SAD
• Symptoms specific to winter-onset SAD, sometimes called winter depression,
may include:
• Irritability
• Tiredness or low energy
• Problems getting along with other people
• Hypersensitivity to rejection
• Heavy, "leaden" feeling in the arms or legs
• Oversleeping
• Appetite changes, especially a craving for foods high in carbohydrates
• Weight gain
Premenstrual Dysphoric D/O
(PMDD)
•
•
•
•
•
•
•
•
•
•
•
•
In most menstrual cycles during the past year, five (or more) of the following
symptoms occurred during the final week before the onset of menses, started
to improve within a few days after the onset of menses, and were minimal or
absent in the week postmenses, with at least one of the symptoms being either
(1), (2), (3), or (4):
(1) marked affective liability (e.g., mood swings; feeling suddenly sad or teaful
or increased sensitivity to rejection)
(2) marked irritability or anger or increased interpersonal conflicts
(3) markedly depressed mood, feelings of hopelessness, or self-deprecating
thoughts
(4) marked anxiety, tension, feelings of being “keyed up” or “on edge”
(5) decreased interest in usual activities (e.g., work, school, friends, hobbies)
(6) subjective sense of difficulty in concentration
(7) lethargy, easy fatigability, or marked lack of energy
(8) marked change in appetite, overeating, or specific food cravings
(9) hypersomnia or insomnia
(10) a subjective sense of being overwhelmed or out of control
(11) other physical symptoms such as breast tenderness or swelling, joint or
muscle pain, a sensation of “bloating,” weight gain
Mood Disorders
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
a) Manic Episode
a mood disorder marked by a hyperactive, wildly optimistic state,
excessive excitement, silliness, poor judgment, abrasive, rapid flight
of ideas
b) Major depression
Lethargic, sleepy, social withdrawal, irritability
Symptoms of Mania
1) Mood or emotional symptoms:
euphoric, expansive, and elevated. In some
cases, dominant mood is irritability. Even
when euphoric, manic people are close to tears
and if frustrated, will burst out crying.
2) Grandiose cognition: manics believe no
limits to their abilities and do not recognize the
painful consequences of trying to carry out their
plans. May be delusional about themselves.
•Between .6 and
1.1 percent of
U.S. population
will have bipolar
disorder in their
lifetime.
•It affects both
sexes equally.
3) Motivational symptoms: hyperactivity has
intrusive, dominating, domineering quality. Some •Onset is sudden.
engage in compulsive gambling, reckless driving,
•First episode
promiscuity, or poor financial investment.
4) Physical symptoms: lessened need for
sleep. After a few days, exhaustion settles in.
occurs between
ages 20 and 30.
Manic Episode
•
•
•
•
•
•
•
•
A period of at least one week during which the person is in an abnormally
and persistently elevated or irritable mood. The person may instead be
predominately irritable. This period of mania must be marked by three of
the following symptoms to a significant degree. If the person is only
irritable, they must experience four of the following symptoms.
Inflated self-esteem or grandiosity (ranges from uncritical self-confidence
to a delusional sense of expertise).
Decreased need for sleep.
Intensified speech (possible characteristics: loud, rapid and difficult to
interrupt, a focus on sounds, theatrics and self-amusement, non-stop
talking regardless of other person’s participation/interest, angry tirades).
Rapid jumping around of ideas or feels like thoughts are racing.
Distractibility (attention easily pulled away by irrelevant/unimportant
things).
Increase in goal-directed activity (i.e. excessively plans and/or pursues a
goal; either social, work/school or sexual) or psychomotor agitation (such
as pacing, inability to sit still, pulling on skin or clothing).
Excessive involvement in pleasurable activities that have a high risk
consequence.
Hypomanic Episode
• A is very similar to a manic one, but less
intense. It is only required to persist
for 4 days and it should be observable
by others that the person is noticeably
different from his or her regular, nondepressed mood and that the change
has an impact on his or her functioning.
Disruptive Mood Dysregulation
Disorder (DMDD)
• The defining characteristic in children is a
chronic, severe and persistent irritability. This
irritability is often displayed by the child as a
temper tantrum, or temper outburst, that
occur frequently (3 or more times per week).
• When the child isn’t having a temper outburst,
they appear to be in a persistently irritable or
angry mood, present most of the day, nearly
every day.
• “Far beyond temper tantrums, DMDD is
characterized by severe and recurrent temper
outbursts that are grossly out of proportion in
intensity or duration to the situation.”
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 Biological Perspective
PET scans show that brain energy consumption
rises and falls with emotional swings
Mood Disorders-Depression
Understanding Mood Disorders
The Social-Cognitive Perspective
• Negative Thoughts and Moods Interact
–Self-defeating beliefs
• Learned helplessness
• Overthinking
–Explanatory style
• Stable, global, internal explanations
Understanding Mood Disorders
Explanatory Style
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
The vicious
cycle of
depression
can be
broken at
any point
Biopsychosocial Approach to
Depression
Aaron Beck is called the
FATHER OF COGNITIVE THERAPY
He believed that:
•depressed people
draw illogical
conclusions about
themselves.
Aaron Temkin
Beck (1921-?)
Professor, Univ
Pennsylvania
PhD: Brown,
•Created the BECK
Yale
SCALES for labeling
clinical depression.
Beck believed that depressed people blame themselves for
normal problems and consider every minor failure a
catastrophe. Depressive Triad- negative thoughts about
themselves, the world and their future.
Aaron Beck’s work with depressed patients convinced him
that depression is primarily a disorder of thinking rather
than of mood. He argued that depression can best be
described as a cognitive triad or negative thoughts about
oneself, the situation or the future.
Cognitive errors included the following:
1) overgeneralizing: drawing global conclusions about worth, ability, or
performance on basis of single fact
2) Selective abstraction: focusing on one insignificant detail and ignoring
others
3) Personalization: incorrectly taking responsibility for events in the world
4) Magnification & minimization: bad events magnified and good events
minimized.
5) Arbitrary inference: drawing conclusions without sufficient evidence
6) Dichotomous thinking: seeing everything in one extreme or its opposite.
Mood Disorders-Depression
Brain
chemistry
Cognition
Mood
Altering any one
component of
the chemistrycognition-mood
circuit can alter
the others
Generally speaking, a deficit of serotonin is
associated with depression.
Mood Disorders-Depression
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
EXAMPLES of Mood Disorders:
Andrea Yates:
postpartum depression
and the insanity plea. It
has been suggested that
at the far end of the
postpartum psychological
spectrum lie postpartum
psychosis. In Andrea’s
case, it represented a
state of mind in which
killing one’s children
seemed the best way to
protect them.
Harrison
Ford:
depression
Richard
Dreyfuss:
bipolar
disorder
Abraham
Lincoln:
Brittany
Spears:
post-partum
depression
and bipolar
disorder
depression
(melancholia)
Drew
Carey:
Jim
Carrey:
depression
suicidal
(twice)
Mood Disorders-Suicide
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
REASONS for suicide:
1)
Unendurable psychological pain: if you reduce the pain just a little, most
suicidal people will choose to live.
2)
Frustrated psychological needs: (security, achievement, trust, friendship)
3)
Search for a solution: Suicide is never done without purpose --“How do I get
out of this?”
4)
Attempt to end consciousness: goal is to stop awareness of painful
existence.
5)
Helplessness & hopelessness: loss of power
6)
Constriction of options: Not seeing the broad picture; limited options.
7)
Ambivalence: Some is normal--In typical case, victim cuts throat and calls for
help.
8)
Communication of intent: 80 percent gives clear clues to family & friends
9)
Departure: quitting job, running away from home, leaving spouse are all
departures but suicide is the ultimate departure.
10) Lifelong coping patterns: look for earlier episodes--often a style of problem
solving that is characterized as “cut and run.”
LONELINESS
Sharon Brehm reports that gender interacts with
marital status in the following ways:
•Married females report greater loneliness than
do married males
•Among those never married, males report more
loneliness than do females
•Among the separated and divorced, males report
greater loneliness than do females
•Among those whose spouse has died, males
report greater loneliness than do females.
REASONS for Loneliness
1) Being unattached
2) Alienation: being misunderstood & feeling different
3) Being alone: coming home to empty house
4) Forced isolation: hospitalized or housebound
5) Dislocation: starting new job or school
Four major strategies in coping with Loneliness:
1) Sad passivity: sleeping, drinking, overeating, watching TV
2) Social contact: calling friend
3) Active solitude: studying, reading, exercising, going to movie
4) Distractions: spending money, going shopping
DRUG TREATMENTS for Depression:
Monoamine oxidase inhibitors (MAOIs)- first type of antidepressant developed. brain.
MAOIs prevent the removal of removing the neurotransmitters norepinephrine, serotonin
and dopamine from the brain., which makes more of these brain chemicals available
Diet restrictions because they can cause dangerously high blood pressure
*Tricyclic antidepressants:
*first to be used--not used as much today.
*affect 2 neurotransmitters: norepinephrine & serotonin
*side affects: drowsiness & weight gain, increased heart rate, decrease in blood
pressure, blurred vision, dry mouth, confusion
*SSRI (Selective Serotonin Reuptake Inhibitor)
*side effects: nausea, diarrhea, tremors, weight loss, headache
*less likely to affect the heart
*some people feel more agitated and anxious on SSRIs, and can become
increasingly suicidal if not detected and treated.
For extreme Depression-Electroconvulsive therapy (ECT) uses small
amounts of electricity applied to the scalp to affect neurotransmitters in the
brain.
TREATMENTS:
*Medical model: For bipolar-- lithium carbonate, carbamazepine,
and valproate. For depression--tricyclics; the newer selective
serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase
inhibitors (MAO inhibitors).
*Psychoanalysis :unconscious conflicts, intrapscyhic
structures
*Learning Theories: Observational learning and socaiil
roles
*Behaviorists: Counterconditoning
*Cognitive Therapies: interpersonal therapy (Beck Scales)
*Humanistic: client-centered therapies, responsibility, active-listening,
emotional support and assistance in recognizing signs of relapse
to avert a full-blown episode
Show
THE MIND
#31 Mood Disorders: Mania & Depression
#32 Mood Disorders: Hereditary Factors
#33 Mood Disorders: Medication and Talk
Therapy
And
THE WORLD OF AbNORMAL PSYCHOLOGY:
#8 Mood Disorders
Dissociative Disorders
Dissociative Disorders
Dissociative Disorders
– conscious awareness becomes separated
(dissociated) from previous memories,
thoughts, and feelings
1) PSYCHOGENIC AMNESIA
2) PSYCHOGENIC FUGUE
3) DISSOCIATIVE IDENTITY DISORDER
(Multiple Personality Disorder)
4) DEPERSONALIZATION DISORDER
Dissociative Disorders
1) Psychogenic Amnesia
– Sudden inability to recall important
information--NOT as a result of physical
“blow” or drug-related.
2) Psychogenic Fugue
DUE TO EXTREME
STRESS!!
– Loss of memory--flees to a new location and
establishes new lifestyle
– After recovery, events during fugue are not
remembered
Dissociative Disorders
3) Dissociative Identity Disorder
– rare dissociative disorder in which a person
exhibits two or more distinct and alternating
personalities
– formerly called multiple personality disorder
*often history of child or sex abuse
In 2008, Herschal Walker, the 1982 Heisman
Trophy winner from the University of Georgia,
released his book “Breaking Free” which
related his experiences with DID. He reported
not being able to remember winning the
Heisman in 1982 or darker events, such
as threatening his then-wife.
Dissociative Identity Disorder
• Dissociative identity disorder (DID)
–Multiple personality disorder
Understanding Dissociative Identity
Disorder
•
•
•
•
•
Genuine disorder or not?
DID rates
Therapist’s creation
Differences are too great
DID and other disorders
4) Depersonalization Disorder
– Persistent, recurring feelings that one is not
real or is detached from one’s own
experience or body.
Symptoms:
*distorted perception of the body
*might feel like he or she is a robot or in a dream
*some might fear they are going crazy and might
become depressed, anxious, or panicky.
For some people, the symptoms are mild and last for
just a short time. For others, symptoms can be chronic
(ongoing) and last or recur for many years, leading to
problems with daily functioning or even to disability.
People with Dissociative Disorders may experience any of the
following:
depression,
eating disorders
mood swings,
headaches,
suicidal tendencies,
amnesias,
sleep disorders (insomnia, night
terrors, and sleep walking),
time loss,
panic attacks and phobias
(flashbacks, reactions to stimuli
or "triggers"),
alcohol and drug abuse,
compulsions and rituals,
psychotic-like symptoms
(including auditory and visual
hallucinations),
trances, and "out of body
experiences."
self-persecution,
self-sabotage
violence (both self-inflicted and
outwardly directed).
Recent
research
suggests the
risk of suicide
attempts
among people
Disorder (PTSD), widely
with trauma
There is
accepted as a major mental disorders may
evidence that
illness affecting 8% of the be even higher
people with
general population in the
than among
trauma disorders
United States, is closely
people who
have higher rates
related to Dissociative
have major
of alcoholism,
Disorders. In fact, 80-100% depression.
chronic medical of people diagnosed with a
illnesses, and Dissociative Disorder also
abusiveness in
have a secondary
succeeding
diagnosis of PTSD
generations.
Dissociative Disorders are now understood
to be fairly common effects of severe
trauma in early childhood, most typically
extreme, repeated physical, sexual, and/or
emotional abuse.
Posttraumatic Stress
EXAMPLES of Dissociative Disorders:
Herschel
Walker: DID
(Univ. Georgia,
Heisman Trophy,
Dallas Cowboys)
TREATMENTS:
*Medical model: therapy to recall the memories, hypnosis or
a medication called Pentothal (thiopental) can sometimes help
to restore the memories
*Psychoanalysis: help an individual deal with the trauma
associated with the recalled memories. Fugue--Hypnosis.
Dissociative identity disorder-- long-term psychotherapy that
helps the person merge his/her multiple personalities into one.
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations (Depersonalization
Dis)
*Humanistic: client-centered therapies, responsibility, activelistening.
SHOW:
Psych in Film, Ver 2, #27, Bourne Identity
and #30, Raising Cain
Oprah “Dissociative Disorders”
SCHIZOPHRENIC
DISORDERS
(also called Psychotic Disorders)
Schizophrenia
(Psychotic Disorders)
Symptoms of Schizophrenia
• Schizophrenia
(split mind) = a
group of severe
disorders characterized
by disorganized and
delusional thinking,
disturbed perceptions,
and inappropriate
emotions and actions.
–Not multiple
personalities
Schizophrenia literally means “split mind,” meaning a split
from reality that shows itself in disorganized thinking, disturbed
perceptions and inappropriate emotions and actions.
1874, Medicene,
Leipzig & Wurtzburg,
Germany
The term coined by
Emil Kraepelin, who
established the
diagnostic category
“dementia praecox”
and Eugen Bleuler,
who introduced the
term “schizophrenia.”
(1857-1939)
Medicene, University
of Bern
PSYCHOTIC: split from reality
Schizophrenia
• It is a chronic, severe, and disabling brain
disorder that has affected people throughout
history. About 1 percent of Americans have this
illness.
• The symptoms of schizophrenia fall into three
broad categories:
Positive symptoms (psychotic behaviors, thoughts
and movements).
Negative symptoms (disruptions to normal
emotions and behaviors).
Cognitive symptoms (poor decision making and
concentration, problems with working memory).
Symptoms of Schizophrenia
Disorganized Thinking
• Disorganized thinking
– Delusions = false beliefs, often of persecution
or grandeur, that may accompany psychotic
disorders.
– Delusions of Persecution (paranoid)
– Delusions of Grandeur
– Delusions of Control
– Delusions of Reference – A neutral
environmental event is believed to have a
special and personal meaning.
Disorganized Thinking and
Speech
*Word Salad- random words and phrases
*Neologisms- a newly coined
word/expression
*Echolalia (also known as echologia or
echophrasia) is the automatic repetition of
vocalizations made by another person
Breakdown in selective attention
Symptoms of Schizophrenia
Disturbed Perceptions
• Disturbed perceptions
– Hallucinations
6 types
• Auditory, Visual,
• Tactile, Olfactory,
• Gustatory and
• Proprioceptive-This was covered under the
category of sleep paralysis. These sensations of
floating, flying, out-of-body experiences and other
dissociative movement events are most likely when
in bed before and after sleeping.
Symptoms of Schizophrenia
Inappropriate Emotions and Actions
• Inappropriate Emotions
–Flat affect
• Inappropriate Actions
–Catatonia
–Disruptive social behavior
Possible symptoms of psychotic illnesses include:
*Disorganized or incoherent speech
*Confused thinking
*Strange, possibly dangerous behavior
*Slowed or unusual movements
*Loss of interest in personal hygiene
*Loss of interest in activities
*Problems at school or work and with relationships
*Cold, detached manner with the inability to express
emotion
*Mood swings or other mood symptoms, such as
depression or mania
CAUSES:
•chemical imbalances (“mad as a hatter”)
•excess D4 dopamine receptors (in autopsies) (drugs that
block dopamine receptors lessen the symptoms)
•now researching neurotransmitter glutamate (direct neurons
to pass along an impulse)
•abnormal brain activity: low in frontal lobes
•research shows (during hallucinations) increased activity in
thalamus, amygdala, and cortex
•greater than normal cerebral cortex tissue loss between
ages 13 and 18.
•genetics: enlarged, fluid-filled cranial cavities
A common finding in
the brains of people
with schizophrenia
is larger than normal
lateral ventricles.
DIANTHESIS-STRESS HYPOTHESIS:
The idea that biological factors may place
the individual at risk for schizophrenia (or
others), but environmental stressors
transform this potential into an actual
disorder.
Types of Schizophrenia
These classicifcations are not in
DSM V.
1) DISORGANIZED SCHIZOPHRENIC
•
confused and incoherent,
•
jumbled speech
•
emotionless or flat or inappropriate, even silly or childlike.
(flat affect or lack of affect)
•
disorganized behavior that may disrupt their ability to
perform normal daily activities (showering or preparing
meals)
•
hallucinations and delusions
Disorganized speech is of two types:
NEOLOGISMS: “new words”
“I had belly bad luck and brutal and outrageous.” (I have
stomach problems and don’t feel good) “I gave all the work
money. (I paid tokens for my meal) I was raised in packs (with
other people) and since I was in littlehood (little girl) she
blamed a few people with minor words (she scolded people).
WORD SALAD: “disorganization”
The lion will have to change from dogs into cats until I can meet my
father and mother and we depart some rats. I live on the front part of
Whitton’s head. You have to work hard if you don’t get into bed. She
did. She said, “Hallelujah, happy landings.” It’s all over for a squab
true tray and there ain’t not squabs, there ain’t no men, there ain’t no
music, there ain’t no nothing besides my mother and my father who
stand alone upon the Island of Capri where there is no ice, there ain’t
no nothing but changers, changers, changers…….
2) CATATONIC SCHIZOPHRENIC
•Physical symptoms
• immobile and unresponsive to the world around them
• very rigid and stiff, unwilling to move
• waxy flexibility
• occasional grimacing or bizarre postures.
• might repeat a word or phrase just spoken by another person.
• increased risk of malnutrition, exhaustion, or self-inflicted injury.
Catatonic excitement: patients become agitated and
hyperactive.
3) PARANOID SCHIZOPHRENIC
• preoccupied with false beliefs (delusions) about being
persecuted or being punished by someone
• thinking, speech and emotions, however, remain fairly
normal.
•the paranoid delusions of persecution or grandiosity
(highly-exaggerated self-importance) are less well
organized--more illogical--than those of the patient with
purely delusional disorder.
•delusions are usually auditory
4) UNDIFFERENTIATED SCHIZOPHRENIC
* diagnosed when the person's symptoms do not clearly
represent one of the other three subtypes.
5) RESIDUAL SCHIZOPHRENIC
* suffered from schizophrenia in the past but no
hallucinations or delusions
• mildly disturbed thinking
• emotionally impoverished
**6) PARANOID DELUSIONAL DISORDER
• characterized by non-bizarre delusions in the absence of
other mood or psychotic symptoms
•delusions involving real-life situations that could be true,
such as being followed, being conspired against or having
a disease
• delusions persist for at least one month.
• non-bizarre refers to situations such as: being followed,
being loved, having an infection, or being deceived by
one’s spouse
• needs to be evaluated with respect to religious and
cultural differences.
Onset and Development
•
•
•
•
•
Statistics on schizophrenia
Onset of the disease
Positive versus negative symptoms
Chronic (process) schizophrenia
Acute (reactive) schizophrenia
Understanding Schizophrenia
Brain Abnormalities
• Dopamine Overactivity
–Dopamine – D4 dopamine
receptor
–Dopamine blocking drugs
• Glutamate
Understanding Schizophrenia
Brain Abnormalities
• Abnormal Brain Activity and Anatomy
–Frontal lobe and core brain activity
–Fluid filled areas of the brain
Understanding Schizophrenia
Brain Abnormalities
• Maternal Virus During Pregnancy
–Studies on maternal activity and
schizophrenia
–Influence of the flu during pregnancy
Understanding Schizophrenia
Genetic Factors
• Genetic predisposition
• Twin studies
• Genetics and
environmental influences
The GENAIN QUADRUPLETS (b.1930) were monozygous
woman all suffered from schizophrenia, demonstrating a large genetic
component to the disease. The girls (Nora, Iris, Myra, Hester) were
fictitiously named for NIMH (National Institute of Mental Health). Both
parents had mental disorders during their lifetime.
Identical Twin studies show:
*48% probability of having schizophrenia if your twin
does.
*single placenta: 6 in 10 chance
*separate placentas: 1 in 10 chance
*one study showed the older the father, the greater risk
of schizophrenia in offspring
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
TREATMENTS:
*Medical model: Start: olanzapine (Zyprexa), quetiapine
(Seroquel), risperidone (Risperdal), or aripiprazole
(Abilify)….Then: chlorpromazine, fluphenazine, and
haloperidol (Haldol)…. Last resort: Clozapine (Clozaril) (has
side effects)
*Psychoanalysis: medication, psychological counseling
and social support.
*Learning Theories:
*Behaviorists: medication, psychological counseling and
social support.
*Cognitive Therapies:
*Humanistic: medication, psychological counseling and
social support.
Tardive dyskinesia is a difficult-to-treat
form of dyskinesia, a disorder resulting in
involuntary, repetitive body movements.
In this form of dyskinesia, the involuntary
movements are tardive, meaning they have a slow
or belated onset.
This neurological disorder frequently appears after
long-term or high-dose use of antipsychotic drugs,
or in children and infants as a side effect from
usage of drugs for gastrointestinal disorders
EXAMPLES of Schizophrenia :
John Nash:
Nobel Prize
Winning
Mathematician
Mary Todd
Lincoln:
former First Lady
of U. S.
Alan Alda’s
mother:
Actor
Show
MOVIE: Broken Minds
And
THE WORLD OF AbNORMAL
PSYCHOLOGY
#9 The Schizophrenias
PBS The New Asylums
http://www.janssen.com/janssen/mindstorm_video.html
Personality Disorders
Personality Disorders
• Personality disorders = psychological
disorders characterized by inflexible and
enduring behavior patterns that impair social
functioning
–Anxiety cluster
–Eccentric cluster
–Dramatic/impulsive cluster
1) Paranoid Personality Disorder (PPD)
2) Obsessive-Compulsive Personality
Disorder(OCPD)
3) Antisocial Personality Disorder
4) Borderline Personality Disorder
5) Schizoid Personality Disorder
6) Schizotypal Personality Disorder
7) Narcissistic Personality Disorder
Personality Disorders
Personality Disorders
*disorders characterized by inflexible and enduring
behavior patterns that impair social functioning
*usually without anxiety, depression, or delusions
**In contrast to other psychological
problems, PDs do NOT want to change.
They believe the problem lies with the
“other” person.
15% of the American
population are affected with
personality disorders (Mayo
Clinic)….46.5 million people
About one in seven U.S. adults has
at least one personality disorder,
and many have more than one.
Obsessive-compulsive PD
Paranoid PD
Antisocial PD
3.6%
Schizoid PD
Schizotypal PD
Avoidant PD
Borderline PD
Histrionic personality disorder
Narcissistic PD
Dependent PD
8%
4.4%
3.1%
3%
2.4%
2%
1.8%
>1%
>1%
Personality Disorder Types
1) Paranoid Personality Disorder
* Belief that others are lying, cheating, exploiting or trying to
harm you
* Perception of hidden, malicious meaning in benign
comments
* Inability to work collaboratively with others
* Emotional detachment
* Hostility toward others
CAUSES:
*Might be learned…. might be traced back to childhood
experiences.
*Studies of identical and fraternal twins suggest that
genetic factors may also play an important role in causing
the disorder. Twin studies indicate that genes contribute to
the development of childhood personality disorders.
Personality Disorder Types
2) Obsessive-Compulsive Personality Disorder
* Excessive concern with order, rules, schedules and lists
* Perfectionism, often so pronounced that you can't complete tasks
because your standards are impossible to meet
Example:
* Inability to throw out even broken, worthless objects
Howard
* Inability to share responsibility with others
Hughes
* Inflexibility about the "right" ethics, ideas and methods
* Compulsive devotion to work at the expense of recreation and
relationships
* Financial stinginess
* Discomfort with emotions and aspects of personal relationships that
you can't control ***interferes with daily life
A physician in this instance is best sticking with the
facts of the presenting problem and underlying disorder rather than
offering vague impressions of their opinion. Since the individual with
this disorder tends to be meticulous and concerned with details, the
treatment regimen -- once accepted -- will likely be adhered to
rigorously, without incident.
Treatment:
Personality Disorder Types
3) Antisocial Personality Disorder
•
•
•
•
•
•
•
•
•
•
Chronic irresponsibility and unreliability
Lack of regard for the law and for others' right
Persistent lying and stealing
Aggressive, often violent behavior
Lack of remorse for hurting others
Lack of concern for the safety of yourself and others
Intelligent, charming
Treatment--Because many people who suffer
social skills
from this disorder will be mandated to therapy
75% men
in a forensic or jail setting, motivation on the
Potentially dangerous patient's part may be difficult to find. Therapy
Example:
Hannibal Lecter in
Silence of the
Lambs
should focus on alternative life issues, such
as goals for when they are released from
custody, improvement in social or family
relationships, learning new coping skills,
etc. ….. part of the therapy should be devoted
to discussing the antisocial behavior and
feelings (or lack thereof).
Antisocial Personality Disorder
• Antisocial personality disorder =
a personality disorder in which the person (usually a
man) exhibits a lack of conscience for wrongdoing,
even toward friends and family members. May be
aggressive and ruthless or a clever con artist.
–Sociopath or psychopath
• Understanding
antisocial personality
disorder
**Although carriers of this personality disorder are
frequently found among street criminals and con artists,
they are also well represented among successful
politicians and business people who put career, money,
and power above everything and everyone.
**Two to three percent of the population in the U.S.
may have antisocial personality disorder.
**Chronic lying, stealing, and fighting are common signs.
**Violations of social norms begin early in life-disrupting class, getting into fights, and running
away from home.
Personality Disorder Types
4) Borderline Personality Disorder
* Difficulty controlling emotions or impulses
* Frequent, dramatic changes in mood, opinions and
plans
* Stormy relationships involving frequent, intense
anger and possibly physical fights
* Fear of being alone despite a tendency to push
people away
* Feeling of emptiness inside
*75% female
Treatment: Dialectical Behavior
Therapy: teaches the client how to learn to
better take control of their lives, their
emotions, and themselves through selfknowledge, emotion regulation, and cognitive
restructuring.
5) Schizoid Personality Disorder
*Lack of interest in social relations
*Inability to express feelings
• Lack of regard for others' opinions
• Extreme introversion
• Emotional distance, even from family members
• Fixation on your own thoughts and feelings
6) Schizotypal Personality Disorder
*Egocentricity, avoidance of others, eccentricity of thought
*Oversensitive & frequently see chance events as related to
themselves.
*Individuals with this disorder usually distort reality more
so than someone with Schizoid Personality Disorder.
*Indifference to and withdrawal from others
* "Magical thinking" — the idea that you can influence
people and events with your thoughts
* Odd, elaborate style of dressing, speaking and
interacting with others
* Talking to yourself
* Belief that messages are hidden for you in public
speeches and displays
* Suspicious or paranoid ideas
Personality Disorder Types
7) Narcissistic Personality Disorder
*Preoccupied with receiving attention & nurturance
*Exaggerated sense of self-importance
Treatment: Hospitalization of patients
with severe Narcissistic Personality occurs
frequently, such as those who are quite
impulsive or self-destructive, or who have
poor reality-testing.
Charlie Manson is the most famous NPD. In 1968, he was found guilty of
being responsible for the famous Tate-LaBianca murders which he had
concocted to start a black-white race war in the U.S. He persuaded his
“followers” to brutally kill actress Sharon Tate who was 8 months
pregnant with child. Three days later his followers killed Mr. & Mrs.
LaBianca in a similar fashion. (see video following)
Another famous NPD is Diane Downs who was
convicted of attempting to kill her 3 children so she
could continue her affair with a man who didn’t want
children. She claimed she stopped her car for a man in
distress and he came up to the vehicle and shot her
children. One daughter died, her son was paralyzed
from the waist down, and the third daughter (8 at the
time) was in such shock that she refused to speak.
Eventually, the third daughter testified against her
mother and was adopted by the district attorney who
prosecuted the case. (see video following)
MOVIE: Small Sacrifices (1989)
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
EXAMPLES of Personality Disorders :
Adolph Hitler:
Anti-Social PD &
Narcissistic PD
There is some
speculation
that Diana,
Princess of
Wales and
Marilyn
Monroe both
suffered from
Borderline
PD.
TREATMENTS:
*Medical model:
There's no cure for these conditions, but therapy
and medication can help. The symptoms of some
personality disorders also may improve with age.
*Psychoanalysis: SchizoidPD--individual therapy (brief), SchizotypalPD-the clinician must exercise care to not directly challenge delusional or
inappropriate thoughts…warm, supportive, and client-centered
environment should be established with initial rapport.
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: BorderlinePD--Dialectical Behavior
Therapy: teaches the client how to learn to better take control of their
lives, their emotions, and themselves through self-knowledge, emotion
regulation, and cognitive restructuring.
*Humanistic: Group setting (BPD), client-centered therapies (OCPD),
responsibility, active-listening, NarcissisticPD--Small staff-patient groups-feelings are shared and patients' comments taken seriously by staff,
constructive work assignments, recreational activities, and opportunities
to sublimate painfully conflictual impulses.
Show
THE MIND
#35 The Mind of The Psychopath
and
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#5 Personality Disorders
Gacy or Bundy
BIOPSYCHOSOCIAL
DISORDERS
1)
2)
3)
4)
5)
CORONARY HEART DISEASE
MIGRAINE HEADACHES
BREAST CANCER
ANOREXIA NERVOSA
BULIMIA NERVOSA
Biopsychosocial Disorders
1) Coronary Heart Disease (Ch 14, p. 539541)
*Lethal blockage of arteries that supply blood to
heart muscle
*Causes: age, gender, family history, blood
pressure, chloresterol, weight, lifestyle,
psychological state (type A personality)
Biopsychosocial Disorders
2) Migraine Headaches (not in book)
*Intensely painful, recurring headache--reduced
flow of bloodto certain parts of brain-overarousal of sympathetic nervous system
*Causes: stress, change in weather, hormonal
changes, neurotransmitter: glutimate
*Family history
***Seeing zigzag lines or flashing lights,
tingling, numbness in arms & legs.
Biopsychosocial Disorders
3) Breast Cancer (Ch 14, p.543-544)
*Over 50, no children, family history
*Stressful life leads to higher level of the
disease
Swedish researchers say that being under
stress may double a woman's risk of
developing breast cancer.They based their
findings on surveys of more than 1,400
Swedish women in the late 1960s who
were part of a long-term health-care study.
They found that women who reported
being under stress had twice the risk of
developing breast cancer as women who
managed to stay cool, calm, and collected.
Biopsychosocial Disorders
4) Anorexia Nervosa (Ch 12, p.454-467)
*Eating disorder, intense abhorrence of
obesity, insistance that one is fat
*Loss of 25%+ original body fat
*Refusal to maintain normal weight
5) Bulimia Nervosa (Ch 12, p. 464-467)
*Unable to stop eating voluntarily
*Preoccupation with weight gain
*Attempt to lose weight thru binge eating, selfinduced vomiting & overuse of laxatives and
diuretics
A surplus of serotonin is associated
with anorexia
EXAMPLES of Biopsychsocial Disorders :
Karen
Carpenter:
Victoria
Beckham:
Died of anorexia
age32 (weighed
80lbs)
Alanis
Morisette:
Jane Fonda:
Actress
TREATMENTS:
*Medical model: Preventative (diet & exercise)
*Psychoanalysis: Hypnosis
*Learning Theories: guided learning
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
1)
2)
3)
4)
5)
INJURY
ALZHEIMERS DISEASE
WERNICKE - KORSAKOFF’S SYNDROME
PARKINSON’S SYNDROME
PARKINSON’s DISEASE
Neurophysical Disorders
1) Injury (not in book)
*Brain trauma
2) Alzheimers (Ch 4, p 177-178)
**trouble remembering recent events, activities, or the
names of familiar people or things
**Age (number of people w/disease doubles every 5 years
past age 65 )
**family history (usually occurs between age 30-60 if it’s
genetic). . . . One risk factor for this type of AD is a protein
called apolipoprotein E (apoE).
**Deficiency of acetylcholine
Neurophysical Disorders
3) Wernicke’s-Korsakoff’s Syndrome (not in book)
*memory disorder caused by a lack of vitamin B1
(thiamine).
*affects short-term memory.
*Most common cause: alcoholism
*A related disorder, Wernicke's syndrome, often occurs
before Korsakoff's syndrome. Because they often occur
together, the range of symptoms caused by the two
diseases is often called Wernicke's-Korsakoff syndrome.
The main symptoms of Wernicke's syndrome occur
acutely. They include:
• Difficulty with walking and balance
• Confusion
• Drowsiness
• Paralysis of some eye muscles
Neurophysical Disorders
3) Korsakoff’s Syndrome
*Thiamine is necessary for memory and other brain
functions. People who drink a lot of alcohol often replace
food with alcohol. As a result, they take in fewer vitamins,
leading to vitamin deficiencies. In addition, alcohol
increases the body's need for B vitamins while interfering
with its ability to absorb, store, and use thiamine.
*A genetic abnormality may make some people more
susceptible to Korsakoff's syndrome when they drink large
amounts of alcohol and consume diets low in vitamins.
Neurophysical Disorders
4) Parkinson’s Syndrome (not in book)
*tremor in hand, foot, mouth, or chin
*stiffness or rigidity of the limbs and trunk
*bradykinesia (slowness of movement)
*postural instability, or impaired balance and coordination
*Occurs in about 1% of people over 65, 15% in ages 74-85, and
over 50% of people over 85
Neurophysical Disorders
• Parkinson’s Disease (not in
book)
caused by the progressive impairment or
deterioration of neurons (nerve cells) in
an area of the brain known as the
substantia nigra. When functioning
normally, these neurons produce a vital
brain chemical known as dopamine.
Dopamine serves as a chemical
messenger allowing communication
between the substantia nigra and
another area of the brain called the
corpus striatum. This communication
coordinates smooth and balanced
muscle movement. A lack of dopamine
results in abnormal nerve functioning,
causing a loss in the ability to control
body movements.
Neurophysical Disorders
• Parkinson’s Disease
– Why Parkinson’s
occurs and how the
neurons become
impaired is not
known. However,
increasing evidence
suggests that it may
be inherited.
TREATMENTS:
*Medical model: Aricept (alzheimer’s—cholinesterase
inhibitors), L-dopa (parkinson’s)
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: discuss irrational
interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
L-dopa (OTC)
**naturally-occurring dietary supplement and psychoactive drug
commonly found in some foods and herbs.
**precursor to the neurotransmitter dopamine, norepinephrine
(noradrenaline), and epinephrine (adrenaline).
**crosses the blood-brain barrier whereas dopamine cannot. Once into
the CNS, it is converted into dopamine.
Cholinesterase inhibitors (Aricept, Exelon)
**Alzheimer’s causes brain cells die and connections among cells are
lost, causing cognitive symptoms to worsen.
**cannot stop the damage, however, they may help lessen or stabilize
symptoms
**prevents the breakdown of acetylcholine
EXAMPLES of Biopsychsocial Disorders :
Mao Zedong:
Mohammed
Ali:
Chinese leader
Prize Fighter
/boxer
Michael J.
Fox:
Actor
Janet Reno:
former U.S.
Attorney Geneeral
Show
THE WORLD OF AbNORMAL
PSYCHOLOGY
#10 Organic Brain Disorders
SUBSTANCE ABUSE
DISORDERS
1)
2)
3)
4)
5)
ALCOHOL
COCAINE
METHALAMPHETAMINES
NICOTINE
ECSTASY
Substance Abuse Disorders
1) Alcohol (Ch 7, p.294-304)
*Drinking impairs life adjustments
*Health, personal relationships, occupational functioning
*Strong relationship between alcohol & violence.
Am I drinking too much?
YES, if you are:
･A woman who has more than seven drinks* per week or more than
three drinks per occasion
･A man who has more than 14 drinks* per week or more than four
drinks per occasion
･Older than 65 years and having more than seven drinks* per week
or more than three drinks per occasion
*--One drink = one 12-oz bottle of beer (4.5 percent alcohol) or one 5-oz glass of wine (12.9 percent alcohol) or 1.5 oz of 80proof distilled spirits.
Substance Abuse Disorders
2) Cocaine (Ch 7, p.294-304)
*Chronic abuse can promote acute
psychotic symptoms & hallucinations
*Activates the part of the brain as areas
of pleasure & rewards (food, sex,
water)
*Long term effects include:
Addiction
Irritability and mood disturbances
Restlessness
Paranoia
Auditory hallucinations
Substance Abuse Disorders
3) Methamphetamines
*synthetic amphetamines or stimulants
that are produced and sold illegally in pill
form, capsules, powder and chunks.
*has a structure similar to dopamine (the brain's
pleasure transmitter) and causes neurons to
release large amounts of dopamine to produce a
high. ……… leads to permanent brain damage
as natural dopamine production sites are
destroyed - forcing the user to become even
more reliant on meth for pleasure.
*known as meth, crank, glass, speed,
crystal, ice, batu, chalk, shabu, or zip
Substance Abuse Disorders
4) Nicotine (Ch 7, p.294-304)
*Poisonous substance in cigarettes
*450,000 related deaths per year.
**Used as a coping device
*About 80 percent of nicotine is broken down to cotinine
by enzymes in your liver.
*Nicotine is also metabolized in your lungs to
cotinine and nicotine oxide.
*Cotinine and other metabolites are excreted in your
urine. Cotinine has a 24-hour half-life, so you can test
whether or not someone has been smoking in the past
day or two by screening his or her urine for cotinine.
Substance Abuse Disorders
4) Nicotine (Ch 7, p.294-304)
A synapse is the site where two neurons come into contact. The
presynaptic neuron releases a neurotransmitter, which binds to receptors
on the postsynaptic cell. This allows signals to be transmitted from neuron
to neuron in the brain.
Substance Abuse Disorders
4) Nicotine (Ch 7, p.294-304)
Nicotine works by docking to a subset of receptors that
bind the neurotransmitter acetylcholine. Acetylcholine
is the neurotransmitter that (depending on what region of
the brain a neuron is in):
* Delivers signals from your brain to your muscles
* Controls basic functions like your energy level, the
beating of your heart and how you breathe
* Acts as a "traffic cop" overseeing the flow of
information in your brain
* Plays a role in learning and memory
Substance Abuse Disorders
5) MDMA (ECSTACY)
*methylenedioxymethamphetamine
*amphetamine family of compounds with
stimulant and psychodelic properties.
*Short-term effects include feelings of mental
stimulation, emotional warmth, enhanced
sensory perception, and increased physical
energy.
*Adverse health effects can include nausea,
chills, sweating, teeth clenching, muscle
cramping, and blurred vision.
Substance Abuse Disorders
5) MDMA (ECSTACY) (cont)
*ecstasy contains a number of other drugs,
including methamphetamine, caffeine,
dextromethorphan, ephedrine, and cocaine.
*has potent effects on the cardiovascular system
and on the body's ability to regulate its internal
temperature……increases the risk of heart
damage
**increases the activity levels of at
least three neurotransmitters:
serotonin, dopamine, and
norepinepherine.
Substance Abuse Disorders
5) MDMA (ECSTACY) (cont)
**Compared to methamphetamine, MDMA triggers a
larger increase in serotonin and a smaller
increase in dopamine.
Serotonin is a major neurotransmitter involved in regulating
mood, sleep, pain, emotion, and appetite, as well
as other behaviors. By releasing large amounts of
serotonin, and also interfering with its synthesis, MDMA
leads to a significant depletion of this
important neurotransmitter. As a result, it takes the
human brain a significant amount of time to rebuild the
store of serotonin needed to perform important
physiological and psychological functions.
TREATMENTS:
*Medical model: methadone relieves pain.
*Psychoanalysis:
*Learning Theories: Twelve-Step Programs
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
MOUSE PARTY: A Mouse on Drugs
http://learn.genetics.utah.edu/content/addiction/drugs/mo
use.html
Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#6 Substance Abuse Disorders
The Meth Epidemic
Psych in Film, Ver 2, #25, Lost
Weekend (alcoholism)
SEXUAL
DISORDERS
1) GENDER IDENTITY DISORDER
(TRANSSEXUALISM)
2) SEXUAL DISFUNCTION
3) PARAPHILIAS
Sexual Disorders
(Ch 12, p.467-482)
1) Gender Identity Disorder (Transsexualism)
*Confusion or uncertainty between biological
sex and gender identity.
2) Sexual Disfunction
*Inhibitions in sexual response
Sexual Disorders
3) Paraphilias
– Fetishism, zoophilia, pedophila, exhibitionism,
voyeurism, masochism, sadism et. al.
– Sexual response to unusual objects or
situations
TREATMENTS:
*Medical model: viagra
*Psychoanalysis:
*Learning Theories: classical conditioning.
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#7 Sexual Disorders
DEVELOPMENTAL
(CHILDHOOD)
DISORDERS
1) ATTENTION DEFICIT HYPERACTIVITY
DISORDER (ADHD)
2) CONDUCT DISORDER
3) SEPARATION ANXIETY DISORDER
4) AUTISM
5) DYSLEXIA
1) Attention Deficit Hyperactivity Disorder (ADHD) (not
in book)
*Maladaptive behavior that interferes with effective task-oriented
behavior
*Impulsive, excessive motor activity, exaggerated muscular activity,
difficulty maintaining attention
*controversial diagnosis
*Critics claim ADHD is overdiagnosed (i.e.)blame
children for unskilled parents or teachers.
*drug treatment includes stimulants
*stimulant drug therapy combined with behavioral
therapy can improve attention and diminished
hyperactivity in 70% of ADHD children.
*Strattera -- a drug used for ADHD is a norepinephrine
reuptake inhibitor
One of the theories as to why Ritalin (stimulants) helps
people with ADHD is that they may have more
dopamine transporters than others. The excess of
transporters removes dopamine from the synapse
before it can reach a dopamine reward receptor in the
receiving neuron, so the attention circuitry in the ADHD
brain is under stimulated.
By blocking transporters, Ritalin allows more
dopamine to reach receptors, thus increasing attention
signaling, which helps people with ADHD to focus.
Ritalin, when taken orally, slowly raises dopamine levels
over the course of an hour or so.
2) Conduct Disorders (not in book)
*Persistant, repetitive violation of rules and disregard for
rights of others
*Fighting, defiance, disobedience, destruction of
property, attention seeking, inattentiveness, overaggressive behavior, bullying, physical aggression,
cruel behavior toward people and pets, destructive
behavior, lying, truancy, vandalism, and stealing.
*ODD--Oppositional Defiant Disorder: disobedient,
hostile behavior towards authority figures
*clinically significant impairment in social, academic, or
occupational functioning.
3) Separation Anxiety Disorder (not in book)
*Excessive anxiety about separation from
people to whom the child is attached
*Unrealistic fears, oversensitivity, selfconsciousness, nightmares, chronic anxiety
4) Autism (p. 147-148, 424, 668)
*Pervasive developmental disorder occurring in infancy
or childhood—1 in 88 children (as of 2008
*Qualitative impairment in reciprocal social interaction
& communication--restricted repertoire of activities &
interests
Example: Sally and Ann are playing together, when Sally puts a piece of candy
in a box and leaves the room. While Sally is gone, Anne opens the box,
removes the candy and stashes it in her purse. When Sally comes back, where
will she look for the candy?
Normal children will say that Sally will look in the box. Autistic
children are most likely to say (if they communicate at all) that
Sally will look in the purse. The autistic child lacks “theory of
mind”. Severely autistic children cannot imagine themselves
in Sally’s place.
5) Dyslexia
*reading difficulties
*affects 1 of 5 children
*involves the abnormalities in the brain’s
language-processing circuits.
Another cause may be language itself:
*English: bizarre spelling menagerie, containing 1120 ways
to spell only 40 different sounds, are more likely to be
dyslexic than
*Italian: 33 combinations of letters for 25 sounds.
TREATMENTS:
*Medical model: Stimulants (ADHD), Ritlan, Strattera
*Psychoanalysis:
*Learning Theories: Token Economy
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
Show
THE WORLD OF AbNORMAL
PSYCHOLOGY:
#11 Behavior Disorders of Childhood
Psych in Film, Ver 2, #26, Mercury
Rising (autism), #15, Parenthood
(special needs child)
ADJUSTMENT
DISORDERS
ADJUSTMENT DISORDERS:
Other conditions that may be a focus of
clinical attention.
*mild depression
*physical complaints
*marital problems
*academic problems
*job problems
*parent-child problems
*bereavement
*malingering (faking an illness)
TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
TREATMENTS:
*Medical model:
*Psychoanalysis:
*Learning Theories:
*Behaviorists:
*Cognitive Therapies: irrational interpretations
*Humanistic: client-centered therapies, responsibility,
active-listening.
Rates of Disorder
Rates of Disorder
• Mental health
statistics
• Influence of poverty
• Other factors
(2008 data, NIMH)
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
Questions for
Review
1) RECALL
In Rosenhan’s study, who discovered that the
“pseudopatients” were feigning mental illness?
a) psychiatrists
b) psychologists
c) Nurses and aides working on the ward
d) Other patients
e) Other physicians
2) APPLICATION
Which of the following symptoms most clearly suggests
the presence of abnormality?
a) hallucinations
b) worries
c) Unusual behavior
d) creativity
e) distraction
3) RECALL
Hippocrates proposed that mental disorder was caused
by
a) Possession by demons
b) An imbalance in four bodily fluids
c) A fungus growing on rye grain
d) Traumatic memories in the unconscious
e) The taking of potions.
4) RECALL
The behavioral perspective emphasizes the influence of
__, while the cognitive perspective emphasizes __.
a) Genetics / conscious processes
b) Conscious processes / unconscious processes
c) Heredity / environment
d) Medical factors / psychological factors
e) The environment / mental process
5) UNDERSTANDING THE CORE CONCEPT
Which of the following would be least likely to be
noticed by a clinician using strictly the medical
model of mental disorder?
a) delusions
b) Severe disturbances in affect
c) An unhealthy family environment
d) A degenerative brain disease
e) hallucinations
6) RECALL
The DSM IV is based on the
a) Cognitive perspective
b) Behavioral perspective
c) Eclectic view
d) Psychoanalytic view
e) medical model
7) RECALL
Which disorder involves extreme swings of mood from
elation to depression?
a) Panic disorder
b) Bipolar disorder
c) schizophrenia
d) Unipolar depression
e) PTSD
8) APPLICATION
According to the preparedness hypothesis, which one of
the following phobias would you expect to be most
common?
a) Fear of snakes (ophidiophobia)
b) Fear of books (bibliophobia)
c) Fear of horses (equinophobia)
d) Fear of the number 13 (triskaidekaphobia)
e) Fear of water (aquaphobia)
9) RECALL
Which of the following disorders involves a deficiency in
memory?
a) phobia
b) Antisocial personality
c) Dissociative fugue
d) obsessive-compulsive diorder
e) schizophrenia
10) RECALL
Which of the following is a disorder in which the
individual displays more than one distinct
personality?
a) schizophrenia
b) Depersonalization disorder
c) Bipolar disorder
d) phobia
e) Dissociative identity disorder
11) RECALL
Which of the following is primarily a disorder of young
American women?
a) Bipolar disorder
b) schizophrenia
c) Anorexia nervosa
d) Antisocial personality disorder
e) Dissociative identity disorder
12) RECALL
Hallucinations and delusions are symptoms of
a) schizophrenia
b) Somatoform disorders
c) Anxiety disorders
d) Depersonalization disorders
e) Panic disorders
13) RECALL
Which category of disorder is most common?
a) schizophrenia
b) Dissociative disorder
c) Eating disorders
d) The adjustment disorders and “other conditions that
may be a focus of clinical attention”
e) Mood disorders
14) UNDERSTANDING THE CORE CONCEPT
The DSM-IV groups most mental disorders by their
a) treatments
b) causes
c) symptoms
d) theoretical basis
e) cures
15) UNDERSTANDING THE CORE CONCEPT
Which unfortunate consequence of diagnosing mental
disorders is emphasized chapter?
a) The inaccuracy of diagnosis
b) Stigmatizing those with mental disorders
c) Adding to the already overcrowded conditions in
mental hospitals
d) That some cultures do not recognize mental
disorders
e) The importance of the insanity defense.
16) RECALL
Which one of the following statements is true?
a) Mental disorders have a similar prevalence in all cultures
b) In general, biology creates mental disorder, while culture
merely shapes the way a person experiences it.
c) Culture-specific stressors occur primarily in developing
countries
d) Cultures around the world seem to distinguish between
people with mental disorders and people who are
visionaries or prophets.
e) Mental disorders are more prevalent in Eastern culture.
17) RECALL
Insanity is
a) Psychological term
b) Psychiatric term, found in DSM-IV under
“psychotic disorders.”
c) Legal term
d) Term that refers either to “neurotic” or “psychotic”
symptoms
e) A classification for those seeking treatment.
18) RECALL
A long-standing pattern of irresponsible behavior that
hurts others without causing feelings of guilt or
remorse is typical of
a) An obsessive-compulsive disorder
b) An antisocial personality disorder
c) A narcissistic personality disorder
d) Paranoid schizophrenia
e) Dissociative fugue.
19) APPLICATION
A young woman wanders into a hospital, claiming not to
know who she is, where she is from, or how she got
there. Her symptoms indicate that she might be
suffering from a(n) ____ disorder
a) anxiety
b) affective
c) personality
d) dissociative
e) mood
20) RECALL
____ has been called the “common cold of
psychopathology” because it occurs so frequently and
because almost everyone has experienced it, at least
briefly, at some time.
a) Obsessive-compulsive disorder
b) Bipolar disorder
c) Depression
d) Paranoid schizophrenia
e) Autism
21) RECALL
A person who suffers from ____ cannot eat normally but
engages in a ritual of “binging”--periodic binges of
overeating--followed by “purging” with induced
vomiting or use of laxitives.
a) Anorexia nervosa
b) Bulimia nervosa
c) Inhibition
d) Mania
e) Depression
22) RECALL
The ____ type of schizophrenia is characterized by
delusions.
a) residual
b) catatonic
c) paranoid
d) undifferentiated
e) disorganized
23) RECALL
Rosenhan believes that his “pseudopatients” were not
recognized as normal because
a) The staff members in the mental hospital were
incompetent
b) The staff members in the mental hospitals were just
as disturbed as the patients
c) Mental illness is a myth
d) Staff members did not expect patients to be normal
e) He denied the existance of psychological disorders
24) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
B
____Extreme
disorders of thinking, involving
persistent false beliefs.
25) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
J developmental disorder marked by
_____A
disabilities in language and social interaction.
26) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
D A class of disorders including bipolar
_____
disorder.
28) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
E A class of disorders including panic
_____
disorder.
29) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
I A disorder characterized by an unstable
_____
personality given to impulsive behavior for which
includes remorse after the fact.
30) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
G A class of disorders including
_____
depersonalization disorder.
31) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
F A class of disorders including conversion
_____
disorder.
32) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
A False sensory experiences that may
_____
suggest a mental disorder.
33) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
C The view that mental disorders are
_____
diseases that have objective physical causes and
require specific treatments.
34) MATCHING
a)
b)
c)
d)
e)
Hallucinations
Delusions
Medical model
Mood disorders
Anxiety disorders
f) Somatoform disorders
g) Dissociative disorders
h) Diathesis-stress hypothesis
i) Borderline personality disorder
j) Autism
H The proposal that genetic factors place the
_____
individual at risk while environmental stress factors
transform this potential into schizophrenic disorder.
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#21, Zimbardo, Psychopathology