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Chapter 16
A. What is Normal?
 Symptoms
of Psychological Disorders
–Deviation from a norm
–Emotional Discomfort
Why do you think
the U.S. has such a
high prevalence of
mental disorders?
A. What is Normal?
 Deviation
from a statistically
calculated norm:
If a person behaves
in a way that a
majority of people do (approximately
68%) then the behavior is normal. If not,
the behavior is abnormal
A. What is Normal?
 Shortcomings
of this definition
–It doesn’t discriminate between
desirable and undesirable
–Just because a statistical majority
of people engage in a particular
behavior does not mean that
society would like to encourage it
as being normal
A. What is Normal?
 Emotional
If a person’s behavior causes him/her
distress than the behavior is
considered to be abnormal
A. What is Normal?
 Shortcomings
of this definition
– Some behavior are so abhorrent that
despite someone’s comfort level if it is
not normal behavior
A. What is Normal?
 Deviation
from a social/cultural
– A cultural norm is what society deems
as being acceptable. There are norms
that cover all types of behaviors.
 When do we notice norms?
A. What is Normal?
 Shortcomings
of this definition
–There are different norms for
different cultures, and different age
groups. Additionally, norms change
over time.
A. What is Normal?
 Maladaptivity
If a behavior interferes with a
person’s ability to function it is
considered to be abnormal. If a
person is still able to function
adequately in everyday life, than it is
not abnormal.
Explaining Psychological Disorders
Biological Factors:
– The earliest supporter of this view was
Hippocrates. He saw mental disorders as being
some kind of physical illness. He believed that
disorders were caused by imbalances of the four
humors (bodily fluids) which are blood, black bile,
phlegm, and yellow bile.
– Hippocrates believed that depression resulted
from an excess of black bile (melancholia)
Explaining Psychological Disorders
 Neurobiological
– This model looks at problems in anatomy and
physiology of the brain and other areas.
– This model dominates modern research on
the causes—and treatments—of psychological
disorders. People who adhere to this model
see mental disorders as being caused by a
physical illness, and believed it can be
diagnosed, treated and cured.
Explaining Psychological Disorders
 Psychological
– In this view, mental disorders are seen as
being caused by inner turmoil or other
psychological events.
– Psychological models: Include the
psychodynamic, cognitive-behavioral, and
phenomenological (humanistic) approaches
Explaining Psychological Disorders
Sociocultural Context:
– Sociocultural explanations rely on
factors such as gender and age, physical
and social situations, cultural values and
expectations, and historical eras.
Culture-general disorders appear in
most societies while culture-specific
forms appear only in certain ones.
Explaining Psychological Disorders
Diathesis-Stress as an Integrative Approach
– Diathesis-stress model:
This model views genetics, early learning, and
biological processes as contributing factors to
psychological disorders.
– In other words, a person’s inherited
characteristics, biological processes, and early
learning experiences may create a predisposition
(or diathesis) for a psychological disorder, but
whether or not the disorder appears depends on
the stressors the person encounters
Classifying Psychological Disorders
A Classification System: DSM-IV-TR
This is the most comprehensive and
authoritative set of guidelines available
for diagnosing psychological disorders. It
includes the symptoms, the exact criteria
that must be met to make a diagnosis,
and the typical course for each mental
Classifying Psychological Disorders
Axis I: Clinical Syndromes: comprises
descriptive criteria of 16 major mental
– Diagnosis of disorders are made on Axes I
and II
– It is on this axis that clinician record any
major disorders that are apparent.
Classifying Psychological Disorders
Axis II: Personality disorders:
these disorders are patterns of personality
traits that are longstanding, maladaptive,
and inflexible and involve impaired
functioning or subjective distress.
Examples include borderline, schizoid, and
antisocial personality disorders) and
mental retardation
Classifying Psychological Disorders
Axis III: General Medical Conditions
Physical disorders of conditions are
recorded on this axis. Examples include
diabetes, arthritis, and hemophilia)
Classifying Psychological Disorders
Axis IV: Psychosocial and
Environmental Problems:
Types and levels of stress, it may be a
negative life event, an environmental
difficulty or deficiency, a familial or other
interpersonal stress, an inadequacy of social
support or personal resources, or another
problem that describes the context in which a
person’s difficulties have developed
Classifying Psychological Disorders
Axis V: Global Assessment of Function
(GAF) Scale:
Has a rating of that ranges from 100
(Superior functioning in a wide range of
activities) to 1 (Persistent danger of
severely hurting self or others).
Estimate are made of the individual’s
current level of adaptive functioning as a
whole and of the individual’s highest level
of functioning in the past year
Classifying Psychological Disorders
 Diagnosis
of disorders are made on
Axes I and II
 Axes III, IV, and V are used to record
supplemental information about the
Classifying Psychological Disorders
 Purposes
and Problems of Diagnosis
– Goals: Help identify appropriate treatment for
clients and to accurately and consistently
group patients with similar disorders so that
research efforts can more easily identify
underlying causes of mental illness
– Limitations
 Validity: Some argue that attempts on improving
the consistency of the diagnosis has taken away
from the validity of the diagnosis
Classifying Psychological Disorders
 Purposes
and Problems of Diagnosis
 Interrater Reliability: Studies have shown
that 80% of the time there is agreement
between independent raters
 Mild
personality disorder, usually does
not impair one’s ability to function in
 Symptoms:
– Depression
– Anxiety
– Self-defeating patterns of behavior
Serious personality disorder, usually
incapacitating preventing one from
functioning in society.
 Symptoms
– Loss of contact with reality
– Hallucinations: inappropriate feelings
that come to us from one of our senses
– Delusions: false but persistent beliefs
despite evidence to the contrary
 Types
of Hallucinations:
– Auditory Hallucinations:
hearing things that are not there
– Visual Hallucinations:
seeing things that aren’t there
 Types of Hallucinations:
– Tactile Hallucinations:
feeling things that aren’t there
– Olfactory Hallucinations:
smelling things that aren’t there
– Gustatory Hallucinations:
tasting things that aren’t there
 Symptoms
of Psychosis
– Delusions: false but persistent beliefs
despite evidence to the contrary
 Types
of Delusions:
– Delusions of Grandeur:
thinking you are someone
of great importance
 Types
of Delusions:
– Delusions of Reference:
thinking that you are the center of
attention, that people are looking at, or
talking about you
– Delusions of Depersonalization:
thinking you are turning into an
inanimate or vegetative object
 Types
of Delusions:
– Delusions of Persecution:
thinking that people are out to get you
or harm you
– Delusions of Guilt:
thinking that you have just committed a
terrible wrong
Anxiety Disorders
Anxiety: Freud called anxiety a “free
floating fear” meaning that it is not attached
to any particular object or event. Anxiety is
a general feeling of doom and dread.
Anxiety disorders are marked by feelings of
excessive apprehension
Anxiety Disorders
 Generalized
Anxiety Disorder:
A person with General Anxiety
Disorder (GAD) is continually tense,
apprehensive, and in a state of
autonomic nervous system (ANS)
arousal. This anxiety is persistent
and many escalate into a panic attack
Anxiety Disorders
 Generalized
Anxiety Disorder:
– People with this disorder worry constantly
about yesterday’s mistakes and
tomorrow’s problems. In particular, they
worry about minor matters related to
family finances, work and personal
illness. They often dread decisions and
brood over them endlessly. Their anxiety
is commonly accompanied by physical
I wish I could tell you exactly what’s the matter. Sometimes
I feel like something terrible has just happened when actually
nothing has happened. Other times, I’m expecting the sky to fall
down any minute. Most of the time I can’t point my finger at
something specific. Still, I feel tense and jumpy. The fact is that
I am tense and jumpy almost all the time. Sometimes my heart
beats so fast, I’m sure it’s a heart attack.
Little things can set it off. The other day I thought a
Supermarket clerk had overcharged me a few cents on an item.
She showed me that I was wrong, but that didn’t end it. I worried
the rest of the day. I kept going over the incident in my mind,
feeling terribly embarrassed at having raised the possibility
that the clerk had committed an error. The tension was so great,
I wasn’t sure I’d be able to go to work in the afternoon. That sort
of thing is painful to live with.
Taylor Manifest Anxiety Scale
1. F
2. T
3. F
4. F
5. T
6. T
7. T
8. T
9. F
Anxiety Disorders
Phobic Disorder: Phobic disorders are
marked by a persistent, irrational fear of a
specific object or situation.
– What’s the difference between a phobia
and a fear?
Phobia is the Greek word
for morbid fear after the
lesser Greek god, Phobos
Anxiety Disorders
Specific Phobias:
involve fear and avoidance of a specific
stimuli or situation.
– About 10% of the general population
will experience a specific phobia at
some point in their lives.
– More than twice as many women as
men suffer from specific phobia.
Anxiety Disorders
Specific phobia tend to fall into four categories
1. Fear of particular situations: such as flying driving,
tunnels, bridges, elevators, crowds, or enclosed placed
2. Fear of features of the natural environment: such
as heights, water, thunderstorms, or lightning
3. Fear of injury or blood: including the fear of
injections, needles, and medical or dental procedures
4. Fear of animals and insects: such as snakes,
spiders, dogs, cats, slugs, or bats
Hilda is 32 years of age and is terrified of
snow. She cannot go outside in the snow.
She cannot even stand to see snow
or hear about it on the weather report.
Her phobia severely constricts her day-today behavior.
Probing in therapy revealed that her phobia
was caused by a traumatic experience at
age 11. Playing at a ski lodge, she was
buried briefly by a small avalanche of snow.
She had no recollection of this experience
until it was recovered in therapy.
Anxiety Disorders
Social Phobias: a fear of being negatively
evaluated by others or publicly embarrassed by
doing something impulsive, outrageous, or
Social phobia goes well beyond the shyness that
everyone sometimes feels at social gatherings.
Rather, the person with social phobia is
paralyzed by fear of social situations, especially
if the social situation involves performing even
routine behaviors in front of others.
Anxiety Disorders
Agoraphobia: a fear of situations the
person views as difficult to escape from if
panic begins to build.
Many people with this
disorder become trapped
in their own homes or
in similar safe zones.
Anxiety Disorders
Phobias are considered anxiety disorders
because they focus general feelings of anxiety
onto a feared object or situation
 General Facts about phobias
– Phobias are twice as high for females than males
– Phobias are more prevalent in blacks than in whites
or Hispanics
– Phobias tend to be chronic (lasts between 24-31
– Typical onset is childhood or young adulthood
Anxiety Disorders
Common Phobias and the Feared Objects
High Places
Open Places
Enclosed Places
Anxiety Disorders
Common Phobias and the Feared Objects
Anxiety Disorders
Panic Disorder: Periodic episodes of
extreme terror (panic attacks) without
warning or obvious cause are characteristic
of people with panic disorder.
Anxiety Disorders
 Obsessive-Compulsive
– Obsessions:
are unwanted thoughts, ideas or mental
images that occur over and over again
– Compulsions:
are repetitive, ritual behaviors, often
involving cleaning or checking.
Anxiety Disorders
Obsession-Compulsive Disorder
marked by persistent uncontrollable intrusions of
unwanted thoughts (obsessions) and urges to
engage in senseless rituals (compulsions)
– Rate: 3% of the general population
– Onset: for males 6-15; for females 20-29
– Demographics: for commonly found among
upper income, highly intelligent groups, males
and females are equally likely to suffer from
this disorder
Anxiety Disorders
The patient was a 49-year-old man whose main
symptom was an obsession with the number 13. If he
heard the word he felt a “shock” and experienced a
subsequent period of acute anxiety. His everyday life
was a continuous effort to avoid any reference to 13, so
much that his activities were seriously handicapped. In
some way or another, it seems as if everyone was
always saying “13” to him. If they met him in the
morning they would say, “Oh, good morning,” or later in
the day it would be “Good afternoon” (13 letters each).
He stayed in bed on the 13th day of each month,
skipped the 13th tread in a stairway, and found it
necessary to count letters and phrases, his steps, and
streets, to avoid the number 13.
Anxiety Disorders
Shirley was an outgoing popular high school student
with average grades. Her one problem was that she
was late for school almost everyday. Before she could
leave the house in the morning, she had to be very sure
that she was clean, so she needed to take showers that
lasted two hours. She also spent a long time dressing,
because each act—for example, putting on her
stockings, underclothes, skirt, and blouse– had to be
counted and repeated precisely 17 times. When asked
about her washing and counting, she said she knew
that is was crazy but that she just had to do it and
couldn’t explain why. She said that she had struggled
against this problem for three years but had no success
Anxiety Disorders
 Causes
of Anxiety Disorders
– Biological Factors:
 Twin studies suggest there may be a weak genetic
predisposition to anxiety disorders. Also, identical
twins reared apart often times have independently
developed phobias. Most anxiety disorders, such
as panic disorder, obsessive-compulsive disorder,
and generalized social phobia, appear to run in
Excessive amounts of serotonin are present in
people with obsessive-compulsive disorder.
Anxiety Disorders
 Causes
of Anxiety Disorders
– Cognitive Factors:
Cognitive theorists maintain that certain styles
of thinking make some people particularly
vulnerable to anxiety disorders. According to
these theorists, some people are more likely to
suffer from problems with anxiety because they
tend to:
 misinterpret harmless situations as threatening
 focus excessive attention on perceived threats
 selectively recall information that seems threatening
Anxiety Disorders
 Causes
of Anxiety Disorders
– Learning Factors
 Learned Helplessness
 Classical Conditioning
 Stimulus Generalization
 Observational Learning
 Operant Conditioning
Somatoform Disorder
Psychological disorders in which the
symptoms take a bodily form without
physical cause. This type of disorder is
more common in Asian, Latin American,
and African cultures where people are less
open about their feelings. Even though
these symptoms have a psychological cause
rather than a medical cause, they are still
genuinely felt.
Somatoform Disorder
 Conversion
– Freud called it hysteria
– A person with conversion disorder
experiences a change or a loss of physical
functioning in a major part of the body for
which there is no medical explanation
(although they are still genuinely felt)
– People with this disorder are strangely
indifferent to their problems
Somatoform Disorder
Conversion Disorder:
– Conversion disorders tend to appear when a
person is under stress.
– These physical symptoms often help reduce stress
by enabling the person to avoid unpleasant
situations. For instance, a stomachache may mean
getting out of going to school.
– Today, conversion disorder is rare. It accounts for
only about 2 percent of diagnoses.
Somatoform Disorder
One university student, for example,
experienced visual impairment that began
each Sunday evening and became total
blindness by Monday morning. Her vision
would begin to return Friday evenings and
was fully restored in time for weekend
football games and other social activities
Somatoform Disorder
 Hypochondriasis:
A person misinterprets normal physical
sensations as symptoms of a disease.
He/She fusses over every symptom. Sympathy may reinforce the complaints
Somatoform Disorder
 Somatization
– In this disorder, a person makes
dramatic, but vague, reports about a
multitude of physical problems rather
than a specific illness
Somatoform Disorder
 Pain
– This disorder is characterized by severe,
often constant, pain with no apparent
physical cause
Dissociative Disorders
 Dissociation:
The process of separating a portion of
the personality that is causing undue
emotional stress from the rest of the
normally functioning personality. (The
individual may view parts of their
activity as separate from him/herself)
Dissociative Disorders
 Types
of Dissociative Disorders
– Dissociative Amnesia
– Dissociative Fugue
– Dissociative Identity Disorder
Dissociative Disorders
Dissociative Amnesia
The failure to recall events or personal
information. A sudden memory
loss. Memory lapses generally
concern the personal aspects
of an individual’s life. Amnesia
can be caused by a traumatic
event (psychogenic) or a head
injury (organic)
Dissociative Disorders
Psychogenic Amnesia vs. Organic Amnesia
1. Loss of memory for both recent
and distant past
2. Lose identity but general
knowledge remains intact
3. Have no anterograde amnesia
(memory loss for events after
amnesia starts)
4. Amnesia often reverses itself very
1. Loss of memory for the
recent past but memory
for distant past is
essentially intact
2. Lose both personal identity
as well as general knowledge
3. Primary symptom is
4. Memory returns gradually for
retrograde amnesia,
anterograde hardly ever
A young man dressed in work clothes came to the emergency room of
a hospital in the city in which he lived with the complaint that he did not
know who was. He seemed dazed, was not intoxicated, and carried no
identification. After being kept in the hospital for a few days, he woke
up one morning in great distress, demanding to know why he was
being kept in the hospital and announcing that he had to leave
immediately to attend to urgent business.
With recovery of his memory, the facts related to his amnesia
emerged. The day his amnesia began, he had been the driver in an
automobile accident that resulted in the death of a pedestrian. Police
officers on the scene were convinced that the driver had not been in the
wrong: The accident had been the pedestrian’s fault. The police told
the driver to fill out a routine form and to plan on appearing at the
coroner’s inquest. The man filled out the form at the home of a friend,
accidentally left his wallet at his friend’s home, and mailed the form.
After mailing the form, he became dazed and amnesiac. He was led to
the hospital by a stranger. The amnesia was probably related to the
stress of the fatal accident, fear of the inquest, and worry that he might
actually have been responsible for the accident.
Dissociative Disorders
 Dissociative
Dissociative Fugue = a sudden loss of
personal memory and the adoption of a
new identity in a new locale
Amnesia + flight from the geographic
3) Dissociative Disorders
 Dissociative
Identity Disorder
This is rare disorder that is characterized
by the development of two or more
separate and independent personalities
within the same person
Dissociative Disorders
Dissociative Identity Disorder
– Each personality has its own set of
memories, typical behaviors (i.e. each
personality has its own voice and
– Frequently none of the personalities has
any awareness of the others. People with
multiple personalities usually are not
The 21 Faces of Sarah
In a well-publicized criminal case, Mark
Peterson, 31, and Oshkosh grocery worker, was
prosecuted for sexually assaulting a 26-year-oldwoman, who, according to her psychiatrist, had at
least 21 distinct personalities.
Peterson met the woman, who introduced
herself to him as Franny, a few days before the
assault. Others present at that time told him that the
woman’s true name was Sarah and that she suffered
from multiple personality disorder. On a coffee shop
date Franny told Peterson about Jennifer, another
personality, whom she described as a “20-year-old
female who likes to dance and have fun.” When
they returned to Peterson’s car, he summoned Jennifer
and asked, “Can I love you?” She answered, “O.K.”
During the encounter, another personality, 6-year-old
Emily, suddenly intruded to peek. Ignoring Peterson’
pleas to keep what happened a secret, Franny and Emily
reported the encounter to Sarah, the predominant
personality. Sarah called the police to report that she
had been sexually assaulted.
Peterson’s defense centered on the idea that the
woman was not mentally ill and had consented to have
sex. The spectacular trial included appearances by
Sarah, Franny, Jennifer, and Emily. Jennifer’s testimony
was perhaps most crucial. When questioned about the
sexual encounter, she said, “I didn’t know what he was
doing.” When asked if she and Peterson had sex,
Jennifer responded, “I don’t know. What’s sex?”
The Wisconsin jury had several issues to consider:
(1) Whether Sarah was mentally ill at the time of the
sexual act, (2) Whether she was able to appraise
Peterson’s conduct, and (3) Whether Peterson knew of
Sarah’s condition. In Wisconsin it is a crime to engage in
sexual intercourse with a person you believe to be
mentally ill and who cannot assess your conduct.
Psychiatrists who had treated Sarah testified that
she was not faking her disorder, was incapable of judging
her action, and had been traumatized when she saw her
father crushed while he was working under a car. Ruth
Reeves, a neighbor and close friend of the woman, told
the court that she had forewarned Peterson of Sarah’s
multiple personality disorder.
Mood Disorders
 Types
of Mood Disorders
–Major Depression
–Dysthymic Disorder
–Bipolar Disorder
(Formerly known as Manic Depression)
5) Mood Disorders
 Major
This is often referred to as the common
cold of psychological disorders.
Why do you think that is?
Mood Disorders
 Major
This is a mood disorder in which a person,
for no apparent reason, experiences two or
more weeks of depressed moods, feeling of
worthlessness and diminished interest or
pleasure in most activities. The person may
become deeply discouraged about everything
and may experience fatigue. Depressed
people often feel that they are helpless.
They feel there is nothing they can do to
change things
Mood Disorders
Symptoms of Depression:
– Persistent depressed mood for most of the day
– Loss of interest or pleasure in all, or almost all,
– Significant weight loss or gain
– Sleep changes
– Fatigue or loss of energy, boredom
– Feelings of worthlessness or unfounded guilt
Mood Disorders
Symptoms of Depression: (continued)
– Reduced ability to concentrate
– Recurrent thoughts of death or suicide
– Physical complaints
– Loss of friends
– Tearfulness
– Poor grade, truancy, disciplinary problems
– Social behavior changes
Mood Disorders
 Dysthymic
A person shows the sad mood, lack of
interest, and loss of pleasure associated
with major depression, but less intensely
and for a longer duration (The duration
must be at least two years to quality)
Mood Disorders
 Suicide
and Depression
– Suicide is most closely tied to
depression than to any other
psychological disorder.
– Suicide rates are high in some northern
European countries, and Japan but low
in Greece, Italy, Ireland and the Middle
East (these countries have strong
religious prohibitions)
Mood Disorders
 Bipolar
(formerly known as manic depressive disorder)
The person alternate between the
hopelessness and lethargy of depression
and the hyperactive, wildly optimistic,
impulsive phase of mania (excited and
overly active periods)
Bipolar Disorder is less common than
major depression
5) Mood Disorders
 Mania
During the manic phase the person may
sing, shout, talk
continuously, move
around rapidly.
He has little need for
Mood Disorders
He is easily irritated if crossed. The
person may show few sexual inhibitions.
His speech may be flighty. It is difficult to
interrupt him. He has grandiose
Bipolar disorder may lead to reckless
spending and investment sprees.
Mood Disorders
Then they go through a normal phase
Then they go
through a
depressive phase.
(The depressive
phase usually
lasts longer than
the manic phase)
Mood Disorders
Bi Polar Disorder
– 1% of the total U.S. population has bipolar disorder. Only 15-25% show a
definite cycles of manic-depressive
– Recovery rate is about 90%.
Mood Disorders
– Biological Factors
Neurotransmitters such as serotonin and
– A shortage of serotonin and norepinephrine is
related to depression. An overabundance is
related to mania.
Hormones such as cortisol
– Mood disorders have also been related to
malfunctions of the endocrine system, especially
the hypothalamic-pituitary-adrenocortical system
Mood Disorders
– Biological Factors
 Genetic influences
– Twin studies have shown there is a hereditary
component to both Bi-Polar and Depression
Disorders. If an identical twin has bi-polar disorder,
the other twin has a 70% chance of also having the
disorder. A fraternal twin has a 20% change of
having bi-polar disorder if his/her twin suffers from
it. People who are adopted and have mood
disorders are more likely to find a history of mood
disorders in their biological families rather than in
their adopted families.
Mood Disorders
– Psychological Factors
 Psychodynamic theorists: Depression is
due to the feelings of loss associated with
childhood or unresolved anger toward parents
(Horney). Freud believed that depression was the
result of a loss of a loved one. He contents that in
addition to grief we feel anger over feelings of
abandonment. Some of that anger is directed
inward which results in depression
Mood Disorders
– Psychological Factors
 Behavioral theorists: Behaviorists believe
that depression is the result of learned
helplessness. They say that people
become depressed when they have no
control over negative events.
Mood Disorders
– Cognitive theorists:
 Cognitive theorists believe that those with
depression have self-defeating beliefs. They tend
to magnify bad experiences and minimize good
experiences. This ruminating style is especially
characteristics of women.
 Depressed people have a tendency to explain bad
events as being stable, global, and internal.
 The
term schizophrenia means
literally “split mind”
 Positive
Symptoms of Schizophrenia
– Break of contact with reality
– Hallucinations
– Delusions
– Disorganized and
Bizarre Behaviors
– Disturbances in
emotions, speech and thoughts
Positive Symptoms of Schizophrenia
– Disturbances in thoughts and speech
 Neologisms:
(literally “new words”). At times, a
schizophrenic’s speech includes the rare
appearance of words and phrases not found in
even the most comprehensive dictionary.
Neologisms (new words) are sometimes formed
by combining parts of two or more regular
words. Neologisms may also involve the use of
common words in a new way
 Positive
Symptoms of Schizophrenia
–Disturbances in thoughts and
 Echolalia:
Repeating words said in their presence
over and over and over again
Positive Symptoms of Schizophrenia
– Disturbances in thoughts and
 Derailment (loose associations):
The tendency for one thought to be logically
unconnected, or only superficially related to
the next. Sometimes the associations are
based on the double meanings or on the way
words sound
Example of Derailment:
He pushed back the blankets from the
bed. He saw the river bed was covered
with small stones washed down from the
quarry. The hunter came fast because he
was following his quarry over the hill.
Positive Symptoms of Schizophrenia
– Disturbances in thoughts and
 Irrelevant Replies:
Giving answer to questions that are not
Example: How old are you? As old as the pyramids
crumbling into dust. Where do you live? I exist in the world,
from it, of it, and by it.
 Positive
Symptoms of Schizophrenia
–Disturbances in thoughts and
 Word Salad:
Combining words and phrases in what appears
to be a completely disorganized fashion.
Unlike neologisms, word salad suggests no
effort to communicate. In word salad, nothing
is related to anything else.
Example of word salad
It’s all over for a squab true tray and 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 is no nothing but
changers, changers, changers. That comes like in
first and last names, so that thing does. Well, it’s my
suitcase, sir. I’ve got to travel all the time to keep my
energy alive.
 Symptoms
of Schizophrenia
–Disturbances in thoughts and
 Clanging:
The pairing of words that have no
relation to one another beyond the
fact that they rhyme or sound alike
Negative Symptoms of Schizophrenia
– Anhedonia: lack of interest in living, loss of
pleasure in life
– Alogia (mutism): Total Silence
– Flat Affect: Person shows no emotion
– Avolition: Loss of motivation
 Types
of Schizophrenia
– Catatonic Schizophrenia
 Agitated
 Immobile
– Paranoid Schizophrenia
– Disorganized Schizophrenia
– Undifferentiated Schizophrenia
 Types
of Schizophrenia
– Paranoid Schizophrenia
Accounts for 40% of schizophrenics;
appears late in life (25-30).
Characterized by delusions of
persecutions & grandeur. These are
often accompanied by hallucinations
supporting the delusion.
 Types
of Schizophrenia
– Paranoid Schizophrenia (continued)
Paranoid Schizophrenics are more likely
than other schizophrenics to have a good
outcome because it tends to be acute.
Under certain circumstances, they may
function relatively well
 Types of Schizophrenia
– Catatonic Schizophrenia:
Accounts for 8% of all schizophrenics. The
major symptoms is a disturbance in motor
activity. The person may remain stiffly
immobile and refuse to speak of be
extremely agitated. Catatonic
Schizophrenia is rarely seen today.
However, it was common up to 30 to 40
years ago
 Types
of Schizophrenia
– Disorganized Schizophrenia
 Accounts for 5% of all schizophrenics.
 Incoherence in expression
 Childish disregard for social conventions
 Resists wearing clothing
 Urinate and defecate at inappropriate
 Disorganized
– May eat with their fingers
– Show emotional responses that are
inappropriate to the situation
– Giggling
– Silly mannerisms
– Inexplicable gestures
 Types
of Schizophrenia
– Undifferentiated Schizophrenia
This accounts for 40% of all
schizophrenics. They have symptoms
of schizophrenics (disordered
thinking, etc) but the symptoms don’t
clearly fit one of the other specific
 Causes of Schizophrenia
– Biological Factors
 Brain Abnormalities: Schizophrenics (this is
more true of schizophrenic with negative
symptoms rather then positive)
tend to have enlarged
ventricles and less brain
tissue than non-schizophrenics
 Causes
of Schizophrenia
– Biological Factors
 Dopamine: In general, those with
schizophrenia have an excess of receptors
for dopamine. Drugs that block dopamine
receptors lessen positive schizophrenia
symptoms. Drugs that increase dopamine
levels (i.e. cocaine, and amphetamines)
increase positive schizophrenia symptoms.
 Causes
of Schizophrenia
– Biological Factors
 Genetics: The odds of any person being
schizophrenic are 1 in 100. The odds rise
to 1 in 10 if one parent has schizophrenia.
If a person has an identical twin with
schizophrenia, the odds are 50 in 100.
 Causes
of Schizophrenia
– Psychological Factors
 There are no psychological factors alone
that cause schizophrenia. However, a life
of a lot of stressors will increase the
chances that a predisposition of
schizophrenia will result in schizophrenic
Personality Disorders
Personality disorders are psychological
disorders characterized by inflexible and
enduring behavioral patterns that impair
social functioning. These disorders usually
do not involve anxiety, depression, or loss
or contact with reality. They may
however, coexist with other psychological
Personality Disorders
Lasting, rigid patterns of behavior
that seriously diminish
Related to Anxiety
Avoidant personality disorder
Dependent personality
Dramatic or Impulsive
Borderline personality
disorder, Antisocial
personality disorder
Odd or Eccentric Behaviors
Paranoid personality disorders,
Schizoid personality disorders
Mental Illness and the Law
to understand the proceedings and charges
against you. If you are declared mentally
incompetent to stand trial you are protected
from prosecution. This is a rare occurrence.
INSANITY: If you are judged to be not guilty
by reason of insanity at the time of the crime it
means that the mental illness prevented the
person from:
1. understanding what he/she was doing
2. knowing that what they were doing was
3. resisting the impulse to do wrong