Download Chapter 16: Specific Disorders and Treatments

Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Chapter 16
Specific Disorders and Treatments
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Progress in Abnormal Psychology


The growth of understanding of mental disorders and their
treatment has paralleled the progress of medical science.
Although we have much yet to learn, we now can make
accurate distinctions between a wide range of disorders
and we can tailor treatments to meet the needs of those
suffering from specific disorders.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Module 16.1

Anxiety and Avoidance Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Anxiety refers to a certain amount of fear and caution in
the face of potential hazards.
 A certain amount of anxiety is normal.
 Anxiety is considered pathological when it interferes with
daily functioning.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Generalized anxiety disorder
 Generalized anxiety disorder (GAD) is the experience
of almost constant and exaggerated worry.
 There is no basis for the worries but the person is
tense, irritable and tired.
 About 5% of the general population will experience
GAD.
 Often it is co-diagnosed with other mood disorders
such as depression.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Panic disorder
 Panic disorder (PD) is characterized by frequent
periods of anxiety and occasional attacks of panic.
 Panic attacks involve rapid breathing, increased heart
rate, chest pains, sweating, trembling and faintness.
 Panic attacks usually last just a few minutes, but can
be much longer.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Panic disorder
 Panic disorder is experienced by 1-3% of adults and
occurs in many cultures.
 More women than men are diagnosed with Panic
Disorder.
 Hyperventilation, or rapid deep breathing, is a key
symptom.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Panic disorder
 Hyperventilation causes the body to react as if
suffocation were occurring.
 The person’s subjective interpretation of the symptoms
of hyperventilation can cause an increase in panic or a
calming down.
 People with panic disorder tend to interpret these
episodes as uncontrollable and life threatening.
 The constant anxiety they experience increases the
likelihood of further panic attacks.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Panic disorder
 Treatments for panic disorder include:
 Psychotherapy
 Anti-depressant drugs
 Advice: “Don’t worry about panic attacks; they won’t
kill you.”
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Panic disorder
 Common co-existing disorders include:
 Social phobia – severe avoidance of other people
and fear of doing anything in public.
 Agoraphobia – an intense fear of open or public
places.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Phobias
 Avoidance behaviors are highly resistant to extinction.
 Phobia is the most common type disorder involving
avoidance behaviors.
 A phobia is strong and persistent fear of a specific object
or situation – so strong it interferes with daily living.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Anxiety

Phobias
 The Prevalence of Phobias
 Not all extreme fears qualify as phobias.
 About 11% of U.S. adults suffer from a phobia at
some point in their lives.
 About 5-6% are experiencing a phobia at any given
time.
 Phobia usually does not persist across the lifetime –
many young adults lose them by middle age.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.2 Most phobias do not last a lifetime. Young people with phobias often
lose them by middle age.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Phobias
 Acquiring a phobia:
 Some fears are innate but many are learned.
 Some phobias can be traced to a specific event.
 The early behaviorists were the first to demonstrate
how fears might be learned.
 This does not account for the fact that some phobias
are much more common and easily acquired than
others.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Phobias
 The most common phobias include:
 Open spaces
 Closed spaces
 Heights
 Lightening and thunder
 Certain animals – (snakes, spiders, dogs)
 Illnesses/germs
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.4 A lab-reared monkey learns to fear snakes from the reactions of a wild-reared
monkey. But if the snake is not visible, the lab-reared monkey fails to learn any fear.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Phobias
 Behavior therapy for phobias
 Systematic desensitization – reduces fear by
gradually exposing people to the object under
controlled conditions. Virtual reality is now being
employed for this kind of therapy.
 Flooding or implosion – a sudden and large-scale
exposure to the object under controlled conditions.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Phobias
 Drug therapies for phobias and anxieties
 Benzodiazepines, a common type of tranquilizer, are
often prescribed for anxiety disorders.
 They suppress symptoms only temporarily and can
be addictive.
 Anti-depressants, which are not likely to be taken
habitually, are used more effectively.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Obsessive-compulsive disorder
 There are two distressing symptoms that comprise
obsessive-compulsive disorder.
 Obsessions are repetitive, unwelcome streams of
thought.
 Compulsions are repetitive, almost irresistible
actions.
 Obsessive thoughts generally lead to compulsive
actions.
 Checking and cleaning are two very common
compulsive behaviors.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Disorders Characterized by Excessive Avoidance

Obsessive-compulsive disorder
 Therapies for obsessive-compulsive disorder:
 Exposure therapy is very similar to systematic
desensitization.
 The patient is exposed to the situation that brings on
the compulsive behavior, but is prevented from
engaging in it.
 The most common drug treatments for this disorder
utilize clomipramine and other serotonin reuptake
inhibiters.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Anxieties and Avoidance

Phobias and anxiety disorders involve the interaction and
influence of cognition and emotion upon each other.

People who suffer from these conditions are aware that
their reactions are exaggerated, but this awareness doesn’t
cure the problem.

These disorders are challenging but psychologists continue
to improve the efficacy of available treatments.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Module 16.2

Substance-Related Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)


Individuals who find it difficult or impossible to quit a
dangerous habit are said to have an addiction to it or a
dependence on it.
People vary widely in how this affects their daily lives and
functioning.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)



Nearly all addictive drugs stimulate the dopamine receptors
in the nucleus accumbens.
Activation of these synapses causes increased attention.
This activation is accompanied by feelings of great
pleasure.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

There are two symptoms involved in the development of a
drug addiction.
 Tolerance – decreased effects of a given dose.
 Withdrawal – unpleasant sensations when the drug is
not used (or too little is used given the development of
tolerance).
 Activities and substances that are not drugs can produce
addictions – suggesting that addiction is a function of the
person, not the drug alone.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Is substance dependence a disease?
 It depends in part on how we define “disease.”
 Psychologists currently favor the use of continuum from
“no addiction” to “severe addiction.”
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Nicotine dependence
 Cigarette smoking is based on nicotine addiction.
 People are generally able to quit smoking more easily if
they have a replacement source of nicotine (i.e. a patch).
 Low-nicotine/low-tar cigarettes do not help people to
quit.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.7 “Low-nicotine” cigarettes have a row of small holes in the filter; room air is
supposed to enter through those holes when the smoker inhales and therefore dilute the
tobacco smoke. If people smoke such cigarettes without covering the air holes, little tar
and nicotine pass through the cigarette, as we see from the relatively clean filter tip.
However, if people cover the holes with their fingers or tape, they will
receive about as much tar and nicotine as they would from any other filtered cigarette.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Alcoholism
 Alcoholism is defined as the habitual overuse of alcohol.
 Treatment of chronic alcoholism is very difficult.
 In order for treatment of alcoholism to be effective, we
need to detect the problem in its early stages.
 We need to identify the factors that put certain people at
risk.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Alcoholism
 Type I alcoholism develops gradually over the lifespan.
 It is equally prevalent in men and women.
 It is generally less severe in its health consequences.
 Type II alcoholism has an early onset.
 It is much more prevalent in men and more severe.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Table 16.3 Type I and Type II alcoholism
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Alcoholism: Risk factors
 Research studies indicate that tendency to addiction is
influenced by genetics.
 Type II alcoholism shows a strong genetic basis.
 Some people with no family history of alcoholism
develop an alcohol problem.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Alcoholism: Risk factors
 Exposure to parental conflict, inadequate supervision,
and abuse can increase the likelihood of alcoholism
emerging later in life.
 Culture also has an influence – prevalence rates vary in
different nations and ethnic groups.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Treatment for alcoholism
 It is very difficult for most people to quit alcohol and the
other drugs.
 Only 10-20% are successful and relapses are very
common.
 Many recovering addicts seek help from mental-health
professionals or self-help groups.
 Such help improves the chances of successful recovery,
but offers no guarantees.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Treatments for alcoholism
 Detoxification is a program of supervised recovery
provided in a hospital setting.
 Outpatient mental-health treatment has about the same
rate of success as detoxification.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Treatments for alcoholism
 The most widespread treatment for alcoholism is offered
by Alcoholic Anonymous (AA).
 AA is a self-help group comprised of people who abstain
from alcohol use and offer help and support to each
other.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Treatments for alcoholism
 Antabuse is the trade name for disulfiram.
 Alcoholics who take Antabuse daily become very sick
when they drink alcohol.
 This treatment is only moderately effective.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Treatments for alcoholism
 Controlled drinking refers to reducing consumption of
alcohol from dependent/abusive to moderate levels.
 Some physicians believe that abstinence is workable for
all alcoholics and believe this is a viable alternative.
 Harm reduction is a similar approach applied to drug
abuse.
 These methods are highly controversial
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Opiate dependence
 A very difficult withdrawal syndrome complicates
recovery from dependence on opiate drugs (i.e. heroin,
morphine).
 Some opiate addicts go “cold turkey” in order to stop
using.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substance Dependence (Addiction)

Opiate dependence
 Recovery programs commonly offer methadone as a
less dangerous replacement for opiates.
 This is a harm reduction strategy that allows recovering
opiate addicts to remain employed and avoid criminal
behavior.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Table 16.4 Comparison of methadone with morphine
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Substances, the Individual, and Society

How we handle the problem of substance dependence and
abuse in our society remains an area of intense debate.

Our current strategies have not eliminated widespread use.

As a citizen, you may be called upon to think about these
issues and help to shape changes in our national drug
policy. As you have learned, there are complex and difficult
issues involved.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Module 16.3

Mood Disorders
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Major depression
 Major depression is an extreme condition.
 It usually persists for months.
 The person experiences little interest in anything, little
pleasure, and little motivation to be productive.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Major depression
 Loss of interest in food and sex are common.
 The person has feelings of worthlessness, guilt and
powerlessness over their lives.
 Sleep abnormalities are associated with depression
(there is a characteristic rapid onset of REM sleep).
 The person may attempt suicide.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.9 When most people go to sleep at their usual time, they progress slowly to
stage 4 and then back through stages 3 and 2, reaching REM sleep toward the end of
their first 90-minute cycle. Depressed people, however, reach REM more rapidly,
generally in less than 45 minutes. They also tend to awaken frequently during the
night.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Seasonal affective disorder (SAD)
 Consistent depression associated with a particular
season of winter is called seasonal affective
disorder.
 It is most common in areas that have little sunlight in
the winter.
 It can be relieved by light therapy, which requires
the depressed person to sit in front of a bright light for
a few hours each day.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.10 Most people feel slightly better during the summer (when the sun is out most of the
day) than during the winter (when there are fewer hours of sunlight). People with seasonal
affective disorder (SAD) feel good in the summer and seriously depressed in the winter (or good
in the winter and depressed in the summer). Seasonal affective disorder is commonest in far
northern locations such as Scandinavia, where the summer days are very long and bright and
the winter days are very short and dark. The disorder is unheard-of in tropical locations such as
Hawaii, where the amount of sunlight per day varies only slightly between summer and winter.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Bipolar disorder
 This condition was once referred to as manicdepressive disorder.
 It involves a cycling of mood between periods of
depression and periods of mania.
 Mania is a state of extreme exuberance and agitation.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Genetic predisposition to depression
 Having close biological relatives who were diagnosed
with depression increases one’s probability of
becoming depressed.
 Having adoptive relatives who were depressed also
increases that probability, but not as much.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Genetic predisposition to depression
 The probability is especially high if one has biological
relatives who were diagnosed with depression before
age 30.
 There is probably no one gene that causes
depression.
 Genes probably influence temperament and therefore
also the way people respond to events in their lives.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Sex differences in depression
 Before adolescence, depression is about equally
common in boys and girls.
 From adolescence onward, women are about twice
as likely to experience depression as men.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Sex differences in depression: hormones
 Women experience more rapid hormonal changes
than men do (menstrual cycles, pregnancy, childbirth
and menopause).
 Postpartum depression is triggered by the rapid
hormonal changes that follow childbirth.
 However, the hormone levels of depressed women
are not significantly different that those of nondepressed women.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Sex differences in depression: coping
 Men generally try to distract themselves when they
are feeling depressed. Women tend to dwell on their
feelings more.
 Ruminating may not be useful for coping and may
make the person feel worse.
 This explanation does not account for why women
and men choose different strategies.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Events that precipitate depression
 People generally become depressed after losses or
other negative events occur.
 There is little relationship between the scale of the
event and the intensity and duration of the
subsequent depression.
 Severe losses early in life may make people more
vulnerable to depression later on in life.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Events that precipitate depression
 Lack of social support also increases vulnerability to
depression.
 As in the case of stress, it is not just the event but
also the person’s interpretation of the event’s
significance that influences the degree of depression.
 The way people think about their lives, as well as the
course of the events, is a factor to consider.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Cognitive aspects of depression
 Every person has an explanatory style in accounting
for successes and failures.
 Internal attributions cite causes within the person.
 External attributions identify causes outside the
person.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Cognitive aspects of depression
 People tend to be more consistent in the type of
attributions that they use to explain their failures.
 People who blame themselves for all failures,
regardless of the circumstances, develop a
pessimistic explanatory style.
 They view their failures as global (consistent over
situations) and stable (consistent over time).
“Depressed people believe that every silver lining has a
cloud.”
-- Kalat
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Treatments for depression
 Cognitive therapy helps the individual develop more
positive beliefs.
 Drug therapies use anti-depressant medications
including the tricyclics, selective serotonin
reuptake inhibitors, monoamine oxidase
inhibitors, and atypical antidepressants.
 St. John’s Wort is a naturally occurring herb that has
antidepressant effects. It should not be used with
other medications.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.13 Antidepressant drugs prolong the activity of the neurotransmitters
dopamine, norepinephrine, and serotonin. (a) Ordinarily, after the release of one of the
neurotransmitters, some of the molecules are reabsorbed by the terminal button, and
other molecules are broken down by the enzyme monoamine oxidase (MAO). (b)
Selective serotonin reuptake inhibitors (SSRIs) prevent reabsorption of serotonin.
Tricyclic drugs prevent reabsorption of dopamine, norepinephrine, and serotonin. (c)
MAO inhibitors (MAOIs) block the enzyme monoamine oxidase and thereby prolong
the effects of the neurotransmitters.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Treatments for depression
 Electroconvulsive shock therapy (ECT) is a wellknown but controversial treatment.
 A brief electrical shock is administered to the patient’s
head.
 It induces a convulsion similar to an epileptic seizure.
 How it works is not fully understood.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Depression
 Treatments for depression
 It is an effective treatment, although the benefits are
temporary. Other treatments must be offered also.
 ECT fell out of favor because it was widely abused
(administered without patient consent, given too
often, used as a threat).
 It is now used only for patients who have treatmentresistant depressions or who are strongly suicidal.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Bipolar disorder
 Bipolar disorder: symptoms
 People whose moods alternate between extremes of
mania and depression are said to suffer from bipolar
disorder.
 When they are experiencing mania, they are
constantly active and uninhibited, and may be very
happy or very irritable.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Bipolar Disorder
 Bipolar Disorder: types
 Psychologists diagnose two types of bipolar disorder.
 Bipolar I disorder involves the experience of at least
one episode of mania.
 Bipolar II disorder involves alternation between
major depression and hypomania, which is a milder
form of mania.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Bipolar disorder
 Bipolar disorder: prevalence
 About 1% of the adult population of the U.S. has been
diagnosed with a Bipolar Disorder.
 It can be difficult to distinguish bipolar from other
disorders (attention deficits, delusions and
hallucinations are also symptoms of other disorders).
 There are hereditary influences on bipolar disorder.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Bipolar disorder
 Drug therapies for bipolar disorder
 Lithium is a naturally occurring chemical that is used
to treat mania.
 How lithium relieves mania is not well understood.
 Lithium is toxic at high doses, so a patient who takes
it must be carefully monitored.
 Valproate and anticonvulsant drugs are also used
to treat bipolar disorders.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Suicide
 Mood disorders and suicide
 People who suffer from depression and bipolar
disorders consider suicide. Some make attempts.
 It is hard to know the true rate of suicide because
some suicides are disguised to look like accidents.
 Suicide rates vary as a function of gender, culture and
age
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.15 Suicide rates differ as a function of age, gender, and culture. The rates shown
here are for 1988; the rate has dropped since then for Hungary, presumably because of
economic and social changes within the country. (Based on data of Lester, 1996)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.15 Suicide rates differ as a function of age, gender, and culture. The rates shown
here are for 1988; the rate has dropped since then for Hungary, presumably because of
economic and social changes within the country. (Based on data of Lester, 1996)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Table 16.5 People most
likely to attempt suicide
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Suicide
 Mood disorders and suicide
 Women make more attempts but tend to employ less
lethal means than do men.
 There is no dependable pattern to suicide, but certain
warning signs and risk factors are associated with it.
 Previous attempts, a history of losses, a recent loss,
and a family history are all likely to raise the risk.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood Disorders

Suicide
 Mood disorders and suicide
 If someone you know is thinking of suicide, try to treat
the person as you would any other person who is in
distress.
 Offer support and friendship, and don’t be afraid to
ask him or her to talk about feelings.
 Encourage the person to seek professional help if you
sense that they are open to the suggestion.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Mood and Mood Disorders

Our capacity to experience emotions is an important part of
our lives. We have a wide range of pleasant and
unpleasant feelings to color our days.

Mood disorders go beyond this typical spectrum, and
victimize the person, distorting their perspective. Our ways
to manage these disorders have improved over the past
decades, providing many with relief from this distortion.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Module 16.4

Schizophrenia
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

What is schizophrenia?
 Many people confuse the term schizophrenia with
dissociative identity disorder or multiple personality
disorder.
 The split in schizophrenia refers to a disconnection of
the intellectual and emotional aspects of the personality.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.16 Although the term schizophrenia is derived from Greek roots meaning
“split personality,” it does not refer to cases where people alternate among different
personalities. Rather, the term originally indicated a split between the intellectual and
emotional aspects of a single personality.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

What is schizophrenia?
 The DSM-IV diagnosis of schizophrenia requires that the
person exhibit a complete deterioration of daily activities
along with at least two of the following symptoms:
 Hallucinations
 Delusions or thought disorders
 Incoherent speech
 Grossly disorganized behavior
 Loss of normal emotional responses and social
behaviors
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Symptoms of schizophrenia
 It is possible for two people with schizophrenia to have
very different symptom patterns
 The symptoms are divided into two broad types.
 Positive symptoms are behaviors that are notable
because of their presence (hallucinations and
delusions, for example).
 Negative symptoms are behaviors that are notable
because of their absence (lack of emotional
expression).
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Symptoms of schizophrenia
 Positive symptoms
 Hallucinations are false sensory experiences.
 Hearing voices is a common auditory hallucination of
schizophrenia.
 Visual hallucinations occur but are less common.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Symptoms of schizophrenia
 Positive symptoms
 Delusions are unfounded beliefs.
 There are three types of delusions associated with
schizophrenia – persecution, grandeur, and ideas
of reference.
 As it is sometimes hard to distinguish between the
unusual opinion and a delusion, one cannot diagnose
a psychotic disorder on the basis of such ideas alone.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Symptoms of schizophrenia
 Positive symptoms
 Disordered thinking refers to a deficit in utilizing
“executive functions.”
 Deficits of attention, difficulty in switching rules and
routines, loose associations, and difficulties with
abstraction are all common types of disordered
thinking in people suffering from schizophrenia.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Types and prevalence
 Four types of schizophrenia
 Undifferentiated
 Catatonic
 Disorganized
 Paranoid
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Four types of schizophrenia
 The symptoms of undifferentiated schizophrenia
include:
 Deterioration of daily functioning
 Hallucinations
 Delusions or thought disorders
 Inappropriate emotions
 None of the symptoms is unusually pronounced or
bizarre.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Four types of schizophrenia
 Catatonic schizophrenia is distinguished by prominent
movement disorder, including either:
 Rigid inactivity
 Excessive activity
 The person is aware of his or her surroundings, but
the nature of the individual’s posture or movement
has no relationship to the outside world.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Four types of schizophrenia
 The symptoms of disorganized schizophrenia include:
 Incoherent speech
 Extreme lack of social relationships
 “Silly” or odd behavior
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Four types of schizophrenia
 The symptoms of paranoid schizophrenia include:
 Elaborate hallucinations and delusions
 The delusions have pronounced themes of
persecution and grandeur.
 Other thought problems tend to be less pronounced,
and some people with paranoid schizophrenia are
relatively intact cognitively.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Prevalence
 Prevalence of schizophrenia
 About 1% of Americans are afflicted with
schizophrenia at some time in the lifespan.
 In general, the rates of this disorder have been
declining over the past 100 years.
 It occurs in many cultures, but is less common in
developing nations.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Prevalence
 Prevalence of schizophrenia
 Schizophrenia is most frequently diagnosed in young
adults.
 Men are usually diagnosed earlier than women.
 The onset is typically sudden, although there are
some markers during childhood.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Causes
 Genetic influences
 Studies of twins and adopted children suggest a
genetic basis for the disease.
 In identical twins, if one member of the pair develops
schizophrenia, there is a 50% chance that the other
will also.
 As with most other genetic research, it is difficult to
control for the effects of the prenatal environment.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.18 The relatives of a schizophrenic person have an increased probability
of developing schizophrenia themselves. Note that children of a schizophrenic mother
have a 17% risk of schizophrenia even if adopted by a family with no schizophrenic
members. (Based on data from Gottesman, 1991)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Causes
 Genetic influences
 So far researchers have not located a specific gene
for schizophrenia.
 It is probably not a single-gene disorder.
 It appears that certain people develop it without a
genetic basis.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Causes
 Brain damage may have some influence on the
development of schizophrenia. Brain scans indicate that:
 The hippocampus and parts of the cerebral cortex are
a little smaller than normal.
 The cerebral ventricles are larger than normal.
 People with schizophrenia have smaller neurons and
fewer synapses in the prefrontal cortex.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Causes
 The neurodevelopmental hypothesis
 The neurodevelopmental hypothesis states that
schizophrenia is the result of nervous system
impairments that develop before or at birth.
 These impairments may be due to genetic or other
reasons.
 Non-genetic risk factors include: poor prenatal care,
difficult pregnancy and labor, and mother’s exposure
to influenza virus.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Therapies for schizophrenia
 Drug therapies
 Antipsychotic or neuroleptic drugs help to relieve
the symptoms of schizophrenia.
 These drugs work gradually and vary in effectiveness
from patient to patient.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Therapies for schizophrenia
 Drug therapies
 Antipsychotic drugs work to block the production of
dopamine at the synapses, which is evidence for the
dopamine hypothesis of schizophrenia.
 An alternative explanation is the glutamate
hypothesis of schizophrenia, which is supported by
the deficient stimulation of glutamate (a
neurotransmitter that is inhibited by dopamine).
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Therapies for schizophrenia
 Drug therapies
 Tremors and involuntary movements begin gradually
in people taking antipsychotics for many years, a
condition known as tardive dyskinesia.
 Atypical antipsychotic medications have been
developed to provide relief without this troublesome
side effect.
 The atypical antipsychotics tend to suppress immune
functioning in many patients, however.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Schizophrenia

Therapies for schizophrenia
 Family therapy for schizophrenia
 Because caring for a schizophrenic family member
can be stressful, family therapy can be useful in a
number of ways.
 It provides direct support for the healthy family
members.
 It reduces the additional risk to the patient by
circumventing negative reactions to him or her by
family members that might promote relapse.
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
Figure 16.20 This graph indicates that during 2 1/2 years following apparent recovery
from schizophrenia, the percentage of schizophrenic patients who remained
improved is higher in the group that received continuing drug treatment than in the
placebo group. But the graph also shows that antipsychotic drugs do not always
prevent relapse. (Based on Baldessarini, 1984)
Introduction to Psychology, 7th Edition, James W. Kalat
Chapter 16: Specific Disorders and Treatments
The Elusiveness of Schizophrenia

Two people with schizophrenia may present their illness in
very different ways. The causes of their illnesses may turn
out to be very different.

Psychologists are still uncertain whether we are looking at
one disorder or several. We still have so much to learn
about this complex illness.