Download Chapter 15: Psychological Disorders

PSYCHOLOGICAL
DISORDERS
/
LECTURE OPENER SUGGESTIONS:
Opening quotes:
“Madness need not be all breakdown. It may also be break-through.” R.D. Laing (1927-1982).
“You shall know the truth and the truth shall make you mad.” Aldous Huxley (1894-1963)
Opening artwork:
Vincent Van Gogh (1853-1890) Corridor in the Asylum, 1889
Portrait of Van Gogh Henri Toulouse-Lautrec (1864-1901)
OPENING THEMES:
For many students, the topic of abnormal psychology represents the high point of the course;
what they have been waiting to learn all semester. Therefore, engaging student interest in the
topic should not be a problem at all. The challenge is choosing the topics to focus on in this very
rich area of content. Working within the structure of the perspectives in psychology will make
this content easier for students to grasp, because the basic parameters have already been laid
down and developed in other chapters. Thus, presenting the possible causes for psychological
disorders should be done in terms of those perspectives. In terms of presenting the disorders, it is
crucial to emphasize the role of DSM-IV-TR (the most recent version) in setting the stage for
reliable diagnoses. DSM-IV-TR also provides a good organizing structure to use in presenting
the disorders. Although there will not be time to devote sufficient attention to all disorders, you
should be able to focus on one or two that are of particular interest to you to use in helping
students gain a conceptualization of disorders as having multiple causes (and, in the next
chapter) multiple approaches to treatment.
KEY CONCEPTS
 Historical perspectives
 Definitions of abnormality
 Models of abnormal behavior
 DSM-IV-TR
 Anxiety disorders
 Somatoform disorders
 Dissociative disorders
 Mood disorders
 Schizophrenia
 Personality disorders
Prologue: Chris Coles
Looking Ahead
MODULE 37: NORMAL VERSUS ABNORMAL: MAKING THE DISTINCTION
Defining Abnormality
Identifying Normal and Abnormal Behavior: Drawing the Line on Psychological
Disorders
Perspectives on Abnormality: From Superstition to Science
The Medical Perspective
The Psychoanalytic Perspective
The Behavioral Perspective
The Cognitive Perspective
The Humanistic Perspective
The Sociocultural Perspective
177
Classifying Abnormal Behavior: The ABCs of DSM
DSM-IV-TR: Determining Diagnostic Distinctions
Conning the Classifiers: The Shortcomings of DSM-IV-TR
How can we distinguish normal from abnormal behavior?
What are the major perspectives on psychological disorders used by mental health
professionals?
What classification system is used to categorize psychological disorders?
Applying Psychology in the 21st Century Suicide Bombers: Normal or Abnormal?
Learning Objectives:
37-1 Discuss the various approaches to defining abnormal behavior.
37-2 Describe and distinguish the various perspectives of abnormality, and apply those
perspectives to specific mental disorders.
37-3 Describe the DSM-IV-TR and its use in diagnosing and classifying mental disorders.
Student Assignments:
Interactivity 61: DSM-IV-TR
Students answer questions about the DSM-IV-TR organization and usage.
Views on Psychological Disorders
Have students complete Handout 12-1, a survey of views on psychological disorders.
Perspectives on Abnormality
Ask students the following questions:
1. How does the medical perspective of abnormality compare with the behavioral
neuroscience perspective in psychology? How are they the same and how are they
different?
2. If you were a mental health professional, how would you integrate the best of each
perspective in treating your clients?
3. Which perspective is the DSM-IV-TR most closely associated with?
Library Research on the DSM-IV-TR
Send students to the library (or other source) to look at the DSM-IV-TR. Ask them these
questions:
1. How do you feel about the idea of categorizing psychological disorders as is done in the
DSM-IV-TR?
2. What was the scientific basis for the DSM-IV-TR?
3. How does the DSM-IV-TR differ from earlier DSMs?
4. What do you think is the most intriguing disorder in the DSM-IV-TR?
Lecture Ideas:
Summary of History of Mental Illness:
Prehistoric times:
Demonic possession was thought to cause psychological disorders. Based on evidence of
trephined skulls, it was thought that prehistoric people tried to release the evil spirits by drilling a
hole in the skull.
178
Ancient Greece and Rome:
The scientific approach emerged. The Greek physician Hippocrates sought a cause within the
body. This approach continued through Roman times with the writings of the physician Galen.
Middle Ages:
Return to belief in spiritual possession and attempts to exorcise the devil out of the mentally ill.
The mentally ill were thrown into prisons and poorhouses.
Renaissance:
First hospital to house the mentally ill was built—St. Mary’s Hospital in Bethlehem (London).
Attempts to provide more humane treatment.
Witch hunts took place starting in the 1500s and continued through the 1700s.
1700s:
Asylums again became overcrowded and conditions deteriorated. By the 1700s, St. Mary’s was
known as “bedlam.”
1800s:
Reform movements began in Europe and the United States:
 Benjamin Rush attempted to devise new methods of treatment (the “tranquilizing chair”)
based on scientific method.
 Dorothea Dix, a Massachusetts schoolteacher, originated the state hospital movement as a
means of providing “moral treatment.”
Early to mid 20th century:
Overcrowding again became prevalent in state mental hospitals. Extreme measures of treatment
were used that were thought by many to be inhumane.
Era of deinstitutionalization—late 20th century:
Invention of antipsychotic medications in the 1950s made it possible for people with severe
disorders to live outside institutions. President Kennedy called for community mental health
centers. However, this has not been completely effective as the problem of homelessness has
arisen.
The Insanity Defense (from Pettijohn’s Connectext)
As discussed in the text, it is difficult to define abnormal behavior. The issue becomes even more
complicated when questions are raised in a court of law about a defendant’s mental condition at
the time he or she is alleged to have committed a crime. When the defendant pleads “not guilty
by reason of insanity,” the court must assess his or her mental condition. The issue of insanity is
decided by a judge or jury after listening to testimony of experts, who are usually psychologists
or psychiatrists.
It is important to remember that in a court, the concept of insanity is legal rather than
psychological. The insanity plea is used in situations where the defendant is judged to be
incapable of knowing right from wrong because of a mental disorder. Although psychologists
may examine the individual and testify in court, the final decision is a legal one, made by the
courts based on legal precedent.
As you are probably aware, even the experts are not in agreement over insanity as a
legitimate defense. In some cases, insanity is used as a means to avoid prosecution. Normally, if
one is judged insane, he or she is committed to a mental hospital until cured. If later judged sane,
he or she is set free, sometimes after only a light sentence. One proposal is to replace the verdict
179
of “not guilty by reason of insanity” with the verdict of “guilty but mentally ill.” Individuals
found “guilty but mentally ill” would be given the proper psychotherapy to treat their mental
disorders, and when they were judged sane, they would be returned to prison to complete their
sentences.
A related issue is the ability of the defendant to stand trial. In order to be brought to trial,
an individual must understand the charge against him or her and be able to prepare a proper
defense with a lawyer. Many times, instead of standing trial, the defendant is judged
“incompetent to stand trial” and is committed to a mental institution for treatment. After being
confined for a period of time, he or she is released if judged competent. Unfortunately, it is
difficult to predict the future behavior of such a person. More research needs to be conducted on
the application of psychological determinations to legal proceedings.
“Madness” and Creativity: The Case of Vincent Van Gogh
The case of Vincent van Gogh (1853-1890) provides an excellent opportunity to discuss the
relationship between “madness” and creativity. Van Gogh is generally considered the greatest
Dutch painter after Rembrandt. His reputation is based largely on the works of the last three
years of his short, 10-year painting career, and he had a powerful influence on expressionism in
modern art. He produced more than 800 oil paintings and 700 drawings, but he sold only one
during his lifetime. His striking colors, coarse brushwork, and contoured forms display the
anguish of the mental illness that drove him to suicide.
Illustrate his case with examples of his late art works, completed while he was a patient at the
asylum in St. Remy.
Discuss the diagnoses that have been ascribed to Van Gogh over the years. They are as follows:
1. Epilepsy
2. Schizophrenia
3. Suppressed form of epilepsy
4. Episodic twilight states
5. Epileptoid psychosis
6. Psychopathy
7. Psychosis of degeneration
8. Schizoform reaction
9. Cerebral tumor
10. Active luetic schizoid and epileptoid disposition
11. Phasic schizophrenia
12. Dementia praecox
13. Meningo-encephalitis luetica
14. Psychotic exhaustion caused by creative effort
15. Atypical psychosis heterogeneously compounded of elements of epileptic and schizoid
disposition.
16. Phasic hallucinatory psychosis.
17. Neurasthenia
18. Chronic sunstroke and the influence of yellow.
19. Psychomotor epilepsy
20. Dromomania
21. Maniacal excitement
22. Turpentine poisoning
23. Hypertrophy of the creative forces
24. Acute mania with generalized delirium
25. Epileptic crises and attacks of epilepsy
180
26. Glaucoma
27. Frontotemporal dementia
28. Xanthopsia caused by digitalis (as treatment for mania)—seeing the world through a
yellow haze.
Numerous web sites discuss Van Gogh’s condition and possible diagnoses;
http://www.psych.ucalgary.ca/PACE/VA-Lab/AVDE-Website/VanGogh.html
http://www.uchsc.edu/news/bridge/2003/jan1/art1.html
Most recently, this diagnosis was published in The American Journal of Psychiatry:
Vincent van Gogh (1853-1890) had an eccentric personality and unstable moods, suffered from
recurrent psychotic episodes during the last 2 years of his extraordinary life, and committed
suicide at the age of 37. Despite limited evidence, well over 150 physicians have ventured a
perplexing variety of diagnoses of his illness. Henri Gastaut, in a study of the artist’s life and
medical history published in 1956, identified van Gogh’s major illness during the last 2 years of
his life as temporal lobe epilepsy precipitated by the use of absinthe in the presence of an early
limbic lesion. In essence, Gastaut confirmed the diagnosis originally made by the French
physicians who had treated van Gogh. However, van Gogh had earlier suffered two distinct
episodes of reactive depression, and there are clearly bipolar aspects to his history. Both episodes
of depression were followed by sustained periods of increasingly high energy and enthusiasm,
first as an evangelist and then as an artist. The highlights of van Gogh’s life and letters are
reviewed and discussed in an effort toward better understanding of the complexity of his illness.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1192528
6&dopt=Abstract
Blumer, D. (2002). “The illness of Vincent Van Gogh.” American Journal of Psychiatry, 159,
519-526.
The Medical Perspective: Genes and Depression
NIMH Report: Gene More Than Doubles Risk of Depression Following Life
Stresses
Among people who suffered multiple stressful life events over 5 years, 43 percent with one
version of a gene developed depression, compared to only 17 percent with another version of the
gene, say researchers funded, in part, by the National Institute of Mental Health (NIMH). Those
with the “short,” or stress-sensitive, version of the serotonin transporter gene were also at higher
risk for depression if they had been abused as children. Yet no matter how many stressful life
events they endured, people with the “long,” or protective, version experienced no more
depression than people who were totally spared from stressful life events. The short variant
appears to confer vulnerability to stresses, such as loss of a job, breaking up with a partner, death
of a loved one, or a prolonged illness, report Drs. Avshalom Caspi and Terrie Moffitt, University
of Wisconsin and King’s College London, and colleagues, in the July 18, 2003, Science.
The serotonin transporter gene codes for the protein in neurons, brain cells, that recycles the
chemical messenger after it’s been secreted into the synapse, the gulf between cells. Since the
most widely prescribed class of antidepressants act by blocking this transporter protein, the gene
has been a prime suspect in mood and anxiety disorders. Yet, its link to depression eluded
detection in eight previous studies.
“We found the connection only because we looked at the study members’ stress history,” noted
Moffitt. She suggested that measuring such pivotal environmental events—which can include
181
infections and toxins as well as psychosocial traumas—might be the key to unlocking the secrets
of psychiatric genetics.
Although the short gene variant appears to predict who will become depressed following life
stress about as well as a test for bone mineral density predicts who will get a fractured hip after a
fall, it’s not yet ready for use as a diagnostic test, Moffitt cautioned. If confirmed, it may
eventually be used in conjunction with other, yet-to-be-discovered genes that predispose for
depression in a “gene array” test that could help to identify candidates for preventive
interventions. Discovering how the “long” variant exerts its apparent protective effect may also
lead to new treatments, added Moffitt.
Everyone inherits two copies of the serotonin transporter gene, one from each parent. The two
versions are created by a slight variation in the sequence of DNA in a region of the gene that acts
like a dimmer switch, controlling the level of the gene’s turning on and off. This normal genetic
variation, or polymorphism, leads to transporters that function somewhat differently. The short
variant makes less protein, resulting in increased levels of serotonin in the synapse and
prolonged binding of the neurotransmitter to receptors on connecting neurons. Its transporter
protein may thus be less efficient at stopping unwanted messages, Moffitt suggests.
Moffitt and colleagues followed 847 Caucasian New Zealanders, born in the early l970s, from
birth into adulthood. Reflecting the approximate mix of the two gene variants in Caucasian
populations, 17 percent carried two copies of the stress-sensitive short version, 31 percent two
copies of the protective long version, and 51 percent one copy of each version.
Based on clues from studies in knockout mice, monkeys, and functional brain imaging in
humans, the researchers hypothesized that the short variant predisposed for depression via a
“gene-by-environment interaction.” They charted study participants’ stressful life events—
employment, financial, housing, health and relationship woes—from ages 21 to 26. These
included debt problems, homelessness, a disabling injury, and being an abuse victim. Thirty
percent had none, 25 percent one, 20 percent two, 11 percent three, and 15 percent four or more
such stressful life experiences. When evaluated at age 26, 17 percent of the participants had a
diagnosis of major depression in the past year and three percent had either attempted or thought
about suicide.
Although carriers of the short variant who experienced four or more life stresses represented only
10 percent of the study participants, they accounted for nearly one quarter of the 133 cases of
depression. Among those with four or more life stresses, 33 percent with either one or two copies
of the short variant—and 43 percent of those with two copies of the short variant—developed
depression, compared to 17 percent of those with two copies of the long variant.
The stressful life events led to onset of new depression among people with one or two copies of
the short gene variant who didn’t have depression before the events happened. The events failed
to predict a diagnosis of new depression among those with two copies of the long variant.
Among those who had experienced multiple stressful events, 11 percent with the short variant
thought about or attempted suicide, compared to 4 percent with two copies of the long variant.
These self-reports were corroborated by reports from participants’ loved ones.
The researchers suggest that effects of genes in complex disorders like psychiatric illnesses are
most likely to be uncovered when such life stresses are measured, since a gene’s effects may
only be expressed, or turned on, in people exposed to the requisite environmental risks.
http://www.nimh.nih.gov/events/prgenestress.cfm
182
The DSM-IV-TR
Summarize the 5 axes of the DSM-IV-TR:
(an axis is a diagnostic dimension)
1. Primary disorder—syndromes, like “illnesses”
2. Long-standing personality problems
3. Physical disorders or illnesses
4. Severity of stressors
5. Level of functioning over past year
Summarize the assumptions of the DSM-IV-TR:
 descriptive
 need for standardized language
Present two areas of criticism of the DSM-IV-TR:
 descriptive
 dimensional ratings may be preferable
Media Presentation Ideas:
Media Resources DVD: History of Mental Illness (6:01)
Outstanding video presenting a summary of beliefs about the causes of psychological disorders
from ancient times to the present.
Media Resources DVD: Alcohol Addiction (6:25)
Show this segment to illustrate the role of the brain in psychological disorders involving
substance abuse.
Media Resources DVD: Freud’s Contribution to Psychology (3:28)
Show this segment, which provides a summary of Freud’s theory and a reenactment of his
methods of treatment.
Slide Show: Vincent Van Gogh
On PowerPoint, display a collection of images from the latter years of Van Gogh’s life, at the
same time playing the song “Vincent” by Don McLean. This is a very effective way to begin a
discussion of Van Gogh’s art and madness.
The Vincent Van Gogh museum online can be found at:
http://www.vangoghgallery.com/painting/main_az.htm
183
Overhead: Historical Perspectives on Abnormality
Historical Views on Treatment of Mental Disorders
Time
Reformer
Technique
Purpose
Stone Ages
Trephining
Drill hole in head to let evil spirits out of the body
Fourth Century B.C.
Hippocrates
(460-377 B.C.)
Rest, exercise, abstinence from alcohol and sex
Restore balance of fluids, or “humors,” in body
Fifteenth Century
Exorcism, torture, hanging
Release evil spirits
Eighteenth Century
Philippe Pinel
(1745-1826)
Reform at Bicetre Asylum in Paris, released patients from chains, classified different types of
psychological disturbances
Restore humanity to patients
Nineteenth Century
Dorothea Dix
(1802-1887)
Separated mentally ill from prisoners, established state mental hospital system
Give good care
Twentieth Century
Clifford Beers
(1876-1943)
National Committee for Mental Hygiene (1909), research
Improve conditions in mental hospitals
Eclectic orientation of therapists
Return patients to society
184
Popular Movie: Historical Perspectives on Abnormality
“One Flew Over the Cuckoo’s Nest” is the classic depiction of life in a psychiatric hospital in the
late 1950s, when ECT was used as punishment.
Overhead: Genetic Contributions to Depression
From the NIMH web site’s description of the 2003 study on genes and depression, show this
overhead:
(http://www.nimh.nih.gov/events/prgenestress.cfm)
Overhead: Heritability of Schizophrenia
This overhead provides support for genetic contributions to schizophrenia by showing the higher
concordance rates with increasing familial relationships.
185
MODULE 38: THE MAJOR PSYCHOLOGICAL DISORDERS
Anxiety Disorders
Phobic Disorder
Panic Disorder
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
The Causes of Anxiety Disorders
Somatoform Disorders
Dissociative Disorders
Mood Disorders
Major Depression
Mania and Bipolar Disorders
Causes of Mood Disorders
Schizophrenia
Solving the Puzzle of Schizophrenia: Biological Causes
Environmental Perspectives on Schizophrenia
The Multiple Causes of Schizophrenia
Personality Disorders
Childhood Disorders
Further Disorders
What are the major psychological disorders?
Learning Objectives:
38-1 Describe the anxiety disorders and their causes.
38-2 Describe the somatoform disorders and their causes.
38-3 Describe the dissociative disorders and their causes.
38-4 Describe the mood disorders and their causes.
38-5 Describe the types of schizophrenia, its main symptoms, and the theories that account for
its causes.
38-6 Describe the personality disorders and their causes.
Student Assignments:
Interactivity 62: Schizophrenia Symptoms
Students watch a brief video of an interview with a client who has schizophrenia and answer
questions about the client’s symptoms and other features of the disorder.
Interactivity 63: Bipolar Disorder Symptoms
Students watch a brief video of an interview with a client who has bipolar disorder and answer
questions about the client’s symptoms and other features of the disorder.
Interactivity 64: Agoraphobia Symptoms
Students watch a brief video of an interview with a client who has agoraphobia and answer
questions about the client’s symptoms and other features of the disorder.
Interactivity 65: Borderline Symptoms
Students watch a brief video of an interview with a client who has bipolar personality disorder
and answer questions about the client’s symptoms and other features of the disorder.
Perspectives on Specific Disorders
186
Ask students the following questions:
Choose the psychological disorder that is of greatest interest to you and answer these questions:
1. State which disorder it is and summarize its diagnostic criteria.
2. Explain why this disorder is considered abnormal behavior.
3. Compare two approaches to understanding this disorder (such as biological vs.
sociocultural) and state which approach you prefer (and why).
Abnormal Psychology in the Media
Have students complete Handout 12-2 on representations of abnormality in the popular media.
Movie Depictions of Psychological Disorders
Ask students the following questions:
1. Describe a movie character who you think is a good example of a psychological disorder.
2. What disorder does this character represent? Why?
3. Do you think that the movie did a good job or a bad job of depicting this disorder? Why?
4. What impact do you think that movies can have on how people feel about psychological
disorders?
PowerWeb: Schizophrenia
“The Schizophrenic Mind,” Sharon Begley, Newsweek, March 11, 2002.
Recent movies and cases in criminal courts have brought the baffling illness schizophrenia to our
attention. This article discusses what schizophrenia is and how it can be treated.
Lecture Ideas:
Summary of Disorders
Provide brief summaries of the major disorders and their symptoms using the following guide:
Major Diagnostic Categories:
Use Figure 38-2 to provide an overview of the major disorders covered in the text.
Anxiety disorders:
 Phobic disorder (specific phobia)—intense and irrational fears.
 Panic disorder—sense of impending doom
 Generalized anxiety disorder—long-term consistent anxiety resulting in physiological
problems
 Obsessive-compulsive disorder—obsessions are recurring, irrational thoughts
compulsions are repetitive, purposeless behaviors.
(Note: Social Phobia is not covered)
Somatoform disorders:
Two major forms of somatoform disorder are:
 Hypochondriasis—constant fear of illness and physical sensations interpreted as signs of
disease.
 Conversion disorder—physical disturbance with psychological cause.
Dissociative disorders:
 Dissociative identity disorder—formerly called multiple personality disorder, involves
several “alters” and a “host” personality.
 Dissociative amnesia—forgetting of personal events with no physiological cause.
187

Dissociative fugue—entering into an altered state of behavior or actions.
Mood disorders:
 Major depressive disorder: Unusually sad mood along with physiological symptoms,
feelings of guilt, low self-esteem, and suicidality.
 Bipolar disorder (formerly manic depression): at least one period of mania, involving
euphoria; may alternate with period of depressed mood.

Schizophrenia
 Decline from previous level of functioning
 Disturbances of thought and language
 Delusions (false beliefs)
 Hallucinations (false perceptions)
 Emotional (affective) disturbance
 Withdrawal
[In addition to these symptoms, there are five subtypes of schizophrenia (see Figure 38-7)]
Personality Disorders:
Symptoms:
 Little personal distress
 May lead seemingly normal lives
 Rigid, inflexible maladaptive personality traits
Three types discussed in text:
 Antisocial personality disorder—impulsiveness, criminal behavior, lack of remorse.
 Borderline personality disorder—instability of self and relationships.
 Narcissistic personality disorder—extreme preoccupation with one’s own appearance,
needs, and concerns.
Forms of Specific Phobia
Below are some of the less common but interestingly named phobias. See how many your
students can guess (knowledge of Latin helps!!). Be careful, though, not to make fun of any of
these phobias, as some students may actually have one of these, though the odds are low.
More phobias can be found on this unauthorized but entertaining web site:
http://www.phobialist.com/
Ablutophobia—Fear of washing or bathing
Aerophobia—Fear of swallowing air
Ambulophobia—Fear of walking
Anablephobia—Fear of looking up
Anemophobia—Fear of wind
Anthrophobia—Fear of flowers
Arachibutyrophobia—Fear of peanut butter sticking to the roof of the mouth.
Arithmophobia—Fear of numbers
Aulophobia—Fear of flutes
Auroraphobia—Fear of Northern Lights
Barophobia—Fear of gravity
Basophobia—Fear of walking
Batophobia—Fear of being close to high buildings
188
Bibliophobia—Fear of books
Blennophobia—Fear of slime
Bogyphobia—Fear of the bogeyman
Cathisophobia—Fear of sitting
Catoptrophobia—Fear of mirrors
Chaetophobia—Fear of hair
Chionophobia—Fear of snow
Chromatophobia—Fear of colors
Chronophobia—Fear of time
Chronomentrophobia—Fear of clocks
Cibophobia—Fear of food
Clinophobia—Fear of going to bed
Cnidophobia—Fear of string
Deciophobia—Fear of making decisions
Dendrophobia—Fear of trees
Dextrophobia—Fear of objects at the right side of the body
Didaskaleinophobia—Fear of school
Eisoptrophobia—Fear of mirrors
Eleutherophobia—Fear of freedom
Eosophobia—Fear of daylight
Epistemophobia—Fear of knowledge
Ergophobia—Fear of work
Ereuthophobia—Fear of the color red
Geliophobia—Fear of laughter
Geniophobia—Fear of chins
Genuphobia—Fear of knees
Geumaphobia—Fear of taste
Gnosiophobia—Fear of knowledge
Graphophobia—Fear of writing
Heliophobia—Fear of the sun
Helmintophobia—Fear of being infested with worms
Hemophobia—Fear of blood
Hippopotomonstrosesquippedaliophobia—Fear of long words
Homichlophobia—Fear of fog
Hypnophobia—Fear of sleep
Ichthyophobia—Fear of fish
Ideophobia—Fear of ideas
Kainophobia—Fear of anything new
Kathisophobia—Fear of sitting down
Lachanophobia—Fear of vegetables
Leukophobia—Fear of the color white
Levophobia—Fear of objects to the left side of the body
Linonophobia—Fear of string
Logophobia—Fear of words
Melanophobia—Fear of the color black
Melophobia—Fear of music
Metrophobia—Fear of poetry
Mnemophobia—Fear of memories
Mottephobia—Fear of moths
Nebulaphobia—Fear of fog
Neophobia—Fear of anything new
189
Nephophobia—Fear of clouds
Nomatophobia—Fear of names
Octophobia—Fear of the number 8
Ommetaphobia—Fear of eyes
Oneirophobia—Fear of dreams
Ophthalmophobia—Fear of opening one’s eyes
Ostraconophobia—Fear of shellfish
Panophobia—Fear of everything
Papyrophobia—Fear of paper
Paraskavedekatriaphobia—Fear of Friday the 13th
Peladophobia—Fear of bald people
Phengophobia—Fear of daylight
Phobophobia—Fear of fear
Photophobia—Fear of light
Phronemophobia—Fear of thinking
Pogonophobia—Fear of beards
Sciophobia—Fear of shadows
Scolionophobia—Fear of school
Selenophobia—Fear of the moon
Siderophobia—Fear of stars
Sitophobia—Fear of food
Sophophobia—Fear of learning
Stasibasiphobia—Fear of walking
Thaasophobia—Fear of sitting
Trichopathophobia—Fear of hair
Triskadekaphobia—Fear of the number 13
Verbophobia—Fear of words
Xanthophobia—Fear of the color yellow
Physician-Assisted Suicide—Relationship to Major Depressive Disorder (from Pettijohn’s
Connectext)
The right of a terminally ill person to commit suicide with the assistance of a physician is
currently a controversial issue in the United States. Suicide is often considered an abnormal
behavior that should be prevented at all costs. There are suicide telephone hot-lines dedicated to
persuading individuals from committing this act. Can suicide be viewed as a normal, rational
behavior? Perhaps the strongest case could be made for terminally ill patients who experience
extreme pain (Humphry, 1992).
Many people now write “living wills” that dictate treatments to be given or refused in the
event of a terminal illness. If a terminally ill person refuses treatment, this might be considered a
type of passive suicide. More controversial is the situation in which a terminally ill person will
not immediately die, but will have to endure a long period of pain and suffering. One alternative
to this situation is “assisted suicide,” in which the individual is helped in the suicide by a
physician. For the past decade, Jack Kevorkian, a Michigan retired pathologist, has been actively
involved in assisted suicides and has lobbied to make assisted suicide legal for mentally
competent individuals.
Opponents argue that potential suicide victims are not mentally competent. Indeed, many
terminally ill patients become severely depressed prior to accepting their situation. It is generally
assumed that depressed patients are not rational about suicide. Some people also voice concerns
that if assisted suicide is sanctioned, there will be more pressure for the elderly to end their lives
prematurely. Someone might not want to be a burden on others, or might believe that relatives
190
don’t want them around. The assisted suicide debate involves legal, medical, and psychological
issues. The solution will not be easy, but will need the cooperation and understanding of many
different factions.
Reference
Humphry, D. (1992). Rational suicide among the elderly. Suicides and Life-Threatening
Behavior, 22, 125-129.
Media Presentation Ideas:
Media Resources DVD: Beautiful Minds: An Interview with John Nash and Son (8:40)
An interview with Nobel prize–winning mathematician John Nash and son provides insight into
the experience of schizophrenia.
Media Resources DVD: Symptoms of Schizophrenia (3:35)
Brief interview with a schizophrenic patient.
Media Resources DVD: Depression: Theories and Treatments (4:02)
Examines the causes of and medications for depression.
Media Resources DVD: Bipolar Disorder (4:34)
Case example of a man with bipolar disorder; includes methods of brain imaging.
Media Resources DVD: Dysthymia (1:44)
Interview of a patient with dysthymia.
Media Resources DVD: PTSD (3:25)
Interview of a patient with PTSD.
Popular Movies and Television Shows
The following are a list of films that portray characters with psychological disorders:
Fatal Attraction”: Borderline personality disorder
“As Good as it Gets”; “Matchstick Men”: Obsessive-compulsive disorder
“Iris”: Alzheimer’s Disease
“A Beautiful Mind”: Schizophrenia (Media Resources has interview with Nash)
“Pollack”: Depression (and alcohol abuse)
“Chicago”: Antisocial personality disorder in females (very unusual!)
“King of Hearts”: Mental illness and society
“Vertigo”: Anxiety disorder (acrophobia)
“Benny and Joon”: Schizophrenia
“What About Bob”: Borderline personality disorder
“Fisher King”: Schizophrenia
“Girl Interrupted”: Borderline personality disorder (and/or depression)
“Gone With the Wind”: Histrionic personality disorder
“Heavenly Creatures”: Shared psychotic disorder
“The Hours”: Major depressive disorder
“I Am Sam”: Mental retardation
“Memento”: Amnestic disorder
“Sybil”: Dissociative identity disorder
“Nurse Betty”: Dissociative fugue
“Rain Man”: Autistic disorder
191
“Single White Female”: Borderline personality disorder
“The Virgin Suicides”: Depression in teens
The television program “ER” provided an excellent example of bipolar disorder in the character
of Abby’s (the nurse) mother, played by Sally Field.
Forms of Phobia
Show these terms and clip art illustrations for a variety of types of phobias:
Panic Disorder
Panic attacks occur without a
specific trigger or stimulus
Agoraphobia
Ailurophobia
Fear of being in a situation in
which escape is difficult, and
in which help for a possible
panic attack would not be
available
Fear of cats
Arachnophobia
Fear of spiders
Cynophobia
Fear of dogs
Equinophobia
Fear of horses
Insectophobia
Fear of insects
Ophidiophobia
Fear of snakes
Rodentophobia
Fear of rodents
Acrophobia
Fear of heights
192
Brontophobia
Fear of thunder
Claustrophobia
Fear of small, enclosed spaces
Mysophobia
Fear of dirt
Nyctophobia
Fear of darkness
MODULE 39: PSYCHOLOGICAL DISORDERS IN PERSPECTIVE
The Prevalence of Psychological Disorders: The Mental State of the Union
The Social and Cultural Context of Psychological Disorders
How prevalent are psychological disorders?
What indicators signal a need for the help of a mental health practitioner?
Exploring Diversity DSM and Culture—and the Culture of DSM
Becoming an Informed Consumer of Psychology Deciding When You Need Help
Learning Objectives:
39-1 Discuss the other forms of abnormal behavior described in the DSM-IV, the prevalence of
psychological disorders, and issues related to seeking help. (pp. 495–498)
Student Assignments:
Interactivity 66: Prevalence of Psychological Disorders
Students answer questions about the prevalence of major psychological disorders.
Web Research
Send students to the Surgeon General’s Report on Mental Health
http://www.surgeongeneral.gov/library/mentalhealth/home.html. This is an extensive web site
with detailed information about the major psychological disorders. Give students instructions to
report on a disorder that they personally found to be the most interesting. Review briefly the
symptoms, causes, and prevalence of this disorder. Indicate how it differs among age-groups
(children, teens, adults, older adults). What are the prospects for the future of finding a cure for
this disorder?
Lecture Ideas:
Surgeon’s General Report
As noted above, the Surgeon General’s Report contains a wealth of information
(http://www.surgeongeneral.gov/library/mentalhealth/home.html). All material in this web site is
in the public domain. Reproduce summaries, figures, and tables either as handouts or as lecture
overheads and slides.
193
Information on Mental Illness from NIMH
Extensive background information on mental illness can be found on this web site:
http://www.nimh.nih.gov/publicat/index.cfm. This web site contains NIMH publications,
including overheads, statistics, professional publications, and information for the public.
Media Presentation Ideas:
National Health Interview Survey (NHIS) Results
The NHIS tracks the health of Americans. These overheads summarize findings from the portion
of the survey concerning mental health (more details can be found at
http://www.cdc.gov/nchs/about/major/nhis/released200303.htm#13.)
194
195
196