1. Myers’ PSYCHOLOGY (7th Ed)
Chapter 16
Psychological Disorders
James A. McCubbin, PhD
Clemson University
Worth Publishers

2. ------------------------------------------------------------------------
Ch. 16: Psy Disorders: “harmful dysfunction” in which behavior is judged to be…
Atypical (violates social-norms): goes against accepted behaviors; but not enough by itself to be a mental disorder… Varies w/ era & culture
Disturbing: causes distress to you or those around you--
Maladaptive—harmful; keeps you from functioning well in your world
Unjustifiable: no apparent reason….sometimes there’s a good reason

3. Historical Perspective
Formerly Perceived Causes
movements of sun or moon
lunacy--full moon
evil spirits; demons ; witches
Ancient Treatments
exorcism, caged like animals, beaten, burned, castrated, mutilated, blood replaced w/ animal’s blood
Lock into attics…chain them up
Changing from “demons” to illness:
-Paris: Philippe Pinel: became head of a mental hospital in 1700’s & saw horrid ways patients were treated…unchained the people & demanded humane treatment

4. Psychological Disorders
Medical Model
concept that diseases have physical causes
can be diagnosed, treated, (& in most cases) cured
assumes “mental” illnesses can be diagnosed on the basis of their symptoms & cured through therapy…& may include treatment in a psychiatric hospital
Used to use psych. hospitals a lot but now most is on out-patient basis
Bio-Psycho-Social Perspective: assumes that biological, socio-cultural, & psychological factors combine & interact to produce psychological disorders
--a combination of causes in a cycle  

5. Psychological Disorders: Biopsychosocial AGAIN! 

6. Etiology
The causes of a disorder or condition --where it comes from…It’s ORIGINS…
EX’s:
Freudians (psychoanalystic  now psychodynamic ) said childhood experiences & anxiety & “fixations” in various stages caused disorders & symptoms
Rogers & Maslow (humanists) said it had to do with concept of “the self” and how society saw/defined you

7. The DSM: Diagnostic & Statistical Manual of Mental Disorders
DSM: classifies a disorder…mainly the symptoms that define that disorder Diagnostic & Statistical Manual of Mental Disorders from American Psychiatric Association’s (4th Edition) = DSM-IV-TR (text revision... WAS the latest)
a widely used system for classifying & defining what constitutes a particular psychological disorders
It does NOT give the Etiology….AND does NOT tell you how to treat a disorder
EX: Psychologists used to classify homosexuality as a mental disorder but when they did the last major revisions (DSM-IV, late ’70’s) it was changed & is no longer considered a disorder

8. Match the Famous ppl w/ mental disorder http://health. discovery
Match the Famous ppl w/ mental disorder NOTE: Some may have more than 1 disorder, some disorders have more than one person affected
ADHD Joan Baez
Agoraphobia Craig Ferguson
Bipolar Disorder Paula Deen
Bulimia Howard Hughes
Depression Brooke Shields
DID (Dissociative identity disorder) Vincent van Gogh
OCD (obsessive compulsive disorder) Emma Thompson
Panic Attacks Michael Phelps
Post-partum depression Elton John
Schizophrenia Herschel Walker
Social Anxiety Carrie Fisher
Substance Abuse John Nash
(answers on LAST slide)

9. REMEMBER: Neurosis vs. Psychosis according to Freud:
2 Important terms Freud used: neurosis & psychosis:
Neurosis: various mental/emotional disorders, such as hypochondria or depression, arising from no apparent organic lesion or change
Involves symptoms such as insecurity, anxiety, depression, & irrational fears, but without psychotic symptoms such as delusions or hallucinations. No longer in scientific use.
Psychosis: having more severe symptoms of disorders: hallucinations, delusions
This IS still used to describe symptoms like hallucinations & delusions—refers to a “break with reality” –meaning see/hear stuff not there…..think some pretty bizarre things are true—like aliens are listening to your thoughts…

10. Psychological Disorders-
DSM-V (DSM-5) is coming out very soon….like this month!)
DSM classifies disorders into a category….major categories are “axes” (plural of “axis”)
Major divisions of mental disorders (there are others):
*anxiety disord. *schizophrenia *dissociative disord.
*mood disorders *personality disord. *somatoform
Psychotic disorders
Person loses contact w/ reality, experiencing irrational ideas & distorted perceptions
Commonly seen in schizophrenia & more severe bipolar
disorders as well as others
Neurotic Disorders: usually distressing/upsetting but… allows one to think rationally & function socially
(this term is seldom used now)

11. Anxiety Disorders: distressing, persistent anxiety or maladaptive behaviors that reduce anxiety for no apparent or rational reason (these are not rare…)
Panic Disorder (panic attacks): marked by a minutes-long episode of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation
Often diagnosed in ER…why?
Generalized Anxiety Disorder: person is tense, apprehensive, and in a state of autonomic nervous system arousal
Phobia: persistent, irrational fear of a specific object or situation
Agoraphobia: fear of unfamiliar places…fear of being away from home
Obsessive-Compulsive Disorder: unwanted repetitive thoughts (obsessions) and/or actions (compulsions)

12. Anxiety Disorders: NOTE: There are many more than just those most common ones on the previous slide…
Common & uncommon fears: extremes = phobias

13. Anxiety Disorders: OCD obsessions & compulsions: Kids & adolescents

14. Explaining anxiety disorders: etiology– cause?
fear conditioning: bad uncontrollable events can cause these (rape victim?)
EX: PTSD: post-traumatic stress disorder
stimulus generalization: person falls…then fears airplanes…
reinforcement: becomes cyclic: anxiety, so do something to relieve it (run away, stay home, etc.), feel better, so you will do this the next time
observational learning: parents, siblings, etc. teach fears to the young
genetic: thru natural selection (many are heritable)
physiological: folks w/ overactive limbic system can be prone to these disorders…& anti-depressants help them

15. Anxiety Disorders PET Scan of brain of
obsessive/ compulsive disorder (OCD)
High metabolic activity (red) in frontal lobe areas involved with directing attention
Over-active amygdala &/or limbic system can affect this
** b/c it’s a stimulant, nicotine increases risk of a 1st episode of anxiety disorders

16. Mood Disorders: Emotional extremes (ups OR downs)
Mild or moderate Depression (aka dysthymic disor.): “common cold” of mental disorders…
Related to lack of N-T’s serotonin & nor-epinephrine
(both affect mood) and can have genetic component
Women more prone to depression…probably b/c of **Hormones **Lack of self-esteem
**Lack of a sense of efficacy ( “I have control, etc.)

17. Major Depressive Disorder
For no apparent reason,
person experiences 2 or more
wks of depressed moods,
feelings of worthlessness,
& diminished interest or
pleasure in most activities
Possibility of suicide is major concern
If drugs & cognitive/behavioral therapy don’t work, this is 1 of few disorders Dr’s. may still use shock (ECT-electroconvulsive) therapy on b/c of fear of suicide

18. Mood Disorders Manic Episodes (“Mania”)
Marked by a hyperactive,
wildly optimistic state
Biological influence: *maybe genetics or..*excess of 2 (maybe 3?) NT’s? ( s___ & especially n___ maybe d__)
EX’s of manic behaviors: Could be 1, some, or all (or some other…) of the following:
-grandiose ideas euphoric optimism
-spending sprees reckless, aggressive
-long periods of no sleep speech becomes loud
-excessive self-esteem poor judgment, egocentric
-increased chances of unprotected sex

19. Bipolar Disorder
Mood disorder in which the person alternates betwn. the hopelessness & lethargy of depression… & the overexcited state of mania
 A “self-portrait”
way up…then way down…& back again…
formerly called manic-depressive disorder

20. Mood Disorders-Bipolar
PET scans show that brain energy consumption rises & falls w/ emotional switches…same person in all 3 of these PET scans
May 17 May 18 May27
Depressed state
Manic state

21. Manic Chocolate deliveries..

22. READ!! P.638 Suicides & differing groups:
National: see #’s: where’s US?
Racial: Euro.-Amer.(W) more than Afr. Amer. (B)
Gender: Which try? Which succeed? Why?
Age: most = older men; increase in older male teens
Other groups:
religious vs. non-relig.
heterosexual/homosexual?
married, single, widowed, divorced?
drug usage?
The Depressed brain:
How do serotonin & norepinephrine affect depression vs. mania?? (Dopamine MAY be involved also)

23. Mood Disorders - Depression & Gender cross-culturally: Females more susceptible

24. Mood Disorders-Depression
Canadian depression rates: M vs F in varying ages

25. Mood Disorders- Suicide Why do more F’s attempt suicide but more M’s commit suicide? Why does rate in males go up sharply in later yrs.?

26. Mood Disorders-Depression
Altering any one component of the chemistry-cognition-mood circuit can alter the others
Genetic: there is a strong genetic link in mood disorders
Physiological (638)
brains differences: lobes, NT’s, activity levels
Social-cognitive: self-defeating beliefs; negative thoughts
-”stable, global,
internal” (b-640)

27. Mood Disorders-Depression
The vicious cycle of depression can be broken at any point
Rumination: dwelling on something
P. 643: Loneliness: “aloneness often breeds loneliness”:
-excluded
-unloved
-constricted
-alienated

28. Dissociative Disorders (Read 644-5)
conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings
Dissociative amnesia: blocking of information regarding a very stressful event; just go on w/ life like it never happened (Freud’s repression)
Dissociative Fugue: go to new place & take up new life after some traumatic event
Dissociative Identity Disorder
rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities
formerly called multiple personality disorder
Some psychologists disbelieve this, say it’s role-playing
It is NOT schizophrenia (though you’ll hear it called that)
V. rare & disputed by most psychologists
Virtually always related to long-term childhood sexual abuse

29. Schizophrenia: This one IS very real…& very sad…
literal translation “split mind” which is why may hear schiz. called multi. personality
a group of severe disorders characterized by:
disorganized and delusional thinking
disturbed perceptions
inappropriate emotions and actions
Delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders
Hallucinations
sensory experiences without sensory stimulation

30. Schizophrenic Art: also 

32. 5 subtypes of schizophrenia: Also… Acute vs. chronic?

33. Schizophrenia: Etiology: Genetic component

34. Schizophrenia in ID Twins: 1 w/ & 1 w/o --indicates some other cause other than genetics… NOTE size of ventricles

35. Positive vs. negative symptoms …
These do NOT relate to good or bad…
Positive: something added…
EX: hallucinations; delusions; excessive emotion….etc.
Negative: something taken away…
EX: -flat affect (no emotion)
-no movement (catatonic)
Onset of schiz.: those predisposed to schiz. have their 1st episode typically between about ages 17 – 35
--some possible warning signs…
EX: poor selective attention

36. Clarification: Positive vs. Negative Schiz. symptoms
Positive symptoms are things that are present in schizophrenics which are absent in normal people, such as delusions, hallucinations, or word salad. 
Negative symptoms are things which are absent in schizophrenics which are present in normal people, such as flat affect, avolition (lack of motivation, etc.) or catatonia.

37. Etiology of schizophrenia:
Environment: Other disorders have effects from from the environment, BUT schiz. very much physiological
…BUT stress can bring on episodes in those who have physiological tendencies already
EX: family interaction & communication can have an
effect (Hi-risk factors RE: schiz.: p. 652)
Dopamine over-activity: too much dopamine in brains of schiz. during autopsies
Brain anatomy: low activity in frontal lobes; enlarged brain cavities (ventricles)
Maternal viruses during mid-pregnancy: is it the virus, or the medications, etc.?
But only 2% seem affected this way…
Genetic factors: there is a genetic link …so if you have a close family member w/ schiz., risk is up

38. Personality Disorders: inflexible, long-lasting behavior patterns that impair social functioning usually without anxiety, depression, or delusions
(SOME below......BUT are others!)
Borderline Personality Disorder: manipulative; can be sexually promiscuous; defensive; high-risk; may threaten suicide for attention
Co-dependent Persn. Disor.: over-dependent on another; will allow another to abuse verbally, emotionally, etc., & tend to make excuses for him/her
-usually women; “passive-aggressive”
Narcissistic Persn. Disor.: It’s ALL about MEEEE!!!
Antisocial Persn. Disor. (aka “sociopaths”)
person (usually male) exhibits a lack of conscience for wrongdoing, even toward friends & family
may be aggressive and ruthless or a clever con artist
Early signs? (See “ppl who abuse animals…”)

39. Anti-social personality disorder: little guilt or effect
Boys who were later convicted of a crime showed relatively low arousal during stress situations

40. Antisocial-Personality Disorders
PET scans illustrate reduced activation in a murderer’s frontal cortex…lacks guilt, etc.
Less related to genetics, more environ.
..\..\Desktop\stored documents\videos psych etc from toshiba JD\Video folder 2013\A Conversation with Richard Ramirez--The Night Stalker--Reported by Mike Watkiss - YouTube.mp4
Normal
Murderer

41. Personality Disorders: Do seem to have an environmental etiology
Personality Disorders: Do seem to have an environmental etiology...often abusive, poor, neglectful parents are involved + birth problems \..\Desktop\stored documents\videos psych etc from toshiba JD\Video folder 2013\Psych Stuff antisocial personality disorder.flv

42. Rates of Psychological Disorders: Hi. Lo. Cultural /gender
Rates of Psychological Disorders: Hi? Lo? Cultural /gender ? ..\AP Psych Docs folder Jan 2012\AP Psy Psych Disorders and Their Statistics docx

43. Somatoform disorders: (Not in yr bk!)
-Preoccupation w/ health…or showing physical symptoms w/ NO true physical problems
Conversion disorder: used to be called “hysterical ___”, i.e., hysterical blindness or hysterical paralysis
Hypochodriasis: hypochondria…preoccupied w/ your health, worried you have everything
Munchausen’s Syndrome or Munchausen by proxy: actually poison or otherwise hurt yourself (or another= proxy) in order to get sympathetic attention (any movie you remember?)

45. Answers to Match the famous ppl w/ mental disorders
ADHD : Michael Phelps
Agoraphobia: Paula Deen
Bipolar Disorder: Carrie Fisher, Vincent van Gogh
Bulimia: Elton John
Depression: Emma Thompson
Dissociative identity disorder (DID): Herschel Walker
OCD: Howard Hughes
Panic Attacks: Paula Deen
Post-partum depression: Brooke Shields
Schizophrenia: John Nash
Social Anxiety: Joan Baez
Substance Abuse: Craig Ferguson, Elton John