1. Chapter 16 Psychological Disorders

2. Quiz
Social nonconformity is the failure to conform to societal norms or the usual minimum standards for social conduct, culturally specific.
Mood disorder is a major disturbance in mood or emotion, such as depression or mania or bipolarity.
Schizophrenia means having a split personality
Everyone who experiences the same traumatic event will experience PTSD.
Once someone is diagnosed with a major mental health disorder, they are considered crazy and there is not much that can be done to help them.

3. What is Normal?
Psychopathology: Scientific study of mental, emotional, and behavioral disorders; abnormal or maladaptive behavior
Subjective Discomfort: Subjective feelings of pain, unhappiness, or emotional distress
Statistical Abnormality: Having extreme scores on some dimension, such as intelligence, anxiety, or depression

4. What is Normal? Continued
Social Nonconformity: Disobeying societal standards for normal conduct; usually leads to destructive or self-destructive behavior
Situational Context: Social situation, behavioral setting, or general circumstances in which an action takes place
Is it normal to walk around strangers naked? If you are in a locker room and in the shower area, yes!

5. Cultural Relativity
Prepare a list of normal behaviors that involve interacting with other people
Who are they normal or abnormal for?
A man? A woman? A culture emphasizing passivity? A culture emphasizing aggression?
Judgments are made relative to the values of one’s culture

6. Figure 16.1: The number of people displaying a personal characteristic may help define what is statistically abnormal.
Fig. 16-1, p. 533

7. Statistical Abnormality
Estimate the number of parties you have attended in the last month.
Estimate the number of hours you have spent watching TV or using the computer (not for homework) in the last week
Estimate the number of hours you have spent with your family in the last week
What should define compulsive partying? Or other compulsive behavior?
What is the cutoff for being addicted to any of these behaviors?

8. Figure 16.2: This MRI scan of a human brain (viewed from the top) reveals a tumor (dark spot). Mental disorders sometimes have organic causes of this sort. However, in many instances no organic damage can be found.
Fig. 16-2, p. 536

9. Clarifying and Defining Abnormal Behavior (Mental Illness)
Maladaptive Behavior: Behavior that makes it difficult to function, to adapt to the environment, and to meet everyday demands
Mental Disorder: Significant impairment in psychological functioning
Those with mental illness lose the ability to adequately control thoughts, behaviors, or feelings

10. Social nonconformity does not automatically indicate psychopathology.

11. General Risk Factors for Contracting Mental Illness
Social Conditions: Poverty, homelessness, overcrowding, stressful living conditions
Family Factors: Parents who are immature, mentally ill, abusive, or criminal; poor child discipline; severe marital or relationship problems
Psychological Factors: Low intelligence, stress, learning disorders
Biological Factors: Genetic defects or inherited vulnerabilities; poor prenatal care, head injuries, exposure to toxins, chronic physical illness, or disability

12. Insanity
Definition: A legal term; refers to an inability to manage one’s affairs or to be aware of the consequences of one’s actions
Those judged insane (by a court of law) are not held legally accountable for their actions
Can be involuntarily committed to a psychiatric hospital
Some movements today are trying to abolish the insanity plea and defense; desire to make everyone accountable for their actions
How accurate is the judgment of insanity?

13. Insanity How do you define insanity?
DSM-IV TR definition: Interferes with daily functioning on the following 2 out of 5 of the following categories.
(page 312)
Legal Defense: When an accused person in a criminal prosecution to avoid liability for the commission of a crime because, at the time of the crime, the person did not appreciate the nature or quality or wrongfulness of the acts.

14. Antisocial Personality Disorder (APD)
A person who lacks a conscience (superego?); typically emotionally shallow, impulsive, selfish, and manipulative toward others
Oftentimes called psychopaths or sociopaths
Many are delinquents or criminals, but many are NOT crazed murderers displayed on television
Create a good first impression and are often charming
Cheat their way through life (e.g., Scott Peterson)

15. APD: Causes and Treatments
Possible Causes:
Childhood history of emotional deprivation, neglect, and physical abuse
Underarousal of the brain
Very difficult to effectively treat; will likely lie, charm, and manipulate their way through therapy

17. Anxiety-Based Disorders
Anxiety: Feelings of apprehension, dread, or uneasiness
Adjustment Disorders: When ordinary stress causes emotional disturbance and pushes people beyond their ability to effectively cope
Usually suffer sleep disturbances, irritability, and depression
Examples: Grief reactions, lengthy physical illness, unemployment

18. Panic Disorder without Agoraphobia
A chronic state of anxiety with brief moments of sudden, intense, unexpected panic (panic attack)
Panic Attack: Feels like one is having a heart attack, going to die, or is going insane
Symptoms include vertigo, chest pain, choking, fear of losing control

19. Specific Phobias
Irrational, persistent fears, anxiety, and avoidance that focus on specific objects, activities, or situations
People with phobias realize that their fears are unreasonable and excessive, but they cannot control them

20. Obsession Recurring images or thoughts that a person cannot prevent
Cause anxiety and extreme discomfort
Enter into consciousness against the person’s will
Most common: Being dirty, wondering if you performed an action (turned off the stove), or violence (hit by a car)
Obsessive-Compulsive Disorder (OCD) : Extreme preoccupation with certain thoughts and compulsive performance of certain behaviors

21. Compulsion
Irrational acts that person feels compelled to repeat against his/her will
Help to control anxiety created by obsessions
Checkers and cleaners

22. The severe obsessions and compulsions of billionaire Howard Hughes led him to live as a recluse for over 20 years. Hughes had an intense fear of contamination. To avoid infection, he constructed sterile, isolated environments in which his contact with people and objects was strictly limited by complicated rituals. Before handling a spoon, for instance, Hughes had his attendants wrap the handle in tissue paper and seal it with tape. A second piece of tissue was then wrapped around the first before he would touch it (Hodgson & Miller, 1982). A spoon prepared as Hughes required is shown at right.

23. Stress Disorders
Occur when stresses outside range of normal human experience cause major emotional disturbance
Symptoms: Reliving traumatic event repeatedly, avoiding stimuli associated with the event, and numbing of emotions

24. Acute Stress Disorder
Psychological disturbance lasting up to one month following stresses from a traumatic event
What does a nervous breakdown look like?
What has broken down?
What nerves are being referred to?

25. Post Traumatic Stress Disorder (PTSD)
Lasts more than one month after the traumatic event has occurred; may last for years
Typically associated with combat and violent crimes (rape, assault, etc.)
Terrorist attacks on September 11th, 2001, likely led to an increase of PTSD

26. Dissociative Disorders
Dissociative Amnesia: Inability to recall one’s name, address, or past
Dissociative Fugue: Sudden travel away from home and confusion about personal identity
Usually triggered by highly traumatic events

27. Split Personality What does split personality mean? What is split?
What would it look like?
How would you treat it?

28. Dissociative Identity Disorder (DID)
Person has two or more distinct, separate identities or personality states; previously known as Multiple Personality Disorder
“Sybil” or “The Three Faces of Eve” are good examples
Often begins with horrific childhood experiences (e.g., abuse, molestation, etc.)
Therapy often makes use of hypnosis
Goal: Integrate and fuse identities into single, stable personality

29. Hypochondriasis
Person is preoccupied with having a serious illness or disease
Interpret normal sensations and bodily signs as proof that they have a terrible disease
No physical disorder can be found

30. Somatization Disorder
Person expresses anxieties through numerous physical complaints
Many doctors are consulted but no organic or physical causes are found

31. Glove Anesthesia
Loss of skin sensitivity in areas normally covered by a glove

32. Theoretical Causes of Anxiety Disorders: Psychodynamic (Freud)
Anxiety caused by conflicts among id, ego, and superego
Forbidden id impulses for sex or aggression are trying to break into consciousness and thus influence behavior; person fears doing something crazy or forbidden
Superego creates guilt in response to these impulses
Ego gets overwhelmed and uses defense mechanisms to cope

33. Psychosis Loss of contact with shared views of reality
Delusions: False beliefs that individuals insist are true, regardless of overwhelming evidence against them

34. Hallucinations
Imaginary sensations, such as seeing, hearing, or smelling things that do not exist in the real world
Most common psychotic hallucination is hearing voices
Note that olfactory hallucinations sometimes occur with seizure disorder (epilepsy)

35. Some More Psychotic Symptoms
Flat Affect: Lack of emotional responsiveness; face is frozen in blank expression
Disturbed Verbal Communication: Garbled and chaotic speech; word salad
Personality Disintegration: When an individual’s thoughts, actions, and no longer connected

36. Other Psychotic Disorders
Organic Psychosis: Psychosis caused by brain injury or disease
Dementia: Most common organic psychosis; serious mental impairment in old age caused by brain deterioration
Archaically known as senility

37. Alzheimer’s Disease
Symptoms include impaired memory, mental confusion, and progressive loss of mental abilities
Ronald Reagan most famous Alzheimer’s victim

38. Former U.S. President Ronald Reagan was diagnosed with Alzheimer’s disease in Like many Alzheimer’s victims, Reagan slipped into a slow mental decline. He died in 2004.
p. 551

39. Figure 16.5: The Mad Hatter, from Lewis Carroll’s Alice’s Adventures in Wonderland. History provides numerous examples of psychosis caused by toxic chemicals. Carroll’s Mad Hatter character is modeled after an occupational disease of the eighteenth and nineteenth centuries. In that era, hat makers were heavily exposed to mercury used in the preparation of felt. Consequently, many suffered brain damage and became psychotic, or “mad” (Kety, 1979).
Fig. 16-5, p. 550

40. Delusional Disorders
Marked by presence of deeply held false beliefs (delusions)
May involve delusions of grandeur, persecution, jealousy, or somatic delusions
Experiences could really occur!
Paranoid Psychosis: Most common delusional disorder
Centers on delusions of persecution

41. Schizophrenia: The Most Severe Mental Illness
Psychotic disorder characterized by hallucinations, delusions, apathy, thinking abnormalities, and “split” between thoughts and emotions
Does NOT refer to having split or multiple personalities

42. Four Subtypes of Schizophrenia
Disorganized: Incoherence, grossly disorganized behavior, bizarre thinking, and flat or grossly inappropriate emotions
Catatonic: Marked by stupor, unresponsiveness, posturing, mutism, and sometimes, by agitated, purposeless behavior
Paranoid type: Preoccupation with delusions; also involves auditory hallucinations that are related to a single theme, especially grandeur or persecution
Undifferentiated: Any type of schizophrenia that does not have specific paranoid, catatonic, or disorganized features or symptoms

43. Can the rigid postures and stupor of a person with catatonic schizophrenia be understood in terms of abnormal body chemistry? Environment? Heredity?
p. 553

44. Causes of Schizophrenia
Psychological Trauma: Psychological injury or shock, often caused by violence, abuse, or neglect
Disturbed Family Environment: Stressful or unhealthy family relationships, communication patterns, and emotional atmosphere
Deviant Communication Patterns: Cause guilt, anxiety, anger, confusion, and turmoil

45. This series of paintings by Louis Wain reflects a troubled personality
This series of paintings by Louis Wain reflects a troubled personality. Wain was a British illustrator who became schizophrenic in middle age. As Wain’s psychosis progressed, his cat paintings became highly abstract and fragmented. In many ways, Wain’s paintings resemble the perceptual changes caused by psychedelic drugs such as mescaline and LSD. Recent research suggests that psychosis may, in fact, be the result of mind-altering changes in brain chemistry.
p. 556

46. This series of paintings by Louis Wain reflects a troubled personality
This series of paintings by Louis Wain reflects a troubled personality. Wain was a British illustrator who became schizophrenic in middle age. As Wain’s psychosis progressed, his cat paintings became highly abstract and fragmented. In many ways, Wain’s paintings resemble the perceptual changes caused by psychedelic drugs such as mescaline and LSD. Recent research suggests that psychosis may, in fact, be the result of mind-altering changes in brain chemistry.
p. 556

47. This series of paintings by Louis Wain reflects a troubled personality
This series of paintings by Louis Wain reflects a troubled personality. Wain was a British illustrator who became schizophrenic in middle age. As Wain’s psychosis progressed, his cat paintings became highly abstract and fragmented. In many ways, Wain’s paintings resemble the perceptual changes caused by psychedelic drugs such as mescaline and LSD. Recent research suggests that psychosis may, in fact, be the result of mind-altering changes in brain chemistry.
p. 556

48. This series of paintings by Louis Wain reflects a troubled personality
This series of paintings by Louis Wain reflects a troubled personality. Wain was a British illustrator who became schizophrenic in middle age. As Wain’s psychosis progressed, his cat paintings became highly abstract and fragmented. In many ways, Wain’s paintings resemble the perceptual changes caused by psychedelic drugs such as mescaline and LSD. Recent research suggests that psychosis may, in fact, be the result of mind-altering changes in brain chemistry.
p. 556

49. Figure 16.6: Over a period of years, Theodore Kaczynski mailed bombs to unsuspecting victims, many of whom were maimed or killed. As a young adult, Kaczynski was a brilliant mathematician. At the time of his arrest, he had become the Unabomber—a reclusive “loner” who deeply mistrusted other people and modern technology. After his arrest, Kaczynski was judged to be suffering from paranoid schizophrenia.
Fig. 16-6, p. 554

50. Biochemical Causes of Schizophrenia
Biochemical Abnormality: Disturbance in brain’s chemical systems or in the brain’s neurotransmitters
Dopamine: Neurotransmitter involved with emotions and muscle movement
Works in limbic system
Dopamine overactivity in brain may be related to schizophrenia
Glutamate: A neurotransmitter; may also be involved

51. Figure 16.7: Lifetime risk of developing schizophrenia is associated with how closely a person is genetically related to a schizophrenic person. A shared environment also increases the risk. (Estimates from Lenzenweger & Gottesman, 1994.)
Fig. 16-7, p. 555

52. Figure 16.8: Dopamine normally crosses the synapse between two neurons, activating the second cell. Antipsychotic drugs bind to the same receptor sites as dopamine does, blocking its action. In people suffering from schizophrenia, a reduction in dopamine activity can quiet a person’s agitation and psychotic symptoms.
Fig. 16-8, p. 556

53. Schizophrenic Brain Images
Computed Tomography (CT) Scan: Computer enhanced X-ray of brain or body
Magnetic Resonance Imaging (MRI) Scan: Computer enhanced three-dimensional image of brain or body; based on magnetic field
MRIs show schizophrenic brains as having enlarged ventricles

54. Stress-Vulnerability Model
Combination of environmental stress and inherited susceptibility cause schizophrenic disorders

55. Mood Disorders
Major disturbances in emotion, such as depression or mania
Depressive Disorders: Sadness or despondency are prolonged, exaggerated, or unreasonable
Bipolar Disorders: Involve both depression and mania or hypomania
Dysthymic Disorder: Moderate depression that lasts for at least two years
Cyclothymic Disorder: Moderate manic and depressive behavior that lasts for at least two years

56. Major Mood Disorders
Lasting extremes of mood or emotion and sometimes with psychotic features (hallucinations, delusions)
Major Depressive Disorder: A mood disorder where the person has suffered one or more intense episodes of depression; one of the more serious mood disorders

57. Bipolar Disorders
Bipolar I Disorder: Person experiences extreme mania and deep depression
Mania: Excited, hyperactive, energetic, grandiose behavior
Bipolar II Disorder: Person is mainly sad but has one or more hypomanic episodes (mild mania)

58. Postpartum Depression
Moderately severe depression that begins within three months following childbirth
Marked by mood swings, despondency, feelings of inadequacy, and an inability to cope with the new baby
May last from two months to one year
Part of the problem may be hormonal

59. Seasonal Affective Disorder (SAD)
Depression that only occurs during fall and winter
May be related to reduced exposure to sunlight
Phototherapy: Extended exposure to bright light to treat SAD

60. Figure 16.12: Seasonal affective disorder appears to be related to reduced exposure to daylight during the winter. SAD affects 1 to 2 percent of Florida’s population, about 6 percent of the people living in Maryland and New York City, and nearly 10 percent of the residents of New Hampshire and Alaska (Booker & Hellekson, 1992).
Fig , p. 561

61. Other Psychological Disorders
Substance Related Disorders: Abuse or dependence on a mind- or mood-altering drug, like alcohol or cocaine
Person cannot stop using the substance and may suffer withdrawal symptoms if they do
Sexual and Gender Identity Disorder: Problems with sexual identity, deviant sexual behavior, or sexual adjustment
Neurosis: Archaic; once used to refer to anxiety, somatoform, dissociative disorders, and to some forms of depression (as a whole group)

62. Mentally Healthy?
What does it mean to be mentally healthy?
What are the basic attributes?
How can we discuss psychopathology (problems) without a thorough understanding of health?
For example: Jahoda’s list:
Accurate self concept, self awareness and self acceptance
Self actualization, full use of potential
Autonomy
Integration, a coherent outlook on life
Accurate perceptions of reality and social sensitivity
Competence and mastery of the environment

63. Deviant Behavior
You get the chance to observe deviant behavior in action.
In groups of 3, one of you will be the deviant behaver, and the other 2 will be the observers.
Go out in the building, or surrounding areas and do something that is not “normal”
The observers will report how your behavior was responded to by other people
Don’t do anything entirely inappropriate, offensive or that would get yourself or me into trouble
See page 533 in your textbooks for an example

64. Deviant Discussion Reactions of the unsuspecting to the “deviant”
Negative sanctions applied by the subjects
Feelings of students before, during and after event
What does it mean to be normal or abnormal? Are your thoughts different now than they were in the beginning of class?

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