MODULE 32 Dissociative, Schizophrenic, & Personality Disorders

“If you talk to God, you are praying. If God talks to you, you have schizophrenia.” - Thomas Szasz

Dissociative Disorders Dissociative disorders: disorders in which the sense of self has become separated (dissociated) from previous memories, thoughts, or feelings – Dissociative disorders are rare – Usually represent a response to overwhelming stress Examples 

Dissociative Amnesia Dissociative amnesia: dissociative disorder characterized by loss of memory in reaction to a traumatic event Possible causes  People exposed to: – Serious personal threats – Military combat – Natural disasters

Dissociative Fugue Dissociative fugue: dissociative disorder characterized by loss of identity and travel to a new location – Extended form of dissociative amnesia – Can last a few hours or years – People can form new identity – Unconscious response to extreme stress

Dissociative Identity Disorder Dissociative identity disorder: rare and controversial dissociative disorder in which an individual exhibits two or more distinct and alternating personalities (formerly multiple personality disorder) – Sub-personalities can differ in age, sex, & self-perception of physical characteristics – Reported changes in brain function or handedness

– Sometimes sub-personalities seem to be aware of one another, sometimes they do not – Diagnosed cases have increased dramatically during last few decades – Average number of personalities have increased from 3 to 12 – Psychologists debate whether condition really exists Power of suggestion?

Mind & Body in Psychological Disorders Somatoform disorders: psychological disorders in which the symptoms take a bodily form without apparent physical cause Hypochondriasis: somatoform disorder characterized by imagined symptoms of illness

Schizophrenic Disorders Schizophrenia: group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and behaviors – Not “split personality”; split represents break from reality – Affects 1% of world’s population; develops in late adolescence or early adulthood – Affects slightly more men than women

Symptoms of Schizophrenia Delusions: false beliefs – More extensive, more complex, longer term than usual delusions – Schizophrenics have trouble focusing attention on appropriate environmental stimuli

Types of delusions: (1)Delusions of grandeur: false beliefs that you are more important than you really are (2)Delusions of persecution: false beliefs that people are out to get you (3)Delusions of sin or guilt: false beliefs of being responsible for some misfortune (4)Delusions of influence: false beliefs of being controlled by outside forces

Hallucinations: false perceptions – Auditory: hearing voices; people telling you what to do – Visual: seeing nonexistent objects or distortions of items or people – Tactile: feeling skin stimulations such as burning or tingling – Distortions of taste or smell * Hallucinations can provide “evidence” of delusions

Inappropriate Emotions or Behaviors: – Express the opposite of appropriate emotion or flat emotions (little or no emotional response) – Inappropriate behaviors may be verbal or physical – Inappropriate actions or complete inaction – Waxy flexibility – Schizophrenics withdraw from affairs of real world

Types of Schizophrenia Paranoid schizophrenia: characterized by delusions (particularly grandeur and persecution) – Auditory, other hallucinations support delusions

Catatonic schizophrenia: characterized by variations in voluntary movements – Alternating between catatonic excitement (rapid movement, delusions, hallucinations) and catatonic stupor (little activity or speech; flat emotion, waxy flexibility)

Disorganized schizophrenia: characterized by bizarre behavior, delusions, and hallucinations – Visibly disturbed; “gone mad” Undifferentiated schizophrenia: characterized by symptoms that are disturbed but are not clearly consistent with paranoid, catatonic, or disorganized types

Causes of Schizophrenia Biological Factors: research shows schizophrenia is more of a brain disorder that a psychological disorder – Genetics: 10% chance of getting illness if parent or sibling has it 50% chance if relative is identical twin

– Brain structure: smaller amounts of brain tissue, larger fluid-filled spaces around tissue Smaller thalamus (responsible for routing of incoming sensory information) – Brain function: less activity in frontal lobes (advanced thinking abilities) Abnormally high number of receptor sites for neurotransmitter dopamine

– Prenatal viruses: maternal viral infection during pregnancy may cause illness Riskiest birth months follow flu season Rates of schizophrenia rise for individuals born a few months after flu epidemic

Psychological Factors: – Freud mistakenly believed illness results when mothers are cold, domineering, and selfish – Stress: may help trigger schizophrenia when genetic predisposition is present – Disturbed family communications: may trigger schizophrenia Cause or result?

Personality Disorders Personality disorders: psychological disorders characterized by rigid and lasting behavior patterns that disrupt social functioning – DSM lists 10 personality disorders divided into 3 clusters- related to anxiety, odd or eccentric behaviors, and dramatic or impulsive behaviors

Personality Disorders Related to Anxiety Avoidant personality disorder: being sensitive about being rejected; relationships become difficult Dependent personality disorder: behaving in clingy, submissive ways; strong need for people to take care of you

Personality Disorders With Odd or Eccentric Behaviors Paranoid personality disorder: showing deep distrust of other people; suspiciousness gets in the way of personal relationships Schizoid personality disorder: detached from social relationships; avoiding intimate interactions with others at all costs

Personality Disorders With Dramatic or Impulsive Behaviors Borderline personality disorder: instability of emotions, self-image, behavior, relationships Antisocial personality disorder (a.k.a. psychopathic or sociopathic personality disorder): the person (usually a man) shows a lack of conscience for wrongdoing and a lack of respect for the rights of others

– Most dramatic and troubling of all personality disorders – Lack of conscience: people are willing to engage in wide-ranging criminal behaviors about which they show no remorse – People often charming and clever – Extreme form: serial killing