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

------------------------------------------------------------------------ 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

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

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  

Psychological Disorders: Biopsychosocial AGAIN! 

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

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

Match the Famous ppl w/ mental disorder http://health. discovery Match the Famous ppl w/ mental disorder http://health.discovery.com/tv/psych-week/articles/celebrities-mental-disorders.html 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)

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…

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)

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)

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

Anxiety Disorders: OCD obsessions & compulsions: Kids & adolescents

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

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

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.)

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

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

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

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

Manic Chocolate deliveries..

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)

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

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

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.?

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)

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

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

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

Schizophrenic Art: also 

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

Schizophrenia: Etiology: Genetic component

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

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

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.

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

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…”)

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

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

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

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 2013.docx

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?)

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