Psychological Disorders

Psychological Disorders
What is a psychological disorder? Anxiety disorders, OCD, and PTSD Substance use and addictive disorders Mood disorders Schizophrenia Other disorders

What Is a Psychological Disorder?
Defining psychological disorders THINKING CRITICALLY ABOUT: ADHD— Normal high energy or disordered behavior? Understanding psychological disorders Classifying disorders—and labeling people CLOSE-UP: Are people with psychological disorders dangerous?

What Is a Psychological Disorder?
Theorists and clinicians consider many perspectives How should we define psychological disorders? How should we understand disorders? How do underlying biological factors contribute to disorder? How do troubling environments influence our well-being? And how do these effects of nature and nurture interact? How should we classify psychological disorders? How can we use labels to guide treatment without stigmatizing people or excusing their behavior?

Defining Psychological Disorders
A syndrome marked by a clinically significant disturbance in a person’s thoughts, feelings, or behaviors Culture and time Diagnosis of specific disorders has varied from culture to culture and over time in the same culture

Percentage of Americans Reporting Certain Psychological Disorders in the Past Year

Understanding Psychological Disorders
The Granger Collection, NYC -- All rights reserved. Once upon a time… Middle Ages: Wide variety of therapies (often cruel or barbaric by today’s standards) used to drive out demons or modify madness Pinel: Opposed brutal treatment and proposed moral treatment; viewed madness as a sickness of mind caused by severe stress and inhumane treatment “MORAL TREATMENT” Under Philippe Pinel’s influence, hospitals sometimes sponsored patient dances, often called “lunatic balls,” depicted in this painting by George Bellows (Dance in a Madhouse).

Understanding Psychological Disorders
The medical model 1800s: Search for physical causes of mental disorders and for curative treatments Mental illness is diagnosed on the basis of symptoms and cured through therapy, including treatment The biopsychosocial approach General approach positing that biological, psychological, and social-cultural factors, all play a significant role in human functioning in the context of disease or illness Medical model the concept that diseases, in this case psychological disorders, have physical causes that can be diagnosed, treated, and, in most cases, cured, often through treatment in a hospital.

ADHD—Normal High Energy or Disordered Behavior?
Attention-deficit/hyperactivity disorder (ADHD) 11 percent of American 4- to 17-year-olds receive this diagnosis after displaying its key symptoms (extreme inattention, hyperactivity, and impulsivity); 2.5 percent have ADHD symptoms Symptoms can be treated with medication and other therapies Debate continues over whether normal high energy is too often diagnosed as a psychiatric disorder, and whether there is a cost to the long-term use of stimulant drugs in treating ADHD

Are psychological disorders universal, or are they culture-specific
Are psychological disorders universal, or are they culture-specific? Explain with examples. What is the biopsychosocial perspective, and why is it important in our understanding of psychological disorders? ANSWER: Some psychological disorders are culture-specific. For example, bulimia nervosa occurs mostly in food-rich Western cultures, and cultures ANSWER: Biological, This broad perspective stresses that our well-being is affected by the interaction of many forces: our genes, brain functioning, inner thoughts and feelings, and the influences of our social and cultural environment.

Classifying Disorders—and Labeling People
Classification in psychiatry and psychology Provides name and description Attempts to predict the future of a disorder Suggests treatment

DSM-5 American Psychiatric Association’s 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Changes Some label changes (e.g., Autism spectrum disorder; intellectual disability) New or altered diagnoses (e.g., disruptive mood dysregulation disorder; prolonged bereavement/depression)—some controversial

DSM-5 Criticism Antisocial personality disorder and generalized anxiety disorder did poorly on field trials DSM-5 contributes to pathologizing of everyday life System labels are society’s value judgments Rosenhan (1973) DSM-5 Benefits System helps mental health professionals communicate and is useful in research

What is the value, and what are the dangers, of labeling individuals with disorders?
ANSWER: Therapists and others use disorder labels to communicate with one another in a common language. Clients may benefit from knowing they are not the only ones with these symptoms. Insurance companies require a diagnosis (a label) before they will pay for therapy. The danger of labeling people is that they will begin to act as they have been labeled, and also that labels can trigger assumptions that will change our behavior toward the people we label.

Anxiety Disorders, OCD, and PTSD
Generalized anxiety disorder Panic disorder Phobias Obsessive-compulsive disorder (OCD) Posttraumatic stress disorder (PTSD) Understanding anxiety disorders, OCD, and PTS

Anxiety Disorders, OCD, and PTSD
Anxiety disorders are marked by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety

Generalized anxiety disorder
Person is constantly tense and uneasy for no apparent reason Panic disorder Person experiences sudden episodes of intense dread and often lives in fear of when the next attack might strike Phobias Person feels irrationally and intensely afraid of a specific object or situation

Obsessive-compulsive disorder
Person is troubled by repetitive thoughts or actions Posttraumatic stress disorder Person has lingering memories, nightmares, and other symptoms for weeks after a severely threatening, uncontrollable event

LIVING WITH ANXIETY DISORDER
NBA basketball player Royce White speaks openly about his generalized associated fear of flying (Wrenn, 2012). Garrett Ellwood/NBAE/Getty Images

General anxiety disorder Symptoms: Continual worrying, often jittery, sleep deprived, concentration difficulties, often experienced with depression Two-thirds are women; decreases with age in many Panic disorder Symptoms: Irregular heartbeat, cheat pains, shortness of breath, choking, dizziness, trembling Smoking increases the risk for attacks

SOME COMMON AND UNCOMMON SPECIFIC FEARS
Researchers surveyed Dutch people to identify the most common events or objects they feared. A strong fear becomes a phobia if it provokes a compelling but irrational desire to avoid the dreaded object or situation. (From Marja et al., 2008.) Specific phobias typically focus on particular animals, insects, heights, blood, or enclosed spaces Not all phobias are so specific. The constant fear of having another panic attack can lead people with panic disorder to avoid situations where panic might strike. Their avoidance itself may lead to a diagnosis of agoraphobia, the fear of again experiencing the dreaded tornado of anxiety.

Classifying Disorders
Sam Greenwood/Getty Images Golfer Charlie Beljan suffered panic and a racing pulse during a PGA golf tournament After finishing, he left and spent the night in a hospital before returning the next day and winning $846,000 PLAYING THROUGH PANIC

Unfocused tension, apprehension, and arousal is called ________ disorder. If a person is focusing anxiety on specific feared objects or situations, that person may have a(n) ________. Those who experience unpredictable periods of frightening physical sensations, may be diagnosed with a(n) ________ disorder. ANSWER: generalized anxiety; phobia; panic

Obsessive-Compulsive Disorder (OCD)
A disorder characterized by unwanted repetitive thoughts (obsessions) and/or actions (compulsions) Occurs when obsessive thoughts and compulsive behaviors interfere with everyday life and cause distress

Post traumatic Stress Disorder (PTSD)
A disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia lingering for four weeks or more after a traumatic experience Often involves battle-scarred veterans (7.6 percent of combatants; 1.4 of noncombatants) and survivors of accidents, disasters, and violent and sexual assaults (two-thirds of prostitutes) Women are at higher risk

Post traumatic Stress Disorder (PTSD)
During his three deployments to Iraq, this Marine Staff Sergeant suffered traumatic brain injury. After his return home, he was diagnosed with posttraumatic stress disorder. He regularly travels two hours each way with his wife to Bethesda Naval Hospital for psychiatric and medical appointments. Whitney Shefte/ The Washington Post via Getty Images BRINGING THE WAR HOME

PTSD Some believe it’s overdiagnosed because of a broad definition of “trauma” May include “normal” bad memories “Debriefing” may exacerbate the problem; reliving the situation may be traumatic

Those who express anxiety through unwanted repetitive thoughts or actions may have a(n) ________ disorder. Those with symptoms of withdrawal, jumpy anxiety, numbness of feeling, and/or insomnia for weeks after a traumatic event may be diagnosed with ________ disorder. ANSWERS: obsessive-compulsive; posttraumatic

Understanding Anxiety Disorders, OCD, and PTSD: How Do Anxious Feelings Arise?
Conditioning Classical conditioning research helps explain how panic-prone people associate anxiety with certain cues Stimulus generalization research demonstrates how a fearful event can later become a fear of similar events Reinforcement (operant conditioning) can help maintain a developed and generalized phobia

Understanding Anxiety Disorders, OCD, and PTSD: How Do Anxious Feelings Arise?
Cognition Observing others can contribute to the development of some fears Olsson and colleagues: Wild monkey research findings Interpretations and expectations shape reactions Hypervigliance

Understanding Anxiety Disorders, OCD, and PTSD
Tim Boyles/ Getty Images Biology Genes: Genetic predisposition to anxiety, OCD, and PTSD The brain: Trauma is linked to new fear pathways, hyperactive danger detection, impulse control, and habitual behavior areas of the brain Natural selection: Biological preparedness to fear threats—easily conditioned and difficult to extinguish FEARLESS? The biological perspective helps us understand why most of us have more fear of heights than does Nick Wallenda, shown here crossing the Grand Canyon in 2013 without a security harness or safety net. Researchers have found genes associated with OCD (Dodman et al., 2010; Hu et al., 2006) and with typical anxiety disorder symptoms (Hovatta et al., 2005).

Researchers believe that anxiety disorders, OCD, and PTSD are influenced by conditioning and cognition. What other factors contribute to these disorders? ANSWER: Biological factors also play a role. They may include inherited temperament and other gene variations; learned fears that have altered brain pathways; and outdated, inherited responses that had survival value for our distant ancestors.

Substance Use and Addictive Disorders
Tolerance and addiction Depressants Stimulants Hallucinogens Understanding substance use disorder

Substance use disorder Involves continued substance craving and use despite significant life disruption and/or physical risk Psychoactive drugs Include chemicals that change perceptions and mood Drug effectiveness Depends on biological effects and the user’s psychological expectations

Tolerance and Addiction
With repeated use, the desired effect requires larger doses Addiction Compulsive craving of drugs or certain behaviors (such as gambling) despite known harmful consequences Withdrawal Discomfort and distress that follow discontinuing an addictive drug or behavior With continued use of alcohol and some other drugs (marijuana is an exception), the user’s brain chemistry adapts to offset the drug’s effect. To experience the same result, the user needs to take larger and larger doses of the substance (Figure 13.2). DRUG TOLERANCE

When Is Drug Use a Disorder?

What is the process that leads to drug tolerance?
ANSWER: With repeated exposure to a psychoactive drug, the drug’s effect lessens. Thus, it takes bigger doses to get the desired effect.

Can you identify the three major categories of psychoactive drugs? The three major categories of psychoactive drugs are depressants, stimulants, and hallucinogens. All do their work at the brain’s synapses. They stimulate, inhibit, or mimic the activity of the brain’s own chemical messengers, the neurotransmitters.

Depressants: Alcohol Unleashing urges Slowed neural processing
Helpful and harmful tendencies are increased Destructive behaviors and consequences occur Binge drinking occurs Slowed neural processing Sympathetic nervous system slows Potential sedative effect and lowered inhibitions Moral and physical judgment is impaired Each year, drinking has contributed to some 1400 deaths, 70,000 sexual assaults, and 500,000 injuries of U.S. college students (Hingson et al., 2002). In one survey of 18,000 students at 140 colleges and universities, almost 9 in 10 students reported harm or abuse by intoxicated peers.

Depressants: Alcohol Memory disruption Expectations
Processing of recent experiences into long-term memory is disrupted (blackouts) Long-term effects on the brain (rat studies) The death of nerve cells and the birth of new cells and impaired growth of synaptic connections is linked to binge drinking Expectations Alcohol users’ expectations influence their behavior 13-10 How do depressants, such as alcohol, influence neural activity and behavior?

ALCOHOL USE DISORDER SHRINKS THE BRAIN
Daniel Hommer, NIAAA, NIH, HHS ALCOHOL USE DISORDER SHRINKS THE BRAIN MRI scans show brain shrinkage in women with alcohol use disorder (left) compared with women in a control group (right).

Depressants Barbiturates Opiates
Depress the activity of the central nervous system, reducing anxiety but impairing memory and judgment Can impair memory and judgment; potentially lethal when combined with alcohol Nembutal, Seconal, and Amytal Opiates Include opium and its derivatives, such as codeine, morphine and heroin; addictive Constrict pupils, slows breathing, causes lethargy Depress neural activity, temporarily lessening pain and anxiety Cause withdrawal when ingestion is stopped

Alcohol, barbiturates, and opiates are all in a class of drugs called ________.
ANSWER: depressants

Stimulants Stimulant drugs
Include caffeine, nicotine, and the more powerful amphetamines (cocaine, Ecstasy, and methamphetamine) that excite neural activity and speed up body functions Involve dilation of pupils, increase in heart and breathing rates, rise in blood sugar, and drop in appetite Often involve increase in energy and self-confidence

Nicotine The stimulating and highly addictive psychoactive drug in tobacco Signals the central nervous system to release a flood of neurotransmitters Diminishes appetite, boosts alertness and mental efficiency, calms anxiety, and reduces sensitivity to pain Involves challenging acute craving and withdrawal symptoms which contribute to relapse

Where there’s smoke . . . The physiological effects of nicotine
Nicotine reaches the brain within 7 seconds, twice as fast as intravenous heroin. Within minutes, the amount in the blood soars.

Why do tobacco companies try so hard to get customers hooked as teens?
ANSWER: Nicotine is powerfully addictive, expensive, and deadly. Those who start paving the neural pathways when young may find it very hard to stop using nicotine. As a result, tobacco companies may have lifelong customers

Stimulants Cocaine Produces a quick rush of euphoria
Involves a crash of agitated depression within 15 to 30 minutes after neurotransmitters drop Produces psychological effects depending on dosage and form consumed and user’s expectations and personality

Cocaine Euphoria and Crash

Stimulants Cocaine Produces quick rush of euphoria
Involves crash of agitated depression within 15 to 30 minutes after neurotransmitters drop Methamphetamine Produces psychological effects depending on dosage and form consumed and user’s expectations and personality Is powerfully addictive Ecstasy (MDMA) A synthetic stimulant and mild hallucinogen Produces euphoria, but with short-term health risks and longer term harm to mood and cognition

Hallucinogens Hallucinogens Marijuana
Distort perceptions and call up sensory images without any input from the senses Marijuana Has leaves containing THC (delta-9- tetrahydrocannabinol) which are smoked or eaten to produce increased sensitivity to colors, sounds, tastes, and smells; lingers in body longer Can also relax, disinhibit, and impair motor and perceptual skills and reaction time

Hallucinogens LSD Powerful hallucinogenic drug; also known as acid (lysergic acid diethylamide) Interferes with serotonin neurotransmitter system From Hallucinations by Ronald K. Siegel, Scientific American 237, (1977) HALLUCINATION OR NEAR DEATH VISION? People under the influence of hallucinogenic drugs often see “a bright light in the center of the field of vision…”

A Guide to Selected Psychoactive Drugs

“How strange would appear to be this thing that men call pleasure
“How strange would appear to be this thing that men call pleasure! And how curiously it is related to what is thought to be its opposite, pain! Wherever the one is found, the other follows up behind.”-- Plato, Phaedo, fourth century B.C.E. How does this pleasure-pain description apply to the repeated use of psychoactive drugs? ANSWER: Psychoactive drugs create pleasure by altering brain chemistry. With repeated use of the drug, the brain develops tolerance and needs more of the drug to achieve the desired effect. (Marijuana is an exception.) Discontinuing use of the substance then produces painful or psychologically unpleasant withdrawal symptoms

Understanding Substance Use Disorder
Evidence of biological vulnerability to particular drugs Twin studies (Kendler et al., 2002) Genetically influenced traits in boys (Masse & Tremblay, 1997) Genes that produce deficiencies in the dopamine reward system Evidence of psychological and social-cultural influences Links between heavy drug use, significant stress or failure, sexual abuse, eating disorders, and depression Exposure to media models Ethnic difference in rates of smoking, drinking, and cocaine use Location and peer influence create additional risk

Studies have found that people who begin drinking in the early teens are much more likely to develop an alcohol use disorder than are those who begin at age 21 or after. What possible explanations might there be for this correlation? ANSWER: Possible explanations include (a) a biological predisposition to both early use and later abuse; (b) brain changes and taste preferences triggered by early use; and (c) enduring habits, attitudes, activities, or peer relationships that could foster alcohol use disorders.

Mood Disorders Major depressive disorder Bipolar disorder
Suicide and self-injury Understanding mood disorders

Mood Disorders Major depressive disorders appear in two principal forms Major depressive disorder A persistent state of hopeless depression Occurs when signs of depression last two or more weeks and are not caused by drugs or a medical condition Bipolar disorder An alternation between depression and overexcited hyperactivity; less common May include seasonal patterns; involves a surge in diagnosis Adults diagnosed with persistent depressive disorder (also called dysthymia) experience a mildly depressed mood more often than not for at least two years (American Psychiatric Association, 2013). They also display at least two of the following symptoms: 1. Problems regulating appetite 2. Problems regulating sleep 3. Low energy 4. Low self-esteem 5. Difficulty concentrating and making decisions 6. Feelings of hopelessness

GENDER AND MAJOR DEPRESSION
Interviews with 89,037 adults in 18 countries (10 of which are shown here) confirm what many smaller studies have found. Women’s risk of major depression is nearly double that of men’s (Bromet et al., 2011).

Diagnosing Major Depressive Disorder

Suicide and Self-Injury
1 million people worldwide; higher risk with diagnosis of depression but may occur with rebound Is more likely to occur when people feel disconnected from or a burden to others Nonsuicidal self-injury (NSS) Includes cutting, burning, and hitting oneself, pulling out hair, inserting objects under the nails or skin, and self-administered tattooing Only 1 in 25 attempts is successful They may engage in NSSI to • gain relief from intense negative thoughts through the distraction of pain. • ask for help and gain attention. • relieve guilt by self-punishment. • get others to change their negative behavior (bullying, criticism). • fit in with a peer group. 13-15 Why do people attempt suicide, and why do some people injure themselves?

People engage in NSSI to
Why? People engage in NSSI to Gain relief from intense negative thoughts through the distraction of pain Ask for help and gain attention Relieve guilt by self-punishment Get others to change their negative behavior (bullying, criticism) Fit in with a peer group

Understanding Mood Disorders
Findings that any theory of depression must explain Behaviors and thoughts change with depression Depression is widespread Women’s risk of major depression is nearly double men’s Most major depressive episodes end on their own With each new generation, depression is striking earlier in life and affecting more people Behaviors and thoughts change with depression. Sensitivity to negative happenings and information; inactivity and lack of motivation, often symptoms of anxiety or substance use disorder Depression is widespread. Found worldwide, causes must be common Women’s risk of major depression is nearly double men’s. Trend begins in adolescence, gap found worldwide, more vulnerability to internal states disorders Most major depressive episodes end on their own. About half time recurs within two years; recovery more likely if first episode is later in life, few previous episodes, ample social support With each new generation, depression is striking earlier in life and affecting more people. Worldwide, young adults are three times more likely than grandparents to be depressed 13-16 How do mood disorders develop? What roles do biology, thinking, and social behavior play?

The Heritability of Various Psychological Disorders
Risk increases if a family member has the disorder Twin studies data estimate heritability of major depression at 37 percent Linkage analysis points to “chromosome neighborhood” Many genes work together and produce interacting small effects that increase the risk for depression Researchers used data from studies of identical and fraternal twins to estimate the heritability of bipolar disorder, schizophrenia, anorexia nervosa, major depressive disorder, and generalized anxiety disorder (Bienvenu et al., 2011).

The depressed brain Brain activity slows during depression Left frontal lobe is less active Scarcity of norepinephrine and serotonin

THE UPS AND DOWNS OF BIPOLAR DISORDER
Courtesy of Drs. Lewis Baxter and Michael E. Phelps, UCLA School of Medicine THE UPS AND DOWNS OF BIPOLAR DISORDER PET scans show that brain energy consumption rises and falls with the patient’s emotional switches. Red areas are where the brain is using energy most rapidly. During depression Brain activity slows Left frontal lobe is less active Scarcity of norepinephrine and serotonin

THE VICIOUS CYCLE OF DEPRESSED THINKING Cognitive therapists attempt to break this cycle, as we will see in Chapter 14, by changing the way depressed people process events. Psychiatrists prescribe medication to try to alter the biological roots of persistently depressed moods.

Psychological and social influences: Social- cognitive perspective Depressed people view the self and the world negatively Learned helplessness may exist with self-defeating beliefs, self-focused rumination, and a self-blaming and pessimistic explanatory style

What does it mean to say that “depression is a whole-body disorder”?
ANSWER: Many factors contribute to depression, including the biological influences of genetics and brain function. Social-cognitive factors also matter, including the interaction of explanatory style, mood, our responses to stressful experiences, and changes in our patterns of thinking and behaving. Depression involves the whole body and may disrupt sleep, energy, and concentration.

Schizophrenia Symptoms of schizophrenia
Onset and development of schizophrenia Understanding schizophrenia

Schizophrenia Definition Symptoms
Psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression Symptoms Disorganized speech Disturbed perceptions Diminished and inappropriate emotions and actions

Schizophrenia Onset and development
Sudden appearance for some; slow-developing for others Recovery is more difficult for slow-developing onset Men are struck earlier, more severely, and slightly more often I in 100 people experience schizophrenia this year; 24 million worldwide with disorder

Understanding Schizophrenia
Brain abnormalities Brain chemistry Excess number of dopamine receptors Abnormal brain activity and anatomy Problems with several brain regions and their interconnections Low activity in frontal lobes More rapid brain tissue loss

Prenatal environment and risk Low birth weight Lack of oxygen during delivery Maternal prenatal nutrition Midpregnancy viral infection (e.g., flu, dense population, season of birth)

RISK OF DEVELOPING SCHIZOPHRENIA
The lifetime risk of developing schizophrenia varies for family members of a person with this disorder. RISK OF DEVELOPING SCHIZOPHRENIA The closer the genetic relationship, the higher the risk. Across countries, barely more than 1 in 10 fraternal twins, but some 5 in 10 identical twins, share a schizophrenia diagnosis. (Adapted from Gottesman, 2001.)

Genetics and risk The odds of being diagnosed with schizophrenia are nearly 1 in 100; 1 in 10 for those with diagnosed family member Adopted children’s risk is related to the biological parents Schizophrenia is influenced by many genes Epigenetic factors influence gene expression

A person with schizophrenia who has ________ (positive/negative) symptoms may have an expressionless face and toneless voice. What factors contribute to the onset and development of schizophrenia? ANSWER: negative ANSWER: Biological factors include abnormalities in brain structure and function, prenatal exposure to a maternal virus, and genetic factors. However, schizophrenia is more likely to develop given a high risk environment.

Other Disorders Eating disorders Dissociative disorders
Personality disorders

Other Disorders Eating disorders Anorexia nervosa
Person (usually an adolescent female) maintains a starvation diet despite being significantly underweight Bulimia nervosa Person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use), fasting, or excessive exercise Binge-eating disorder Significant binge eating, followed by distress, disgust, or guilt, but without the purging, fasting, or excessive exercise that marks bulimia nervosa Anorexia Often begins with dieting that doesn’t stop Fear of being fat, low self-esteem May come from competitive, high-achieving families Bulimia nervosa Weight shifts within or above normal range Preoccupation with food About 1 percent of American women in teens or late twenties usually Binge-eating disorder May be overweight 2.8 percent of Americans

People with ________ (anorexia nervosa/bulimia nervosa) continue to want to lose weight even when they are underweight. Those with ________ (anorexia nervosa/bulimia nervosa) tend to have weight that fluctuates within or above normal ranges. ANSWERS: anorexia nervosa; bulimia nervosa

Other Disorders Dissociative disorder
Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings Dissociative identity disorder (DID) Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities— formerly called multiple personality disorder

Dissociative Disorders: The Arguments
Critics question Short history of DID Lower incidence outside North America Suggest it could be self-perception instead of a disorder Others support Different areas of the brain and body states associated with differing personalities What do you think?

The psychodynamic and learning perspectives agree that dissociative identity disorder symptoms are ways of dealing with anxiety. How do their explanations differ?

Personality Disorders
Inflexible and enduring behavior pattern that impairs social functioning; may include withdrawal or avoidance of social contact, insecurity, instability, or manipulative behaviors Antisocial personality disorder Lack of conscience for wrongdoing, even toward friends and family members; impulsive, fearless, irresponsible; some genetic tendencies, including low arousal Typically male; emerges before age 15; influenced by nature and nurture

Are people with psychological disorders dangerous?
The majority of violent crimes are committed by those with no diagnosed disorders There is little risk of violence or harm to a stranger from casual contact with an individual who has a mental disorder Alcohol or drugs, previous violence, and gun availability are better predictors of violence

Psychological Disorders

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