1. Chapter 12: Psychological Disorders

2. Learning Outcomes
Define psychological disorders and describe their prevalence.
Describe the symptoms and possible origins of anxiety disorders.

3. Learning Outcomes
Describe the symptoms and possible origins of dissociative disorders.
Describe the symptoms and possible origins of somatoform disorders.

4. Learning Outcomes
Describe the symptoms and possible origins of mood disorders.
Describe the symptoms and possible origins of schizophrenia.
Describe the symptoms and possible origins of personality disorders.

5. What are Psychological Disorders?
LO1 Define psychological disorders and describe their prevalence.

6. Truth or Fiction?
A man shot the President of the United States in front of millions of television witnesses and was found not guilty by a court of law.
Truth or Fiction? A man shot the President of the United States in front of millions of television witnesses and was found not guilty by a court of law. TRUE John Hinckley was diagnosed with severe psychological disorders and found not guilty of an assassination attempt on President Reagan’s life.
insanity - a legal term descriptive of a person judged to be incapable of recognizing right from wrong or of conforming his or her behavior to the law

7. Truth or Fiction?
A man shot the President of the United States in front of millions of television witnesses and was found not guilty by a court of law.
TRUE!
Truth or Fiction? A man shot the President of the United States in front of millions of television witnesses and was found not guilty by a court of law. TRUE John Hinckley was diagnosed with severe psychological disorders and found not guilty of an assassination attempt on President Reagan’s life.
insanity - a legal term descriptive of a person judged to be incapable of recognizing right from wrong or of conforming his or her behavior to the law

8. Psychological Disorders
Characterized by
Rare or unusual behavior
Faulty perceptions or interpretations of reality
Severe personal distress
Self-defeating behaviors
Dangerous behaviors
Socially unacceptable behaviors
psychological disorders - patterns of behavior or mental processes that are connected with emotional distress or significant impairment in functioning
hallucination - a perception in the absence of sensory stimulation that is confused with reality
ideas of persecution - erroneous beliefs that one is being victimized or persecuted

9. Truth or Fiction? Anxiety is abnormal.
Truth or Fiction? Anxiety is abnormal. FICTION Anxiety can actually be perfectly normal, as on the eve of a big test or when on a first date.

10. Truth or Fiction? Anxiety is abnormal. FICTION!
Truth or Fiction? Anxiety is abnormal. FICTION Anxiety can actually be perfectly normal, as on the eve of a big test or when on a first date.

11. Perspectives on Psychological Disorders
Demonological Model
Medical Model
Contemporary Psychological Models
Diathesis –stress model
Biopsychosocial model

12. Classifying Psychological Disorders
Diagnostic and Statistical Manual (DSM)
Includes information on medical conditions, psychosocial problems and global assessment of functioning
Concerns about reliability and validity of the standards
Predictive validity
predictive validity – in this usage, the extent to which a diagnosis permits one to predict the course of a disorder and the type of treatment that may be of help

13. Prevalence of Psychological Disorders
About 50% of us will experience a psychological disorder at some time
Most often starts in childhood or adolescence
Slightly more than 25% will experience a psychological disorder in any given year

14. Insanity Plea M’Naghten rule Raised in about 1% of cases
Defendant did not understand what he was doing at the time or did not realize it was wrong
Raised in about 1% of cases

15. Anxiety Disorders
LO2 Describe the symptoms and possible origins of anxiety disorders.

16. Anxiety Disorders Psychological features of anxiety
Worrying, fear of worst happening, fear of losing control, nervousness, inability to relax
Physical features of anxiety
Arousal of sympathetic branch of autonomic nervous system
anxiety disorders - disorders characterized by excessive worrying, fear of losing control, nervousness, and inability to relax

17. Phobic Disorders Specific phobias Social phobias Agoraphobia
Irrational fears of specific objects or situations
Social phobias
Persistent fears of scrutiny by others
Agoraphobia
Fear of being in places from which it would be difficult to escape or receive help
specific phobia - persistent fear of a specific object or situation
claustrophobia - fear of tight, small places
acrophobia - fear of high places
social phobia - an irrational, excessive fear of public scrutiny
agoraphobia - fear of open, crowded places

18. Panic Disorder
Abrupt attack of acute anxiety not triggered by a specific object or situation
Physical symptoms
Shortness of breath, heavy sweating, tremors, pounding of the heart
Other symptoms that may “feel” like a heart attack
panic disorder – recurrent experiencing of attacks of extreme anxiety in the absence of external stimuli that usually elicit anxiety

19. Generalized Anxiety Disorder
Persistent anxiety
Cannot be attributed to object, situation, or activity
Symptoms include
Motor tension
Autonomic overarousal
Excessive vigilance
generalized anxiety disorder – feelings of dread and foreboding and sympathetic arousal of at least 6 months’ duration

20. Obsessive-Compulsive Disorder
Obsessions
Recurrent, anxiety-provoking thoughts or images that seem irrational and beyond control
Compulsions
Thoughts or behaviors that tend to reduce the anxiety connected with obsessions
Irresistible urges to engage in specific acts, often repeatedly
obsessive–compulsive disorder (OCD) - an anxiety disorder defined by recurrent, anxiety-provoking thoughts or images that seem irrational and beyond control (obsessions) and seemingly irresistible urges to engage in thoughts or behaviors that tend to reduce the anxiety (compulsions)

21. Stress Disorders Posttraumatic stress disorder (PTSD)
Caused by a traumatic event
May occur months or years after event
Acute stress disorder
Unlike PTSD, occurs within a month of event and lasts 2 days to 4 weeks
post-traumatic stress disorder (PTSD) - a disorder that follows a distressing event outside the range of normal human experience and that is characterized by features such as intense fear, avoidance
acute stress disorder - a disorder, like PTSD, that is characterized by feelings of anxiety and helplessness and caused by a traumatic event; acute stress disorder occurs within a month of the event and lasts from 2 days to 4 weeks

22. Sleep Problems Among Americans Before and After September 11, 2001
Figure 12.1 Sleep Problems Among Americans Before and After September 11, Insomnia is one of the symptoms of stress disorders. A poll by the National Sleep Foundation found that Americans had a greater frequency of sleep problems after the terrorist attacks of September 11, 2001.

23. Origins of Anxiety Disorders
Psychological
Phobias as conditioned fears
Cognitive bias toward focusing on threats
Biological
Genetic factors
Natural selection
Biopsychosocial

24. Dissociative Disorders
LO3 Describe the symptoms and possible origins of dissociative disorders.

25. Dissociative Disorders
A splitting of mental processes such as thoughts, emotions, identity, memory, or consciousness
dissociative disorders – disorders in which there are sudden, temporary changes in consciousness or self-identity

26. Types of Dissociative Disorders
Dissociative Amnesia
Suddenly unable to recall important personal information; not due to biological problems
Dissociative Fugue
Abruptly leaves home or work and travels to another place, no memory of previous life
dissociative amnesia – a dissociative disorder marked by loss of memory or self-identity; skills and general knowledge are usually retained
dissociative fugue – a dissociative disorder in which one experiences amnesia and then flees to a new location

27. Types of Dissociative Disorders
Dissociative Identity Disorder
Two or more identities, each with distinct traits, “occupy” the same person
Formerly known as multiple personality disorder
Dissociative identity disorder (DID) (formerly termed multiple personality disorder) - a disorder in which a person appears to have two or more distinct identities or personalities that may alternately emerge

28. Origins of Dissociative Disorders
Learning/cognitive – may have learned to not think about or keep disturbing ideas out of one’s mind
Culture-bound to U.S. and Canada

29. Somatoform Disorders
LO4 Describe the symptoms and possible origins of somatoform disorders.

30. Somatoform Disorders
Physical problems (such as paralysis, pain, or persistent belief of serious disease) with no evidence of a physical abnormality
somatoform disorders - disorders in which people complain of physical (somatic) problems even though no physical abnormality can be found

31. Conversion Disorder
Major change in, or loss of, physical functioning, although there are no medical findings to explain the loss of functioning.
Not intentionally produced
la belle indifference
conversion disorder - a disorder in which anxiety or unconscious conflicts are “converted” into physical symptoms that often have the effect of helping the person cope with anxiety or conflict
la belle indifference - a French term descriptive of the lack of concern for their (imagined) medical problem sometimes shown by people with conversion disorders

32. Hypochondriasis
Insistence of serious physical illness, even though no medical evidence of illness can be found
May seek opinion of one doctor after another
hypochondriasis - a somatoform disorder characterized by persistent belief that one is ill despite lack of medical findings

33. Origins of Somatoform Disorders
Biopsychosocial perspective
Psychologically, the disorder has to do with what one focuses on to the exclusion of conflicting information
Susceptible to being hypnotized
Tendencies toward perfectionism and rumination (heritable)

34. Mood Disorders
LO5 Describe the symptoms and possible origins of mood disorders.

35. Mood Disorders Characterized by disturbance in expressed emotions
mood disorders - a disturbance in expressed emotions, generally involving excessive or inappropriate sadness or elation

36. Types of Mood Disorders
Major Depressive Disorder
Persistent feelings of sadness, loss of interest, feelings of worthlessness or guilt, and inability to concentrate
About 50% of those with MDD experience severe symptoms
Poor appetite, weight loss, agitation, psychomotor retardation
major depressive disorder - a serious to severe depressive disorder in which the person may show loss of appetite, psychomotor retardation, and impaired reality testing
psychomotor retardation - slowness in motor activity and (apparently) in thought

37. Truth or Fiction? Feeling elated is not always a good thing.
Truth or Fiction? Feeling elated is not always a good thing. TRUE It is true that feeling “up” is not always a good thing, as in the manicky phase of bipolar disorder.

38. Truth or Fiction? Feeling elated is not always a good thing. TRUE!
Truth or Fiction? Feeling elated is not always a good thing. TRUE It is true that feeling “up” is not always a good thing, as in the manicky phase of bipolar disorder.

39. Types of Mood Disorders
Bipolar disorder
Mood swings from ecstatic elation to deep depression
Manic behaviors
Argumentative, rapid flight of ideas,
Depressive behaviors
Lethargy, insomnia
bipolar disorder - a disorder in which the mood alternates between two extreme poles (elation and depression); also referred to as manic depression
manic - elated, showing excessive excitement
rapid flight of ideas - rapid speech and topic changes, characteristic of manic behavior

40. Origins of Mood Disorders
Psychological
Learning theorists
Lack reinforcement and have an external locus of control
Learned helplessness
Cognitive
Perfectionism and unrealistic expectations
Attributional styles
learned helplessness - a possible explanation for some depressive behavior, based on findings that organisms in aversive situations learn to show inactivity when their behavior is not reinforced
attributional style - the tendency to attribute one’s behavior to internal or external factors, stable or unstable factors, and global or specific factors

41. Origins of Mood Disorders
Biological
Genetics – neuroticism
Neurotransmitter - serotonin
Biopsychosocial
Biologically predisposed
Self-efficacy expectations
Attitudes
neuroticism - a personality trait characterized largely by persistent anxiety

42. Women and Depression
Women are twice as likely to be diagnosed with depression
Begins to emerge in adolescence
During childbearing years – more likely to develop depression
Origins
Role of estrogen
Rumination
Demands placed on women

43. Suicide
Suicide is the third leading cause of death among 15- to 24-year-olds

44. Risk Factors in Suicide
Feelings of depression, hopelessness
Adolescent psychological problems
Stressful life events – exit events
Familial experience with psychological disorders and/or suicide
Adolescent psychology problems
confusion about self
impulsiveness
emotional instability
interpersonal problems

45. Sociocultural Factors in Suicide
More common among college students than people of the same age who do not attend college
Older people are more likely to commit suicide than teenagers
Suicide rate among older unmarried or divorced people is double that of older married people

46. Sociocultural Factors in Suicide
One in six Native Americans has attempted suicide
African Americans are least likely to attempt suicide
Three times as many females attempt suicide
Five times as many males succeed in suicide

47. Myths about Suicide
Individuals who fail at suicide are only seeking attention
Discussion of suicide prompts suicide attempts
People who would take their own lives are insane
NOTE: These are the myths and as such, all three are false:
Individuals who fail at suicide are not only seeking attention. In fact, many people who do commit suicide have made prior attempts
Discussing suicide with a person who is depressed does not prompt a suicide attempt. In fact, people who are depressed and promise NOT to commit suicide seems to be preventive in some situations
Suicidal thinking is not necessarily bizarre thinking, but rather the point at which they believe they have run out of options

48. Schizophrenia
LO6 Describe the symptoms and possible origins of schizophrenia.

49. Schizophrenia
Severe psychological disorder characterized by disturbances in
thought and language,
perception and attention,
motor activity,
mood,
withdrawal and absorption in fantasy

50. Positive Versus Negative Symptoms
Positive symptoms
Presence of inappropriate behaviors
Agitated behavior, hallucinations, delusions, disorganized thinking, nonsensical speech
Negative symptoms
Absence of appropriate behaviors
Flat, emotionless voices, blank faces, rigid, motionless bodies, mutism
positive symptoms - those symptoms of schizophrenia that indicate the presence of inappropriate behavior, such as hallucinations, delusions, agitation, and inappropriate giggling
negative symptoms - those symptoms of schizophrenia that reflect the absence of appropriate behavior, such as blank faces, monotonic voices, and motionless bodies
mutism - refusal to talk

51. Problems in Thinking and Language
Thought disorder
Thinking and communication become unraveled
Delusions
of grandeur
of persecution
of reference
delusions - false, persistent beliefs that are unsubstantiated by sensory or objective evidence

52. Problems in Perception
Hallucinations
May be visual or auditory
Motor activity may become wild or slowed
Stupor
Hallucinations – that the person cannot distinguish from reality
stupor - a condition in which the senses, thought, and movement are dulled

53. Truth or Fiction?
People with schizophrenia may see and hear things that are not really there.
Truth or Fiction? People with schizophrenia may see and hear things that are not really there. TRUE It is true that people with schizophrenia may see and hear things that are not really there. Those “things” are called hallucinations.

54. Truth or Fiction?
People with schizophrenia may see and hear things that are not really there.
TRUE!
Truth or Fiction? People with schizophrenia may see and hear things that are not really there. TRUE It is true that people with schizophrenia may see and hear things that are not really there. Those “things” are called hallucinations.

55. Types of Schizophrenia
Paranoid Schizophrenia
Systematized delusions
Disorganized Schizophrenia
Incoherence; extreme social impairment
Catatonic Schizophrenia
Motor impairment; waxy flexibility
paranoid schizophrenia - a type of schizophrenia characterized primarily by delusions—commonly of persecution—and by vivid hallucinations
disorganized schizophrenia - a type of schizophrenia characterized by disorganized delusions and vivid hallucinations
catatonic schizophrenia - a type of schizophrenia characterized by striking motor impairment
waxy flexibility - a feature of catatonic schizophrenia in which people can be molded into postures that they maintain for quite some time

56. Explaining Schizophrenia
Psychological
Behaviorists – conditioning and observational learning
Sociocultural
Socioeconomic class

57. Explaining Schizophrenia
Biological
Brain differences
Heredity
Complications during pregnancy and birth
Birth during winter
Dopamine theory of schizophrenia
Brain disorder – Focus on amount of gray matter, size of ventricles (hollow spaces), activity levels in the rain, and brain chemistry
Dopamine theory of schizophrenia suggests that people with schizophrenia over utilize dopamine

58. Average Rates of Loss of Gray Matter Among Normal Adolescents and Adolescents Diagnosed with Schizophrenia
Figure 12.2: Average Rates of Loss of Gray Matter Among Normal Adolescents and Adolescents Diagnosed with Schizophrenia - High-resolution MRI scans show rates of gray matter loss in normal 13- to 18-year-olds and among adolescents of the same age diagnosed with schizophrenia. Maps of brain changes reveal profound, progressive loss in schizophrenia (right). Loss also occurs in normal adolescents (left), but at a slower rate.

59. Relationship to a Person Diagnosed with Schizophrenia and Likelihood of Being Diagnosed with Schizophrenia Oneself
Figure 12.3: Relationship to a Person Diagnosed with Schizophrenia and Likelihood of Being Diagnosed with Schizophrenia Oneself.

60. Explaining Schizophrenia
Biopsychosocial perspective
Genetic predisposition
Genetic vulnerability interacts with other factors

61. The Biopsychosocial Model of Schizophrenia
Figure 12.4: The Biopsychosocial Model of Schizophrenia - According to the biopsychosocial model of schizophrenia, people with a genetic vulnerability to the disorder experience increased risk for schizophrenia when they encounter problems such as viral infections, birth complications, stress, and poor parenting. People without the genetic vulnerability would not develop schizophrenia despite such problems.

62. Personality Disorders
LO7 Describe the symptoms and possible origins of personality disorders.

63. Personality Disorders
Characterized by enduring patterns of behavior that are maladaptive and inflexible
Impair personal or social functioning
Source of distress
personality disorders - enduring patterns of maladaptive behavior that are sources of distress to the individual or others

64. Types of Personality Disorders
Paranoid Personality Disorder
Interpret other’s behavior as threatening or demeaning
Schizotypal Personality Disorder
Peculiarities of thought, perception, or behavior
Schizoid Personality Disorder
Indifference to relationships and flat emotional response
paranoid personality disorder - a personality disorder characterized by persistent suspiciousness but not involving the disorganization of paranoid schizophrenia
schizotypal personality disorder - a personality disorder characterized by oddities of thought and behavior but not involving bizarre psychotic behaviors
schizoid personality disorder - a personality disorder characterized by social withdrawal

65. Truth or Fiction?
Some people can kill or maim others without any feelings of guilt.
Truth or Fiction? Some people can kill or maim others without any feelings of guilt. TRUE When they persistently violate the rights of others and are in repeated conflict with the law, they may be diagnosed with antisocial personality disorder.

66. Truth or Fiction?
Some people can kill or maim others without any feelings of guilt.
TRUE!
Truth or Fiction? Some people can kill or maim others without any feelings of guilt. TRUE When they persistently violate the rights of others and are in repeated conflict with the law, they may be diagnosed with antisocial personality disorder.

67. Types of Personality Disorders
Borderline Personality Disorder
Instability in relationships, self-image, and mood
Antisocial Personality Disorder
Persistently violate the law
Show no guilt or remorse and are largely undeterred by punishment
Avoidant Personality Disorder
Avoid relationships for fear of rejection
borderline personality disorder - a personality disorder characterized by instability in relationships, self-image, mood, and lack of impulse control
antisocial personality disorder - the diagnosis given a person who is in frequent conflict with society, yet who is undeterred by punishment and experiences little or no guilt and anxiety
avoidant personality disorder - a personality disorder in which the person is unwilling to enter relationships without assurance of acceptance because of fears of rejection and criticism

68. Origins of Personality Disorders
Biological
Genetic factors
Personality traits that may be inherited
Antisocial personality – less gray matter in prefrontal cortex

69. Explaining Personality Disorders
Psychological
Learning theory
Childhood experiences
Cognitive
Misinterpretation of other people’s behaviors
Sociocultural
Borderline personality – may reflect the fragmented society in which one lives