1. Abnormal Behavior *
A psychological disorder, causing distress, disability, or dysfunction. Defined symptomatically by the DSM.

2. Biopsychosocial Model *
biological factors
come from the body
e.g., genes; neurotransmitters
psychological factors
come from the individual
e.g., patterns of negative thinking; stress responses
social factors
come from society and culture
e.g., socioeconomic status, homelessness, abuse
Key concept is
Interaction.

3. Statistics on Disorders
1 in 4 affected each year
Each year prevalence: 18.1% anxiety disorders;
1% schizophrenia; 4.4% alcohol use disorder
More lower SES
Mentally ill stigmatized
Many disorders comorbid.
Comorbid = more than one disorder at a time
Most severe disorders in a small group of people
6% of population have 3 or more disorders

4. DSM * Diagnostic and Statistical Manual
American Psychiatric Association
Currently DSM-5
Common language and standard criteria for classifying mental disorders
Controversies include:
Cultural bias (e.g. sexual disorders)
Medical rather than behavioral model
Diagnosing, e.g. ADHD, autism.

5. Diagnosing Disorder: The DSM
The DSM organizes disorders by category. Within a diagnostic category, clinicians may also identify specifiers and rate severity.

6. Categories of Disorders include:
Obsessive Compulsive and Related Disorders
Neurodevelopmental Disorders
Dissociative disorders
Substance Related and Addictive Disorders
Depressive Disorders
Bipolar and related disorders
Schizophrenia spectrum and other psychotic disorders
Anxiety Disorders
Somatic Symptom and Related Disorders
Trauma and Stressor-Related Disorders
Feeding and Eating Disorders
Sexual Dysfunction
Personality Disorders
Autism Spectrum Disorders
Neurocognitive Disorders

7. Anxiety Disorders
Anxiety – irrational fear, dread, or agitation; physiological arousal
1. Phobias: unreasonable fear; avoidance
a. Specific phobia – clearly defined object or situation, e.g. dogs
b. Social phobia – extreme shyness or discomfort in social situations
2. Panic Disorder *
Sudden attacks of terror leading to behavioral changes & physical symptoms

8. Phobias
An anxiety disorder characterized by intense fear of specific situations or objects.
The individual knows the fear is irrational.
Common phobias include animals, heights, closed places, needles
Social phobias
An irrational fear and avoidance of any social or performance situation in which one might embarrass or humiliate oneself in front of others
Shaking, blushing, sweating, or appearing clumsy, foolish, or incompetent
Most common type of anxiety disorder
Ricky Williams

9. Phobias
Specific phobias- A marked fear of a specific object or situation.
Phobic items include (ordered by frequency of occurrence):
Situational phobias (elevators, airplanes, enclosed places, tunnels)
Fear of natural environment (storms or water)
Animal phobias (dogs, snakes, insects, or mice)
Blood injection-injury phobia (fear of seeing blood or receiving an injection

10. Panic Disorder
An anxiety disorder marked by unpredictable minutes-long episodes of intense fear and other frightening sensations (heart pounding, shortness of breath, choking sensations, dizziness)
Visit doctors and emergency rooms quite frequently
Person is often left with fear of having another panic attack
Can lead to agoraphobia-intense fear of being in a situation from which no escape is possible if the person experienced a panic attack.

11. Post Traumatic Stress Disorder * Obsessive Compulsive Disorder *
a. Obsessions *
Repetitive, distressing or frightening thoughts
b. Compulsions *
Repetitive behaviors
(an attempt to calm the thoughts)
OCD love poem

12. Examples of obsessions:
Concern for order and constancy
Cleanliness (body or living space)
Forbidden sexual thoughts
Examples of compulsions:
Hand washing
Checking
Collecting
Repeating behaviors (in and out of a door)
Arranging things
Cleaning

13. Etiology of Anxiety Disorders
Biological factors
Genetic predisposition
GABA circuits in the brain
Conditioning and learning
Acquired through classical conditioning
Maintained through operant conditioning
Cognitive factors
Judgments of perceived threat
Stress—a precipitator
Twin studies and family studies suggest a moderate genetic predisposition to anxiety disorders. Abnormalities in neurotransmitter activity at GABA synapses have been implicated in some types of anxiety disorders, and abnormalities in serotonin synapses have been implicated in panic and obsessive-compulsive disorders.
Many anxiety responses, especially phobias, may be caused by classical conditioning and maintained by operant conditioning.
Cognitive theories hold that certain styles of thinking, overinterpreting harmless situations as threatening, for example, make some people more vulnerable to anxiety disorders.
Stress also appears to precipitate the onset of anxiety disorders.

14. Figure 13.4 Conditioning as an explanation for phobias

15. Figure 13.3 Twin studies of anxiety disorders

16. Dissociative Disorders
Disorders in which, under unbearable stress, consciousness becomes dissociated from a person’s identity, her/his memories of important personal events, or both
Types of Dissociative Disorders:
Dissociative Amnesia: retrograde forgetting of autobiographical info
Dissociative Fugue: forgets…and leaves old life
Depersonalization Disorder: everything’s surreal
Dissociative Identity Disorder
14.19
How do the various dissociative disorders affect behavior?
Copyright © 2011 Pearson Education, Inc. All rights reserved.

17. Dissociative Disorders
Disorders which, under unbearable stress, consciousness becomes dissociated from a person’s identity or her/his memories of important personal events, or both
Dissociative Amnesia
A complete or partial loss of the ability to recall personal information or identify past experiences
Cannot be attributed to forgetfulness or substance abuse.
Often caused by traumatic experience or
A situation creating unbearable anxiety causing the person to escape by “forgetting”
Victims of 9-11 tragedy were discovered in mental hospital months later with dissociative amnesia
Brought to hospitals with no identification and couldn’t recall it
Sufferers forget name, age, address, and may not recognize parents, family or friends
Do not forget how to carry out routine tasks
basic personality remains intact
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18. Dissociative Identity Disorder *
2 or more distinct personalities in the same person
Memory disruption regarding the “alter”
Rare
Some psychologists don’t believe the disorder really exists
NOT the same as Schizophrenia

19. Copyright © Allyn & Bacon 2006
Schizophrenia
A severe psychological disorder characterized by loss of contact with reality, hallucinations, delusions, inappropriate or flat affect, some disturbance in thinking, social withdrawal, and/or other bizarre behavior
Positive Symptoms
(added)
Hallucinations
Delusions
Derailment
Inappropriate affect
Negative Symptoms
(loss of deficiency)
Social Withdrawal
Apathy
Loss of motivation
Lack of goal-directed behavior
Very limited speech
Slow movements
Poor hygiene
Poor problem-solving
Distorted sense of time
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20. Schizophrenia * Video – Gerald Psychosis: loss of contact with reality
Positive symptoms – hallucinations, delusions, inappropriate affect, disorganized speech and behavior
Negative symptoms – social withdrawal, deterioration of adaptive behavior, flat affect, poor problem solving abilities
Cognitive symptoms – problems with focus, memory, problem-solving; control

21. Symptoms of Schizophrenia
Delusions and irrational thought
Delusions are false beliefs that are maintained even though they are clearly out of touch with reality.
Distorted perceptions (Hallucinations)
Sensory perceptions that occur in the absence of real stimulus. Usually auditory.
Disturbed emotions
Some show a flattening of emotion.
Some show inappropriate emotional responses.

22. Brain Abnormalities in Schizophrenia
Several abnormalities in brain structure and function have been found
Low levels of neural activity in the frontal lobes
Defects in neural circuitry of the cerebral cortex and limbic system
Reduced volume in hippocampus, amygdala, thalamus, and frontal lobes
Abnormal lateralization of brain functions slow communications between left and right hemispheres
Abnormal dopamine activity is common
May result from cocaine abuse
Medication effective in reducing symptoms of schizophrenia block dopamine action
One third who take these medications do not show improvement
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23. Etiology of Schizophrenia
Genetic vulnerability
Neurochemical factors
Structural abnormalities of the brain
The neurodevelopmental hypothesis
Expressed emotion
Precipitating stress
Research has linked schizophrenia to a genetic vulnerability and changes in neurotransmitter activity at dopamine, and perhaps serotonin, receptors. Structural abnormalities in the brain, such as enlarged ventricles, are associated with schizophrenia, as are metabolic abnormalities in the prefrontal and temporal lobes. Researchers theorize that positive symptoms are related to prefrontal abnormalities and negative symptoms to temporal abnormalities. The question remains to be answered re: whether these abnormalities are cause or consequence of schizophrenia.
The neurodevelopmental hypothesis of schizophrenia asserts that it is attributable to disruptions in maturational processes of the brain before or at the time of birth that are caused by prenatal viral infections or malnutrition, obstetrical complications, and other brain insults.
Studies of expressed emotion, or the degree to which a relative of a person with schizophrenia displays highly critical or emotionally overinvolved attitudes toward the patient, suggest that expressed emotion is a good predictor of the course of schizophrenic illness, negatively impacting prognosis.
Precipitating stress and unhealthy family dynamics have also been shown to be related to schizophrenia.

24. Possible Causes of Schizophrenia *
Genes – runs in families
Brain– loss of neurons; enlarged ventricles
Neurotransmitters – e.g. excess dopamine
Poverty, malnutrition, disease
Prenatal damage – e.g. viruses
Stress
Substance Abuse may trigger
Interactions between items above

25. Causes of Schizophrenia
Genetic vulnerability
Evidence suggests heredity plays a role
Identical twins concordance rates-48%
Offspring of two schizophrenic parents has about a 46% probability of developing the condition.

26. Copyright © Allyn & Bacon 2006
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27. Causes of Schizophrenia
Effects of Prenatal environment
Malnutrition
Prenatal viral infections and birth complications
Effects of the family environment
Results of research shows that a degree of disorganized communication at home that does not harm most children may have damaging effects on those genetically predisposed to schizophrenia

28. Depressive Disorders *
Major depressive disorder *
Low mood (despair) - withdrawal, loss of interest & pleasure; eating & sleeping disturbance Video‬‏
More than 2 weeks
Impaired functioning
Twice as many women
May have psychotic features
Suicidal thoughts or attempts

29. Risk Factors for Suicide *
Diagnosable psychiatric disorder
Male, esp. older and physically ill
Method (guns succeed more than pills)
Prior attempts, family history, exposure
History of being abused
Incarceration
High risk behavior
Adolescence 2% attempt

30. Suicide and Race, Gender, and Age
Mood disorders, schizophrenia, and substance abuse are major risk factors for suicide in all age groups
Suicide risk increases when exposed to troubling life stressor
Suicidal behavior runs in families
30,000-31,000 suicides are reported annually in the U.S.
Suicide rates far lower for white and African American women than men
Older Americans are at far greater risk than young people
90% of individual who commit suicide leave clues
Verbally – “you won’t be seeing me again”
Behavioral – giving away most valued possessions
Taking unnecessary risks
Showing personality changes
Losing interest in favorite activities
Warning signs should be taken seriously
Encourage them to get professional help or call 24-hour hotline
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31. Bipolar and related disorders * Video‬‏
Mood & energy swings from low (depression) to high (mania); near normal in between
Mania *
Exceptional energy, enthusiasm, agitation,
irritability, reckless
behavior.

32. Causes of Mood Disorders
Neurological Correlates
Heredity and abnormal brain structure and chemistry
Abnormal levels of serotonin linked to depression and suicide
Neurotransmitter abnormalities may reflect genetic variations
Heritability of depressive disorder is 70%, environment 30%
Twins of those diagnosed with bipolar disorder:
50% of identical twins also diagnosed
7% of fraternal twins also diagnosed
14.11
What are some suggested causes of mood disorders?

33. Personality Disorders *
Inflexible patterns of thinking, feeling or relating to others
These patterns cause problems in personal, social & work situations.
Inability to understand needs of others
Three “clusters”
A) Odd, eccentric
B) Dramatic/erratic, BPD Video
C) Anxious/inhibited

34. Personality Disorders
Characteristics of personality disorders
Extremely difficult to get along with
Unstable work and social histories
Know their behavior causes problems, yet seem unable to change
Blame other people or situations for their problems
Treatment options are few
Most seek treatment by legal authorities or family members
Seldom engage in self-reflection essential for success
Psychological and behavioral factors that lead to a personality disorder diagnosis may be resolved to some degree or become less severe over time
14.20
What features are shared by all of the personality disorders?

35. Personality Disorders
Three clusters
Dramatic, Emotional: Histrionic Narcissistic Antisocial
Borderline
Anxious, Fearful: Avoidant
Dependent
Obsessive-Compulsive
Odd, Eccentric: Paranoid
Schizoid
Schizotypal

36. Antisocial Personality Disorder *
Pervasive pattern of violating the rights of others
3x more males
Alcohol, drug abuse
Egocentric, impulsive
Lie, cheat, steal, criminal behavior
Biological and environmental factors

37. Personality Disorder Antisocial Personality Disorder
Most troubling and heavily researched personality disorder
Disregards rights, feelings; manipulates, etc. without remorse
Aggressive, irresponsible, reckless, willing to break the law
Breaks the law, lies, cheats, exploits, and fails to hold jobs
Typically a male, whose lack of conscience becomes plain before age 15

38. Somatic Symptom Disorders *
Substantial physical symptoms
May have no documented illness or may have a real illness with “overreaction”.
Stress-related
More females
Distressing and disruptive
Contrast with illness anxiety disorder –exaggerated “normal” physical sensations and no real physical illness.