1. Psychological Disorders Abnormal Behaviors Modules 65-69

2. Psychological Disorders
Perspectives on Psychological Disorders
Defining Psychological Disorders
Understanding Psychological Disorders
Classifying Psychological Disorders
Labeling Psychological Disorders

3. Psychological Disorders
Anxiety Disorders
Generalized Anxiety Disorder and Panic Disorder
Phobias
Obsessive-Compulsive Disorders
Post-Traumatic Stress Disorders
Anxiety Disorder Explanation

4. Psychological Disorders
Mood Disorders
Major Depressive Disorders
Bipolar Disorder
Mood Disorder Explanation
Schizophrenia
Symptoms of Schizophrenia
Subtypes of Schizophrenia

5. Psychological Disorders
Schizophrenia
Understanding Schizophrenia
Personality Disorders
Rates of Psychological Disorders

6. Psychological Disorders
I felt the need to clean my room … spent four to five hour at it … At the time I loved it but then didn't want to do it any more, but could not stop … The clothes hung … two fingers apart …I touched my bedroom wall before leaving the house … I had constant anxiety … I thought I might be nuts.
Marc, diagnosed with
obsessive-compulsive disorder
(from Summers, 1996)

7. Whenever I get depressed it’s because I’ve lost a sense of self
Whenever I get depressed it’s because I’ve lost a sense of self. I can’t find reasons to like myself. I think I’m ugly. I think no one likes me.
Greta, diagnosed with depression (from Thorne, 1993
Voices, like the roar of a crowd, came. I felt like Jesus; I was being crucified.
Stuart, diagnosed with schizophrenia (from Emmons et al., 1997)

8. Psychological Disorders
People are fascinated by the exceptional, the unusual, and the abnormal. This fascination may be caused by two reasons:
During various moments we feel, think, and act like an abnormal individual.
Psychological disorders may bring unexplained physical symptoms, irrational fears, and suicidal thoughts.

9. Psychological Disorders
To study the abnormal is the best way of understanding the normal.
William James ( )
There are 450 million people suffering from psychological disorders (WHO, 2004).
Depression and schizophrenia exist in all cultures of the world.

10. Defining Psychological Disorders
A psychological disorder is a syndrome marked by a “clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior” (American Psychiatric Association, 2013).
Disturbed, or dysfunctional, behaviors are maladaptive—they interfere with normal day-to-day life.
OBJECTIVE 1| Identify criteria for judging whether behavior is psychologically disordered.
Distress often accompanies dysfunctional behaviors.

11. Defining Psychological Disorders
Young men of the West African Wodaabe tribe put on elaborate makeup and costumes to attract women. Young American men may buy flashy cars with loud stereos to do the same. Each culture may view the other’s behavior as abnormal.

12. Understanding Psychological Disorders
Ancient Treatments of psychological disorders include trephination, exorcism, being caged like animals, being beaten, burned, castrated, mutilated, or transfused with animal’s blood.
OBJECTIVE 2| Contrast the medical model of psychological disorders with the biopsychosocial perspective on disordered behavior.
John W. Verano
Trephination (boring holes in the skull to remove evil forces)

13. Medical Perspective
Philippe Pinel ( ) from France, insisted that madness was not due to demonic possession, but an ailment of the mind.
Mental illness- is also called psychopathology
George Wesley Bellows, Dancer in a Madhouse, © 1997 The Art Institute of Chicago
Dance in the madhouse.

14. Medical Model
The concept that diseases or psychological disorders have physical causes that can be diagnosed, treated, and in most cases, cured, often through treatment in a hospital.
Mental illness is also called psychopathology.

15. Biopsychosocial Approach
Assumes that genetic predispositions and physiological states, inner psychological dynamics, and social and cultural circumstances— combine and interact to produce psychological disorders.
This approach recognizes that mind and body are inseparable.

16. Classifying Psychological Disorders
In psychiatry and psychology, diagnostic classification aims not only to describe a disorder but also to predict its future course, imply appropriate treatment, and stimulate research into its causes.
The most common system for describing disorders and estimating how often they occur is the American Psychiatric Association’s 2013 Diagnostic and Statistical Manual of Mental Disorders, now in its fifth edition (DSM-5).

17. The New DSM-5 Some diagnostics labels have changed.
Ex. “Autism” and “Asperger’s syndrome” are no longer included; they have been combined into “autism spectrum disorder”
Ex. “Mental retardation” has become “intellectual disability.”
Ex. New categories include “hoarding disorder” and “binge-eating disorder.”

18. An Example of a Diagnosis
A person may be diagnosed with and treated for “insomnia disorder” if he or she meets all of the following criteria:
Is dissatisfied with sleep quantity or quality (difficulty initiating, maintaining, or returning to sleep).
Sleep disturbance causes distress or impairment in everyday functioning.
Occurs at least three nights per week.
Present for at least three months.
Occurs despite adequate opportunity for sleep.
Is not explained by another sleep disorder (such as narcolepsy).
Is not caused by substance use or abuse.
Is not caused by other mental disorders or medical conditions

19. Goals of DSM
Describe (400) disorders.
Determine how prevalent the disorder is.
Disorders outlined by DSM-V are reliable. Therefore, diagnoses by different professionals are similar.
Critics have long faulted the DSM for casting too wide a net and bringing “almost any kind of behavior within the compass of psychiatry” (Eysenck et al., 1983). They worry that the DSM-5 will extend the pathologizing of everyday life—for example, by turning bereavement grief into depression and boyish rambunctiousness into ADHD (Frances, 2013).

20. Labeling Psychological Disorders
Critics of the DSM-IV argue that labels may stigmatize individuals.
Once we label a person, we view that person differently (Farina, 1982). Labels create preconceptions that guide our perceptions and our interpretations.
OBJECTIVE 4| Discuss the potential dangers and benefits of using diagnostic labels.
Asylum baseball team (labeling)

21. Labeling Psychological Disorders
2. Labels may be helpful for healthcare professionals when communicating with one another and establishing therapy.

22. Labeling Psychological Disorders
3. “Insanity” labels raise moral and ethical questions about how society should treat people who have disorders and have committed crimes.
Elaine Thompson/ AP Photo
Theodore Kaczynski
(Unabomber)

23. Rates of Psychological Disorders

25. Rates of Psychological Disorders
The U.S. National Institute of Mental Health (2008, based on Kessler et al., 2005) estimates that 26 percent of adult Americans “suffer from a diagnosable mental disorder in a given year”.

26. Who is most vulnerable to mental disorders?
The incidence of serious psychological disorders has been doubly high among those below the poverty line (CDC, 1992).
Does poverty cause disorders? Or do disorders cause poverty? It is both, though the answer varies with the disorder. Schizophrenia understandably leads to poverty. Yet the stresses and demoralization of poverty can also precipitate disorders, especially depression in women and substance use disorder in men (Dohrenwend et al., 1992).

27. Feelings of excessive apprehension and anxiety.
Anxiety Disorders
Feelings of excessive apprehension and anxiety.
3Types
Generalized anxiety disorders
Phobias
Panic disorders
OBJECTIVE 5| Define anxiety disorder, and explain how this condition differs from normal feelings of stress, tension, or uneasiness.

28. Generalized Anxiety Disorder
Symptoms
Persistent and uncontrollable tenseness and apprehension.
2. Autonomic arousal.
Inability to identify or avoid the cause of certain feelings.
Constantly worried bad things might happen.
Plagued by muscular tension, agitation and sleeplessness.
OBJECTIVE 6| Contrast the symptoms of generalized anxiety disorder and panic disorder.

29. Generalized Anxiety Disorder
One of generalized anxiety disorder’s worst characteristics is that the person may not be able to identify, and therefore deal with or avoid, its cause. To use Sigmund Freud’s term, the anxiety is free-floating.
Many people with generalized anxiety disorder were maltreated and inhibited as children (Moffitt et al., 2007a). As time passes, however, emotions tend to mellow, and by age 50, generalized anxiety disorder becomes fairly rare (Rubio & López-Ibor, 2007).

30. Generalized Anxiety Disorder
Treatments
Psychotherapy with or without drugs
The most frequently prescribed are tranquilizers that belong to the group known as benzodiazepines: diazepam, and alprazolam

31. Panic Disorder
Entails an anxiety tornado. Panic strikes suddenly, wreaks havoc, and disappears.
Minute-long episodes of intense dread which may include feelings of terror, chest pains, choking, or other frightening sensations.
Heart palpitations and shortness of breath is sometimes mistaken for a heart attack.
Anxiety is a component of both disorders. It occurs more in the panic disorder, making people avoid situations that cause it.

32. Panic Disorder Treatments
Usually with drugs belonging to the group of benzodiazepines, antidepressants (Prozac-reuptake inhibitors), and psychotherapy.

33. Phobia
Marked by a persistent and irrational fear of an object or situation that disrupts behavior.
OBJECTIVE 7| Explain how a phobia differs from fears we all experience.
Some common and uncommon specific fears This Dutch national interview study identified the commonality of various specific fears. A strong fear becomes a phobia if it provokes a compelling but irrational desire to avoid the dreaded object or situation. (From Delpa et al., 2008.)

34. Phobias
Social anxiety disorder (formerly called social phobia) is shyness taken to an extreme.
an intense fear of being scrutinized by others
avoid potentially embarrassing social situations
eating out, or going to parties—or will sweat or tremble when doing so

35. Kinds of Phobias Agoraphobia Phobia of open places. Acrophobia
Phobia of heights.
Claustrophobia
Phobia of closed spaces.
Hemophobia
Phobia of blood.
Social
Phobia of performing in social situations.

36. Obsessive-Compulsive Disorder
Persistence of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) that cause distress.
Obsessive thoughts and compulsive behaviors cross the fine line between normality and disorder when they persistently interfere with everyday living and cause distress.
Checking to see if the door is locked is OK
Checking the door 10 times is NOT.
Washing your hands over and over until they are raw is NOT OK.
OCD is more common among teens and young adults than among older people (Samuels & Nestadt, 1997).
OBJECTIVE 8| Describe the symptoms of obsessive-compulsive disorder.

37. Obsessive-Compulsive Disorder

38. Obsessive-Compulsive Disorder
Treatments
Exposure therapy
Antidepressant drugs

39. Brain Imaging
A PET scan of the brain of a person with Obsessive-Compulsive Disorder (OCD). High metabolic activity (red) in the frontal lobe areas are involved with directing attention.
Brain image of an OCD

40. Post-Traumatic Stress Disorder
Four or more weeks of the following symptoms constitute post-traumatic stress disorder (PTSD):
Haunting memories
2. Nightmares
3. Social withdrawal
OBJECTIVE 9| Describe the symptoms of post-traumatic stress disorder, and discuss survivor resiliency.
4. Jumpy anxiety
5. Sleep problems
Bettmann/ Corbis

41. Post-Traumatic Stress Disorder
Is not just do to a war situation.
PTSD symptoms have also been reported by survivors of accidents, disasters, and violent and sexual assaults (including an estimated two-thirds of prostitutes).
Some psychologists believe that PTSD has been overdiagnosed, due partly to a broadening definition of trauma (Dobbs, 2009; McNally, 2003).

42. Resilience to PTSD
Only about 1 in 10 women and 1 in 20 of men react to traumatic situations and develop PTSD.
More than 9 in 10 New Yorkers, although stunned and grief-stricken by 9/11, did not respond pathologically.
All major religions of the world suggest that surviving a trauma leads to the growth of an individual.
Indeed, suffering can lead to “benefit finding”-post-traumatic growth: positive psychological changes as a result of struggling with extremely challenging circumstances and life crises.

43. Explaining Anxiety Disorders
Freud’s psychoanalytic theory proposed that, beginning in childhood, people repress intolerable impulses, ideas, and feelings and that this submerged mental energy sometimes produces mystifying symptoms, such as anxiety.
Today’s psychologists have instead turned to two contemporary perspectives—learning and biological.
OBJECTIVE 10| Discuss the contributions of the learning and biological perspectives to our understanding of the development of anxiety disorders.

44. The Learning Perspective
Learning theorists suggest that fear conditioning leads to anxiety.
Classical conditioning
Fear dogs because once bitten; accidents.
This anxiety then becomes associated with other objects or events (stimulus generalization) and is reinforced.
When a person fears heights after a fall and later develops a fear of flying.
John Coletti/ Stock, Boston

45. The Learning Perspective: Observational Learning
Investigators believe that fear responses are inculcated through observational learning.
Young monkeys develop fear when they watch other monkeys who are afraid of snakes.
Humans likewise learn fears by observing others (Olsson et al., 2007).

46. Cognition
Our interpretations and irrational beliefs can also cause feelings of anxiety.
People with anxiety disorder also tend to be hypervigilant.
A pounding heart becomes a sign of a heart attack.
A lone spider near the bed becomes a likely infestation.

47. The Biological Perspective
Natural Selection:
We humans seem biologically prepared to fear threats faced by our ancestors.
Our phobias focus on such specific fears: spiders, snakes, and other animals; enclosed spaces and heights; storms and darkness.
Therefore, fear preserves the species.
Twin studies suggest that our genes may be partly responsible for developing fears and anxiety. Twins are more likely to share phobias. .

48. The Biological Perspective: The Brain
Generalized anxiety, panic attacks, PTSD, & even obsessions &compulsions are manifested biologically as an over-arousal of brain areas involved in impulse control and habitual behaviors.
The anterior cingulate cortex, a brain region that monitors our actions and checks for errors, seems especially likely to be hyperactive in those with OCD.
S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action
monitoring in obsessive-compulsive disorder. Psychological Science, 14,
Anterior Cingulate Cortex
of an OCD patient.

49. Mood Disorders Abnormal disturbances in emotion or mood.
Emotional extremes of mood disorders come in two principal forms.
Major depressive disorder
Bipolar disorder
OBJECTIVE 12| Define mood disorders, and contrast major depressive disorder and bipolar disorder.

50. Dysthymic Disorder A milder form of major depression
Dysthymic disorder lies between a blue mood and major depressive disorder. “ Down-in-the-dumps” mood that fills most of the day, nearly everyday. It can last for two or more years.
Chronic low energy
Low self-esteem
Difficulty concentrating & making decisions
May sleep and eat too much or too little
Major Depressive
Disorder
Blue
Mood
Dysthymic

51. Major Depressive Disorder
Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002).
Depression is the number one reason people seek mental health services and the leading cause of disability worldwide.

52. Major Depressive Disorder
Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions.
Signs include:
Problems regulating appetite
Problems regulating sleep
Low energy
Low self-esteem
Difficulty concentrating and making decisions
Feelings of hopelessness

54. Treatments of Mood Disorders
Selective serotonin reuptake inhibitors (SSRI’s)-antidepressant drugs
Prozac, Zoloft
Psychotherapy

55. Bipolar Disorder
Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder.
Mania-hyperactive and wildly optimistic state.
Grandiose optimism and self esteem is a symptom of the manic state.
Ex. Reckless investments, spending sprees, and unsafe sex; they may find advice irritating.

56. Bipolar Disorder Bipolar Disorder Mania (manic)
Overtalkative, overactive, elated, little need for sleep, etc.
Disruptive Mood Dysregulation Disorder-
Adolescent mood swings-rage to bubbly; emotional volatility
Bipolar disorder and creativity
Composers, artists, poets, novelists and entertainers seem especially prone

57. Bipolar Disorder The spectrum of emotions Depressive Symptoms
Manic Symptoms
Gloomy
Elation
Withdrawn
Euphoria
Inability to make decisions
Desire for action
Tired
Hyperactive
Slowness of thought
Multiple ideas

58. Treatment of Bipolar Disorder
Lithium-a mood stabilizer that prevents the manic episodes (prevents neurons from being overstimulated)
Lithium is often combined with antipsychotics and antidepressants.

59. Understanding Depressive and Bipolar Disorders
Many behavioral and cognitive changes accompany depression
Depression is widespread
Women’s risk of major depression is nearly double men’s
Most major depressive episodes self-terminate
Stressful events related to work, marriage and close relationships often proceed depression
With each new generation, depression is striking earlier and affecting more people

60. Understanding Depressive and Bipolar Disorders

61. Biological Perspective
Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%).
Linkage analysis and association studies link possible genes and dispositions for depression.
OBJECTIVE 14| Summarize the contribution of the biological perspective to the study of depression, and discuss the link between suicide and depression.
Jerry Irwin Photography

62. Neurotransmitters & Depression
A reduction of norepinephrine and serotonin has been found in depression.
Drugs that alleviate mania reduce norepinephrine.
Pre-synaptic
Neuron
Serotonin
Norepinephrine
Post-synaptic
Neuron

63. The Depressed Brain
PET scans show that brain energy consumption rises and falls with manic and depressive episodes.
Courtesy of Lewis Baxter an Michael E.
Phelps, UCLA School of Medicine

64. Suicide
The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide.
National differences
Racial differences
Gender differences
Age differences
Other differences
Suicide Statistics

65. Social-Cognitive Perspective
The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.
OBJECTIVE 15| Summarize the contribution of the social-cognitive perspective to the study of depression, and describe the events in the cycle of depression.

66. Understanding Depressive and Bipolar Disorders The Social-Cognitive Perspective
Negative Thoughts and Moods Interact
Self-defeating beliefs
Learned helplessness
Rumination- compulsive fretting; overthinking about our problems
Explanatory style
Stable, global, internal explanations
Cause versus indictor of depression?

68. Depression Cycle Negative stressful events.
Pessimistic explanatory style.
Hopeless depressed state.
These hamper the way the individual thinks and acts, fueling personal rejection.

69. Module 68: Schizophrenia Spectrum

70. Schizophrenia
If depression is the common cold of psychological disorders, schizophrenia is the cancer.
Nearly 1 in a 100 suffer from schizophrenia (about 60 % men), and throughout the world over 24 million people suffer from this disease (WHO, 2011).
Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women.

71. Symptoms of Schizophrenia
The literal translation is “split mind,”-not multiple personalities, but a split from reality.
A group of severe disorders characterized by the following:
Disorganized and delusional thinking.
Disturbed perceptions.
Inappropriate emotions and actions.
OBJECTIVE 16| Describe the symptoms of schizophrenia, and differentiate delusion and hallucinations.
Psychosis- a psychotic disorder marked by irrationality and lost contact with reality.

72. Disorganized & Delusional Thinking
This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”
(Sheehan, 1982)
This monologue illustrates fragmented, bizarre thinking with distorted beliefs called delusions (“I’m Mary Poppins”).
Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”).

73. Disorganized & Delusional Thinking
Many psychologists believe disorganized thoughts occur because of selective attention failure (fragmented and bizarre thoughts).
Word salad- jumbled ideas

74. Disturbed Perceptions
A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory.
Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign
August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg
L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg

75. Inappropriate Emotions & Actions
A schizophrenic person may laugh at the news of someone dying or show no emotion at all (apathy).
Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).

76. Subtypes of Schizophrenia
Schizophrenia is a cluster of disorders. These subtypes share some features, but there are other symptoms that differentiate these subtypes.
OBJECTIVE 17| Distinguish the five subtypes of schizophrenia, and contrast chronic and reactive schizophrenia.

77. Positive and Negative Symptoms
Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (positive symptoms).
Also known as Type I
Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals (negative symptoms).
Also known as Type II

78. Chronic and Acute Schizophrenia
When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms (Type II).
When schizophrenia rapidly develops (acute/reactive) recovery is better; responsive to drug therapy. Such schizophrenics usually show positive symptoms (Type I).

79. Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.
Brain Abnormalities
Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.
OBJECTIVE 18| Outline some abnormal brain functions and structures associated with schizophrenia, and discuss the possible link between prenatal viral infections and schizophrenia.

80. Abnormal Brain Activity
Brain scans show abnormal activity in the frontal cortex (decreased neural firing), thalamus (over activity-hallucinations), and amygdala (increased activity-paranoia) of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions
Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro
Imaging and Judith L. Rapport, National Institute of Mental Health

81. Abnormal Brain Morphology
Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles, which indicates shrinkage of brain tissue.
Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

82. Viral Infection
Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.

83. Understanding Schizophrenia Genetic Factors
Genetic predisposition
Twin studies

84. Genetic Factors
The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991).
Identical
Both parents
Fraternal
One parent
Sibling
Nephew or niece
Unrelated
OBJECTIVE 19| Discuss the evidence for a genetic contribution to the development of schizophrenia.

85. Psychological Factors
Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983).
The genetically identical Genain
sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors.
OBJECTIVE 20| Describe some psychological factors that may be early signs of schizophrenia in children.
Courtesy of Genain Family
Genain Sisters

86. Understanding Schizophrenia Psychological Factors
Possible warning signs
Mother severely schizophrenic
Birth complications (low weight/oxygen deprivation)
Separation from parents
Short attention span
Disruptive or withdrawn behavior
Emotional unpredictability
Poor peer relations and solo play

87. Treatments for Schizophrenia
Type I –Positive
Typical neuroleptic drugs that reduce levels of dopamine.
Mainly reduces the positive symptoms
Ex. Thorazine
Atypical neuroleptic drugs also reduce levels of dopamine and affects the amount of serotonin present.
These types of drugs have some effects on negative symptoms.
Clozapine

88. Module 69: Other Disorders

89. What are Somatoform Disorders?
A psychological disorder in which distressing symptoms take a somatic (bodily) form without apparent physical causes.
Ex. Vomiting, prolonged pain, dizziness, blurred vision, difficulty swallowing…
Conversion disorder- a rare type of somatoform disorder in which a person experiences very specific genuine physical symptoms for which no physiological basis can be found
Ex. Paralysis or blindness
Illness Anxiety Disorder
Formally known as hypochondriasis
People interpret normal sensations (a stomach cramp today, a headache tomorrow) as symptoms of a dreaded disease.

90. Dissociative Disorder
A rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder.
Conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings.
Symptoms
1. Having a sense of being unreal.
2. Being separated from the body.
3. Watching yourself as if in a movie.
OBJECTIVE 11| Describe the symptoms of dissociative disorders, and explain why some critics are skeptical about dissociative identity disorder.

91. Dissociative Disorders Understanding Dissociative Identity Disorder
Genuine disorder or not?
DID rates-between only two per decade
In the 80’s the rates exploded to more
than 20,000
Therapist’s creation
May reflect role-playing to therapists
suggestions
May be a result of feelings of
anxiety

92. Feeding and Eating Disorders
Anorexia nervosa
Bulimia nervosa
Binge eating disorder

93. Feeding and Eating Disorders
Anorexia nervosa: an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly (15 percent or more) underweight.
Usually begins as a weight-loss diet
People with anorexia—usually adolescents and 9 times out of 10 females—drop significantly below normal weight.
They feel fat, fear being fat, and remain obsessed with losing weight, and sometimes exercise excessively.
About half of those with anorexia display a binge-purge-depression cycle.

94. Feeding and Eating Disorders
Bulimia nervosa: an eating disorder in which a person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use) or fasting.
Binge-purge eaters—mostly women in their late teens or early twenties—eat in spurts, sometimes influenced by friends who are bingeing (Crandall, 1988).
Unlike anorexia, bulimia is marked by weight fluctuations within or above normal ranges, making the condition easy to hide.

95. Feeding and Eating Disorders
Binge-eating disorder: significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa.
A national study funded by the U.S. National Institute of Mental Health reported that, at some point during their lifetime:
0.6 percent of people meet the criteria for anorexia,
1 percent for bulimia, and
2.8 percent for binge-eating disorder

96. So, how can we explain these disorders?
Mothers of girls with eating disorders tend to focus on their own weight and on their daughters’ weight and appearance (Pike & Rodin, 1991).
Families of bulimia patients have a higher-than-usual incidence of childhood obesity and negative self-evaluation (Jacobi et al., 2004).
Families of anorexia patients tend to be competitive, high-achieving, and protective (Pate et al., 1992; Yates, 1989, 1990)
Low self esteem/evaluation
Genetics
Cultural influences

97. Personality Disorders
Personality disorders are disruptive, inflexible and enduring behavior patterns that impair one’s social functioning.
They are three clusters of personality disorders:
A-Eccentric/odd behavior
B- Dramatic/impulsive behaviors
C-Anxiety
OBJECTIVE 21| Contrast the three clusters of personality disorders, and describe the behaviors and brain activity associated with antisocial personality disorders.

98. Personality Disorders
Cluster A-Odd/Eccentric
Schizoid PD- expresses eccentric behaviors such as emotionless disengagement
Cluster B- Dramatic/Impulsive
Histrionic PD-exhibits dramatic or impulsive behaviors; shallow, attention-getting emotions and goes to great lengths to gain others praise and reassurance.
Narcissistic PD- exaggerates their own importance, aided by fantasies. They find criticism hard to accept, often reacting with rage or shame.
Antisocial personality disorder
Cluster C-Anxiety/Fearful
Avoidant PD- expresses anxiety, such as fearful sensitivity to rejection.

99. Antisocial Personality Disorder-Cluster B
Sometimes called a sociopath or psychopath.
A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. May be aggressive and ruthless or a clever con artist.
Symptoms include: lies, steals, fight, display unrestrained sexual behavior
They feel and fear little.
They express little regret over violating others’ rights.
Lack of conscience becomes plain before age 15.
Despite their remorseless and sometimes criminal behavior, criminality is not an essential component of antisocial behavior (Skeem & Cooke, 2010).

100. Understanding Antisocial Personality Disorder
Like mood disorders and schizophrenia, antisocial personality disorder has biological and psychological reasons.
Youngsters, before committing a crime, respond with lower levels of stress hormones than others do at their age.

101. Understanding Antisocial Personality Disorder
PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study repeat offenders had 11% less frontal lobe activity compared to normals (Raine et al., 1999; 2000).
Courtesy of Adrian Raine,
University of Southern California
Normal
Murderer

102. Understanding Antisocial Personality Disorder
The likelihood that one will commit a crime doubles when childhood poverty is compounded with obstetrical complications-premature birth- (Raine et al., 1999; 2000).

103. Developmental Disorders
Autism-characterized by disabilities in language, social interaction, the ability to understand another person’s state of mind, cognitive development and repetitive behavior
Occurs in about 1 in 500 children and often is first suspected at about years of age, when the child fails to develop language.
Most experts believe it is a brain disorder with a genetic basis.
Asperger’s Syndrome- high functioning autism; children with high intelligence have deficits in social interaction.

104. Rates of Psychological Disorders
OBJECTIVE 22| Discuss the prevalence of psychological disorders, and summarize the findings on the link between poverty and serious psychological disorders.

105. Risk and Protective Factors
Risk and protective factors for mental disorders (WHO, 2004).

106. Risk and Protective Factors