Myers’ PSYCHOLOGY (6th Ed) Chapter 15 Psychological Disorders James A. McCubbin, PhD Clemson...
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Transcript of Myers’ PSYCHOLOGY (6th Ed) Chapter 15 Psychological Disorders James A. McCubbin, PhD Clemson...
Myers’ PSYCHOLOGY
(6th Ed)
Chapter 15
Psychological Disorders
James A. McCubbin, PhDClemson University
Worth Publishers
NUMBERS
1.7 MILLION INPATIENTS PER YEAR.2.4 MILLION PUTPATIENTS PER YEAR.400 MILLION WORLD WIDE WITH A
MENTAL DISORDER.
MANY ARE HOMELESS
Psychological Disorders
Psychological Disorder a “harmful dysfunction” in which
behavior is judged to be:atypical- not enough in itselfdisturbing- varies with time & culturemaladaptive- harmfulunjustifiable- sometimes there’s a
good reason
Historical Perspective
Perceived Causes movements of sun or moon
lunacy- full moon evil spirits
Ancient Treatments exorcism, caged like animals, beaten, burned, castrated,
mutilated, blood replaced with animal’s blood, teeth pulled, boiled alive, extremities torn off.
Pinel: the first to treat patients humanely.
Psychological Disorders
Medical Model concept that diseases have physical causes can be diagnosed, treated, and in most
cases, cured assumes that these “mental” illnesses can
be diagnosed on the basis of their symptoms and cured through therapy, which may include treatment in a psychiatric hospital
Psychological Disorders
Bio-psycho-social Perspective assumes that
biological, sociocultural, and psychological factors combine and interact to produce psychological disorders
Biological(Evolution, individual
genes, brain structures
and chemistry)
Psychological(Stress, trauma,
learned helplessness, mood-related perceptions
and memories)
Sociocultural(Roles, expectations, definition of normality
and disorder)
Psychological Disorders- Etiology
DSM-IV American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)
a widely used system for classifying psychological disorders
Describe, predict, imply
Psychological Disorders- Etiology
Neurotic disorder (term seldom used now) usually distressing but that allows one to think
rationally and function socially Freud saw the neurotic disorders as ways of
dealing with anxietyPsychotic disorder
person loses contact with reality experiences irrational ideas and distorted
perceptions
Anxiety DisordersAnxiety Disorders
distressing, persistent anxiety or maladaptive behaviors that reduce anxiety
Generalized Anxiety Disorder person is tense, apprehensive, and in a state
of autonomic nervous system arousalPhobia
persistent, irrational fear of a specific object or situation
Anxiety DisordersCommon and uncommon fears
Afraid of it Bothers slightly Not at all afraid of it
Beingclosed in,
in a smallplace
Being alone
In a house
at night
Percentageof peoplesurveyed
100
90
80
70
60
50
40
30
20
10
0Snakes Being
in high,exposedplaces
Mice Flyingon an
airplane
Spidersand
insects
Thunderand
lightning
Dogs Drivinga car
Being In a
crowdof people
Cats
Anxiety Disorders
Obsessive-Compulsive Disorder characterized by unwanted repetitive
thoughts (obsessions) and/or actions (compulsions)
Panic Disorder marked by a minutes-long episode of intense
dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensation
Anxiety DisordersCommon Obsessions and Compulsions AmongPeople With Obsessive-Compulsive Disorder
Thought or Behavior Percentage*Reporting Symptom
Obsessions (repetitive thoughts)
Concern with dirt, germs, or toxins 40
Something terrible happening (fire, death, illness) 40
Symmetry order, or exactness 24
Excessive hand washing, bathing, tooth brushing, 85or grooming
Compulsions (repetitive behaviors)
Repeating rituals (in/out of a door, 51up/down from a chair)Checking doors, locks, appliances, 46car brake, homework
Anxiety Disorders
PET Scan of brain of person with Obsessive/ Compulsive disorder
High metabolic activity (red) in frontal lobe areas involved with directing attention
Mood Disorders
Mood Disorders characterized by emotional extremes
Major Depressive Disorder a mood disorder in which a person, for
no apparent reason, experiences two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities
Mood DisordersManic Episode
a mood disorder marked by a hyperactive, wildly optimistic state
Bipolar Disorder a mood disorder in which the person
alternates between the hopelessness and lethargy of depression and the overexcited state of mania
formerly called manic-depressive disorder
Mood Disorders-Depression
Percentageof population
aged 18-84experiencing
majordepression
at somepoint In life
20
15
10
5
0 USA Edmonton Puerto Paris West Florence Beirut Taiwan Korea New Rico Germany Zealand
Around the worldwomen are more
susceptible todepression
Mood Disorders-Depression
12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+
Age in Years
10%
8
6
4
2
0
Percentagedepressed
Females
Males
Mood Disorders- Suicide
15-24 25-34 35-44 45-44 55-64 65-74 75-84 85+
Suicides per100,000 people
70
60
50
40
30
20
10
0
Males Females
The higher suicide rateamong men greatly increases in late adulthood
Mood Disorders-SuicideIncreasing rates of teen suicide
1960 1970 1980 1990 2000Year
12%
10
8
6
4
2
0
Suicide rate,ages 15 to 19(per 100,000)
Mood Disorders-Bipolar
PET scans show that brain energy consumption rises and falls with emotional swings
Depressed state Manic state Depressed state
Mood Disorders-Depression
Altering any one component of the chemistry-cognition-mood circuit can alter the others
Brainchemistry
Cognition
Mood
Mood Disorders-Depression
A happy or depressed mood strongly influences people’s ratings of their own behavior
Negative Positivebehaviors behaviors
Self-ratings
35%
30
25
20
15
Percentage ofobservations
Mood Disorders-Depression
The vicious cycle of depression can be broken at any point
1Stressful
experiences
4Cognitive and
behavioral changes
2Negative
explanatory style
3Depressed
mood
SOMATOFORM DISORDERS
Distressing symptoms take a somatic (bodily) form, without any apparent physical cause.
Emotional DistressConversion disorder: anxiety is converted
into a physical symptom.Hysterical blindness
Amnesia – psychogenic Fugue: amnesia with travel & identity
replacementHypochondrias – keep going to doctors
Dissociative Disorders
Dissociative Disorders conscious awareness becomes separated
(dissociated) from previous memories, thoughts, and feelings
Dissociative Identity Disorder rare dissociative disorder in which a person
exhibits two or more distinct and alternating personalities
formerly called multiple personality disorder/Sybil – not a true DID. Eve – Chris Sizemore – 3 personalities.
Spano’s studies indicates it varies by therapist and by countries. U.S. vs. the rest of the world.
Schizophrenia
Schizophrenia literal translation “split mind” a group of severe disorders characterized by:
disorganized and delusional thinkingdisturbed perceptionsinappropriate emotions and actionsDisorganized speech – word salad.Disorganized behavior. Disturbance for 6 months or more.
CAUSES???
Prenatal viral infection? Prenatal malnutrition OBGyn complications during delivery Other brain insults Diathesis – Stress Model: proposes that some
persons develop schizophrenia because of an underlying vulnerability (diathesis) that is compounded by stress.
Genetic and environment conditions needed to cross the threshold.
Schizophrenia
POSITIVE SYMTOMS: Delusions
false beliefs, often of persecution or grandeur, that may accompany psychotic disorders. Bizarre bhavior.
Hallucinations false sensory experiences such as seeing
something without any external visual stimulus. 63% are auditory.
SCHIZOPHRENIA
Negative symptoms:Apathy, flattened affect,
social withdrawal, inattentive, slowed or no speech.
Schizophrenia
Subtypes of Schizophrenia
Paranoid: Preoccupation with delusions or hallucinations
Disorganized: Disorganized speech or behavior, or flat or inappropriate emotion
Catatonic: Immobility (or excessive, purposeless movement), extreme negativism, and/or parrotlike repeating of
another’s speech or movements
Undifferentiated Schizophrenia symptoms without fitting one of the or residual: above types
schizophrenia
Enlarged cerebral ventricles MRI shows damage to frontal and
temporal areas.Dopamine hypothesis: elevated
levels of dopamine.Thalamus appears smaller and there
seems less metabolic activity.
Schizophrenia
Lifetime riskof developingschizophrenia
for relatives of a schizophrenic
40
30
20
10
0 Generalpopulation
Siblings Children Fraternaltwin
Childrenof two
schizophrenia victims
Identicaltwin
schizophrenia
10 years after diagnosis….25% complete recovery25% improved, extensive support is
needed15% hospitalized, no imporvement10% died ( often by suicide)25% improved, moderately
independent.
Personality Disorders
Personality Disorders disorders characterized by
inflexible and enduring behavior patterns that impair social functioning
usually without anxiety, depression, or delusions
Personality Disorders
Antisocial Personality Disorder disorder in which the person
(usually man) exhibits a lack of conscience for wrongdoing, even toward friends and family members
may be aggressive and ruthless or a clever con artist
Schizoid: detachment from social relationships.
PERSONALITY DISORDER
Blatantly disregards and violates the rights of others.
Borderline: erratic, unstable relationships, feeling of emptiness, self-destructive.
Histrionic: exaggerated, overly dramatic, attention seeking behavior, provocative.
Narcissistic: grandiose sense of self importance, exaggerates abilities, need for admiration, pretentions.
PERSONAILITY DISORDERS
Avoidant personality disorder: social inhibition die to feelings of inadequacy; hypersensitive to criticism.
Dependent/co-dependent: needs to be taken care of. Clingy.
OCD personality disorder: orderliness, personal control, rules, tasks
Personality DisordersPET scans illustrate reduced activation in a
murderer’s frontal cortex
Normal Murderer
Personality Disorders
Percentageof criminaloffenders
35
30
25
20
15
10
5
0Total crime Thievery Violence
Childhoodpoverty
Obstetricalcomplications
Both poverty and obstetrical complications
Rates of Psychological Disorders
Percentage of Americans Who Have Ever Experienced Psychological Disorders
Disorder White Black Hispanic Men Women Totals
Ethnicity Gender
Alcohol abuse or dependence 13.6% 13.8% 16.7% 23.8% 4.6% 13.8%
Generalized anxiety 3.4 6.1 3.7 2.4 5.0 3.8
Phobia 9.7 23.4 12.2 10.4 17.7 14.3
Obsessive-compulsive disorder 2.6 2.3 1.8 2.0 3.0 2.6
Mood disorder 8.0 6.3 7.8 5.2 10.2 7.8
Schizophrenic disorder 1.4 2.1 0.8 1.2 1.7 1.5
Antisocial personality disorder 2.6 2.3 3.4 4.5 0.8 2.6