© 2014 John Wiley & Sons, Inc. All rights reserved. Studying Psychological Disorders Anxiety Disorders Depressive and Bipolar Disorders Schizophrenia Other

© 2014 John Wiley & Sons, Inc. All rights reserved.

Studying Psychological DisordersAnxiety DisordersDepressive and Bipolar DisordersSchizophreniaOther DisordersGender and Cultural Effects

• Studying Psychological Disorders• Anxiety Disorders• Depressive and Bipolar Disorders• Schizophrenia• Other Disorders• Gender and Cultural Effects

Chapter twelvePsychological Disorders

realworldpsychology


Things You’ll Learn in Chapter 12Q1

How can media coverage of shootings increase negative attitudes about people with mental illness?

Why do people with a phobia see the object that frightens them as larger than it really is?

Can eating fast food lead to depression later on?

Why are children who experience trauma at increased risk of developing schizophrenia later in life?

How do changes in the brain help explain severe antisocial personality disorder?

Are symptoms of depression easier to recognize in women than in men?

Q2

Q3

Q4

Q6

Q5

STUDYING PSYCHOLOGICAL DISORDERS


• Abnormal behavior = patterns of behaviors, thoughts, or emotions considered pathological (diseased or disordered)

• Four criteria for diagnosing abnormal behavior:1. Deviance2. Dysfunction3. Distress4. Danger

Identifying and Explaining Disorders


• Our understanding of the cause of abnormal behavior has changed over time:

• Stone Age: demon possession – bore a hole in the skull (trephining) to release evil spirits

• Middle Ages: demon possession– Exorcism

• Renaissance: witchcraft– Torture, imprisonment, death



• Asylums were created after Middle Ages as a quiet retreat for the ill (and to protect society), but they became inhumane prisons

• Philipp Pinel (1792) created medical model = the diagnostic perspective that assumes that diseases have physical causes that can be diagnosed, treated, and possibly cured

• This gave rise to psychiatry = the branch of medicine that deals with diagnosis, treatment, and prevention of mental disorders



• Modern psychology offers multifaceted approach for explaining abnormal behavior



• Labeling people “mentally ill” creates problems:– Removes responsibility for their actions– Labels can become self-perpetuating, encouraging

abnormal behavior– Public may develop negative attitudes



• The public reports more negative attitudes about mental illness after intense media coverage of a mass shooting, despite the fact that most people with mental illness are not violent (McGinty et al., 2013)

Q1How can media coverage of shootings increase negative attitudes about people with mental illness?

• Diagnostic and Statistical Manual of Mental Disorders (DSM) = a classification system developed by the American Psychiatric Association that is used to describe abnormal behaviors

• Most recent revision in 2013• Insanity = the legal (not clinical) designation for the

state of an individual judged to be legally irresponsible or incompetent to manage his/her own affairs because of mental illness

Classifying Psychological Disorders


• Groups 400 disorders into 22 categories• Comorbidity = the co-occurrence of two or more

disorders in the same person at the same time, as when a person suffers from both depression and alcoholism

Understanding and Evaluating the DSM


Benefits:• Scientific study of disorders• Communication among

mental health professionals• Education

Criticisms:• Overdiagnosis• Cultural bias• Reinforces use of labels

ANXIETY DISORDERS


• Anxiety disorder = a mental disorder characterized by overwhelming tension and irrational fear accompanied by psychological arousal

Anxiety Disorders


• Generalized anxiety disorder (GAD) = an anxiety disorder characterized by persistent, uncontrollable, and free-floating, nonspecified anxiety– Not focused on any specific threat; chronic and

uncontrollable

Describing Anxiety Disorders


• Panic disorder = an anxiety disorder in which sufferers experience sudden and inexplicable panic attacks; symptoms include difficulty breathing, heart palpitations, dizziness, trembling, terror, and feelings of impending doom– May be caused by frightening experiences, prolonged stress,

and even exercise; persistent concern about future attacks



• Phobia = a persistent and intense, irrational fear and avoidance of a specific object or situation– Agoraphobia – restricts normal activities due to fear of a

panic attack in crowded, enclosed, or wide-open places– Specific phobia – fear of a specific object or situation

(needles, rats, spiders, heights…)– Social phobia (or social anxiety disorder) – irrational fear of

embarrassing oneself; fear of public speaking and eating in public



realworldpsychology

• Participants viewed five different tarantulas in a glass tank and estimated their size by drawing a line on an index card – those with spider phobia drew the longest lines (Vasey et al., 2012)


Why do people with a phobia see the object that frightens them as larger than it really is?

Q2

• The biopsychosocial model acknowledges the roles of psychological, biological and sociocultural processes

Explaining Anxiety Disorders


• Psychological Factors:– Faulty cognition – habits of thinking that make

them prone to fear; hypervigilant; magnify ordinary threats

– Maladaptive learning – inadvertent and improper conditioning (remember Little Albert?) and social learning



• Biological Factors:– Evolutionary predisposition – fear things that were

dangerous to ancestors– Overreaction of the autonomic nervous system– Drugs, caffeine, and nicotine can trigger anxiety

attack



• Sociocultural Factors: – Sharp rise in past 50 years in anxiety disorders

corresponds with increased mobility, decreased job security, and decreased family support

– Anxiety disorders have different forms in different cultures• In Japan, social phobia is fear of embarrassing others,

not self



DEPRESSIVE AND BIPOLAR DISORDER


• Depressive disorders = a group of mental disorders, including disruptive mood dysregulation disorder and major depressive disorder, characterized by sad, empty, or irritable moods that interfere with the ability to function

• Symptoms may include trouble sleeping, weight gain or loss, fatigue, problems concentrating, profound feelings of sadness or guilt, suicidal thoughts

• Unipolar depression – depressive episode ends and person returns to normal emotional level

Describing Depressive & Bipolar


• Bipolar disorder = a mental disorder characterized by repeated episodes of mania (unreasonable elation, often with hyperactivity) alternating with depression– Manic episodes include: unrealistically high self-esteem,

inflated sense of importance, poor judgment, hyperactivity, lack of sleep, rapid thoughts and speech



• Manic episodes may last a few days or even months; depressive episodes generally last three times longer

• Low risk for bipolar disorder (0.5 to 1.6%), but among the most debilitating and lethal disorders with 10 to 20% suicide rate



• Biological factors play a significant role in depressive and bipolar disorders– Changes to brain structure implicated in study of

former NFL players with concussions: 24% show clinical depression

– Depression and bipolar show genetic links– Moderate depression may be a normal and

healthy response to a very real loss; clinical depression is an extreme version

Explaining Depressive & Bipolar


• Negative thinking, demanding perfection, feelings of rejection can contribute to depression

• Learned helplessness = Seligman’s term for a state of helplessness or resignation, in which human or nonhuman animals learn that escape from something painful is impossible; the organism stops responding and may become depressed

• Attributing failure to causes that are internal, stable, and global make depression worse

• Suicide is a major danger of depressive and bipolar disorder; many people suffering with the disorder fail to recognize their own symptoms and need for help

Explaining Depressive & Bipolar


SCHIZOPHRENIA


• Schizophrenia = a group of severe disorders involving major disturbances in perception, language, thought, emotion, and behavior– 1 out of 100 people; half of people admitted to

mental hospitals are diagnosed with schizophrenia– Emerges in late teens to mid-30s; rarely prior to

adolescence or after age 45– Equally prevalent in men and women, but strikes

men earlier and more severely

Schizophrenia


• The term schizophrenia means “split mind”, referring to the fragmenting of though processes and emotions

• NOT the same as split personality or multiple personality disorder

Schizophrenia


• Perception – senses are either enhanced or blunted; sensory information is jumbled and distorted

• Hallucinations = a false, imaginary sensory perception that occurs without an external, objective source– Auditory hallucinations – hearing voices and sounds – is

most common

• Rarely, people with schizophrenia hurt others in response to distorted perception; more likely to be self-destructive and suicidal

Symptoms of Schizophrenia


• Language and thought – words lose usual meaning and association, logic is impaired, thoughts are disorganized and bizarre, conversation jumps from topic to topic, phrases and words are jumbled in “word salad”

• Delusions = a false or irrational belief maintained despite clear evidence to the contrary– Delusions of persecution– Delusions of grandeur– Delusions of reference



• Emotion – emotions are exaggerated and fluctuate rapidly; some have flattened affect with almost no emotional response

• Behavior – unusual actions have special meaning to the sufferer; could become cataleptic or nearly immobile



1. Positive schizophrenia symptoms – additions to or exaggerations of normal thought processes, including delusions and hallucinations– Develops more rapidly, better prognosis for recovery

2. Negative schizophrenia symptoms – loss or absence of normal thought processes and behaviors, including impaired attention, limited/toneless speech, flat affect, social withdrawal– Develops more slowly

Types of Schizophrenia


Biological theories of schizophrenia:• Genetics – the risk for schizophrenia increases when someone

in family has the disorder• Neurotransmitters – overactivity in certain dopamine

neurons; drugs that decrease dopamine decrease some symptoms

• Brain abnormalities – larger cerebral ventricles (fluid-filled spaces in the brain); lower level of activity in frontal lobe

Explaining Schizophrenia


• Heritability of schizophrenia is only 48% for identical twins, so nongenetic factors must contribute

Psychosocial contributors:1. Diathesis-stress model = a hypothesis about the cause of

certain disorders, such as schizophrenia, which suggests that people inherit a predisposition (or “diathesis”) that increases their risk for mental disorders if they are exposed to certain extremely stressful life experiences

2. Family communication disorders – unintelligible speech, contradictory messages; critical and hostile





• Children who experience severe stress before age 16 are three times more likely to develop schizophrenia (Bentall et al., 2012)

Why are children who experience trauma at increased risk of developing schizophrenia later in life?Q4

OTHER DISORDERS


• Obsessions - Persistent, unwanted, fearful thoughts – Fear of germs, fear of being hurt, troubling religious or

sexual thoughts

• Compulsions - irresistible urges to perform an act or repeated ritual – Repeatedly checking, counting, cleaning, washing

• Compulsions help relieve anxiety created by the obsession

Obsessive-Compulsive Disorder (OCD)


• Dissociative disorder = a personality disorder marked by a disturbance in the integration of identity, memory, or consciousness– In dissociative disorders, significant aspects of

experience are split apart from memory or consciousness

– Primarily environmental causes; few or no genetic influence

Dissociative Disorders


• Dissociative identity disorder (DID) = a mental disorder characterized by the presence of two or more distinct personality systems in the same individual at different times; previously known as multiple personality disorder

Dissociative Disorders


• Personality disorder = a mental disorder characterized by chronic, inflexible, maladaptive personality traits that cause significant impairment of social and occupational functioning

Personality Disorders


• Antisocial personality disorder = the pervasive pattern of disregard for, and violation of, the rights of others, beginning in childhood or early adolescence and continuing into adulthood

• Also called psychopath, sociopath, dissocial personality disorder

Antisocial Personality Disorder


Symptoms:– Unlawful behaviors, deceitful and manipulative behaviors,

impulsivity, irritability and aggression, consistent irresponsibility, reckless disregard for self and others, lack of remorse

– Charming and persuasive

Causes:– Genetic predisposition: biochemical disturbances, reduced

gray matter, right hemisphere abnormalities– Environmental causes: abusive parenting styles, emotional

deprivation, harsh and inconsistent discipline, antisocial parental behavior





• MRI of criminals in prison for violent crimes show reduced gray matter volume in prefrontal cortex (Gregory et al., 2012)

How do changes in the brain help explain severe antisocial personality disorder?Q5

• Borderline personality disorder (BPD) = a mental disorder characterized by severe instability in emotion and self-concept, along with impulsive and self-destructive behaviors

• Originally a term for someone on the border between neurosis and schizophrenia, but no longer retains that meaning

Borderline Personality Disorder


Symptoms:• Extreme difficulty in relationships• Chronic feelings of depression, emptiness, fear of

abandonment• Engage in destructive, impulsive behaviors, self-

mutilation, suicide• See themselves in absolute terms – perfect or

worthless; constantly seek reassurance from others



Causes:• Environmental factors: history of neglect in

childhood; emotional deprivation; physical, sexual, or emotional abuse

• Biological: BPD runs in families; impaired functioning in frontal lobe and limbic system



GENDER AND CULTURAL EFFECTS


• Windigo or wiitiko psychosis appears in Native American tribes – symptoms start with loss of appetite, diarrhea, vomiting, and insomnia; sufferers believe they are possessed by the spirit of a windigo (a cannibal giant with heart and entrails of ice); victims become severely depressed, see people turning into beavers; may become obsessed with cannibalistic thoughts and even attack and kill loved ones

Gender and Cultural Effects


Does the DSM help diagnose this disorder?

• Gender differences exist in the rates of certain psychological disorders

• Women experience depression at double the rate for men, around the world. Why?– Poverty is a well-known contributor; women are more likely

than men to fall into lowest socioeconomic groups– Women experience more sexual trauma, partner abuse, and

chronic stress– Women ruminate more frequently than men; internalize

negative emotions rather than external problem solving– Men may be better at hiding or redirecting emotions that are

stereotypically feminine (crying, social withdrawal)

Gender Differences


realworldpsychology

• Most common signs of depression (crying, low energy, dejected facial expressions, and withdrawal from social activities) are more socially acceptable for women than men

• Male depression may be underdiagnosed because men are raised to better hide and redirect emotions (Fields & Cochran, 2011)

• Instead, men may show aggression, act Impulsively, and engage in substance abuse


Are symptoms of depression easier to recognize in women than in men?

Q6

• Rates of schizophrenia differ around the world• Due to actual difference in prevalence or from

differences in definition, diagnosis, and reporting?

• In industrialized nations, prognosis for schizophrenia is worse. Why?– Core symptoms of schizophrenia make it harder to

survive in industrialized nations– Reduced social support and responsibility among

family and friends

Culture and Schizophrenia


• Most research on disorders is conducted in Western cultures, which can limit understanding of disorders

• Cultural-general symptom – a group of symptoms that appear across cultures

• Culture-bound symptoms – a group of symptoms that appear in only select cultures– Cultures may have different

names and understanding of similar experiences

Avoiding Ethnocentrism



Documents

© 2014 John Wiley & Sons, Inc. All rights reserved. Studying Psychological Disorders Anxiety Disorders Depressive and Bipolar Disorders Schizophrenia Other