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PowerPoint® Presentation by Jim Foley
© 2013 Worth Publishers
Chapter 15Psychological
Disorders
What we’ll seek to understand...
What does it mean to have a mental disorder?
Defining and classifying disorders Anxiety disorders, including OCD and
PTSD Mood disorders, including depression
and bipolar disorder Schizophrenia Sample of other disorders:
Dissociative disorders Eating disorders Personality disorders
Rates, vulnerability, and protective factors
Why Learn about Psychological Disorders?
Reasons for curiosity:personal familiarity with psychological symptomsknowing someone else with the disorderhearing about how prevalent and socially devastating some disorders have become in societywanting to learn more about mental health and human nature
Perspectives on Psychological Disorders
Defining psychological disorders
Thinking critically about ADHD
Understanding psychological disorders
Classifying psychological disorders
Labeling psychological disorders
Insanity and responsibility
How do we decide when a set of symptoms are severe enough to be
called a disorder that needs treatment?
Can we define specific disorders clearly enough so that we can know that we’re all referring to the same
behavior/mental state?
Can we use our diagnostic labels to guide treatment rather than to
stigmatize people?
Questions to Keep in Mind
Psychological disorders are: patterns of thoughts, feelings, or actions that are deviant, distressful, and dysfunctional.
Disorder refers to a state of mental/behavioral ill health.
Patterns refers to finding a collection of symptoms that tend to go together, and not just seeing a single symptom.
For there to be distress and dysfunction, symptoms must be sufficiently severe to interfere with one’s daily life and well being.
Deviant means differing from the norm.
Terms from the Definition
“Deviant”?
To deviate, in general, means to vary from what typically would happen.
In psychology, a behavior or mental state is considered deviant by a culture when it is different from what would be expected in that culture.
A disorder may also be a deviation from a typical developmental pathway.
Defining Deviance: The Role of Context and
Culture Context: whether a behavior varies from expectation depends on the situation in which the behavior occurs Yelling for hours is not deviant when it happens at a football game. Culture: these painted faces might seem deviant when viewed from a different culture
Is Attention-Deficit/ Hyperactivity Disorder (ADHD)
a disorder? Is it deviant? Do some people have a level of
inattentiveness, impulsiveness, or restlessness that goes beyond laziness or immaturity?
Is it distressful? Is the person enjoying being energetic, or are they frustrated that they can’t sustain focus?
Is there dysfunction? Are the symptoms harmless fun, or do they negatively impact work and relationships?
Understanding the Nature of Psychological Disorders One reason to diagnose a disorder is to make
decisions about treating the problem. To treat a disorder, it helps to understand the
nature/cause of the psychological symptoms. Based on older understanding of
psychological disorders, treatments have included: exorcising evil spirits, beatings, caging/restraint, and
Pinel’s New Approach Philippe Pinel (1745-1826) and others sought to
reform brutal treatment by promoting a new understanding of the nature of mental disorders.
Pinel proposed that mental disorders were not caused by demonic possession, but by environmental factors such as stress and inhumane conditions.
Pinel’s “moral treatment” involved improving the environment and replacing the asylum beatings with patient dances.
From the humane view to the scientific view of the mentally ill:Pinel’s humane environmental interventions improved lives but often did not effectively treat mental illness
But then…
The Medical Model
Psychological disorders can be seen as psychopathology, an illness of the mind.
Disorders can be diagnosed, labeled as a collection of symptoms that tend to go together.
People with disorders can be treated, attended to, given therapy, all with a goal of restoring mental health.
The discovery that the disease of syphilis causes mental symptoms (by infecting the brain) suggested a medical model for mental illness.
Mental disorders can arise in the interaction between nature and nurture caused by biology, thoughts, and the sociocultural environment.
The Biopsychosocial Approach
Cultural Influences on Disorders
Examples: Bulimia Nervosa: binging/purging, in the United StatesRunning amok: violent outbursts, in MalaysiaHikikomori: social withdrawal, in Japan
Culture-bound syndromes are disorders which only seem to exist
within certain cultures; they demonstrate how culture can play a role in both causing and defining
a disorder.
Classifying Psychological DisordersWhy create classifications of mental illness? What is the value of talking about diagnoses instead of just talking about individuals?1.Diagnoses create a verbal shorthand for referring to a list of associated symptoms.2.Diagnoses allow us to statistically study many similar cases, learning to predict outcomes.3.Diagnoses can guide treatment choices.
The Diagnostic and Statistical Manual
It’s easier to count cases of autism if we have a clear definition.Versions: DSM-IV-TR, DSM-V (May 2013)The DSM is used to justify payment for treatment.It’s consistent with diagnoses used by medical doctors worldwide.
The Five “Axes” of Diagnosis
Categories of Diagnoses
Critiques of Diagnosing with the DSM
1. The DSM calls too many people “disordered.”
2. The border between diagnoses, or between disorder and normal, seems arbitrary.
3. Decisions about what is a disorder seem to include value judgments; is depression necessarily deviant?
4. Diagnostic labels direct how we view and interpret the world, telling us which behavior and mental states to see as disordered.
Stigma and Stereotypes
Many people think a diagnostic label means being seen as tainted, weak, and weird.Because of this, many psychologists believe we should use extreme caution in diagnosing and labeling.
However:these negative views/stigma come from popular cultural views of mental illness, and not from the DSM. [Does a diabetes diagnosis create stigma? No. Bipolar diagnosis? Yes.]the DSM may contain the information to correct inaccurate perceptions of mental illness.
Insanity and Responsibility Jared Loughner shot many people,
including a U.S. Representative, in 2011. Loughner had schizophrenia and
substance abuse problems, a combination associated with increased violence.
What is the appropriate consequence?
To what degree, if any, should he be held responsible for his actions?
Anxiety Disorders
GAD: Generalized Anxiety Disorder
Emotional-cognitive symptoms include worrying, having anxious feelings and thoughts about many subjects, and sometimes “free-floating” anxiety with no attachment to any subject. Anxious anticipation interferes with concentration.
Physical symptoms include autonomic arousal, trembling, sweating, fidgeting, agitation, and sleep disruption.
Panic Disorder: “I’m Dying”
A panic attack is not just an “anxiety attack.” It may include:many minutes of intense dread or terror. chest pains, choking, numbness, or other frightening physical sensations. Patients may feel certain that it’s a heart attack.a feeling of a need to escape. Panic disorder refers to repeated and unexpected panic attacks, as well as a fear of the next attack, and a change in behavior to avoid panic attacks.
Specific PhobiaA specific phobia is more than just a strong fear or dislike. A specific phobia is diagnosed when there is an uncontrollable, irrational, intense desire to avoid the some object or situation. Even an image of the object can trigger a reaction--“GET IT AWAY FROM ME!!!”--the uncontrollable, irrational, intense desire to avoid the object of the phobia.
Some Fears and PhobiasWhat trends are evident here? Which varies more, fear or phobias? What does this imply?
Agoraphobia is the avoidance of situations in which one will fear having a panic attack, especially a situation in which it is difficult to get help, and from which it difficult to escape.
Social phobia refers to an intense fear of being watched and judged by others. It is visible as a fear of public appearances in which embarrassment or humiliation is possible, such as public speaking, eating, or performing.
Some Other Phobias
Obsessive-Compulsive Disorder [OCD] Obsessions are intense, unwanted
worries, ideas, and images that repeatedly pop up in the mind.
A compulsion is a repeatedly strong feeling of “needing” to carry out an action, even though it doesn’t feel like it makes sense.
When is it a “disorder”? Distress: when you are deeply
frustrated with not being able to control the behaviors
or Dysfunction: when the time and
mental energy spent on these thoughts and behaviors interfere with everyday life
Common OCD Behaviors
Common pattern: RECHECKING Although you know that you’ve already made sure the door is locked, you feel you must check again. And again.
Percentage of children and adolescents with OCD reporting these obsessions or compulsions:
Post-Traumatic Stress Disorder
[PTSD]About 10 to 35 percent of people who experience trauma not only have burned-in memories, but also four weeks to a lifetime of:
repeated intrusive recall of those memories.
nightmares and other re-experiencing.
social withdrawal or phobic avoidance.
jumpy anxiety or hypervigilance.
insomnia or sleep problems.
Which People get PTSD? Those with less control in the
situation Those traumatized more frequently Those with brain differences Those who have less resiliency Those who get re-traumatized
Resilience and Post-Traumatic GrowthResilience/recovery after trauma may include:some lingering, but not overwhelming, stress.finding strengths in yourself.finding connection with others.finding hope.seeing the trauma as a challenge that can be overcome. seeing yourself as a survivor.
Understanding Anxiety Disorders: Explanations from Different Perspectives
Psychodynamic/Freudian: repressed impulses
Classical conditioning:
overgeneralizing a conditioned
response
Operant conditioning:
rewarding avoidance
Observational learning:
worrying like mom
Cognitive appraisals:
uncertainty is danger
Evolutionary: surviving by
avoiding danger
Understanding Anxiety Disorders: Freudian/Psychodynamic Perspective Sigmund Freud felt that
anxiety stems from repressed childhood impulses, socially inappropriate desires, and emotional conflicts.
We repress/bury these issues in the unconscious mind, but they still come up, as anxiety.
Operant Conditioning and Anxiety
Classical Conditioning and Anxiety
We may feel anxious in a situation and make a decision to leave. This makes us feel better and our anxious avoidance was just reinforced.
If we know we have locked a door but feel anxious and compelled to re-check, rechecking will help us temporarily feel better.
The result is an increase in anxious thoughts and behaviors.
In the experiment by John B. Watson and Rosalie Rayner in 1920, Little Albert learned to feel fear around a rabbit because he had been conditioned to associate the bunny with a loud scary noise.
Sometimes, such a conditioned response becomes overgeneralized. We may begin to fear all animals, everything fluffy, and any location where we had seen those, or even fear that those items could appear soon along with the noise.
The result is a phobia or generalized anxiety.
Observational Learning and
Anxiety Experiments with humans
and monkeys show that anxiety can be acquired through observational learning. If you see someone else avoiding or fearing some object or creature, you might pick up that fear and adopt it even after the original scared person is not around.
In this way, fears get passed down in families.
Cognition and Anxiety
Cognition includes worried thoughts, as well as interpretations, appraisals, beliefs, predictions, and ruminations.
Cognition includes mental habits such as hypervigilance (persistently watching out for danger). This accompanies anxiety in PTSD.
In anxiety disorders, such cognitions appear repeatedly and make anxiety worse.
Examples of Cognitions that can Worsen Anxiety:
Cognitive errors, such as believing that we can predict that bad events will happen
Irrational beliefs, such as “bad things don’t happen to good people, so if I was hurt, I
must be bad”
Mistaken appraisals, such as seeing aches as diseases, noises as dangers, and strangers as
threats
Misinterpretations of facial expressions and actions of others, such as thinking “they’re
talking about me”
Biology and Anxiety: An Evolutionary Perspective
3. Dangerous yet non-phobic subjects: We are likely to become cautious about, but not phobic about:
GunsElectric wiring
Cars Evolutionary psychologists believe that ancestors
prone to fear the items on list #1 were less likely to die before reproducing.
There has not been time for the innate fear of list #3 (the gun list) to spread in the population.
1. Human phobic objects: Snakes
HeightsClosed spaces
Darkness
2. Similar but non-phobic objects: FishLow placesOpen spacesBright light
Biology and Anxiety: Genes
Studies show that identical twins, even raised separately, develop similar phobias (more similar than two unrelated people).
Some people seem to have an inborn high-strung temperament, while others are more easygoing.
Temperament may be encoded in our genes.
Genes and Neurotransmitters
Genes regulate levels of neurotransmitters.People with anxiety have problems with a gene associated with levels of serotonin, a neurotransmitter involved in regulating sleep and mood. People with anxiety also have a gene that triggers high levels of glutamate, an excitatory neurotransmitter involved in the brain’s alarm centers.
Biology and Anxiety: The Brain
Traumatic experiences can burn fear circuits into the amygdala; these circuits are later triggered and activated.
Anxiety disorders include overarousal of brain areas involved in impulse control and habitual behaviors.
The OCD brain shows extra activity in the ACC, which monitors our actions and checks for errors.
ACC = anterior cingulate gyrus
Mood Disorders
Major depressive disorder [MDD] is: more than just feeling “down.” more than just feeling sad
about something.
Bipolar disorder is: more than “mood swings.” depression plus the problematic
overly “up” mood called “mania.”
Criteria of Major Depressive Disorders
Depressed mood most of the day, and/or Markedly diminished interest or pleasure in activities Significant increase or decrease in appetite or weight Insomnia, sleeping too much, or disrupted sleep Lethargy, or physical agitation Fatigue or loss of energy nearly every day Worthlessness, or excessive/inappropriate guilt Daily problems in thinking, concentrating, and/or
making decisions Recurring thoughts of death and suicide
Major depressive disorder is not just one of these symptoms.It is one or both of the first two, PLUS three or more of the rest.
Major Depression:Not Just a Depressive Reaction
Some people make an unfair criticism of themselves or others with major depression: “There is nothing to be depressed about.”
If someone with asthma has an attack, do we say, “what do you have to be gasping about?”
It is bad enough to have MDD that persists even under “good” circumstances. Don’t add criticism by implying the depression is an exaggerated response.
Depression is EverywhereDepression shows up in people seeking treatment: Phobias are the most common (frequently experienced) disorder, but depression is the #1 reason people seek mental health services.Depression appears worldwide: Per year, depressive episodes happen to about 6 percent of men and about 9 percent of women. Over the course of a lifetime, 12 percent of Canadians and 17 percent of Americans experience depression.
Depression: The “Common Cold” of Disorders?Although both are “common” (occurring frequently and pervasively), comparing depression to a cold doesn’t work. Depression: is more dangerous because of suicide risk.has fewer observable symptoms.is more lasting than a cold, and is less likely to go away just with time.is much less contagious.And…depressive pain is beyond sniffles.
Seasonal Affective Disorder [SAD] Seasonal affective disorder is more than simply disliking
winter. Seasonal affective disorder involves a recurring seasonal
pattern of depression, usually during winter’s short, dark, cold days.
Survey: “Have you cried today”? Result: More people answer “yes” in winter.
Percentage who cried
Men Women
August 4 7
December 8 21
Bipolar Disorder Bipolar disorder was once called
“manic-depressive disorder.” Bipolar disorder’s two polar opposite
moods are depression and mania.
Mania refers to a period of hyper-elevated mood that is euphoric, giddy, easily irritated, hyperactive, impulsive, overly optimistic, and even grandiose.
Contrasting SymptomsDepressed mood: stuck feeling
“down,” with:Mania: euphoric, giddy, easily
irritated, with: exaggerated pessimism social withdrawal lack of felt pleasure inactivity and no initiative difficulty focusing fatigue and excessive desire to
sleep
exaggerated optimism hypersociality and sexuality delight in everything impulsivity and overactivity racing thoughts; the mind
won’t settle down little desire for sleep
Many famous and successful people have lived with the ups and downs of bipolar disorder. Some speculate that the depressive periods gave them ideas, and the manic episodes gave them creative energy. Any evidence of mood swings here?
Bipolar Disorder and Creative Success
Bipolar Disorder in Children and Adolescents Does bipolar disorder
show up before adulthood, and even before puberty?
Many young people have cycles from depression to extended rage rather than mania.
The DSM-V may have a new diagnosis for these kids: disruptive mood dysregulation disorder.
Understanding Mood Disorders
Why are mood disorders so pervasive, and more common among the young, and especially among women?
Why Does Depression Have so Many Symptoms?
Understanding Mood DisordersCan we explain…
why does depression often go away on its own?
the course/development of reactive depression? Often, time heals a mood disorder, especially when the mood issue is in reaction to a stressful event. However, a significant proportion of people with major depressive disorder do not automatically or easily get better with time.
Suicide and Self-Injury
Every year, 1 million people commit suicide, giving up on the process of trying to cope and improve their emotional well-being.
This can happen when people feel frustrated, trapped, isolated, ineffective, and see no end to these feelings.
Non-suicidal self-injury has other functions such as sending a message, or self-punishment.
Understanding Mood Disorders
Biological aspects and explanations
Social-cognitive aspects and explanations
EvolutionaryGenetic
Brain /Body
Negative thoughts and negative mood
Explanatory style The vicious cycle
An Evolutionary Perspective on the Biology of Depression Depression, in its milder, non-
disordered form, may have had survival value.
Under stress, depression is social-emotional hibernation. It allows humans to: conserve energy. avoid conflicts and other
risks. let go of unattainable
goals. take time to contemplate.
Biology of Depression: GeneticsEvidence of genetic influence on depression:1.DNA linkage analysis reveals depressed gene regions2.twin/adoption heritability studies
Biology of Depression: The Brain Brain activity is diminished in depression and increased in mania. Brain structure: smaller frontal lobes in depression and fewer
axons in bipolar disorder Brain cell communication (neurotransmitters):
more norepinephrine (arousing) in mania, less in depression reduced serotonin in depression
Preventing or Reducing Depression: Using Knowledge of the Biology of Depression
1. Adjust neurotransmitters with medication.
2. Increase serotonin levels with exercise.
3. Reduce brain inflammation with a healthy diet (especially olive and fish oils).
4. Prevent excessive alcohol use .
Depressive Explanatory
Style
Low Self-Esteem
Learned Helplessness
Rumination
Discounting positive information and assuming the worst about self, situation, and the future Self-defeating
beliefs such as assuming that one (self) is unable to cope, improve, achieve, or be happy
Depression is associated with:
Stuck focusing on what’s bad
Understanding Mood Disorders: The Social-Cognitive Perspective
Depressive Explanatory Style
Mood/result that goes along with
these views:
How we analyze bad news predicts mood.
Assumptions about the problem
The problem is:
The problem is:
The problem is:
Problematic event:
Depression’s Vicious CycleA depressed mood may develop when a person with a
negative outlook experiences repeated stress.
The depressed mood changes a person’s style of thinking and interacting in a way that makes stressful experience more likely.
Schizophrenia:the mind is split from reality, e.g. a split from one’s own thoughts so that they appear as hallucinations.
Psychosis refers to a mental split from reality and
rationality.Schizophrenia symptoms include:disorganized and/or delusional thinking.disturbed perceptions.inappropriate emotions and actions.
Positive + presence of problematic behaviors
Negative - absence of
healthy behaviors
Hallucinations (illusory perceptions), especially auditory
Delusions (illusory beliefs), especially persecutory
Disorganized thought and nonsensical speech
Bizarre behaviors
Flat affect (no emotion showing in the face)
Reduced social interaction
Anhedonia (no feeling of enjoyment)
Avolition (less motivation, initiative, focus on tasks)
Alogia (speaking less) Catatonia (moving less)
Positive and Negative Symptoms of Schizophrenia
Schizophrenia Symptoms:Problems in Thinking and Speaking Disorganized speech, including the
“word salad” of loosely associated phrases
Delusions (illusory beliefs), often bizarre and not just mistaken; most common are delusions of grandeur and of persecution
Problems with selective attention, difficulty filtering thoughts and choosing which thoughts to believe and to say out loud
? ! ? !
? ! ? !
People with schizophrenia often experience hallucinations, that is, perceptual experiences not shared by others.
The most common form of hallucination is hearing voices that no one else hears, often with upsetting (e.g. shaming) content.
Hallucinations can also be visual, olfactory/smells, tactile/touch, or gustatory/taste.
You’re evil!Am I evil?
Schizophrenia Symptoms:Disturbed Perceptions
Odd and socially inappropriate responses such as looking bored or amused while hearing of a death
Flat affect: facial/body expression is “flat” with no visible emotional content
Impaired perception of emotions, including not “reading” others’ intentions and feelings
Schizophrenia Symptoms:Inappropriate Emotions
Odd and socially inappropriate behavior can be caused by symptoms such as:errors in social perception. disorganized, unfiltered thinking. delusions and hallucinations.
The schizophrenic body exhibits symptoms such as: repetitive behaviors such as rocking and rubbing. catatonia, such as sitting motionless and unresponsive for hours.
Schizophrenia Symptoms:Inappropriate Actions/Behavior
Onset and Development of Schizophrenia
Onset: Typically, schizophrenic symptoms appear at the end of adolescence and in early adulthood, later for women than for men.
Prevalence: Nearly 1 in 100 people develop schizophrenia, slightly more men than women.
Development: The course of schizophrenia can be acute/reactive or chronic.
Course of Schizophrenia
Acute/Reactive Schizophrenia In reaction to stress, some people develop positive symptoms such as hallucinations.
– Recovery is likely.Chronic/Process Schizophrenia develops slowly, with more negative symptoms such as flat affect and social withdrawal.
– With treatment and support, there may be periods of a normal life, but not a cure.
– Without treatment, this type of schizophrenia often leads to poverty and social problems.
Subtypes of Schizophrenia
What’s going on in the brain in schizophrenia?
Too many dopamine/D4 receptors help to explain paranoia and hallucinations; it’s like taking amphetamine overdoses all the time.
Poor coordination of neural firing in the frontal lobes impairs judgment and self-control.
The thalamus fires during hallucinations as if real sensations were being received.
There is general shrinking of many brain areas and connections between them.
Abnormal brain structure and
activity
Understanding Schizophrenia
Understanding Schizophrenia
Are there biological risk factors affecting early development?
low birth weight maternal diabetes older paternal age famine oxygen deprivation during delivery maternal virus during mid-pregnancy
impairing brain development
Biological Risk Factors
Schizophrenia is more likely to develop in babies born: during and after flu epidemics.in densely populated areas.a few months after flu season.after mothers had the flu during the second trimester, or had antibodies showing viral infection.The lesson is to:
Schizophrenia is somewhat more likely to develop when one or more of these factors is present:
get flu shots with early fall pregnancies.
Understanding SchizophreniaAre there genetic risk factors? If so, we would see more similar schizophrenia risk shared between identical twins than fraternal twins (graph below). Do we?
Having adoptive siblings (or parents) with schizophrenia does not increase the likelihood of developing schizophrenia.
Genetic FactorsIf one twin has schizophrenia, the chance of the other one also having it are much greater if the twins are identical.
Even in identical twins, genetics do not fully predict schizophrenia.
This could be because of environmental differences.
First difference: twins in separate placentas.
Genetic and Prenatal Causes
Only one of two twins has the enlarged ventricles seen in schizophrenia.
Even if maternal flu during the second trimester doubles the risk of schizophrenia, this means only 2 percent of these babies develop the disorder.
Genetics may differentiate these 2 percent.
Research shows many genes linked to schizophrenia, but it may take environmental factors to turn on these genes.
Understanding Schizophrenia
Are there psychological causes?
Research does not support the idea that social or psychological factors (such as parenting) alone can cause schizophrenia.
However, there may be factors such as stress that affect the onset of schizophrenia.
Until we find a mechanism of causation, all we may have is a list of factors which correlate with increased risk.
Social-Psychological
Factors
Understanding Schizophrenia
Predicting Schizophrenia: Early Warning Signs
early separation from parents
short attention span disruptive OR withdrawn
behavior emotional unpredictability poor peer relations and/or
solitary play
having a mother with severe chronic schizophrenia
birth complications, including oxygen deprivation and low birth weight
poor muscle coordination
Social/psychological factors which tend to
appear before the onset of
schizophrenia:
Biological factors which tend to appear before the onset of
schizophrenia:
Other Disorders
Dissociative Disorders
Eating Disorders
Personality Disorders
Dissociation refers to a separation of conscious awareness from thoughts, memory, bodily sensations, feelings, or even from identity.
Dissociation can serve as a psychological escape from an overwhelmingly stressful situation.
A dissociative disorder refers to dysfunction and distress caused by chronic and severe dissociation.
Dissociative Disorders
Loss of memory with no known physical cause; inability to recall selected memories or any memories
“Running away” state; wandering away from one’s life, memory, and identity, with no memory of these
Development of separate personalities
Dissociative Amnesia:
Dissociative Fugue
Dissociative Identity Disorder (D.I.D.)
Examples:
Dissociative Identity Disorder (D.I.D.) formerly “Multiple Personality Disorder”
In the rare actual cases of D.I.D., the personalities: are distinct, and not present in consciousness at the same time.may or may not appear to be aware of each other.
Alternative Explanations for D.I.D.
Dissociative “identities” might just be an extreme form of playing a role.D.I.D. in North America might be a recent cultural construction, similar to the idea of being possessed by evil spirits.Cases of D.I.D. might be created or worsened by therapists encouraging people to think of different parts of themselves.
D.I.D., or DID Not? Evidence that D.I.D. is Real
Different personalities have involved:different brain wave patterns.different left-right handedness.different visual acuity and eye muscle balance patterns.Patients with D.I.D. also show heightened activity in areas of the brain associated with managing and inhibiting traumatic memories.
Explaining fragmentation of personality from different perspectivesPsychoanalytic perspective:
diverting idCognitive perspective:
coping with abuseLearning perspective:
dissociation paysSocial influence:
therapists encourage
Definition PrevalenceAnorexia Nervosa
Compulsion to lose weight, coupled with certainty about
being fat despite being 15 percent or more underweight
0.6 percent meet criteria at
some time during lifetime
Bulimia Nervosa
Compulsion to binge, eating large amounts fast, then purge by losing
the food through vomiting, laxatives, and extreme exercise
1.0 percent
Binge-Eating Disorder
Compulsion to binge, followed by guilt and depression 2.8 percent
These may involve: unrealistic body image and extreme body ideal.a desire to control food and the body when one’s situation can’t be controlled. cycles of depression.health problems.
Eating Disorders
Anorexia nervosaBulimia nervosa
Binge-eating disorder
Eating Disorders: Associated Factors
Family factors: having a mother focused on her weight, and on child’s appearance and weightnegative self-evaluation in the familyfor bulimia, if childhood obesity runs in the familyfor anorexia, if families are competitive, high-achieving, and protectiveCultural factors:unrealistic ideals of body appearance
Personality disorders are enduring patterns of
social and other behavior that impair
social functioning.
There are three “clusters”/categories of personality disorders.Anxious: e.g., Avoidant P.D., ruled by fear of social rejectionEccentric/Odd: e.g. Schizoid P.D., with flat affect, no social attachmentsDramatic: e.g. Histrionic, attention-seeking; narcissistic, self-centered; antisocial, amoral
Personality Disorders
Antisocial Personality Disorder [APD]
Antisocial personality disorder refers to acting impulsively or fearlessly without regard for others’ needs and feelings.
The diagnostic criteria include a pattern of violating the rights of others since age 15, including three of these:
DeceitfulnessDisregard for safety of self or
othersAggressiveness
Failure to conform to social norms
Lack of remorseImpulsivity and failure to plan
aheadIrritability
Irresponsibility regarding jobs, family, and money
Which Kids May Develop APD as Adults?About half of children with persistent antisocial behavior develop lifelong APD.Which kids are at risk? Psychological factors:those who in preschool were impulsive, uninhibited, unconcerned with social rewards, and low in anxiety. those who endured child abuse, and/or inconsistent, unavailable caretaking.
Biological APD Risk FactorsAntisocial or unemotional biological relatives increases risk.
Some associated genes have been identified.
Risk factors include body-based fearlessness, lower levels of stress hormones, and low physiological arousal in stressful situations such as awaiting receiving a shock.Fear conditioning is impaired.Reduced prefrontal cortex tissue leads to impulsivity.Substance dependence is more likely.
Antisocial PD ≠ Criminality
Many career criminals do show empathy and selflessness with family and friends.Many people with A.P.D. do not commit crimes.
Antisocial CrimeIf antisocial personality disorder is not a full picture of most criminal activity, what can we say about people who commit crime, especially violent crime?
Biosocial roots of crime: birth complications and poverty combine to increase risk.
Biosocial Roots of Crime: The BrainPeople who commit murder seem to have less tissue and activity in the part of the brain that suppresses impulses.
Other differences include: less amygdala response when viewing violence.an overactive dopamine reward-seeking system.
How common are psychological disorders?
Countries vary greatly in the percentage of people reporting mental health issues in the past year.
Rates of Psychological
Disorders
This list takes a closer look at the past-year prevalence of various mental health diagnoses in the United States.
Who is at risk of mental disorders?Who is less at risk?
Risks and Protective Factors for Mental Disorders
Outcomes for People with Psychological Disorders
There are risks to be watchful of, obstacles to be overcome, and improvements to be made, often with the help of with treatment.Some people with psychological disorders do not recover.Some achieve greatness, even with a psychological disorder.
