Psychological Disorders

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Chapter 16

• Psychological Disorders

2
A. What is Normal?

• Symptoms of Psychological Disorders
• Deviation from a norm
• Maladaptive
• Emotional Discomfort

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Why do you think the U.S. has such a high
prevalence of mental disorders?
4
A. What is Normal?

• Deviation from a statistically calculated norm
• If a person behaves in a way that a majority
  of people do (approximately 68) then the
  behavior is normal. If not, the behavior is
  abnormal

abnormal
abnormal
normal
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A. What is Normal?

• Shortcomings of this definition
• It doesnt discriminate between desirable and
  undesirable abnormality
• Just because a statistical majority of people
  engage in a particular behavior does not mean
  that society would like to encourage it as being
  normal

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A. What is Normal?

• Emotional Discomfort
• If a persons behavior causes him/her distress
  than the behavior is considered to be abnormal

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A. What is Normal?

• Shortcomings of this definition
• Some behavior are so abhorrent that despite
  someones comfort level if it is not normal
  behavior

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A. What is Normal?

• Deviation from a social/cultural norm
• A cultural norm is what society deems as being
  acceptable. There are norms that cover all types
  of behaviors.
• When do we notice norms?

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A. What is Normal?

• Shortcomings of this definition
• There are different norms for different cultures,
  and different age groups. Additionally, norms
  change over time.

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A. What is Normal?

• Maladaptivity
• If a behavior interferes with a persons
  ability to function it is considered to be
  abnormal. If a person is still able to function
  adequately in everyday life, than it is not
  abnormal.

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Explaining Psychological Disorders

• Biological Factors
• The earliest supporter of this view was
  Hippocrates. He saw mental disorders as being
  some kind of physical illness. He believed that
  disorders were caused by imbalances of the four
  humors (bodily fluids) which are blood, black
  bile, phlegm, and yellow bile.
• Hippocrates believed that depression resulted
  from an excess of black bile (melancholia)

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Explaining Psychological Disorders

• Neurobiological model
• This model looks at problems in anatomy and
  physiology of the brain and other areas.
• This model dominates modern research on the
  causesand treatmentsof psychological disorders.
  People who adhere to this model see mental
  disorders as being caused by a physical illness,
  and believed it can be diagnosed, treated and
  cured.

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Explaining Psychological Disorders

• Psychological Processes
• In this view, mental disorders are seen as being
  caused by inner turmoil or other psychological
  events.
• Psychological models Include the psychodynamic,
  cognitive-behavioral, and phenomenological
  (humanistic) approaches

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Explaining Psychological Disorders

• Sociocultural Context
• Sociocultural explanations rely on factors such
  as gender and age, physical and social
  situations, cultural values and expectations, and
  historical eras. Culture-general disorders
  appear in most societies while culture-specific
  forms appear only in certain ones.

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Explaining Psychological Disorders

• Diathesis-Stress as an Integrative Approach
• Diathesis-stress model
• This model views genetics, early learning, and
  biological processes as contributing factors to
  psychological disorders.
• In other words, a persons inherited
  characteristics, biological processes, and early
  learning experiences may create a predisposition
  (or diathesis) for a psychological disorder, but
  whether or not the disorder appears depends on
  the stressors the person encounters

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Classifying Psychological Disorders

• A Classification System DSM-IV-TR
• This is the most comprehensive and
  authoritative set of guidelines available for
  diagnosing psychological disorders. It includes
  the symptoms, the exact criteria that must be met
  to make a diagnosis, and the typical course for
  each mental disorder.

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Classifying Psychological Disorders

• Axis I Clinical Syndromes comprises
  descriptive criteria of 16 major mental
  disorders)
• Diagnosis of disorders are made on Axes I and II
• It is on this axis that clinician record any
  major disorders that are apparent.

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Classifying Psychological Disorders

• Axis II Personality disorders
• these disorders are patterns of personality
  traits that are longstanding, maladaptive, and
  inflexible and involve impaired functioning or
  subjective distress. Examples include
  borderline, schizoid, and antisocial personality
  disorders) and mental retardation

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Classifying Psychological Disorders

• Axis III General Medical Conditions Physical
  disorders of conditions are recorded on this
  axis. Examples include diabetes, arthritis, and
  hemophilia)

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Classifying Psychological Disorders

• Axis IV Psychosocial and Environmental
  Problems
• Types and levels of stress, it may be a
  negative life event, an environmental difficulty
  or deficiency, a familial or other interpersonal
  stress, an inadequacy of social support or
  personal resources, or another problem that
  describes the context in which a persons
  difficulties have developed

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Classifying Psychological Disorders

• Axis V Global Assessment of Function (GAF)
  Scale
• Has a rating of that ranges from 100 (Superior
  functioning in a wide range of activities) to 1
  (Persistent danger of severely hurting self or
  others).
• Estimate are made of the individuals current
  level of adaptive functioning as a whole and of
  the individuals highest level of functioning in
  the past year

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Classifying Psychological Disorders

• Diagnosis of disorders are made on Axes I and II
• Axes III, IV, and V are used to record
  supplemental information about the patient

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Classifying Psychological Disorders

• Purposes and Problems of Diagnosis
• Goals Help identify appropriate treatment for
  clients and to accurately and consistently group
  patients with similar disorders so that research
  efforts can more easily identify underlying
  causes of mental illness
• Limitations
• Validity Some argue that attempts on improving
  the consistency of the diagnosis has taken away
  from the validity of the diagnosis

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Classifying Psychological Disorders

• Purposes and Problems of Diagnosis
• Limitations
• Interrater Reliability Studies have shown that
  80 of the time there is agreement between
  independent raters

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Neurosis

• Mild personality disorder, usually does not
  impair ones ability to function in society.
• Symptoms
• Depression
• Anxiety
• Self-defeating patterns of behavior

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Psychosis

• Serious personality disorder, usually
  incapacitating preventing one from functioning in
  society.
• Symptoms
• Loss of contact with reality
• Hallucinations inappropriate feelings that come
  to us from one of our senses
• Delusions false but persistent beliefs despite
  evidence to the contrary

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Psychosis

• Types of Hallucinations
• Auditory Hallucinations
• hearing things that are not there
• Visual Hallucinations
• seeing things that arent there

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Psychosis

• Types of Hallucinations
• Tactile Hallucinations
• feeling things that arent there
• Olfactory Hallucinations
• smelling things that arent there
• Gustatory Hallucinations
• tasting things that arent there

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Psychosis

• Symptoms of Psychosis
• Delusions false but persistent beliefs despite
  evidence to the contrary

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Psychosis

• Types of Delusions
• Delusions of Grandeur
• thinking you are someone
• of great importance

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Psychosis

• Types of Delusions
• Delusions of Reference
• thinking that you are the center of attention,
  that people are looking at, or talking about you
• Delusions of Depersonalization
• thinking you are turning into an inanimate or
  vegetative object

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Psychosis

• Types of Delusions
• Delusions of Persecution
• thinking that people are out to get you or harm
  you
• Delusions of Guilt
• thinking that you have just committed a
  terrible wrong

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Anxiety Disorders

• Anxiety Freud called anxiety a free floating
  fear meaning that it is not attached to any
  particular object or event. Anxiety is a general
  feeling of doom and dread. Anxiety disorders are
  marked by feelings of excessive apprehension

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Anxiety Disorders

• Generalized Anxiety Disorder
• A person with General Anxiety Disorder (GAD) is
  continually tense, apprehensive, and in a state
  of autonomic nervous system (ANS) arousal. This
  anxiety is persistent and many escalate into a
  panic attack

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Anxiety Disorders

• Generalized Anxiety Disorder
• People with this disorder worry constantly about
  yesterdays mistakes and tomorrows problems. In
  particular, they worry about minor matters
  related to family finances, work and personal
  illness. They often dread decisions and brood
  over them endlessly. Their anxiety is commonly
  accompanied by physical symptoms

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I wish I could tell you exactly whats the
matter. Sometimes I feel like something terrible
has just happened when actually nothing has
happened. Other times, Im expecting the sky to
fall down any minute. Most of the time I cant
point my finger at something specific. Still, I
feel tense and jumpy. The fact is that I am
tense and jumpy almost all the time. Sometimes
my heart beats so fast, Im sure its a heart
attack. Little things can set it off. The other
day I thought a Supermarket clerk had
overcharged me a few cents on an item. She
showed me that I was wrong, but that didnt end
it. I worried the rest of the day. I kept
going over the incident in my mind, feeling
terribly embarrassed at having raised the
possibility that the clerk had committed an
error. The tension was so great, I wasnt sure
Id be able to go to work in the afternoon. That
sort of thing is painful to live with.
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Taylor Manifest Anxiety Scale
1. F 11. T 21. T 31. T 41. T
2. T 12. F 22. T 32. F 42. T
3. F 13. T 23. T 33. T 43. T
4. F 14. T 24. T 34. T 44. T
5. T 15. F 25. T 35. T 45. T
6. T 16. T 26. T 36. T 46. T
7. T 17. T 27. T 37. T 47. T
8. T 18. F 28. T 38. F 48. T
9. F 19. T 29. F 39. T 49. T
10.T 20. F 30. T 40. T 50. F
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Anxiety Disorders

• Phobic Disorder Phobic disorders are marked by
  a persistent, irrational fear of a specific
  object or situation.
• Whats the difference between a phobia and a fear?

Phobia is the Greek word for morbid fear after
the lesser Greek god, Phobos
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Anxiety Disorders

• Specific Phobias
• involve fear and avoidance of a specific stimuli
  or situation.
• About 10 of the general population will
  experience a specific phobia at some point in
  their lives.
• More than twice as many women as men suffer from
  specific phobia.

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Anxiety Disorders

• Specific phobia tend to fall into four categories
• 1. Fear of particular situations such as
  flying driving,
• tunnels, bridges, elevators, crowds, or
  enclosed placed
• 2. Fear of features of the natural environment
  such
• as heights, water, thunderstorms, or
  lightning
• 3. Fear of injury or blood including the fear
  of
• injections, needles, and medical or
  dental procedures
• 4. Fear of animals and insects such as
  snakes, spiders, dogs, cats, slugs, or bats

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Hilda is 32 years of age and is terrified
of snow. She cannot go outside in the snow.
She cannot even stand to see snow or hear about
it on the weather report. Her phobia severely
constricts her day-to- day behavior. Probing
in therapy revealed that her phobia was caused
by a traumatic experience at age 11. Playing at
a ski lodge, she was buried briefly by a small
avalanche of snow. She had no recollection of
this experience until it was recovered in
therapy.
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Anxiety Disorders

• Social Phobias a fear of being negatively
  evaluated by others or publicly embarrassed by
  doing something impulsive, outrageous, or
  humiliating.
• Social phobia goes well beyond the shyness that
  everyone sometimes feels at social gatherings.
  Rather, the person with social phobia is
  paralyzed by fear of social situations,
  especially if the social situation involves
  performing even routine behaviors in front of
  others.

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Anxiety Disorders

• Agoraphobia a fear of situations the person
  views as difficult to escape from if panic begins
  to build.
• Many people with this
• disorder become trapped
• in their own homes or
• in similar safe zones.

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Anxiety Disorders

• Phobias are considered anxiety disorders because
  they focus general feelings of anxiety onto a
  feared object or situation
• General Facts about phobias
• Phobias are twice as high for females than males
• Phobias are more prevalent in blacks than in
  whites or Hispanics
• Phobias tend to be chronic (lasts between 24-31
  years)
• Typical onset is childhood or young adulthood

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Anxiety Disorders

• Common Phobias and the Feared Objects Acrophobia
• High Places
• Agoraphobia
• Open Places
• Astraphobia
• Thunderstorms
• Claustrophobia
• Enclosed Places

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Anxiety Disorders

• Common Phobias and the Feared Objects
• Hematophobia
• Blood
• Mysophobia
• Contamination
• Pyrophobia
• Fire
• Xenophobia
• Foreigners/Strangers
• Hippophobia
• Horses

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Anxiety Disorders

• Panic Disorder Periodic episodes of extreme
  terror (panic attacks) without warning or obvious
  cause are characteristic of people with panic
  disorder.

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Anxiety Disorders

• Obsessive-Compulsive Disorder (OCD)
• Obsessions
• are unwanted thoughts, ideas or mental images
  that occur over and over again
• Compulsions
• are repetitive, ritual behaviors, often
  involving cleaning or checking.

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Anxiety Disorders

• Obsession-Compulsive Disorder
• marked by persistent uncontrollable intrusions
  of unwanted thoughts (obsessions) and urges to
  engage in senseless rituals (compulsions)
• Rate 3 of the general population
• Onset for males 6-15 for females 20-29
• Demographics for commonly found among upper
  income, highly intelligent groups, males and
  females are equally likely to suffer from this
  disorder

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Anxiety Disorders

• The patient was a 49-year-old man whose main
  symptom was an obsession with the number 13. If
  he heard the word he felt a shock and
  experienced a subsequent period of acute anxiety.
  His everyday life was a continuous effort to
  avoid any reference to 13, so much that his
  activities were seriously handicapped. In some
  way or another, it seems as if everyone was
  always saying 13 to him. If they met him in
  the morning they would say, Oh, good morning,
  or later in the day it would be Good afternoon
  (13 letters each). He stayed in bed on the 13th
  day of each month, skipped the 13th tread in a
  stairway, and found it necessary to count letters
  and phrases, his steps, and streets, to avoid the
  number 13.

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Anxiety Disorders

• Shirley was an outgoing popular high school
  student with average grades. Her one problem was
  that she was late for school almost everyday.
  Before she could leave the house in the morning,
  she had to be very sure that she was clean, so
  she needed to take showers that lasted two hours.
  She also spent a long time dressing, because
  each actfor example, putting on her stockings,
  underclothes, skirt, and blouse had to be
  counted and repeated precisely 17 times. When
  asked about her washing and counting, she said
  she knew that is was crazy but that she just had
  to do it and couldnt explain why. She said that
  she had struggled against this problem for three
  years but had no success

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Anxiety Disorders

• Causes of Anxiety Disorders
• Biological Factors
• Twin studies suggest there may be a weak genetic
  predisposition to anxiety disorders. Also,
  identical twins reared apart often times have
  independently developed phobias. Most anxiety
  disorders, such as panic disorder,
  obsessive-compulsive disorder, and generalized
  social phobia, appear to run in families.
• Excessive amounts of serotonin are present in
  people with obsessive-compulsive disorder.

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Anxiety Disorders

• Causes of Anxiety Disorders
• Cognitive Factors
• Cognitive theorists maintain that certain
  styles of thinking make some people particularly
  vulnerable to anxiety disorders. According to
  these theorists, some people are more likely to
  suffer from problems with anxiety because they
  tend to
• misinterpret harmless situations as threatening
• focus excessive attention on perceived threats
• selectively recall information that seems
  threatening

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Anxiety Disorders

• Causes of Anxiety Disorders
• Learning Factors
• Learned Helplessness
• Classical Conditioning
• Stimulus Generalization
• Observational Learning
• Operant Conditioning

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Somatoform Disorder

• Psychological disorders in which the symptoms
  take a bodily form without physical cause. This
  type of disorder is more common in Asian, Latin
  American, and African cultures where people are
  less open about their feelings. Even though
  these symptoms have a psychological cause rather
  than a medical cause, they are still genuinely
  felt.

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Somatoform Disorder

• Conversion Disorder
• Freud called it hysteria
• A person with conversion disorder experiences a
  change or a loss of physical functioning in a
  major part of the body for which there is no
  medical explanation (although they are still
  genuinely felt)
• People with this disorder are strangely
  indifferent to their problems

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Somatoform Disorder

• Conversion Disorder
• Conversion disorders tend to appear when a person
  is under stress.
• These physical symptoms often help reduce stress
  by enabling the person to avoid unpleasant
  situations. For instance, a stomachache may mean
  getting out of going to school.
• Today, conversion disorder is rare. It accounts
  for only about 2 percent of diagnoses.

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Somatoform Disorder

• One university student, for example,
  experienced visual impairment that began each
  Sunday evening and became total blindness by
  Monday morning. Her vision would begin to return
  Friday evenings and was fully restored in time
  for weekend football games and other social
  activities

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Somatoform Disorder

• Hypochondriasis
• A person misinterprets normal physical
  sensations as symptoms of a disease.

He/She fusses over every symptom. Sympathy may
reinforce the complaints
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Somatoform Disorder

• Somatization Disorder
• In this disorder, a person makes dramatic, but
  vague, reports about a multitude of physical
  problems rather than a specific illness

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Somatoform Disorder

• Pain Disorder
• This disorder is characterized by severe, often
  constant, pain with no apparent physical cause

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Dissociative Disorders

• Dissociation
• The process of separating a portion of the
  personality that is causing undue emotional
  stress from the rest of the normally functioning
  personality. (The individual may view parts of
  their activity as separate from him/herself)

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Dissociative Disorders

• Types of Dissociative Disorders
• Dissociative Amnesia
• Dissociative Fugue
• Dissociative Identity Disorder

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Dissociative Disorders

• Dissociative Amnesia
• The failure to recall events or personal
  information. A sudden memory
• loss. Memory lapses generally
• concern the personal aspects
• of an individuals life. Amnesia
• can be caused by a traumatic
• event (psychogenic) or a head
• injury (organic)

I forgot
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Dissociative Disorders

• Psychogenic Amnesia vs. Organic Amnesia
• 1. Loss of memory for both recent 1. Loss of
  memory for the
• and distant past recent past but
  memory for distant past is
  essentially intact
• 2. Lose identity but general 2. Lose both
  personal identity
• knowledge remains intact as well as
  general knowledge
• 3. Have no anterograde amnesia 3. Primary
  symptom is
• (memory loss for events after
  anterograde
• amnesia starts)
• 4. Amnesia often reverses itself very 4. Memory
  returns gradually for
• abruptly retrograde amnesia,
• anterograde hardly ever
• returns

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A young man dressed in work clothes came to the
emergency room of a hospital in the city in which
he lived with the complaint that he did not know
who was. He seemed dazed, was not intoxicated,
and carried no identification. After being kept
in the hospital for a few days, he woke up one
morning in great distress, demanding to know why
he was being kept in the hospital and announcing
that he had to leave immediately to attend to
urgent business. With recovery of his memory,
the facts related to his amnesia emerged. The
day his amnesia began, he had been the driver in
an automobile accident that resulted in the death
of a pedestrian. Police officers on the scene
were convinced that the driver had not been in
the wrong The accident had been the
pedestrians fault. The police told the driver
to fill out a routine form and to plan on
appearing at the coroners inquest. The man
filled out the form at the home of a friend,
accidentally left his wallet at his friends
home, and mailed the form. After mailing the
form, he became dazed and amnesiac. He was led
to the hospital by a stranger. The amnesia was
probably related to the stress of the fatal
accident, fear of the inquest, and worry that he
might actually have been responsible for the
accident.
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Dissociative Disorders

• Dissociative Fugue
• Dissociative Fugue a sudden loss of personal
  memory and the adoption of a new identity in a
  new locale
• Amnesia flight from the geographic location

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3) Dissociative Disorders

• Dissociative Identity Disorder
• This is rare disorder that is characterized
• by the development of two or more
  separate and
  independent personalities
• within the same person

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Dissociative Disorders

• Dissociative Identity Disorder
• Each personality has its own set of memories,
  typical behaviors (i.e. each personality has its
  own voice and mannerisms).
• Frequently none of the personalities has any
  awareness of the others. People with multiple
  personalities usually are not violent.

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The 21 Faces of Sarah In a well-publicized
criminal case, Mark Peterson, 31, and Oshkosh
grocery worker, was prosecuted for sexually
assaulting a 26-year-old-woman, who, according to
her psychiatrist, had at least 21 distinct
personalities. Peterson met the woman, who
introduced herself to him as Franny, a few days
before the assault. Others present at that time
told him that the womans true name was Sarah and
that she suffered from multiple personality
disorder. On a coffee shop date Franny told
Peterson about Jennifer, another personality,
whom she described as a 20-year-old
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female who likes to dance and have fun. When
they returned to Petersons car, he summoned
Jennifer and asked, Can I love you? She
answered, O.K. During the encounter, another
personality, 6-year-old Emily, suddenly intruded
to peek. Ignoring Peterson pleas to keep what
happened a secret, Franny and Emily reported the
encounter to Sarah, the predominant personality.
Sarah called the police to report that she had
been sexually assaulted. Petersons defense
centered on the idea that the woman was not
mentally ill and had consented to have sex. The
spectacular trial included appearances by Sarah,
Franny, Jennifer, and Emily. Jennifers
testimony was perhaps most crucial. When
questioned about the sexual encounter, she said,
I didnt know what he was doing. When asked if
she and Peterson had sex, Jennifer responded, I
dont know. Whats sex?
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The Wisconsin jury had several issues to
consider (1) Whether Sarah was mentally ill at
the time of the sexual act, (2) Whether she was
able to appraise Petersons conduct, and (3)
Whether Peterson knew of Sarahs condition. In
Wisconsin it is a crime to engage in sexual
intercourse with a person you believe to be
mentally ill and who cannot assess your
conduct. Psychiatrists who had treated Sarah
testified that she was not faking her disorder,
was incapable of judging her action, and had been
traumatized when she saw her father crushed while
he was working under a car. Ruth Reeves, a
neighbor and close friend of the woman, told the
court that she had forewarned Peterson of Sarahs
multiple personality disorder.
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Mood Disorders

• Types of Mood Disorders
• Major Depression
• Dysthymic Disorder
• Bipolar Disorder
• (Formerly known as Manic Depression)

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5) Mood Disorders

• Major Depression
• This is often referred to as the common cold
  of psychological disorders.
• Why do you think that is?

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Mood Disorders

• Major Depression
• This is a mood disorder in which a person, for
  no apparent reason, experiences two or more weeks
  of depressed moods, feeling of worthlessness and
  diminished interest or pleasure in most
  activities. The person may become deeply
  discouraged about everything and may experience
  fatigue. Depressed people often feel that they
  are helpless. They feel there is nothing they
  can do to change things

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Mood Disorders

• Symptoms of Depression
• Persistent depressed mood for most of the day
• Loss of interest or pleasure in all, or almost
  all, activities
• Significant weight loss or gain
• Sleep changes
• Fatigue or loss of energy, boredom
• Feelings of worthlessness or unfounded guilt

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Mood Disorders

• Symptoms of Depression (continued)
• Reduced ability to concentrate
• Recurrent thoughts of death or suicide
• Physical complaints
• Loss of friends
• Tearfulness
• Poor grade, truancy, disciplinary problems
• Social behavior changes

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Mood Disorders

• Dysthymic Disorder
• A person shows the sad mood, lack of interest,
  and loss of pleasure associated with major
  depression, but less intensely and for a longer
  duration (The duration must be at least two years
  to quality)

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Mood Disorders

• Suicide and Depression
• Suicide is most closely tied to depression than
  to any other psychological disorder.
• Suicide rates are high in some northern European
  countries, and Japan but low in Greece, Italy,
  Ireland and the Middle East (these countries have
  strong religious prohibitions)

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Mood Disorders

• Bipolar Disorder
• (formerly known as manic depressive disorder)
• The person alternate between the hopelessness
  and lethargy of depression and the hyperactive,
  wildly optimistic, impulsive phase of mania
  (excited and overly active periods)
• Bipolar Disorder is less common than major
  depression

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5) Mood Disorders

• Mania
• During the manic phase the person may
• sing, shout, talk
• continuously, move
• around rapidly.
• He has little need for
• sleep.

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Mood Disorders

• Mania
• He is easily irritated if crossed. The person
  may show few sexual inhibitions. His speech may
  be flighty. It is difficult to interrupt him.
  He has grandiose optimism.
• Bipolar disorder may lead to reckless spending
  and investment sprees.

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Mood Disorders

• Then they go through a normal phase

Then they go through a depressive phase. (The
depressive phase usually lasts longer than the
manic phase)
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Mood Disorders

• Bi Polar Disorder
• 1 of the total U.S. population has bi-polar
  disorder. Only 15-25 show a definite cycles of
  manic-depressive behaviors.
• Recovery rate is about 90.

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Mood Disorders

• CAUSES OF MOOD DISORDERS
• Biological Factors
• Neurotransmitters such as serotonin and
  norepinephrine
• A shortage of serotonin and norepinephrine is
  related to depression. An overabundance is
  related to mania.
• Hormones such as cortisol
• Mood disorders have also been related to
  malfunctions of the endocrine system, especially
  the hypothalamic-pituitary-adrenocortical system
  (HPA)

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Mood Disorders

• CAUSES OF MOOD DISORDERS
• Biological Factors
• Genetic influences
• Twin studies have shown there is a hereditary
  component to both Bi-Polar and Depression
  Disorders. If an identical twin has bi-polar
  disorder, the other twin has a 70 chance of also
  having the disorder. A fraternal twin has a 20
  change of having bi-polar disorder if his/her
  twin suffers from it. People who are adopted and
  have mood disorders are more likely to find a
  history of mood disorders in their biological
  families rather than in their adopted families.

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Mood Disorders

• CAUSES OF MOOD DISORDERS
• Psychological Factors
• Psychodynamic theorists Depression is due to the
  feelings of loss associated with childhood or
  unresolved anger toward parents (Horney). Freud
  believed that depression was the result of a loss
  of a loved one. He contents that in addition to
  grief we feel anger over feelings of abandonment.
  Some of that anger is directed inward which
  results in depression

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Mood Disorders

• CAUSES OF MOOD DISORDERS
• Psychological Factors
• Behavioral theorists Behaviorists believe that
  depression is the result of learned helplessness.
  They say that people become depressed when they
  have no control over negative events.

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Mood Disorders

• CAUSES OF MOOD DISORDERS
• Cognitive theorists
• Cognitive theorists believe that those with
  depression have self-defeating beliefs. They
  tend to magnify bad experiences and minimize good
  experiences. This ruminating style is especially
  characteristics of women.
• Depressed people have a tendency to explain bad
  events as being stable, global, and internal.

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Schizophrenia

• The term schizophrenia means literally split
  mind

95
Schizophrenia

• Positive Symptoms of Schizophrenia
• Break of contact with reality
• Hallucinations
• Delusions
• Disorganized and
• Bizarre Behaviors
• Disturbances in
• emotions, speech and thoughts

96
Schizophrenia

• Positive Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Neologisms
• (literally new words). At times, a
  schizophrenics speech includes the rare
  appearance of words and phrases not found in even
  the most comprehensive dictionary. Neologisms
  (new words) are sometimes formed by combining
  parts of two or more regular words. Neologisms
  may also involve the use of common words in a new
  way

97
Schizophrenia

• Positive Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Echolalia
• Repeating words said in their presence over and
  over and over again

98
Schizophrenia

• Positive Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Derailment (loose associations)
• The tendency for one thought to be logically
  unconnected, or only superficially related to the
  next. Sometimes the associations are based on
  the double meanings or on the way words sound

99
Schizophrenia

• Example of Derailment
• He pushed back the blankets from the bed. He
  saw the river bed was covered with small stones
  washed down from the quarry. The hunter came
  fast because he was following his quarry over the
  hill.

100
Schizophrenia

• Positive Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Irrelevant Replies
• Giving answer to questions that are not
  relevant
• Example How old are you? As old as the
  pyramids crumbling into dust. Where do you live?
  I exist in the world, from it, of it, and by it.

101
Schizophrenia

• Positive Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Word Salad
• Combining words and phrases in what appears to
  be a completely disorganized fashion. Unlike
  neologisms, word salad suggests no effort to
  communicate. In word salad, nothing is related
  to anything else.

102
Schizophrenia

• Example of word salad
• Its all over for a squab true tray and there
  aint no music, there aint no nothing besides my
  mother and my father who stand alone upon the
  Island of Capri where there is no ice, there is
  no nothing but changers, changers, changers.
  That comes like in first and last names, so that
  thing does. Well, its my suitcase, sir. Ive
  got to travel all the time to keep my energy
  alive.

103
Schizophrenia

• Symptoms of Schizophrenia
• Disturbances in thoughts and speech
• Clanging
• The pairing of words that have no relation to
  one another beyond the fact that they rhyme or
  sound alike

104
Schizophrenia

• Negative Symptoms of Schizophrenia
• Anhedonia lack of interest in living, loss of
  pleasure in life
• Alogia (mutism) Total Silence
• Flat Affect Person shows no emotion
• Avolition Loss of motivation

105
Schizophrenia

• Types of Schizophrenia
• Catatonic Schizophrenia
• Agitated
• Immobile
• Paranoid Schizophrenia
• Disorganized Schizophrenia
• Undifferentiated Schizophrenia

106
Schizophrenia

• Types of Schizophrenia
• Paranoid Schizophrenia
• Accounts for 40 of schizophrenics appears
  late in life (25-30). Characterized by delusions
  of persecutions grandeur. These are often
  accompanied by hallucinations supporting the
  delusion.

107
Schizophrenia

• Types of Schizophrenia
• Paranoid Schizophrenia (continued)
• Paranoid Schizophrenics are more likely than
  other schizophrenics to have a good outcome
  because it tends to be acute. Under certain
  circumstances, they may function relatively well

108
Schizophrenia

• Types of Schizophrenia
• Catatonic Schizophrenia
• Accounts for 8 of all schizophrenics. The
  major symptoms is a disturbance in motor
  activity. The person may remain stiffly immobile
  and refuse to speak of be extremely agitated.
  Catatonic Schizophrenia is rarely seen today.
  However, it was common up to 30 to 40 years ago

109
Schizophrenia

• Types of Schizophrenia
• Disorganized Schizophrenia
• Accounts for 5 of all schizophrenics.
• Incoherence in expression
• Childish disregard for social conventions
• Resists wearing clothing
• Urinate and defecate at inappropriate times

110
Schizophrenia

• Disorganized Schizophrenia (continued)
• May eat with their fingers
• Show emotional responses that are inappropriate
  to the situation
• Giggling
• Silly mannerisms
• Inexplicable gestures

111
Schizophrenia

• Types of Schizophrenia
• Undifferentiated Schizophrenia
• This accounts for 40 of all schizophrenics.
  They have symptoms of schizophrenics (disordered
  thinking, etc) but the symptoms dont clearly fit
  one of the other specific types

112
Schizophrenia

• Causes of Schizophrenia
• Biological Factors
• Brain Abnormalities Schizophrenics (this is
  more true of schizophrenic with negative symptoms
  rather then positive)
• tend to have enlarged
• ventricles and less brain
• tissue than non-schizophrenics

113
Schizophrenia

• Causes of Schizophrenia
• Biological Factors
• Dopamine In general, those with schizophrenia
  have an excess of receptors for dopamine. Drugs
  that block dopamine receptors lessen positive
  schizophrenia symptoms. Drugs that increase
  dopamine levels (i.e. cocaine, and amphetamines)
  increase positive schizophrenia symptoms.

114
Schizophrenia

• Causes of Schizophrenia
• Biological Factors
• Genetics The odds of any person being
  schizophrenic are 1 in 100. The odds rise to 1
  in 10 if one parent has schizophrenia. If a
  person has an identical twin with schizophrenia,
  the odds are 50 in 100.

115
Schizophrenia

• Causes of Schizophrenia
• Psychological Factors
• There are no psychological factors alone that
  cause schizophrenia. However, a life of a lot of
  stressors will increase the chances that a
  predisposition of schizophrenia will result in
  schizophrenic symptoms

116
Personality Disorders

• Personality disorders are psychological disorders
  characterized by inflexible and enduring
  behavioral patterns that impair social
  functioning. These disorders usually do not
  involve anxiety, depression, or loss or contact
  with reality. They may however, coexist with
  other psychological disorders.

117
Personality Disorders Lasting, rigid patterns of
behavior that seriously diminish functioning.
Dramatic or Impulsive Behaviors Borderline
personality disorder, Antisocial personality
disorder
Related to Anxiety Avoidant personality
disorder Dependent personality disorder
Odd or Eccentric Behaviors Paranoid personality
disorders, Schizoid personality disorders
118
Mental Illness and the Law

• MENTALLY INCOMPETENT Being unable to understand
  the proceedings and charges against you. If you
  are declared mentally incompetent to stand trial
  you are protected from prosecution. This is a
  rare occurrence.
• INSANITY If you are judged to be not guilty by
  reason of insanity at the time of the crime it
  means that the mental illness prevented the
  person from
• 1. understanding what he/she was doing
• 2. knowing that what they were doing was wrong
• 3. resisting the impulse to do wrong