Chapter 14:Psychological Disorders

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Normal Brain

Individual with Schizophrenia

Defining Psychological Disorders• How do we know whether behavior should be

classified as a disorder?

• Depression - where does the normal blues leave off and disordered depression begin

• Anxiety.

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• Three criteria used to judge whether a behavior is disordered: Is the behavior. . .

Deviant? Does it deviate from norm?Distressful/disturbing to others? Dysfunctional/disabling (harmful) to self and

perhaps others?

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History of Psychological Disorders and Treatment

• Prehistoric times - bizarre and unusual behavior was thought to be due to evil spirits

• Greek and Roman civilizations - natural causes

• Hippocrates did not believe that evil spirits defiled the body.

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• Europe entered the dark ages

• For many hundreds of years, until the 1700 and 1800s bizarre behavior again was thought to have supernatural causes

• In the late 1400s, a pope issued a papal decree stating that there were witches in the woods and they should not be tolerated.

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• Two monks wrote a book about how to detect and treat witches

• Detection: look for a mark on body - the mark of the devil

• Detection: torture them until they confess

• Treatment: burn them at the stake or behead them and then burn them at the stake

• Many thousands were killed.

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• Why would the pope, the church, and society favor such barbaric treatment?

• The pope took his authority from the Bible

• Exodus 22:18 - “Thou shalt not suffer a witch to live.”

• A time of great superstition when people could not rationally explain disease and other calamities.

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• During 1800s, the medical model gradually emerged

• A mental illness needs to be diagnosed on the basis of symptoms and cured through therapy

• In around 1900, scientists discovered an infectious brain disease which produced a disordered mind and bizarre behavior

• This gave a boost to medical model

• What disease was it?

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The Biopsychosocial Perspective• Assumes that biological, social, and

psychological factors combine to produce psychological disorder

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Classifying Psychological Disorders• DSM-IV: the Diagnostic and Statistical

Manual of Mental Disorders (4th edition).

• A system for classifying psychological disorders.

• The DSM-IV defines and describes 16 clinical syndromes (categories) of mental disorder

• Some major categories: - Substance related disorders

- Anxiety disorders

- Mood disorders

- Schizophrenia

- Personality disorders

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Labeling of Psychological Disorders • David Rosenhan’s study (1973)

• He and seven colleagues went to mental hospitals complaining of hearing voices

• What happened?

• Labels affect how we perceive one another

• Labels have the power to stigmatize people

• Labels and the popular media.

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Anxiety Disorders1) Generalized anxiety disorders - can escalate into

panic attacks: tense, uneasy, arousal2) Phobias - irrational fears

3) Obsessive-Compulsive disorders - – obsessions (repetitive thoughts: germs, something terrible

happening, order or exactness)– compulsions (repetitive behaviors: excessive hand

washing/bathing, repeated rituals, excessive checking) Case of Kevin.

– Post-traumatic Stress Disorder – memories, nightmares, jumpy, insomnia after trauma.

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Dissociative Disorders:

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• Disorders in which conscious awareness becomes separated from previous memories and thoughts

• Dissociative Identity Disorder - formerly known as Multiple Personality Disorder

• Understanding Dissociative Identity Disorder.

Somatoform Disorders:• Disorders which take a bodily form without

apparent physical cause• Conversion Disorder• Hypochondriasis

Mood Disorders

1. Major depressive disorder

2. Bipolar disorder

• Major depressive disorder -

a person experiences two or more weeks of depressed moods for no apparent reason.

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• Symptoms– feelings of worthlessness– loss of interest– appetite, sleep, energy level, sexuality – thinking affected: thoughts slowed, person

expects negative outcomes,– things will not get better, suicidal ideas, difficulty

making decisions

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Some Further Information

• Depression widespread - called common cold of mental disorders

• About 6% of population experiences major depression

• Depression increasing, only 1% for those born before 1905

• Major depression - usually lasts six months or less.

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• Women are twice as vulnerable to major depression

• Stressful events related to work, marriage, and close relationships often precede depression.

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Genetic and Biological Causes

• If one identical twin develops major depression, the chances are about 1 in 2 that the other twin will also

• Searching for the genes that put people at risk

• Norepinephrine, a neurotransmitter, is over abundant during mania and scarce during depression

• Serotonin is scarce during depression.

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• Bipolar disorder - formerly known as manic depressive disorder

• The person alternates between depression and the overexcited state of mania

• Manic symptoms and other information:– overtalkative, overactive, elated– has little need for sleep– fewer sexual inhibitions– grandiose optimism and self-esteem.

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– can fuel creativity– the elated mood returns to normal or plunges into

a depression– less common than major depression, occurs in

about 1% of the population– afflicts as many men as women– If one identical twin develops bipolar, the chances

are 7 in 10 that the other twin will also

• Case of Nancy.

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Schizophrenia• Severe disorder – adolescence or young adult• Characterized by disorganized and delusional

thinking,

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• Symptoms and other information:

– delusions: false beliefs, often of persecution or grandeur

– hallucinations: false perceptions (sensory experiences without sensory stimulation) which

– are usually auditory (hearing voices).

disturbed perceptions,and inappropriate emotions and actions

– inappropriate emotions: laughing, crying, and exhibiting anger at inappropriate times

– Nonsensical communication– inappropriate actions: such as, continually rocking or

remaining motionless for hours– afflicts about 1% of population– can develop gradually (called chronic) and recovery is

doubtful– can develop suddenly (called acute) and recovery is

more likely– Onset in adolescence or young adulthood.

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Causes of Schizophrenia:• Recent studies link this disorder with brain

abnormalities and genetic predispositions

• Dopamine overreactivity - excess of receptors for dopamine

• Brain anatomy - shrinking of limbic system areas

• Problems during prenatal period

• Genetic factors - if one identical twin develops this disorder, chances are one in two the other will also

• The Cases of Bob and Missy.

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Personality Disorders:• Antisocial Personality Disorder - formerly

called a sociopath or a psychopath– typically male, developing before 15– exhibits lack of conscience and often unrestrained

sexual behavior– express little regret and guilt over violating

other’s rights– unconcerned with social rewards and low in

anxiety even as children.

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