Psychological Disorders
4/17/2009
Chapter 15:
Psychological Disorders
Historical Perspective

Brown Unit 12
Perceived Causes

movements of sun or moon

When Adaptation Breaks Down

lunacy--full
y
moon/evil
/
spirits
p
Ancient Treatments

exorcism, caged like animals, beaten,
burned, castrated, mutilated, blood
replaced with animal’s blood
Copyright © Allyn & Bacon 2009
Historical Perspective

Historical Perspective
Archaeologists have found human skulls
with ________– holes bored into the skull
with stone age instruments (presumably to
let out evil spirits) 200,000 to 10,000 BP
(years before the present).

Historical Perspective

1800’s the medical model of mental
disorders arose and asylums were
constructed to house the insane
insane. At
Bethlem Asylum some Londoners would
visit to watch the lunatics as a form of
amusement (__________).
Four D’s of Mental Illness




Deviance
Distress
Dysfunction
Danger


©2001 Prentice Hall
14th-16th century madness was deemed
due to __________________, and some
mentally ill individuals were burned at the
stake for witchcraft. (In some societies the
mentally ill became Shamans).
In modern populations about __% may show
serious mental disturbances (equal rates in all
societies).
Caution: do not diagnose yourself (or anyone
else).
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Psychological Disorders
4/17/2009
Psychological Disorders: A
General
Outlook
Psychological Disorders: Defining
Normal and Abnormal
Psychological Disorder


Diagnosis: A Necessary Step
Three necessary conditions



The person experiences significant
_______________.
The source of the problem resides in the
_________.
The problem is not a deliberate reaction to
conditions, such as poverty, government policy,
or other conflicts with society.

Psychological Disorders-Etiology



“Mathematics Disorder”

Not everything is based on scientific data

American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders (Fourth Edition)

The process of identifying and
grouping mental disorders with
similar symptoms
Criticisms of the DSM-IV
DSM-IV

Diagnosis



a widely used system for classifying
psychological disorders
presently distributed as DSM-IV-TR
(text revision)

Tells us little beyond difficulties learning math
Some disorders are based on subjective committee
decisions
High level of _____________among diagnoses
Exclusive reliance on a categorical model

Some mental disorders may better fit a
dimensional model, where disorders differ from
normal functioning by degree rather than kind (e.g.,
depression, anxiety)
Copyright © Allyn & Bacon 2009
Psychiatric Diagnosis Across
Cultures

Many mental illnesses are specific to certain
cultures (culture-bound)

Koro – in a number of Asian countries, men with this
penis and testicles are
condition falselyy believe their p
disappearing and receding into their abdomen
Bulimia nervosa - unique to Western cultures

Anorexia nervosa - more culturally universal



Likely genetic, but triggered by sociocultural expectations
Many mental disorders are culturally universal
(schizophrenia, alcoholism, psychopathic
personality)
Disorders- The symptoms
remain, but the names change:

Neurotic Disorder (term seldom used
now)


usually distressing but that allows one
to think rationally and function socially
Psychotic Disorder


person loses contact with _________
experiences irrational ideas and
distorted perceptions
Copyright © Allyn & Bacon 2009
©2001 Prentice Hall
2
Psychological Disorders
Psychological Disorders:
Models of Abnormality

Medical Model

The perspective that mental disorders are caused by
biological conditions and can be treated through medical
intervention

Psychodynamic Model (Freud)

Humanistic Model

Behavioral Model




Psychopathology is caused by unconscious conflicts and
can be treated by uncovering the unconscious mind
Psychopathology is due to conditional love, and can be
treated by giving unconditional love
Psychopathology is due to faulty learning and can be
treated by employing systematic desensitization, modeling,
and token economies
Cognitive Model

Psychopathology is due to faulty thinking and can be
treated by challenging irrational thoughts
4/17/2009
Psychological Disorders
A: Anxiety Disorders
B: Somatoform Disorders
C: Dissociative Disorders
D: Sexual Disorders
E: Eating Disorders
F: Substance Abuse
G: Mood Disorders
H: Schizophrenic Disorders
I: Personality Disorders
A: Anxiety Disorders

Anxiety: increased
__________accompanied by feelings of
_____________
One of the most common
psychopathologies affecting 15-20% of
the adult population
Generalized Anxiety Disorder



Panic Disorder







Sudden and intense feelings of terror, dying, dread, fear of
loosing control.
Sweating, trembling, chest pains, shortness of breath, choking,
nausea, dizziness, chills – subjects may end up in the ER
thinking that they are having a heart attack.
Oft occurs without
Often
ith t a specific
ifi trigger
ti
(out
( t off th
the bl
blue).
)
Subjects can’t predict when or where the attack will arise.
Subjects form associations between the attack and the place of
its onset.
Subjects begin to ________activities associated with the place
of onset, and in the end may avoid leaving the house for fear of
an attack being triggered by some associated place or activity.
Some evidence of a genetic predisposition.
The most common form of anxiety disorders.
©2001 Prentice Hall
Excess worry of a _____________, but not
about any specific thing.
The reasons for the worry are difficult to
identify, but the fears and worry are very real
and are of clinical significance if the worry
prevents the subject from fulfilling normal
role obligations.
Twice as common in women as in men.
Phobic Disorder

Extreme __________fear of specific
objects or situations, and the subject’s
fear interferes with the fulfillment of
normal role obligations.
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Psychological Disorders
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Anxiety Disorders
Obsessive-Compulsive
Disorder
Frequency of the Most Prevalent
Simple Phobias

 Simple
Ph bi : An
Phobia
A
intense,
irrational fear
of a specific
object or
situation.


Common Obsessions
and Compulsions
___________– recurrent, persistent and
intrusive thoughts.
____________– repetitive behaviors
performed to reduce anxiety and
prevent something bad from happening.
Runs in families.
Obsessive & Compulsive PET


Post-Traumatic Stress
Disorder
What Happens to People with
OCD



A study of untreated
OCD patients found
that about 66%
improved after 10
years.
And, 80% improved
within 40 years.
However, very few
became symptomfree and some
became worse.
©2001 Prentice Hall
PET Scan of brain of
person with Obsessive/
Compulsive disorder
High metabolic activity
(red) in frontal lobe
areas involved with
directing attention


Persistent re-experience of past
traumatic events (flashbacks, thoughts,
dreams – subjects feel that they are rere
living the traumatic event).
Subjects ______stimuli associated with
the traumatic event, and this disrupts
their capacity to fulfill normal role
obligations.
4
Psychological Disorders
Cultural Influences on Anxiety
Disorders
Three findings from cross-cultural
comparisons are:




4/17/2009
PRS

Anxietyy is universal and is exhibited byy
the same bodily reactions.
Culture influences the cognitive
component of anxiety, i.e., what people
worry about and their beliefs about the
causes of it.
Treatment needs to acknowledge
cultural diversity.

Subjects experience symptoms typically
associated with ____________, but
there is no medical basis for their
symptoms.



1: Somatization disorder
2: Hypochrondriasis disorder
3: Conversion disorder
1: Somatization Disorder





2: Hypochondriasis Disorder




Subject is preoccupied with the
possibility of a disease or illness, and
_______________bodily
bodily symptoms of a
potential illness.
Impairs the subject’s ability to fulfill
normal role obligations.
Equal prevalence in males and females.
_______is worse than the _________.
©2001 Prentice Hall
T/F
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
B: Somatoform Disorders

Women are less likely than men to
develop anxiety disorders.
Subjects experience specific symptoms
(gastrointestinal pain, neurological symptoms,
physical complaints, etc.).
Typically begins before age 30.
Impairs the subject’s ability to fulfill social
and occupational obligations.
Twice as common in women compared to
men.
___________are worse than the
_______over them.
Sensitivity in People with
Hypochondriasis



Both hypochondriacs and
controls put their foot into tub
of ice water.
Heart rate and hand
temperature were recorded.
Hypochondriacs



removed their foot sooner
rated cold as more
unpleasant
Hypochondriacs show more
physiological reactivity to
stimulation.
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Psychological Disorders
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3: Conversion Disorder





(AKA ___________).
Subject experiences significant physical impairment
(deafness, blindness, paralysis) with no organic basis.
The impairment may prevent the subject from
fulfilling normal role obligations.
obligations
LaBelle indifference – subject stoically accepts their
unfortunate fate and exhibit little motivation to seek
treatment.
Subject’s initially believe that their problem has an
organic basis, and resist the idea that the cause may
be psychological…eventually they may accept the
idea that the cause is psychological.

Subjects with ___________ disorders
experience symptoms associated with
physical illness, yet there is no
medical basis for their symptoms.




A.
B.
C.
D.

In “Glove Anesthesia”
(shown), the person
reports numbness in
the hand but sensation
in the arm.
arm
However, four different
nerve tracts provide
sensation to both the
hand and lower arm.
 The physical
symptoms do not
Symptoms Neural Wiring
match the
physiological reality.
C: Dissociative Disorders
PRS

Glove Anesthesia: A Conversion
Disorder
Anxiety
Somatoform
Dissociative
Affective
1: Amnesia


2: Fugue State


A dissociative disorder involving a partial or
complete loss of memory
A form of amnesia in which a person “forgets”
forgets
his or her identity, wanders from home, and
starts a new life
3: Dissociative Identity Disorder (DID):


A condition in which an individual develops
two or more distinct identities
Formerly known as “Multiple Personality Disorder.”
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
1: Dissociative Amnesia




Prolonged __________loss. Memory
loss may last for hours, days, months,
years, forever.
Caused by an emotional _________and
and
is not associated with illness or brain
injury.
Onset is ________.
Over-learned skills – reading, musical
ability (procedural memory) are
retained.
©2001 Prentice Hall
2: Dissociative Fugue


(AKA traveling amnesia)
Subject relocates, adopts a new
identity and is unable to recall their
identity,
past life.
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Psychological Disorders
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3: Dissociative Identity
Disorder





(AKA __________________)
Subject possesses two or more distinct identities (often 8-10 or
more).
Each identity state takes control of the person at different
times.
A very ____disorder (believed to be 3 times more common in
women compared to men).
May arise in some subjects who experienced physical or sexual
abuse as children. During an abusive episode a child may enter
a dissociative state and pretend that the abuse is not really
happening to them, they have no memory of the abuse, and it
feels like another part of them (or another person) was actually
abused.
PRS

Disorders characterized by an
impairment in normal memory are
called _____________ disorders.




A.
B.
C.
D.
Dissociative
Somatoform
Anxiety
Affective
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
D: Sexual and Gender
Identity Disorder







Sexual dysfunction disorder
Sexual arousal disorder
Orgasmic disorder
Premature ejaculation
Paraphilias
Sadism
Masochism
Sexual Dysfunction Disorder

Subject has an _________to sexual activity
(disturbance in desire and arousal).


Sex




Sexual arousal disorder: inability to
carry intercourse to completion.
Orgasmic disorder: absence of orgasm.
orgasm
Premature ejaculation:
Both medical and psychological factors
may play a role in these conditions.
©2001 Prentice Hall
Estimated: 15% of men, 20-35% of women
There is no standard regarding the level of
interest or activity an individual must
maintain to be considered normal. (A subject
is not dysfunctional unless they perceive
themselves as being dysfunctional).
Paraphilias

Recurrent and intense sexual urges,
fantasies and behaviors involving nonhuman objects, non
non-consenting
consenting children
or adults. May contain an element of
_______________________.



Fetishes
Frotteurism
Pedophilia
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Psychological Disorders
4/17/2009
Fetishes

An inanimate object (usually women’s
clothing) is necessary for arousal.


Frotteurism

Bestiality – animals
Necrophilia – human waste
Touching or rubbing against (or
fantasize of doing so) a non-consenting
person.

May happen ‘accidentally’ in public.
Pedophilia


Sexual urges involving ____________.
Power asymmetry.
Sadism

Sexual arousal requires the infliction of
_______ (and or humiliation) on others.
Masochism

Sexual arousal requires receiving pain
(and or humiliation).
E: Eating Disorders

Disturbances in eating that involve
maladaptive and unhealthy efforts to control
weight.

Anorexia – subjects starve themselves to
dangerous levels.



Bulimia – recurrent episodes of binge eating and
purging (laxatives & vomiting).


©2001 Prentice Hall
Distortion in body image.
Preoccupation with food.
Vicious binging/purging cycle.
Preoccupied with trying to please others.
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Psychological Disorders
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F: Substance Related
Disorders

G: Affective (Mood) Disorders
Maladaptive patterns of substance use
leading to clinically significant
impairment (5-7% of USA population)


Substance _______– recurrent substance
use leading to failure to fulfill role
obligations, exposure to risk, recurrent
legal problems
Substance __________– increase dose
needed to achieve desired effect,
symptoms of withdrawal

Depression

Bipolar Disorder
Mood Disorders

Types of Depression
Depression
Characterized by sadness, despair,
feelings of worthlessness, and low selfesteem
 Depression is universal.
 Depression rates are on the rise.
 Women are twice as likely to seek treatment
for it.
 Some people get depressed on a seasonal
basis.
 Depressive episodes often last only a few
weeks.







Negative life events.
Severe loss early in life.
Absent or poor social support
symptoms.
Family history of depression:


16% fraternal twins
67% identical twins
©2001 Prentice Hall
___________– the depression just
occurred out of the blue.
Depression: Ages of First
Onset
Risk Factors for Depression

___________– the depression is in
response to an external event (death of
a loved one, failed exam).



Depression is seldom
identified before
_____________.
Rates of depression
i
increase
through
th
h
adulthood.
It is most commonly
diagnosed in
______________.
First onset of
depression is rare
among the elderly.
9
Psychological Disorders
Gender Differences in
Depression


Clinical depression (longer than 2
weeks) is twice as common in women
compared to men.
Gender differences in attributions of the
cause of ‘bad’ events.


Women are more likely to _______
themselves when something bad happens.
Men are more likely to blame the situation
when something bad happens.
4/17/2009
Theories of Depression
Explanatory Styles and
Depression


Explanatory styles
among first-year college
students were assessed.
Two years later
later, those
with a negative style
(tendency to attribute
negative events to
factors that are internal,
stable, and global) were
more likely to
experience a major or
minor depressive
disorder.
The Vicious Cycle of
Depression

Depression can lead to behaviors that cause
social rejection, which worsens depression.
Symptoms of Depression







Zung’s Self-Rating Scale for
Depression







1.
2.
3
3.
4.
5.
6.
7.
I feel down-hearted and blue.
Morning is when I feel the best.
I have crying spells or feel like it.
it
I have trouble sleeping at night.
I eat as much as I used to.
I still enjoy sex.
I notice that I am losing weight.
©2001 Prentice Hall
Feelings of sadness
Appetite disturbance: weight loss or gain
Apathy – lost of interest in hobbies, sports,
sex, other activities
Sleep disturbances
Inability to concentrate
Inability to make a decision
Recurrent thoughts of suicide
Zung







8. I have trouble with constipation.
9. My heat beats faster than normal.
10. I get tired for no reason.
11. My mind is as clear as it used to be.
12. I find it easy to do the things that I used
to do.
13. I am restless and can’t keep still.
14. I feel hopeful about the future.
10
Psychological Disorders
4/17/2009
Mood Disorders
Suicide: The Ultimate “Solution”




Roughly one million people worldwide
commit suicide each year.
Women are three times more likely to
attempt suicide but men are four times
more successful.
About 75% of suicides are committed
by people who suffered from
depression.
The single best predictor is a sense of
_________________.
Suicide




Suicide Pacts



Contagious effect – counseling directed to
reduce feelings of guilt if an associate does
not also commit suicide.
__________effect – Marilyn Monroe
committed suicide in 1963, in 1964 a 12%
increase in the suicide rate occurred.
Suicide notes: the biggest problems are
relationship problems.
Suicide is the ___leading
leading cause of death in
the USA.
Suicide rate is highest in the elderly, and
increasing in teenagers.
Suicide is the _____ leading cause of death
in the 15-24 year age bracket (behind
accidents).
Warning Signs




Mood DisordersSuicide
Suicide is more likely when a depressed
person begins to feel a little bit better (they
may lack the energy to commit suicide when
they
h are at the
h bottom).
b
)
A period of calm after intense agitation (relief
because they have made a decision to die).
Giving away possessions.
Talking about death.
Treatment



©2001 Prentice Hall
Depression is a potentially fatal
disorder.
In the absence of any treatment depression
has a very good chance of disappearing
within 9 months of onset.
Treatment reduces the depth of depression
depression,
risk of suicide, duration of depression, and
dependency.
_____– selective serotonin reuptake inhibitors
(Prozac) increase effective serotonin levels in
the brain. Drugs may take 3-10 days to
effect mood (suicide risk may still be
present).
11
Psychological Disorders
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Convulsions


ECS
Epileptics have a very low rate of mental
illness. Could convulsions be helpful?
“A strong challenge to the body may elicit a
protective reaction that could have a
beneficial effect on mental state.”








Immersion in cold water
Injection with small pox
Injection with malaria
Injection with typhoid fever
Horse serum injections
ECS – electroconvulsive shock

Depressions that come out of the ‘blue’
are called ________ depressions.


Disrupts recent memories and may
damage long-term memory.
For some patients ECS use displays a
pattern resembling addiction (shock –
improvement – depression, shock –
improvement – depression…6 mo cycles).
Brain Activity in Bipolar
Disorder
PRS

Used today to induce convulsions in
depressed patients who fail to respond
to other treatments.
A. Reactive
B. Endogenous

Bipolar disorder


A rare mood disorder characterized by wild
fluctuations from mania to depression
These are fluctuations in brain activity from
depression (top), to mania (middle), and
back to depression (bottom) in someone with
bipolar disorder.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Mood Disorders-Bipolar

PET scans show that brain energy
consumption rises and falls with emotional
switches
Bipolar Disorder




Depressed state
©2001 Prentice Hall
Manic state
Depression alternates with mania.
“I just remember feeling wonderful. I felt like a glass of pop
with too many bubbles – they just came bursting out and I
laughed and sang. And I remember everyone else stopped, but
I didn’t, I couldn’t – it was if I was out of control.”
M i state
Manic
t t usually
ll abates
b t within
ithi 3 months.
th Some
S
creative
ti
artists work in bursts of 2-3 months, and this may coincide with
a modest pulse of mania. (Nietzsche: “One must harbor chaos
within oneself to give birth to a dancing star.”).
Mania is associated with excess norepinephrine. Lithium helps
stabilize norepinephrine and serotonin levels in about 70% of
bipolar patients
Depressed state
12
Psychological Disorders
Is There a Connection between
Creativity and Mental Illness?
4/17/2009
H: Schizophrenic Disorders

Schizophrenic Disorders
Disorders involving gross
distortions of thoughts and
perceptions and by loss of
contact with reality


The rate of mental illness (in general) is
slightly higher among those in the arts than
those in other professions.
Conglomeration of
Dysfunctions
The Symptoms of Schizophrenia


Incoherent Thinking
____________


______________



F l beliefs
False
b li f
Sensory experiences that occur in
the absence of actual stimulation
Disturbance of Affect
Bizarre Behavior

Symbolism: sunshine = love of family



Increased sensitivity:

Social withdrawal

Loss of _____ boundaries




Psychotic mannerisms







Soil clothing with urine & feces, public
masterbation
©2001 Prentice Hall
Fearful that people can read their mind, o that they have
merged with a TV set
Inconsistent & variable
Hallucinations

Object is absent. Auditory are most common, hear voices
from radiators, etc.

Distortions

Delusions


Pacing, touching switch plates
Slovenly appearance & poor social manners


Mimic behavior of others
Stereotyped behavior
isolated and alienated
Conglomeration of
Dysfunctions
Grotesque postures
Echopraxia
p
T sensory & emotional
To
ti
l stimuli
ti li
Variability
Conglomeration of
Dysfunctions

Indirect patterns of speech, thought
Word salad

Object is present, but its dimensions expand or contract.
Incorrect beliefs that cannot be correct by logical discussions
(cows heart transplant connected to the heating plant).
Faulty logic

“The Virgin Mary was a virgin, I am a virgin, therefore, I am
the Virgin Mary.”
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Psychological Disorders
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Types of Schizophrenia
Conglomeration of
Dysfunctions

Flat affect

Inappropriate emotional responses



Incoherent speech




Shadow speech
T: “Why are you here?”
P: “I cannot fail to let him see that I am barren and wasted. The
Prime Minister is yelling, but I feel cold!” (Resembles some
aphasias).
Paranoid: Delusions or hallucinations
often include extreme suspiciousness and
hostility
Undifferentiated: Do not clearly fit into a

type
Mutism

Catatonic: Exhibit extremes in motor
behavior
Laugh at the horrible way dear mother died
Echolalia
Disorganized: Exhibit signs of illogical
thinking and speech

Reduced emotional responsiveness



May last from hours to years

Residual: Experienced prior episodes of
schizophrenia but are not currently
exhibiting symptoms
________________


(AKA Hebephrenic)
Inappropriate joy and silliness. May speak in
clang where word choices are based on
sound, not semantic meaning.


Catatonic


T: “How do you feel today?”
P: “Who can tell me the name of my song? I
don’t know but it won’t be long. It won’t be short,
tall, none at all. My head hurts, my knees hurt,
my nephew, his uncle, my aunt. My God I am
happy, not a care in the world. My hair’s been
curled, the flag’s unfurled. This is my country, the
land that I love!”

Paranoid

Delusions of __________________

Some evidence suggests that these
subjects may be more intelligent and have
a better prognosis compared to other
subtypes.
©2001 Prentice Hall
Movement disorder
___________catatonia – waxy flexibility,
mutism
__________catatonia – wild uncontrolled
behavior, pull sinks off walls, gouge out
eyes. Prior to modern drugs patients could
die of exhaustion following one wild
episode (strait jackets).
Undifferentiated

Lack of motivation for basic living, loss
of interest in life, avoidance of others,
lack of appetite, difficulty in completing
tasks, fatigue, increase sleeping, vague
nervousness.
14
Psychological Disorders
4/17/2009
Schizophrenic Disorders
Types of Schizophrenia
Positive Symptoms
Positive and Negative Symptoms




__________Symptoms include cognitive,
emotional, and behavioral excesses.
Examples of positive symptoms are
hallucinations, delusions, thought disorders,
and bizarre behaviors.
___________symptoms include cognitive,
emotional, and behavioral deficits.
Examples of negative symptoms are apathy,
flattened affect, social withdrawal, inattention,
and slowed speech or no speech.
Negative Symptoms



Drug treatments are most helpful in
reducing the expression of positive
symptoms. Recall the discussion of the
norepinephrine and dopamine
pathways, and a possible role in
schizophrenia.
Schizophrenia
Appear to be due to brain damage.
Apparent similarities between schizophrenia
and multiple sclerosis:

Infection early in life in a genetically susceptible
individual will cause brain damage from one’s own
immune system.




Higher rates for late winter births.
Higher rates for people living in crowded conditions.
Higher rates for individuals who spent their childhood in
northern climates.
Pattern of episodic attacks, followed by near complete
remissions, recurrent attacks, followed by partial
remissions, slow steady progression…
Theories of Schizophrenia
Genetic Relationships and
Schizophrenia

The risk of
developing
schizophrenia in
one’s lifetime
increases as the
genetic relatedness
with a diagnosed
schizophrenic
increases.
PRS

In schizophrenia _________ symptoms
are associated with neurotransmitter
imbalances, whereas _____________
symptoms are associated with brain
tissue loss.


A. Positive/negative
B. Negative/positive
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
©2001 Prentice Hall
15
Psychological Disorders
4/17/2009
I: Personality Disorders
Pseudopatients

1960’s 7 fake patients complained at the admissions
ward of hearing a voice saying “thud, empty, or
hollow”. Used fake names and did not reveal their
profession, but answered all other questions
correctly,
l and
d acted
d normally.
ll






6/7 diagnosed as schizophrenic
All were given drugs (flushed down toilet)
Saw a therapist 6.8 minutes per day
All took notes, and kept a diary (but it was regarded as part
of their illness)
Average length of hospitalization – 19 days (max 52)
Discharged – schizophrenia in remission (deception was
never detected)

Personality Disorders
disorders characterized by ________
and enduring
g behavior patterns
p
that
impair social functioning
usually without anxiety, depression, or
delusions


Subjects tend to see themselves as
__________________


Three clusters
Cluster 1

Characterized by odd eccentric
behaviors



Antisocial Personality Disorder



disorder in which the person (usually
man) exhibits a lack of __________ for
wrongdoing, even toward friends and
family members
may be aggressive and ruthless or a
clever con artist
©2001 Prentice Hall
Characterized by dramatic impulsive behavior

Paranoid – mistrustful of everyone
Schizoid – withdrawn, avoid intimacy
Schizotypal – cognitive distortions,
superstitious, wear strange clothing
Personality Disorders

Cluster 2



Borderline – huge mood swings, self destructive, unstable
interpersonal relationships (film: Fatal Attraction).
Histrionic – always on stage, need for attention, obsessed
with appearance.
appearance
Narcissistic – exaggerated self importance.
Antisocial – unconcerned about the safety & welfare of
others, deceitful, manipulative, lack of remorse, charming
con-artists. Most resistant to treatment, dangerous to self
and others, most likely to go to prison.
Personality Disorders

PET scans illustrate reduced activation
in a murderer’s frontal cortex
Normal
Murderer
16
Psychological Disorders
4/17/2009
Comorbidity of Disorders
Cluster 3

Characterized by ________ and anxious
behaviors.











Only 6 of these are used:
1. hypochondriasis
2. dissociative
3 comorbidity
3.
bd
4. compulsion(s)
5. obsession(s)
6. delusion(s)
7. hallucination(s)
8. phobia(s)
1. Strongly held beliefs that have no
basis in reality are called _____.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Chb 2009
Q3.
2. _____ disorders involve disruptions
in consciousness, memory, identity or
perception.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
©2001 Prentice Hall
The tendency for people diagnosed
with one mental disorder to exhibit
symptoms of other disorders as well
Q1

Q2.

Comorbidity

Avoidant – socially inhibited
Obsessive-compulsive – preoccupied with
order and perfectionism
Dependent – excess need to be cared for,
and to care for others
Cooperate Group Challenge



3. A _____ is an intense fear of an
object or a situation that’s greatly out of
proportion of its actual threat.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
17
Psychological Disorders
4/17/2009
Q4.

Q5.
4. Persistent ideas, thoughts, or
impulses that are unwanted and
inappropriate and cause distress are
called _____.

Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Political Correctness
& Mental Health
Q6.

6. An individual’s constant
preoccupation with the notion that he is
suffering from a serious disease is
called _____.
Could the April 16, 2007 Virginia Tech
Shootings have been prevented?
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Political Correctness
& Mental Health




5. One of the problems with DSM-IV is
the high degree of _____ among many
of its diagnoses.
Patient Rights
Privacy Act
Mainstreaming
Broadcast journalism and the public’s
right to know
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Patient Rights




Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
©2001 Prentice Hall
Patients cannot be _________ to seek treatment
without a court order.
A patient who elects to be treated cannot be kept in
an institution for more than 48 hours should theyy
choose to leave (unless a court order requires them
to remain for treatment).
The full spectrum of many disorders cannot be
detected within a 48 hour observation window.
Disorders are not stable over time, and assessments
conducted at different points in time will result in
different diagnoses (all of which are correct).
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
18
Psychological Disorders
4/17/2009
Mainstreaming
Privacy Act


A psychiatric evaluation obtained from a
voluntary admission __________ be sent to
the patient’s parents, work or institution, or
other
h agencies without
h
the
h patient’s
’
_______________.
Recently law suits have been pending at MIT
and Oregon Institute of Technology for
parents not being advised of their children’s
serious mental disorders.


The American with Disabilities Act gives
mentally ill students the _____ to be in
college. About __% of college students are
estimated to have serious mental health
issues. Drugs may help
h l them
h
cope, but
b they
h
may go off their drugs. It is politically correct
to promote the full social integration of
individuals who would have may have been
institutionalized or excluded from society in
previous generations.
This leads to both good and bad outcomes.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Broadcast journalism and the
public’s right to know


The media saturates the airways with images
of tragedy, and _______ fame appears to be
one of the goals for some perpetrators of
violence.
l
In the UK the public’s right to know is not
fulfilled until a case comes to trial. The
longer the delay between an event and its
reportage may tend to reduce the motivation
to perpetrate violence.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Cho Seung-Hui

Alienation:


Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Cho Seung-Hui

Sense of injustice and inequality:

“Your Mercedes wasn’t enough, you brats.
golden necklaces weren’t enough,
g ,
Your g
you snobs….You had everything.”
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
©2001 Prentice Hall
“You have vandalized my heart, raped my
soul and torched myy conscience”.
71% of school shooters felt “bullied,
persecuted or injured by others”.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Cho Seung-Hui

Belief that the problem is not
within one’s self, but due to
failures of society:

“You had a hundred billion chances and
ways to avoid today, but you have decided
to spill my blood. You forced me into a
corner and gave me only one option. The
decision was yours. Now you have blood
on your hands that will never wash off.”
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
19
Psychological Disorders
4/17/2009
Cho Seung-Hui

Media attention and a quest for power
are prime motivations:



Calls Eric and Dylan, the Columbine High
perpetrators “martyrs”
martyrs .
“Thanks to you, I die like Jesus Christ, to inspire
generations of the weak and defenseless
people.”
Media attention is the social conduit that allows
the perpetrators of violence to imagine a kinship
with other “martyrs”. The act may reduce their
sense of alienation.
Media Sensationalism and
Provocation of Unstable Viewers



Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Cho Seung-Hui


December 14, 2005 a psychiatric
evaluation concluded that Cho’s “affect
is flat… He denies suicidal ideations. He
does not acknowledge symptoms of a
thought disorder. His insight and
judgment are normal.”
He was approved for outpatient
treatment.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
©2001 Prentice Hall
University of Colorado student arrested for
expressing the idea that you can’t really
blame the VT gunman for killing 32 students
(intimidated classmates).
classmates)
Lewis & Clark University student detained for
wearing an ammunition belt to a VT vigil.
Media sensationalism masquerades as
responsible broadcast journalism, it tends to
disrespect the victims and fulfills the power
and fame motive of the perpetrator.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
Cho Seung-Hui

Unless an individual makes an ______
threat to himself or others, the privacy
act and patient right statues prevent an
institution from taking any action. You
can recommend counseling, but those
afflicted with personality disorders are
convinced that there is nothing wrong
with them, and tend to resist treatment.
Psychology, 4/e by Saul Kassin
©2004 Prentice Hall
20