Psychopathology and
the Brain
Schizophrenia
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Comes from Greek words meaning
“split” and “mind”
People with schizophrenia do NOT
have split personalities
“split mind” refers to the fact that
people with schizophrenia are split off
from reality and can’t distinguish what
is real from what is not real
Demographics
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One of the most common mental
illnesses
Affects 1 % of the population
Men show first signs in early 20’s while
women in late 20’s
US spends $32.5 billion per year
Symptoms
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“psychosis” – psychotic element; state
in which people cannot tell what is real
and what is not
Delusions – bizarre, false beliefs;
paranoia, grandiosity
Hallucinations – unreal perceptions of
environment; auditory, visual,
olfactory, tactile
More Symptoms
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Disorganized Thinking/Speech
Negative Symptoms – the absence of
normal behavior
Catatonia – immobility and “waxy
flexibility”
Types of Schizophrenia
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Disorganized Schizophrenia
Catatonic Schizophrenia
Paranoid Schizophrenia
Brain and Schizophrenia
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Larger than normal lateral ventricles – part of
the ventricular system; contain cerebrospinal
fluid
Causes of Schizophrenia:
Genetics
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Twin studies have shown that tendency for
both monozygotic twins to develop
schizophrenia is between 30 to 50%; the
tendency for dizygotic twins and siblings to
develop schizophrenia is 15%
Adoption Studies – 13% of biological
relatives of adoptees with schizophrenia had
the disease, but only 2% of biological
relatives of normal adoptees had
schizophrenia
Causes of Schizophrenia:
Environment
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Family Stress
Poor social interactions
Infections or viruses at an early age
Trauma at an early age
Genetic makeup combines with nongenetic factors to cause schizophrenia
Causes of Schizophrenia:
Neurotransmitters
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Dopamine Theory – schizophrenia
caused by an overactive dopamine
system in the brain; dopamine is a
neurotransmitter that allows nerve
cells in the brain to send messages to
each other; dopamine imbalance may
affect the way a person’s brain can
react to stimuli
Many drugs for schizophrenia block
dopamine receptors
Schizophrenia:
Medication
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Antipsychotic medications – drugs do
not cure disease, but reduce
symptoms
Some drugs have Parkinson’s Diseaselike side effects
Counseling also helps
Bipolar Disorder
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Characterized by changes in mood,
behavior, and energy levels
Affects approximately 1.2% of the
population
First episode often occurs in
adolescence and can be triggered by a
traumatic event; some people are
symptom-free in between episodes
Symptoms: Mania phase
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Abnormally elevated mood
Inflated self-esteem
Reduced need for sleep
Excessive talkativeness
Racing thoughts
Distractibility
Activities done to excess
Pursuit of risky behavior or activities
Symptoms: Depression
Phase
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Mania can quickly and without warning
change to depression/sadness
Loss of interest
Changes in appetite – weight gain/loss
Changes in sleep patterns
Agitation
Loss of energy
Trouble concentrating/thinking
Repeated thoughts of suicide/death
Accompanying Symptoms
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Psychosis
Delusions
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Bipolar Disorder and the
Brain
Examination of brain tissue after people with BD have died
Brain imaging
New theory – mitochondrial malfunction
Mitochondria – vital organelle for energy production
2000 – Kato, University of Tokyo – based on abnormal brain
energy metabolism in bipolar patients measured by brain
scans and mitochondrial depletion in autopsied bipolar
brains; searched for mutant mitochondrial DNA – two suspect
genes
March 2004, Archives of General Psychiatry, Christine Konradi
- Harvard and McLean Hospital - studied brain tissue in
hippocampus and found expression of genes that coded for
mitochondrial proteins in bipolar patients decreased
Famous People with BD
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Abraham Lincoln and Theodore
Roosevelt
George Handel, Robert Schumann,
Ludwig van Beethoven
Leo Tolstoy, Virginia Woolf, Ernest
Hemingway, Charles Dickens
Sir Isaac Newton
Patty Duke, Linda Hamilton, JeanClaude van Damme
Multiple Personality
Disorder
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Presence of two or more distinct
identities, each with its own unique,
and enduring way of relating to the
world or self
At least two of these identities
recurrently take control of the person’s
behavior
An inability to recall important
personal information to an extent that
History of MPD
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Virtually unknown 30 years ago –
became more common about 10 years
ago
Why?
W. S. Taylor and Mabel Martin in 1944
– fewer than 100 documented cases
1985 to 1995 – abuot 40,000 new
cases
Why More Common?
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previously not diagnosed
does mind choose pathology from
options presented by culture?
was called something different in the
past – came in form of dead relative
possession in 19th century European
culture
Causes
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Childhood trauma – usually sexual
abuse before age 5
Experts believe alter arises to protect
person from overwhelming memories
and protect secrets from outsiders
Case Study: Eve
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Thigpen and Cleckley, 1953
Rooted from traumatic events
witnessed growing up in South during
Depression
Eve White – wife and mother; Eve
Black – party girl; Jane – mature
intellectual
Total of 22 personalities
Case Study: Sybil
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True name – Shirley Mason
Set the standard for MPD as a
syndrome rooted in child abuse
16 separate personalities all
having unique talents and
characteristics, such as piano
playing or having British
accent; some were male
Dr. Wilbur – Freudian
psychologist
1998 – several publications
exposed Sybil case as scam
Dr. Herbert Spiegel - only
multiple personality in
psychoanalytic setting; just
extremely suggestible hysteric
To ensure the book deal, Sybil
had to be multiple; Dr. Wilbur’s
archives will be opened in
2005…
MPD in Court
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Billy Mulligan – accused of robberies and rapes at
OSU; by the time faced trial, 10 of 23 personalities
surfaced; one with British accent, one could write
fluent in Arabic, one was 16, one was 8…
Juanita Maxwell – bludgeoned elderly woman to
death with a lamp but had no memory of crime;
went to trial and violent alter came out
Critics say that vast majority of patients
misdiagnosed, faked, or unconsciously created by
clinician who makes diagnosis
Problem: when evidence overwhelming against
defendant, only way attorney can mitigate sentence
is insanity defense
Often very hard to identify whether truly have
disorder
Resources
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http://www.mcmanweb.com
http://www.crimelibrary.com/criminal_
mind/psychology/multiples
http://faculty.washington.edu/chudler/
neurok.html