S UMMER AT THE A CADEMY
Introduction to Psychology
Days 11 & 12: Psychological Disorders
Ms. Mary-Liz Fuhrman

TOPICS
 Perspectives
 Anxiety Disorders
 Mood Disorders
 Schizophrenia
 Personality Disorders
 Rates of Psych. Disorders

W HAT DO YOU KNOW ?
 What Psychological disorders do you know?
 Why do you think it is important to study and understand these disorders?
 Why do we tend to be fascinated by psychological disorders?

“T
O STUDY THE ABNORMAL IS THE BEST WAY
OF UNDERSTANDING THE NORMAL
”- W
ILLIAM
J AMES
 Common Disorders:
 Depression
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Obsessive-Compulsive Disorder
Schizophrenia
ADD/ADHD
 Our curiosity:
 We exhibit some of characteristics at different points – we relate to some of these disorders
 450 million people suffer from psychological disorders

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS
Questions To Be Considered…
 How should we define psychological disorders?
 How should we understand disorders?
 Sicknesses to be cured or reactions to environment?
 How should we classify disorders? How do we help people without adding labels?

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS D EFINING P SYCHOLOGICAL
D ISORDERS
 Psychological Disorder: deviant, distressful, and dysfunctional behavior patterns
 Persistently harmful thoughts, feelings, and actions
 Q: What is deviant behavior?
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Standards for deviance vary by culture and context
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What are our standards for behavior in the US? How might these be different in other countries?
Vary over time
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Homosexuality
 What are some common diagnoses today that may be controversial?

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS D EFINING P SYCHOLOGICAL
D ISORDERS C ONT
’
D
 Distress
 Problematic, stressful, worrisome
 Dysfunctional
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When thoughts and behaviors interfere in daily activities
KEY in defining disorders

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS U NDERSTANDING
P SYCHOLOGICAL D ISORDERS
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Medical Model
1800’s
 Diseases have physical causes that can be diagnosed, treated and cured.
 Diagnosed based on symptoms and treated with therapy
 Hospitalization
 Depression &
Schizophrenia
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Biopsychosocial
Approach
Nature and nurture
Cultural Influences
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Depression and
Schizophrenia are found worldwide
Anorexia Nervosa is western
Different causes of anxiety in different cultures
Takes into account
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Biological: genetics, evolution
Psychological: stress, mood
Social-Cultural: roles, expectations

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS C LASSIFYING P SYCHOLOGICAL
D ISORDERS
 Classification based on symptoms
 Diagnostic classification describes and predicts
 DSM-IV: the APA Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)
 Pros and Cons of Diagnosing
 -Pro: $$ insurance -Con: illness = stigma
 Describes various disorders and prevalence
 Offers standards, consistency, and organization for subjective symptoms

P ERSPECTIVES ON P SYCHOLOGICAL
D ISORDERS L ABELING P SYCHOLOGICAL
D ISORDERS
 Labels affect how we perceive people
 Normal v. Different
 Movies/Media
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Accurate: A Beautiful Mind
“Freaks”- Silence of the Lambs
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Changes “reality”
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Students are “slow”
Someone is “hostile”

ANXIETY DISORDERS
 What are some anxiety provoking situations?
 What is anxiety?
 A feeling of apprehension, often characterized by feelings of stress. (WebMD)
 Anxiety Disorder: psychological disorder characterized by distressing, persistent, anxiety or maladaptive behaviors that reduce anxiety

ANXIETY DISORDERS
G ENERALIZED A NXIETY D ISORDER
 Person is continually tense, apprehensive, and in a state of autonomic nervous system arousal
 Symptoms are common; persistence is key in diagnosing
 Symptoms: dizziness, heart palpitations, sweating, edgy, shaky
 2/3 women
 Tense, jittery, worried, sleepless
 Twitching, sweating, trembling, fidgeting
 Concentration is difficult
 Hard to find one cause
 Often linked with depression

ANXIETY DISORDERS
P ANIC D ISORDER
 Disorder marked by unpredictable minutes-long episodes (attacks) of intense dread n which a person experiences terror and accompanying chest pain, choking, or other frightening sensations
 1 in 75 people
 Panic Attacks affect social interactions and daily life
 Withdrawal and avoidance of social situations/ interactions that cause attacks

ANXIETY DISORDERS
P HOBIAS
 Persistent, irrational fear and avoidance of a specific object, activity, or situation
 Disrupts behavior and daily life
 Social Phobia
 Common Phobias:
 Being alone -storms -water -height
 close spaces -flying -blood -animals

ANXIETY DISORDERS
O BSESSIVE -C OMPULSIVE D ISORDER
 Unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
 Interfere with everyday life and cause distress
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Check to see if the door is closed- normal
Checking the door 10 times everyday- abnormal
 Late teens, early twenties

ANXIETY DISORDERS
O BSESSIVE -C OMPULSIVE D ISORDER :
C OMMON O BSESSIONS AND C OMPULSIONS
 Obsessions
 Dirt, germs, toxins
 Fire, death, illness
 Compulsions
 Excessive handwashing, bathing, tooth-brushing, or grooming
 Repeating rituals
 Symmetry, order, or exactness
 Checking doors, locks, appliances, homework

ANXIETY DISORDERS
P OST - T RAUMATIC S TRESS D ISORDER
 Haunting memories, nightmares, social withdrawal, anxiety, and/or insomnia that lingers for 4 weeks+ after a traumatic experience
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Veterans
Accident and Disaster Survivors
Sexual Assault Victims
 Trauma: direct exposure to serious threats
 Controversial

ANXIETY DISORDERS
E XPLAINING A NXIETY D ISORDERS
 Anxiety includes feelings and thoughts
 Freud said we repress these feelings from childhood
 Two contemporary Perspectives
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Learning Perspective
Biological Perspective

ANXIETY DISORDERS
E XPLAINING A NXIETY D ISORDERS : L EARNING
P ERSPECTIVE
 Fear Conditioning
 Classical conditioning —associate anxiety with certain cues
 People, places, environments
 Stimulus Generalization
 Fear heights —begin to fear flying
 Reinforcement maintains
 Observational Learning
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Observing others’ fears
 If your mom is afraid of heights, you may also develop that fear

ANXIETY DISORDERS
E XPLAINING A NXIETY D ISORDERS : B IOLOGICAL
P ERSPECTIVE
 Natural Selection
 Fears faced by our ancestors —way to protect ourselves
 What do we learn NOT to fear?
 Genes
 Temperament: sensitive, high strung
 Family esp. twins
 Brain
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Over arousal of brain areas for impulse control
Fear-learning experiences can traumatize the brain

D ISSOCIATION AND M ULTIPLE P ERSONALITIES
 Dissociative Disorders: conscious awareness becomes seperated from previous memories, thoughts, and feelings
 Stressful situations —dissociate self from them
 Dissociative Identity Disorder: person exhibits 2 or more distinct and alternating personalities
 A.k.a. multiple personality disorder
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Is this a more exaggerated version of our ability to vary ourselves? Are we playing roles?
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Support: Brain and body states; memories fail to transfer
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Skeptics: only few cases reported before 1960 when it was first noted in the DSM; less in North America —cultural phenomenon
 Seen as a way to cope w/ anxiety and protect selves
 WHAT DO YOU THINK?

TREATMENT OPTIONS (ADAA)
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Behavior Therapy
The goal of Behavior Therapy is to modify and gain control over unwanted behavior. The individual learns to cope with difficult situations, often through controlled exposure to them. This kind of therapy gives the individual a sense of having control over their life.
Cognitive Therapy
The goal of Cognitive Therapy is to change unproductive or harmful thought patterns. The individual examines his feelings and learns to separate realistic from unrealistic thoughts. As with Behavior Therapy, the individual is actively involved in his own recovery and has a sense of control.
Cognitive-Behavior Therapy (CBT)
Many therapists use a combination of Cognitive and Behavior Therapies, this is often referred to as CBT. One of the benefits of these types therapies is that the patient learns recovery skills that are useful for a lifetime.
Relaxation Techniques
Relaxation Techniques help individuals develop the ability to more effectively cope with the stresses that contribute to anxiety, as well as with some of the physical symptoms of anxiety. The techniques taught include breathing re-training and exercise.
Medication
Medication can be very useful in the treatment of anxiety disorders, and it is often used in conjunction with one or more of the therapies mentioned above.
Sometimes anti-depressants or anxiolytics (anti-anxiety medications) are used to alleviate severe symptoms so that other forms of therapy can go forward.
Medication is effective for many people and can be either a short-term or long-term treatment option, depending on the individual.

T AKING S IDES :
I SSUE 11: D OES ADHD E XIST ?
 What is ADHD? Why is it so controversial?
 Class Survey: Does ADHD Exist?
 Questions
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3) Medication v. Other treatments?
4) Side effects for medications; pros & cons

 YES
 Scientists and scholars agree that it exists
 Neuro-imaging studies show brain irregularities
 Meets scientific criteria for valid psychological disorder
 Twin studies —heritable
 NO
 No stable definition
 Neuro-imaging studies do not adequately show that it is a biochemical disorder
 Prevalence is due to unrealistic cultural expectations
 Heritability is debatable

W HAT DO THESE FAMOUS NAMES HAVE IN
COMMON ?
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Walt Whitman
Ernest Hemingway
Ludwig von Beethoven
Kurt Cobain
Isaac Newton
Edgar Allen Poe
Vincent Van Gough
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Kurt Vonnegut
Billy Joel
Brooke Shields
Jim Carrey
Abraham Lincoln
Rodney Dangerfield
Tim Burton

MOOD DISORDERS
 What is mood?
 relatively lasting emotional or affective state
 What are mood disorders?
 Mood Disorders: psychological disorders characterized by emotional extremes
 2 Principal forms:
 1) Major Depressive Disorder
 2) Bipolar Disorder

MOOD DISORDERS
M AJOR D EPRESSIVE D ISORDER
 What are some common symptoms of depression?
 Discouraged, dissatisfied, isolated, lethargic, changes in sleeping and eating patterns, suicidal thoughts
 What are some common causes of depression?
 Academic successes/failures, social stresses, relationships, family stressors
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Depression is the “common cold” of psychological disorders
 #1 reason people seek psychological help

MOOD DISORDERS
M AJOR D EPRESSIVE D ISORDER ( CONT
’
D )
 Anxiety is a response to the threat of the future loss; Depression is a response to the past and current loss.
 Q: When do these responses become maladaptive?
 Major Depressive Disorder: a mood disorder in which a person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities.
 Grasping for breath for a few minutes after a run v. chronic short breath

MOOD DISORDERS
B IPOLAR D ISORDER
 Major depression usually ends and people often return back to previous state…sometimes, they rebound with the opposite emotional extreme
 Mania: mood disorder marked by a hyperactive, wildly optimistic state
 Alternating between mania and depression signals
Bipolar disorder
 Formerly known as Manic-Depressive Disorder
 Manic Phase: talkative, overactive, elated, little sleep
 Maladaptive Symptoms: grandiose optimism and selfesteem
 Less common than Major Depression
 Affects men and women equally
 Mild forms of bipolar may fuel creativity

MOOD DISORDERS
B IPOLAR D ISORDER ( CONT
’
D )
 Mild forms of bipolar may fuel creativity
 Walt Whitman
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Ernest Hemingway
Ludwig von Beethoven
Kurt Cobain
Isaac Newton
Edgar Allen Poe
Vincent Van Gough
Kurt Vonnegut

MOOD DISORDERS
E XPLAINING M OOD D ISORDERS
 Theories of depression must explain:
 Behavioral and cognitive changes accompany depression
 Depression is widespread
 Women are nearly twice as vulnerable to major depression
 Most major depressive episodes self-terminate
 Stressful events related to work, marriage, and close relationships often precede depression
 The rate of depression is increasing and striking earlier with each generation

G ENDER AND D EPRESSION : W ORLDWIDE
Why are females consistently more depressed?

MOOD DISORDERS
T HE B IOLOGICAL P ERSPECTIVE
 Genetic predispositions, biochemical imbalances, negative thoughts, and melancholy mood
 GENETIC INFLUENCES
 Increase in vulnerability if parent/sibling is diagnosed
 Adopted children with mood disorders have biological links
 Genes alone have small effects – when they combine with other genes and nongenetic factors risk rises
 DEPRESSED BRAIN
 Norepinephrine and Serotonin- scarce in depression
 Omega-3 fatty acids low- support brain and mental health

MOOD DISORDERS
T HE S OCIAL -C OGNITIVE P ERSPECTIVE
 Self-defeating beliefs and negative explanatory style feed cycle of depression
 Negative Thoughts and Negative Moods Interact
 Self-defeating beliefs – learned helplessness
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“I’ll never be able to do this”
 Who do we blame?
 Blame self: depressed
 Blame others: anger

MOOD DISORDERS
T HE S OCIAL -C OGNITIVE P ERSPECTIVE
E XPLANATORY STYLE AND DEPRESSION : R OMANTIC
B REAK -U P
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Stable
“I’ll never get over this”
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Temporary
“This is tough but I’ll get through this”
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Global
“Without him, I can’t do anything”
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Specific
“I miss him but I still have my friends and family”
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Internal
“It’s all my fault”
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External
“Yes I made mistakes, but so did he and it was not working”
 RESULT: Depression
 RESULT: Successful
Coping

MOOD DISORDERS
T HE S OCIAL -C OGNITIVE P ERSPECTIVE
E XPLANATORY STYLE AND DEPRESSION :
_____________
 Stable  Temporary
 Global
 Specific
 External
 Internal
 RESULT: Depression
 RESULT: Successful
Coping

Stressful Events Negative Explanatory Style
Cognitive and Behavioral
Changes
Depressed Mood

S CHIZOPHRENIA
 1 in 100 people suffer from Schizophrenia
 Who is likely to develop it?
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Adolescents into young adulthood
No cultural influences
Equal for males and females
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Men develop earlier, more severely, more often
 Schizophrenia : group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate actions and emotions.
 “Split Mind”—Split from reality

S CHIZOPHRENIA
S
S
Disorganized Thinking
 Delusions : false beliefs that may accompany psychotic disorders
 Often of grandeur or persecution * Paranoid tendencies are more prone
 Possibly due to a breakdown in selective attention/sensory processing
Disturbed Perceptions
 hallucinations
Inappropriate Emotions and Actions
 Angry for no reason; laughing at sad events
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Flat affect: “zombie”
 Behaviors: senseless and compulsive
 Catatonia : motionless for hours

S CHIZOPHRENIA
S
S
Cluster of disorders that share common features but distinguishing symptoms :
 Positive Symptoms : hallucinations, talk is disorganized and deluded, inappropriate laughter, tears, or rage
 Negative Symptoms : toneless voices, expressionless faces, mute or rigid bodies
 Positive symptoms = inappropriate behaviors
 Negative Symptoms = absence of behaviors

S CHIZOPHRENIA
T YPES OF S CHIZOPHRENIA
Chronic or Process Schizophrenia
 Develops slowly, gradually, from a long history of social inadequacy
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Exhibit negative symptom of withdrawal
Recovery is unlikely
Acute or Reactive Schizophrenia
 Develops quickly, as a reaction to stress
 Recovery is likely
-Men more often exhibit negative symptoms and chronic schizophrenia
-Outlook is better for those with positive symptoms — reactive condition responds to drug therapy

S CHIZOPHRENIA
5 S UBTYPES OF S CHIZOPHRENIA
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Paranoid
Preoccupation with delusions or hallucinations, often with themes of persecution or grandiosity
Disorganized
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Disorganized speech or behavior or flat or inappropriate emotion
Catatonic
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Immobility, extreme negativism, and/or parrot-like repetition of another’s speech or movements
Undifferentiated
 many and varied symptoms
Residual
 withdrawal, after hallucinations and delusions have disappeared

S CHIZOPHRENIA
U
S
Brain Abnormalities
 Dopamine overactivity – high levels may increase positive symptoms
 Drugs to decrease dopamine
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Little effect on negative symptoms
Abnormal Brain Activity and Anatomy
 Frontal lobes (reasoning and problem solving)
 Decline in brain waves
 Fluid-filled areas and shrinking cerebral tissue
 Possibly due to problems in prenatal development and/or delivery

S CHIZOPHRENIA
U
S
Psychological Factors
 Environmental causes
 Warning Signs
 Mother with severe and long-lasting schizophrenia
 Birth complications
 Separation from parents
 Short attention span and poor muscle coordination
 Disruptive/withdrawn behavior
 Emotional unpredictability
 Poor peer relations and solo play
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 Some maladaptive behavior patterns impair people’s social functioning without anxiety, depression, or delusions
REMEMBER…
(Personality: Enduring pattern of thinking, feeling and acting)
 Personality Disorders : characterized by inflexible and enduring behavior patterns that impair social functioning
 Grouped into 3 Clusters in the DSM-IV

PERSONALITY DISORDERS: C LUSTERS

PERSONALITY DISORDERS: C LUSTERS
Cluster B- Dramatic/Erratic Cluster
Antisocial
Borderline Personality Disorder
Unstable identity, unstable relationships, unstable or impulsive emotions; unstable sense of self
Histrionic
Dramatic or impulsive behaviors; use features of physical appearance to draw attention to selves
(clothes, makeup, hair color)
Narcissistic Personality Disorder
Self-focused, exaggerating own importance and success; require constant attention and excessive admiration

PERSONALITY DISORDERS: C LUSTERS
Cluster C- Anxious/Fearful Cluster
Avoidant
Anxiety, fearful sensitivity to rejection and criticism causing withdrawal
Dependent
Lacking self-confidence and sense of autonomy; view selves as weak; passive and agreeable
Obsessive-Compulsive
Perfectionist, preoccupied with details, rules, schedules, etc.; pay attention to details so much that they may never finish a project

A
P
D
Antisocial Personality Disorder : person exhibits a lack of conscience for wrong doing, even toward friends and family. May be aggressive and ruthless or a clever con artist
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Formerly called sociopath or psychopath
Usually males
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Often begins before age 15
Stealing, fighting, displays unrestrained sexual behaviors
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 Jobs, relationships (spouse and parent), assaultive or otherwise criminal

A
P
D
Antisocial Personality Disorder and Criminals
 Most criminals do not fit the description
 Many show responsibility and remorse for their actions
(concern for family and friends)
 Antisocial Personalities feel and fear little, express little regret over violating others’ rights

PERSONALITY DISORDERS
U NDERSTANDING A NTISOCIAL P ERSONALITY
D ISORDER
 Biological and psychological
 Relatives of those w/ antisocial tendencies are at an increased risk for antisocial behavior
 Reduced activity in the Frontal Lobes
 Antisocial behavior has been detected as early as ages 3-6
 Boys who become aggressive or antisocial adolescents may have been impulsive, uninhibited, low in anxiety as young children
 Environment/Society
 1960s to 1990s

R
P
D
How prevalent are the various disorders? Who is most vulnerable to them? At what times of life?
 1 in 7 Americans
 Britain: 1 in 6
 Australia: 1 in 6 to 1 in 7
 World Health Organization study in 2004
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Lowest Rate: Shanghai
Highest Rate: United States
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When people immigrate to the US their mental health declines over time

P ERCENTAGE OF A MERICANS WHO HAVE EXPERIENCED SELECTED
PSYCHOLOGICAL DISORDERS IN THE PRIOR YEAR
(U.S. N ATIONAL I NSTITUTE OF M ENTAL H EALTH IN 2002)
Disorder
Alcohol Abuse
Generalized Anxiety
Phobias
OCD
Mood Disorder
Schizophrenia
Antisocial Personality
Percentage
5.2
4.0
7.8
2.1
5.1
1.0
1.5

R ATES OF P SYCHOLOGICAL D ISORDERS
 Predictor: Poverty
 Does poverty cause disorders or do disorders cause poverty?
 Varies with disorder
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Schizophrenia leads to poverty
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Stress and demoralization of poverty can cause depression and substance abuse
 Risk Factors and Protective Factors
 Usually experience by early adulthood (by age 24)
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Antisocial personality (age 8) and phobias (age 10) are among the earliest to appear
Alcohol Abuse, OCD, Bipolar, and Schizophrenia by age 20

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RISK AND PROTECTIVE FACTORS FOR MENTAL DISORDERS
Academic Failure
Birth Complications
Caring for chronically ill patients
Child abuse/neglect
Chronic insomnia
Chronic pain
Family disorganization/conflict
Low Birth Weight
Low Socioeconomic Status
Medical Illness
Neurochemical Imbalance
Parental Mental Illness
Parental Substance abuse
Personal loss/bereavement
Poor work skills and habits
Reading disabilities
Sensory Disabilities
Social incompetence
Stressful life events
Substance Abuse
Trauma experiences
• Aerobic Exercise
• Community offering empowerment, opportunity, and security
• Economic independence
• Feelings of security
• Feelings of master and control
• Good parenting
• Literacy
• Positive attachment and early bonding
• Problem-solving skills
• Resilient coping with stress and adversity
• Self-esteem
• Social and work skills
• Social support from family and friends