Dissociative Disorders Conscious awareness becomes separated (dissociated) from painful previous memories, thoughts, and feelings. Symptoms 1. Having a sense of being unreal. 2. Being separated from the body. 3. Watching yourself as if in a movie. Dissociative Identity Disorder (DID) A disorder in which a person exhibits two or more distinct and alternating personalities, formerly called multiple personality disorder. Chris Sizemore (DID) DID Critics • Between 1930 to 1960 the diagnosis was only 2 percent • Since it made it to DSM in 1980’s the reported cases has jumped to 20,000 • Number of personalities mushroomed from 3 to 12 per patient • This disorder is unknown in Japan and India DID Critics Critics’ Arguments 1. Role-playing by people open to a therapist’s suggestion. 2. Learned response that reinforces reductions in anxiety. Personality Disorders Personality disorders are characterized by inflexible and enduring behavior patterns that impair social functioning. They are usually without anxiety, depression, or delusions. Antisocial Personality Disorder A disorder in which the person (usually men) exhibits a lack of conscience for wrongdoing, even toward friends and family members. Formerly, this person was called a sociopath or psychopath The pattern normally begins in late childhood ½ children who show the pattern become sociopaths, unable to keep a job, irresponsible, and assaultive, or criminal. Understanding Antisocial Personality Disorder Like mood disorders and schizophrenia, antisocial personality disorder has biological and psychological reasons. Youngsters, before committing a crime, respond with lower levels of stress hormones than others do at their age. Understanding Antisocial Personality Disorder PET scans of 41 murderers revealed reduced activity in the frontal lobes. In a follow-up study, repeat offenders had 11% less frontal lobe activity (Raine et al., 1999; 2000). Courtesy of Adrian Raine, University of Southern California Normal Murderer Mood Disorders Emotional extremes of mood disorders come in two principal forms. 1. Major depressive disorder 2. Bipolar disorder Major Depressive Disorder Depression is the “common cold” of psychological disorders. In a year, 5.8% of men and 9.5% of women report depression worldwide (WHO, 2002). Blue mood Major Depressive Disorder Gasping for air after a hard run Chronic shortness of breath Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. 1. 2. 3. 4. Signs include: Lethargy and fatigue Feelings of worthlessness Loss of interest in family & friends Loss of interest in activities Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Depressive Symptoms Manic Symptoms Gloomy Elation Withdrawn Euphoria Inability to make decisions Tired Slowness of thought Desire for action Hyperactive Multiple ideas Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Earl Theissen/ Hulton Getty Pictures Library The Granger Collection Wolfe George C. Beresford/ Hulton Getty Pictures Library Bettmann/ Corbis Whitman Clemens Hemingway Theory of Depression Depression is prevalent worldwide Gender differences Depression is increasing, especially in the teens. Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). PET scans show that brain energy consumption rises and falls with manic and depressive episodes. The Depressed Brain •Neurotransmitters: • Norepineprine: Smoke releases norepinehrine • Serotonine •Drugs block the reuptake, or the chemical breakdown of these two neurotransmitters •Jogging has the same effect •Deep brain stimulation Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles. Negative Thoughts and Moods Explanatory style plays a major role in becoming depressed. Depression Cycle 1. Negative stressful events. 2. Pessimistic explanatory style. 3. Hopeless depressed state. 4. These hamper the way the individual thinks and acts, fueling personal rejection. 5. Break the cycle by moving to a different environment, reversing our self blame, turning our attention outward, or engage in more pleasant and rewarding activities Schizophrenia The literal translation is “split mind” which refers to a split from reality. A group of severe disorders characterized by the following: 1. Disorganized and delusional thinking. 2. Disturbed perceptions. 3. Inappropriate emotions and actions. Symptoms of Schizophrenia Positive symptoms: the presence of inappropriate behaviors (hallucinations, disorganized or delusional talking) Negative symptoms: the absence of appropriate behaviors (expressionless faces, rigid bodies) Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” (Sheehan, 1982) Other forms of delusions delusions of This monologue illustratesinclude, fragmented, bizarre persecution is following me”) or thinking with (“someone distorted beliefs called delusions grandeur (“I am a king”). (“I’m Mary Poppins”). Disturbed Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory. L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign Inappropriate Emotions & Actions A schizophrenic person may laugh at the news of someone dying or show no emotion at all (flat affect). Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia). Onset and Development of Schizophrenia Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease (WHO, 2002). Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women. Chronic and Acute Schizophrenia When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms. When schizophrenia rapidly develops (acute/reactive) recovery is better. Such schizophrenics usually show positive symptoms. Understanding Schizophrenia Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Drugs that blocks dopamine receptors help with symptoms Drugs that increase dopamine level (amphetamines, cocaine) increase the symptoms Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 2001). 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated