For your initial post this week, answer the questions below either through a 2-paragraph summary (3-5 sentences minimum each paragraph), or you can simply number your responses. ?Don’t

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Psychological Disorders

Tiffany Daniels, M.S.

Here’s Johnny!

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• This chapter is essentially the “Abnormal Psychology” sampler platter for General Psychology classes.

• If you enjoy this material, I highly recommend taking a full Abnormal Psychology course, where you can learn much more about psychopathology in much more depth and detail.

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Abnormal Behavior • Psychologists consider abnormal

behavior that which is: • Deviant (atypical or unexpected) • Dysfunctional (maladaptive) • Distressful (person doesn’t desire it) • Dangerous (at risk of self-harm or

harming others) • Over a long period of time.

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But, A Word of Caution! • It is important to note that much of what any

given society considers to be normal and abnormal is quite arbitrary, meaning that behaviors are not inherently good or bad until society deems them so.

• Examples: Smoking, Illicit Drug Use, Prostitution, etc…

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Theoretical Approaches to Psychological Disorders

• Medical model – views psychological disorders as medical diseases with a biological origin (individuals with disorders are patients to be treated by doctors)

• This is the reason why many of the terms have phrases like illness, disorder, & pathology in them.

• According to this view, psychological disorders may be caused by brain abnormalities, neurotransmitter imbalances, or disordered genes.

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Prior to the Medical Model….

• Before the Medical Model of Abnormal Behavior was developed, prevailing Zeitgeists (a German word for “Spirit of the Times”) believed that abnormal behaviors were often due to demonic possession, witchcraft, or God’s wrath.

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Theoretical Approaches to Psychological Disorders

• Psychological Approach • Includes the psychodynamic, behavioral/social,

trait, cognitive, and humanistic perspectives which view psychological disorders as being caused by either unconscious conflicts that produce anxiety, rewards and punishments in the environment, abnormal variations of personality traits, maladaptive thought processes, and the inability to achieve one’s full potential, respectively.

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Theoretical Approaches to Psychological Disorders

• Sociocultural Approach • Emphasizes social contexts that may

contribute to the development of psychological disorders (an individual’s home life, socioeconomic status, gender, ethnicity, culture)

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Theoretical Approaches to Psychological Disorders

• Biopsychosocial Model

• Interactionist approach

• Looks at biological, social, and psychological factors that contribute to the development of psychological disorders.

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Problems with Classifying Abnormal Behavior

• Can lead to labeling, stigma (shame) & even discrimination.

• Remember the self-fulfilling prophecy. If someone has expectations of feeling depressed because they have been labeled depressed by a doctor, are they more likely to be depressed? YES!

• On the other hand, having a label for how we are feeling can provide some comfort. “Oh I’m feeling this way because I have depression. Whew! I’m not going crazy after all!”

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The DSM-5

• DSM-5 – the classification manual for psychological disorders first developed by the American Psychiatric Association in 1952 (has since been revised 4 times, the latest edition came out in May 2013).

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The DSM-5 • The DSM-5 is much improved over earlier editions. • It is not perfect, but is better than nothing.

• Please note that the DSM is not impervious to societal pressures and labels of what is or is not a disorder.

• For example, homosexuality was considered a mental disorder in the DSM-II, which was used as recently as 1973. Some disorders were not included in earlier editions due to lack of clinical or research support.

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This lecture will provide a brief overview of the following:

• Neurodevelopmental disorders • Schizophrenia • Depressive Disorders • Bipolar & Related Disorders • Trauma-and-Stressor-Related Disorders • Anxiety Disorders • Obsessive-Compulsive & Related Disorders • Dissociative Disorders • Personality Disorders

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Neurodevelopmental Disorders

• Most commonly first diagnosed in childhood • Includes autism spectrum disorder, ADHD,

specific learning disorder, intellectual disability • Associated with atypical brain development,

genetic differences, and/or prenatal exposure to teratogens

• More on these disorders if you take Developmental Psych, Abnormal Psych, or both!

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Schizophrenia • A severe psychological

disorder that is characterized by highly disordered thought processes, referred to as psychotic because they are so far removed from reality.

• Unlike its portrayal in Jim Carey’s movie Me, Myself, and Irene (2000) Schizophrenia does NOT involve multiple personalities.

Although you may chuckle at the shirt below, it is actually very UNACCURATE.

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Schizophrenia

• A better example of schizophrenia can be found by watching A Beautiful Mind (2001) starring Russell Crowe as “John Nash.”

• This was also based on a true story.

• Schizophrenia involves the split of one personality from reality (not multiple personalities)

• About 1.1% of American adults have schizophrenia in a given year.

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Schizophrenia

• May include delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior (catatonia), and negative symptoms (they are not showing symptoms that “normal” people have)

• Examples of negative symptoms: flat affect, avolition (reduced motivation), alogia (reduced speech), anhedonia (reduced pleasure), asociality

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Schizophrenia

• Potential causes: genetic predisposition, brain structure abnormalities, neurotransmitter imbalances, stress (often due to poverty), poor relationships with others/family, lack of social support

• Diathesis-stress model – views the disorder as being caused by a combination of biogenetic disposition and stress

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Schizophrenia

• In the U.S. approximately 600,000 individuals are classified as homeless (sadly). Approximately 200,000 of them suffer from schizophrenia. Question: Does schizophrenia act as a catalyst for homelessness or does homelessness contribute to the development of schizophrenia??

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Schizophrenia in the movies

• http://www.youtube.com/watch?v=eb46yXP211 w

• http://www.youtube.com/watch?v=GvF4-C1EuJU • http://www.youtube.com/watch?v=ymzHr_Uvp7

w Anderson Cooper: https://www.youtube.com/watch?v=yL9UJVtgPZY

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Depressive Disorders

• Common feature of the depressive disorders is a sad, empty, or irritable mood, accompanied by somatic (body) and cognitive changes that significantly affect the individual’s capacity to function.

• Includes: Major Depressive Disorder, Persistent Depressive Disorder, Premenstrual Dysphoric Disorder, and others

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Major Depressive Disorder

• Major Depressive Disorder – mood disorder characterized by a major depressive episode and depressed characteristics, such as lethargy and hopelessness, lasting at least 2 weeks.

Uma Thurman and Larry King are 2 celebrities who have experienced depression

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Major Depressive Disorder • Major depressive episode must include at

least 5 of the 9 symptoms: 1) Depressed mood most of the day 2) Reduced pleasure in activities 3) Significant weight loss or gain 4) Sleep disturbances 5) Agitation 6) Fatigue/loss of energy 7) Feeling worthless 8) Problems thinking, focusing, or making decision 9) Preoccupation with death/suicide

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Persistent Depressive Disorder (Dysthymia)

• PDD – depressive disorder that is generally more chronic and has fewer symptoms than major depressive disorder.

• To be diagnosed with PDD, the individual must not have experienced a major depressive episode and have been in a depressed mood for at least 2 years (in children or adolescents, minimum 1 year).

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PMDD, cont…

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Bipolar & Related Disorders

• These disorders involve mood swings that include one or more episodes of mania (an overexcited, unrealistically optimistic state) and depression

• Manic episodes are like the opposite of depressive episodes.

• Includes: Bipolar I, Bipolar II, and others

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Manic Episode • Distinct period of abnormally and

persistently elevated, expansive or irritable mood lasting at least 1 week

• Three or more of the following are present: • Inflated self-esteem or grandiosity • Decreased need for sleep • More talkative than usual • Flight of ideas • Distractibility • Increase in goal-directed activity • Excessive involvement in risky activities

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Bipolar I Disorder • Individuals with bipolar disorder often

engage in risky behaviors during manic episodes. It’s like they feel that nothing can harm them and that they are on top of the world.

• Manic individuals lack sleep due to their highly aroused state, have been known to spend large sums of money in shopping sprees, jump off buildings because they feel invincible, you get the point…

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Bipolar I vs. Bipolar II • Bipolar I – Involves the presence of a manic

episode which may have been preceded or followed by hypomanic or major depressive episodes

• Hypomanic episodes are shorter in duration and cause less impairment in social & occupational functioning.

• Bipolar II – individuals are cycling between hypomanic and major depressive episodes (full manic episodes not present)

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Depressive Disorders & Bipolar Disorder

• Potential causes: • Genetics • Underactive areas in

the brain (depression) • Overactive areas in

the brain (mania) • Problems with

regulation of neurotransmitters

• Hormone fluctuation problems

• Inadequate social relationships

• Catastrophic thinking • Poor coping styles • Learned helplessness • Pessimistic thinking • Low socioeconomic

status • Stress • Poor social support

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Depressive Disorders & Bipolar Disorder

• Unfortunately, depressive & bipolar disorders are often linked with suicide attempts.

• Suicide is one of the leading causes of death in this country. Due to time constraints, we will not be covering suicide here.

• Please read in the text about what to do and what not to do if somebody you know is threatening to commit suicide.

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Trauma and Stressor-Related Disorders

• Includes acute stress disorder, adjustment disorder and others…

• For the sake of time, we will be focusing on Post-Traumatic Stress Disorder (PTSD)

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Post-Traumatic Stress Disorder (PTSD)

• PTSD – develops through exposure to a traumatic event, severely oppressive situations, severe abuse, and natural/unnatural disasters.

• About 3.5% of American adults suffer from PTSD • Symptoms include: flashbacks, reduced ability to

feel certain emotions (such as joy), excessive agitation, lack of focus, memory loss, anxiety, and more…

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PTSD • Individuals more

likely to develop PTSD: war veterans, sexual abuse and assault victims, victims of natural and unnatural disasters (Hurricane Katrina, the Holocaust, 9/11, the Japan earthquake/tsunami)

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Anxiety Disorders • Anxiety Disorders – Psychological disorders

that feature persistent, excessive fear (emotional response to real or perceived imminent threat) and anxiety (anticipation of future threat)

• Often involves muscle tension, vigilance, panic attacks

• Includes: Generalized Anxiety Disorder, Panic Disorder, Specific Phobia, and others…

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Generalized Anxiety Disorder • Generalized Anxiety Disorder (GAD) is an

anxiety disorder that consists of persistent anxiety for at least 6 months; the individual cannot specify the reasons for the anxiety

• Approximately 3% of American adults experience GAD in any given year

Potential causes: genetic predisposition, neurotransmitter GABA deficiency, respiratory abnormalities, history of traumas

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Panic Disorder • Panic Disorder – an anxiety disorder marked

by recurrent sudden onsets of intense apprehension or terror (panic attacks).

• Can occur with or without agoraphobia (cluster of fears centered on public places and on an inability to escape or to find help should one become incapacitated)

• Famous people who have suffered from panic disorder: Darwin, Kim Basinger, NFL running back Earl Campbell

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Panic Disorder • About 2.7% of American adults suffer

from panic disorder in any given year

• Potential causes: hyperactive Autonomic Nervous System, hormonal factors, neurotransmitter problems, and a profound fear of fear.

• The movie CopyCat (1995) is a great example of an individual who has panic disorder with agoraphobia.

Edvard Munch’s “The Scream”(1893)

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Specific Phobia

• Specific Phobia (“phobic disorder”) – an anxiety disorder in which the individual has an irrational, overwhelming, persistent fear of a particular object or situation.

• These phobias are disruptive, uncontrollable, and the individual will go to great lengths to avoid their fear.

• About 8.7% of Americans can be diagnosed with a specific phobia in any given year.

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Specific Phobia

Five main types of specific phobia:

– Animal (dog, cat, snake, spider)

– Environmental Type (Tornado, Lightning)

– Situational-Type (tight spaces, bridges, tunnels)

– Blood-Injection-Injury Type (needles, blood)

– Other (clowns, choking, vomiting, loud noises)

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Specific Phobia • Name that Phobia: • Arachnophobia? • Hydrophobia? • Nyctophobia? • Thanatophobia? • Cynophobia? • Gamophobia? • Chianophobia? • Paraskavedekatriaphobia? • Arachibutyrophobia? • **Sidenote: None of these are on the exam

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Specific Phobia • Name that Phobia: • Arachnophobia? Fear of spiders • Hydrophobia? Fear of water • Nyctophobia? Fear of darkness • Thanatophobia? Fear of death • Cynophobia? Fear of dogs • Gamophobia? Fear of marriage • Chionophobia? Fear of snow • Paraskavedekatriaphobia? Fear of Friday the 13th • Arachibutyrophobia? Fear of peanut butter sticking

to the roof of your mouth

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Specific Phobia

• Potential causes: genetics, learned associations, evolution, etc…

“Bob Wiley” in What About Bob? (1991) had numerous fears to overcome. “Baby steps! Baby steps!”

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Obsessive-Compulsive and Related Disorders

• Includes OCD, body dysmorphic disorder, trichotillomania (hair-pulling disorder), excoriation (skin-picking disorder), hoarding disorder

• For the sake of time, we will focus on OCD

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Obsessive-Compulsive Disorder (OCD)

• Obsessive-Compulsive Disorder – individual has anxiety-provoking thoughts that will not go away (obsessions) and/or urges to perform repetitive, ritualistic behaviors to prevent or produce some future situation (compulsions)

• About 1% of adults have OCD in any given year

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OCD • Remember: Obsessions are thoughts (i.e.,

worrying), and compulsions are actions usually initiated to relieve the anxiety caused by those thoughts.

• Compulsions often involve the “three C’s:” Counting, Cleaning, Checking

• Causes of OCD: genetics, overactivity in certain parts of the brain, serotonin depletion, extreme life stress

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OCD • Celebrities with OCD include Marc

Summers, Lena Dunham, David Sedaris, Howie Mandel, and Howard Stern.

• http://www.youtube.com/watch?v=0Y 8EyIY-_I0

• http://www.youtube.com/watch?v=B wj5wy3NlOs

• http://www.youtube.com/watch?v=0s 6fTrSnoIw

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Dissociative Disorders

• Dissociative Disorders – psychological disorders that involve a sudden loss of memory or change in identity

• Includes: Dissociative amnesia with or without fugue, and dissociative identity disorder (DID), and others

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Dissociative amnesia with or without fugue

• Dissociative amnesia – dissociative disorder involving extreme memory loss caused by extensive psychological stress (a psychogenic amnesia as opposed to organic amnesia, which is cause by brain damage/injury).

• The individual may also unexpectedly travels away from home (called fugue) and assumes a new identity

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Dissociative amnesia with or without fugue

• Just as suddenly, they can return home and resume their former lives as if nothing happened.

• It is rare, but cases of dissociative amnesia with or without fugue have been reported

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Dissociative Identity Disorder

• Dissociative Identity Disorder – formerly called multiple personality disorder, this is the most dramatic but LEAST common dissociative disorders

• Individuals with D.I.D. have two or more distinct personalities or selves.

• Note: D.I.D. is NOT schizophrenia!!!!!!

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Common Types of Alters • Persecutor – These alters inflict pain or

punishment on the other personalities by engaging in self-mutilating behaviors, such as self-cutting or suicide attempts.

• Helper – These types offer advice to other personalities or provide functions the host personality is unable to perform.

• Child – Most common type of alter; likely created following childhood traumatic event as a means to cope with it

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Dissociative Identity Disorder

• In DID, one personality tends to dominate at a time, while the other stays dormant.

• People DID often claim to have amnesia for events that occur while other alters are in control.

• Potential causes: high rates of traumatic physical/sexual abuse in childhood, genetics

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Dissociative Identity Disorder

• The TV movie Sybil (1976) stars Sally Field and is another example of Dissociative Identity Disorder.

• **Movie is based on a true story.

• Current controversy as to whether or not Sybil was a hoax.

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Personality Disorders

• Chronic, maladaptive cognitive- behavioral patterns that are thoroughly integrated into the individual’s personality

• Grouped into 3 clusters: odd/eccentric (Cluster A), dramatic/emotionally problematic (Cluster B), chronic- fearfulness/avoidant (Cluster C)

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Odd/Eccentric • Includes the paranoid, schizoid, and

schizotypal disorders • Paranoid Personality Disorder:

individuals lack trust, and are suspicious of others (Adolf Hitler)

• Schizoid Personality Disorder: individuals form inadequate social relationships, withdraw from others, may be described as “cold” (Willy Wonka, Squidward)

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Odd/Eccentric

• Schizotypal Personality Disorder: often show odd thinking patterns that reflect eccentric beliefs, overt hostility **Not as bizarre in their thinking as individuals with schizophrenia (Willy Wonka, Doc Brown)

• Many professionals are starting to view schizophrenia on a continuum, with Schizotypal being a mild form of schizophrenia (“schizophrenia light,” if you will)

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Dramatic/Emotionally Problematic • Includes: histrionic, narcissistic, borderline and

antisocial personality disorders • Histrionic Personality Disorder: “Drama

Queens” seek lots of attention and overreact in situations (ex: Michael Scott)

• Narcissistic Personality Disorder: Unrealistic sense of self-importance, extreme love for self, do not take criticism well, lack empathy for others, manipulating to get what they want (ex: Jenna & Tracy on 30 Rock, Walter White/Heisenberg)

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Dramatic/Emotionally Problematic

• Borderline Personality Disorder: emotionally unstable, impulsive, irritable, unstable sense of self, anxious (Bella Swan in Twilight New Moon, The Cable Guy, Glenn Close in Fatal Attraction, Single White Female, Girl Interrupted, Ali Larter in “Obsessed”)

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Dramatic/Emotionally Problematic • To be diagnosed with Borderline Personality

Disorder, 5 or more of these symptoms must be present:

• Frantic efforts to avoid being abandoned • Unstable/intense interpersonal relationships • Markedly and persistently unstable self-image or sense of self • Impulsivity in at least 2 areas that are potentially self-damaging

(spending $, sex, substance abuse, reckless driving, binge eating) • Recurrent suicidal behavior • Unstable/extreme emotional responses • Chronic feelings of emptiness • Inappropriate, intense anger/problems controlling anger • Temporary stress-related paranoia or severe dissociative symptoms

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Dramatic/Emotionally Problematic

• Antisocial Personality Disorder: law- breaking, guiltless individuals who are exploitive, self-indulgent, intrusive (ex: The Joker, The Grinch, politicians, CEOs, Wall Street?)

• Please note that antisocial and asocial are two different words. So if your friend is staying at home and won’t meet you at the club, are they antisocial or asocial??

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Dramatic/Emotionally Problematic • Antisocial personality disorder DSM-5 diagnostic

criteria include: • Failure to conform to social norms or obey the law • Deceitfulness, lying, using aliases, conning others for personal

gain • Impulsivity • Irritability, aggressiveness, getting into fights, perpetrating assaults • Reckless disregard for safety of self or others • Consistent irresponsibility • Lack of remorse for others

• Psychopaths are a subgroup of individuals with ASPD who engage in violence to get what they want (includes serial killers such as Ted Bundy, John Wayne Gacy)

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Side note: Do you know the difference between a psychopath

and a sociopath? • Generally, they are used interchangeably.

Most agree that a combination of factors underlie antisocial behavior. Those using the diagnosis of “psychopath”may be leaning towards genetic (hereditary) explanations for the behavior, whereas those using the phrase “sociopath” are leaning towards environmental explanations of the behavior.

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Chronic-Fearfulness/Avoidant

• Includes the avoidant, dependent, and obsessive- compulsive personality disorders

• Avoidant Personality Disorder: individuals are extremely shy and inhibited around others, even though they want relationships, are often sensitive to rejection and have low self-esteems (Michael Jackson?)

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Chronic-Fearfulness/Avoidant

• Dependent Personality Disorder: individuals lack self-confidence, do not express their own opinions, rather they take on the opinions of their partners/friends, cling to stronger personalities who they may allow to walk all over them (ex: , Buster Bluth from Arrested Development, Julia Roberts’ character in “Runaway Bride” and maybe Taylor Swift????)

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Chronic-Fearfulness/Avoidant

• Obsessive-Compulsive Personality Disorder: obsessed with perfectionism, are often rigid, stubborn, and have extremely high standards for oneself and others (ex: your psych professor!)

• They are fixated on having things done the “right way”

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Obsessive-Compulsive Personality Disorder

• Often, their preoccupation with

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