Chapter

Psychologi
15
cal
Disorders

PowerPoint

Presentation
by Jim Foley
2013 Worth Publishers

What well seek to

understand...
What does it mean to have a
mental disorder?
Defining and classifying disorders
Anxiety disorders, including OCD
and PTSD
Mood disorders, including
depression and bipolar disorder
Schizophrenia
Sample of other disorders:
Dissociative disorders
Eating disorders
Personality disorders
Rates, vulnerability, and
protective factors

Why Learn about Psychological

Disorders?
Reasons for curiosity:
personal familiarity with
psychological symptoms
knowing someone else with the
disorder
hearing about how prevalent
and socially devastating some
disorders have become in
society
wanting to learn more about
mental health and human nature

Perspectives on Psychological
Disorders
Defining
psychological
disorders
Thinking critically
about ADHD
Understanding
psychological
disorders
Classifying
psychological
disorders
Labeling
psychological
disorders
Insanity and
responsibility

Questions to Keep in Mind

How do we decide when a set
of symptoms are severe
enough to be called a
disorder that needs
treatment?
Can we define specific
disorders clearly enough so
that we can know that were
all referring to the same
behavior/mental state?
Can we use our diagnostic
labels to guide treatment
rather than to stigmatize
people?

Psychological disorders
are:
patterns of thoughts, feelings, or
actions that are deviant,
distressful, and dysfunctional.

Terms from the Definition

Disorder refers to a state of
mental/behavioral ill health.
Patterns refers to finding a collection
of symptoms that tend to go together,
and not just seeing a single
symptom.
For there to be distress and
dysfunction, symptoms must be
sufficiently severe to interfere with
ones daily life and well being.
Deviant means differing from the
norm.

Deviant?
To deviate, in general,
means to vary from
what typically would
happen.
In psychology, a
behavior or mental
state is considered
deviant by a culture
when it is different from
what would be expected
in that culture.
A disorder may also be
a deviation from a
typical developmental
pathway.

Defining Deviance:
The Role of Context
and Culture

Context: whether a
behavior varies from
expectation depends on the
situation in which the
behavior occurs Yelling for
hours is not deviant when it
happens at a football game.
Culture: these painted
faces might seem deviant
when viewed from a
different culture

Is Attention-Deficit/
Hyperactivity Disorder
(ADHD)
a disorder?
Is it deviant? Do some people have a level of
inattentiveness, impulsiveness, or restlessness
that goes beyond laziness or immaturity?
Is it distressful? Is the person enjoying being
energetic, or are they frustrated that they cant
sustain focus?
Is there dysfunction? Are the symptoms
harmless fun, or do they negatively impact
work and relationships?

Understanding the Nature

of Psychological Disorders
One reason to diagnose a disorder is to
make decisions about treating the
problem.
To treat a disorder, it helps to understand
the nature/cause of the psychological
symptoms.
Based on older
understanding of
psychological disorders,
treatments have included:
exorcising evil spirits,
beatings, caging/restraint,
and

Pinels New
Approach

Philippe Pinel (1745-1826) and others sought to

reform brutal treatment by promoting a new
understanding of the nature of mental disorders.
Pinel proposed that mental disorders were not
caused by demonic possession, but by
environmental factors such as stress and
inhumane conditions.
Pinels moral treatment involved improving the
environment and replacing the asylum beatings
with patient dances.

From the humane

view to the
scientific view of
the mentally ill:
Pinels humane
environmental
interventions
improved lives but
often did not
effectively treat
mental illness
But
then

The
Medical
Model

The discovery that the

disease of syphilis causes
mental symptoms (by
infecting the brain)
suggested a medical
model for mental illness.

Psychological disorders can be seen

as psychopathology, an illness of
the mind.
Disorders can be diagnosed, labeled
as a collection of symptoms that
tend to go together.
People with disorders can be treated,
attended to, given therapy, all with a
goal of restoring mental health.

The Biopsychosocial
Approach

Mental disorders can arise in the

interaction between nature and
nurture caused by biology,
thoughts, and the sociocultural
environment.

Cultural Influences on
Disorders
Culture-bound syndromes
are disorders which only
seem to exist within certain
cultures; they demonstrate
how culture can play a role
in both causing and
defining a disorder.
Examples:
Bulimia Nervosa: binging/purging, in the United
States
Running amok: violent outbursts, in Malaysia
Hikikomori: social withdrawal, in Japan

Classifying Psychological
Disorders
Why create classifications of mental
illness? What is the value of talking about
diagnoses instead of just talking about
individuals?
1.Diagnoses create a verbal shorthand for
referring to a list of associated symptoms.
2.Diagnoses allow us to statistically study
many similar cases, learning to predict
outcomes.
3.Diagnoses can guide treatment choices.

The Diagnostic
and Statistical
Manual
Its easier to count
cases of autism if
we have a clear
definition.
Versions: DSM-IVTR, DSM-V (May
2013)
The DSM is used
to justify payment
for treatment.
Its consistent with
diagnoses used by
medical doctors
worldwide.

The Five Axes of

Diagnosis

Categories
of
Diagnoses

Critiques of Diagnosing
with the DSM
1. The DSM calls too many people
disordered.
2. The border between diagnoses, or
between disorder and normal,
seems arbitrary.
3. Decisions about what is a disorder
seem to include value judgments;
is depression necessarily deviant?
4. Diagnostic labels direct how we
view and interpret the world,
telling us which behavior and mental
states to see as disordered.

Stigma and Stereotypes

Many people think a diagnostic
label means being seen as
tainted, weak, and weird.
Because of this, many
psychologists believe we should
use extreme caution in
diagnosing and labeling.
However:
these negative views/stigma
come from popular cultural views
of mental illness, and not from
the DSM. [Does a diabetes
diagnosis create stigma? No.
Bipolar diagnosis? Yes.]
the DSM may contain the
information to correct inaccurate
perceptions of mental illness.

Insanity and Responsibility

Jared Loughner shot many people,
including a U.S. Representative, in
2011.
Loughner had schizophrenia and
substance abuse problems, a
combination associated with increased
violence.

To what degree, if
any, should he be
held responsible for
his actions?
What is the
appropriate
consequence?

Anxiety Disorders

GAD:
Generalized
Anxiety
Emotional-cognitive
Disorder
symptoms include

worrying, having anxious

feelings and thoughts about
many subjects, and
sometimes free-floating
anxiety with no attachment
to any subject. Anxious
anticipation interferes with
concentration.
Physical symptoms
include autonomic arousal,
trembling, sweating,
fidgeting, agitation, and
sleep disruption.

Panic
Disorder:
Im
Dying
A panic attack is not just an

anxiety attack. It may include:

many minutes of intense dread
or terror.
chest pains, choking,
numbness, or other frightening
physical sensations. Patients
may feel certain that its a heart
attack.
a feeling of a need to escape.
Panic disorder refers to
repeated and unexpected panic
attacks, as well as a fear of the
next attack, and a change in
behavior to avoid panic attacks.

Specific
Phobia
A specific phobia is more

than just a strong fear or

dislike. A specific phobia is
diagnosed when there is an
uncontrollable, irrational,
intense desire to avoid
the some object or
situation. Even an image of
the object can trigger a
reaction--GET IT AWAY
FROM ME!!!--the
uncontrollable, irrational,
intense desire to avoid
the object of the phobia.

Some Fears and Phobias

What trends are evident
here? Which varies more,
fear or phobias? What does
this imply?

Some Other Phobias

Agoraphobia is the
avoidance of situations
in which one will fear
having a panic attack,
especially a situation in
which it is difficult to
get help, and from
which it difficult to

Social phobia refers to an

intense fear of being
watched and judged by
others. It is visible as a fear
of public appearances in
which embarrassment or
humiliation is possible, such
as public speaking, eating, or

Obsessive-Compulsive
[OCD]
ObsessionsDisorder
are intense,
unwanted worries, ideas, and
images that repeatedly pop up in
the mind.
A compulsion is a repeatedly
strong feeling of needing to
carry out an action, even though
it doesnt feel like it makes
sense.
When is it a disorder?
Distress: when you are deeply
frustrated with not being able
to control the behaviors
or
Dysfunction: when the time
and mental energy spent on
these thoughts and behaviors
interfere with everyday life

Common OCD Behaviors

Percentage of children and adolescents with
OCD reporting these obsessions or compulsions:

Common pattern: RECHECKING

Although you know that youve
already made sure the door is
locked, you feel you must check
again. And again.

Post-Traumatic
Stress
Disorder
[PTSD]
About 10 to 35 percent
of people who
experience trauma not
only have burned-in
memories, but also four
weeks
to aintrusive
lifetime of:
repeated
recall of those
memories.
nightmares and other
re-experiencing.
social withdrawal or
phobic avoidance.
jumpy anxiety or
hypervigilance.

Which People get

PTSD?
Those with less control in the

situation
Those traumatized more
frequently
Those with brain differences
Those who have less resiliency
Those who get re-traumatized

Resilience and
Post-Traumatic
Growth
Resilience/recove
ry after trauma
may include:
some lingering,
but not
overwhelming,
stress.
finding strengths
in yourself.
finding
connection with
others.
finding hope.
seeing the
trauma as a
challenge that
can be overcome.

Understanding Anxiety
Disorders: Explanations from
Different Perspectives
Psychodyna
mic/
Freudian:
repressed
impulses

Classical
conditioning
:
overgeneralizi
ng a
conditioned
response

Operant
conditioning
: rewarding
avoidance

Observation
al learning:
worrying like
mom

Cognitive
appraisals:
uncertainty is
danger

Evolutionary
: surviving by
avoiding
danger

Understanding Anxiety
Disorders:
Freudian/Psychodynamic
Perspective
Sigmund Freud
felt

that anxiety stems

from repressed
childhood impulses,
socially inappropriate
desires, and
emotional conflicts.
We repress/bury
these issues in the
unconscious mind,
but they still come
up, as anxiety.

Classical
Conditioning
Anxiety
Inand
the experiment
by John

B. Watson and Rosalie

Rayner in 1920, Little
Albert learned to feel fear
around a rabbit because
he had been conditioned
to associate the bunny
with a loud scary noise.
Sometimes, such a
conditioned response
becomes
overgeneralized. We may
begin to fear all animals,
everything fluffy, and any
location where we had
seen those, or even fear
that those items could
appear soon along with
the noise.

Operant
Conditioning
and
Anxiety
We
may feel
anxious in a

situation and make a

decision to leave. This
makes us feel better and
our anxious avoidance
was just reinforced.
If we know we have
locked a door but feel
anxious and compelled to
re-check, rechecking will
help us temporarily feel
better.
The result is an increase
in anxious thoughts and
behaviors.

Observation
al Learning
and Anxiety
Experiments with
humans and monkeys
show that anxiety can
be acquired through
observational
learning. If you see
someone else avoiding
or fearing some object
or creature, you might
pick up that fear and
adopt it even after the
original scared person is
not around.
In this way, fears get
passed down in families.

Cognition
and Anxiety

Cognition includes worried

thoughts, as well as
interpretations, appraisals,
beliefs, predictions, and
ruminations.
Cognition includes mental
habits such as
hypervigilance
(persistently watching out
for danger). This
accompanies anxiety in
PTSD.
In anxiety disorders,
such cognitions appear
repeatedly and make
anxiety worse.

Examples of Cognitions
that can Worsen Anxiety:
Cognitive errors, such as believing
that we can predict that bad events
will happen
Irrational beliefs, such as bad
things dont happen to good people,
so if I was hurt, I must be bad
Mistaken appraisals, such as
seeing aches as diseases, noises as
dangers, and strangers as threats
Misinterpretations of facial
expressions and actions of others,
such as thinking theyre talking
about me

Biology and Anxiety:

An Evolutionary
Perspective
1. Human phobic
2. Similar but non-

objects: phobic objects:

Snakes Fish
Heights Low places
Closed spaces Open spaces
Bright
light
3. Dangerous Darkness
yet non-phobic
subjects:

We are likely to become cautious about, but not phobic

about:
Guns
Electric wiring
Cars

Evolutionary psychologists believe that

ancestors prone to fear the items on list
#1 were less likely to die before
reproducing.
There has not been time for the innate

Biology and Anxiety:

GenesGenes
and

Neurotransmitters

Studies show that

identical twins, even
raised separately,
develop similar
phobias (more similar
than two unrelated
people).
Some people seem to
have an inborn highstrung temperament,
while others are more
easygoing.
Temperament may be
encoded in our genes.

Genes regulate levels of

neurotransmitters.
People with anxiety have
problems with a gene
associated with levels of
serotonin, a
neurotransmitter involved
in regulating sleep and
mood.
People with anxiety also
have a gene that triggers
high levels of glutamate,
an excitatory
neurotransmitter involved
in the brains alarm
centers.

Biology and Anxiety: The

Brain
Traumatic
experiences can
burn fear circuits
into the amygdala;
these circuits are
later triggered and
activated.
Anxiety disorders
include
overarousal of
brain areas
involved in impulse
control and
habitual behaviors.

The OCD brain shows

extra activity in the ACC,
which monitors our
actions and checks for
ACC = anterior cingulate gyrus
errors.

Mood Disorders
Major depressive disorder
[MDD] is:
more than just feeling
down.
more than just feeling
sad about something.
Bipolar disorder is:
more than mood swings.
depression plus the
problematic overly up
mood called mania.

Criteria of Major Depressive

Disorders
Major depressive
disorder is not just one of these
symptoms.
It is one or both of the first two, PLUS three or more
of the rest.
Depressed mood most of the day, and/or
Markedly diminished interest or pleasure in
activities
Significant increase or decrease in appetite or
weight
Insomnia, sleeping too much, or disrupted sleep
Lethargy, or physical agitation
Fatigue or loss of energy nearly every day
Worthlessness, or excessive/inappropriate guilt
Daily problems in thinking, concentrating, and/or
making decisions
Recurring thoughts of death and suicide

Major Depression:
Not Just a Depressive
Reaction
Some people make an

unfair criticism of
themselves or others
with major depression:
There is nothing to be
depressed about.
If someone with asthma
has an attack, do we say,
what do you have to be
gasping about?
It is bad enough to have
MDD that persists even
under good
circumstances. Dont add
criticism by implying the
depression is an
exaggerated response.

Depression is Everywhere
Depression shows up in
people seeking treatment:
Phobias are the most
common (frequently
experienced) disorder, but
depression is the #1 reason
people seek mental health
services.
Depression appears
worldwide:
Per year, depressive
episodes happen to about 6
percent of men and about 9
percent of women.
Over the course of a lifetime,
12 percent of Canadians and
17 percent of Americans
experience depression.

Depression: The Common

Cold of Disorders?
Although both are common
(occurring frequently and
pervasively), comparing depression
to a cold doesnt work.
Depression:
is more dangerous because of
suicide risk.
has fewer observable symptoms.
is more lasting than a cold, and is
less likely to go away just with time.
is much less contagious.
Anddepressive pain is beyond
sniffles.

Seasonal Affective Disorder

[SAD]

Seasonal affective disorder is more than

simply disliking winter.
Seasonal affective disorder involves a recurring
seasonal pattern of depression, usually during
winters short, dark, cold days.
Survey: Have you cried today? Result: More
people answer yes in winter.

Percentage who cried

Men

Women

August

December

21

Bipolar Disorder
Bipolar disorder was once called
manic-depressive disorder.
Bipolar disorders two polar
opposite moods are depression
and mania.

Mania refers to a
period of hyperelevated mood that is
euphoric, giddy, easily
irritated, hyperactive,
impulsive, overly
optimistic, and even
Contrasting Symptoms
grandiose.
Depressed mood: stuck
Mania: euphoric, giddy,

feeling down, with:

exaggerated pessimism
social withdrawal
lack of felt pleasure
inactivity and no
initiative
difficulty focusing
fatigue and excessive
desire to sleep

easily irritated, with:

exaggerated optimism
hypersociality and
sexuality
delight in everything
impulsivity and
overactivity
racing thoughts; the
mind wont settle down
little desire for sleep

Bipolar Disorder and

Creative
Success
Many famous
and successful
people have lived

with the ups and downs of bipolar disorder.

Some speculate that the depressive periods
gave them ideas, and the manic episodes gave
them creative energy. Any evidence of mood
swings here?

Bipolar Disorder in Children

and Adolescents
Does bipolar disorder
show up before
adulthood, and even
before puberty?
Many young people
have cycles from
depression to
extended rage rather
than mania.
The DSM-V may have
a new diagnosis for
these kids: disruptive
mood dysregulation
disorder.

Understanding Mood
Disorders
Why are mood disorders so
pervasive, and more common
among the young, and
especially among women?

Why Does Depression

Have so Many
Symptoms?

Understanding Mood
Disorders
Can we explain

why does depression often

go away on its own?
the course/development
of reactive depression?
Often, time heals a mood
disorder, especially when
the mood issue is in
reaction to a stressful
event. However, a
significant proportion of
people with major
depressive disorder do not
automatically or easily get
better with time.

Suicide and Self-Injury

Every year, 1 million people commit
suicide, giving up on the process of trying
to cope and improve their emotional wellbeing.
This can happen when people feel
frustrated, trapped, isolated, ineffective,
and see no end to these feelings.
Non-suicidal self-injury has other
functions such as sending a message, or
self-punishment.

Understanding Mood
Disorders
Biological
aspects and
explanations

Social-cognitive
aspects and
explanations

Evolutionary
Genetic
Brain /Body

Negative thoughts
and negative mood
Explanatory style
The vicious cycle

An Evolutionary
Perspective on the Biology
Depression, in its milder,
ofnon-disordered
Depression
form, may
have had survival value.
Under stress, depression is
social-emotional
hibernation. It allows
humans to:
conserve energy.
avoid conflicts and other
risks.
let go of unattainable
goals.
take time to contemplate.

Biology of Depression:
Genetics

Evidence of genetic influence on depression:

1.DNA linkage analysis reveals depressed
gene regions
2.twin/adoption heritability studies

Biology of Depression: The

Brain
Brain activity is diminished in depression and increased in
mania.
Brain structure: smaller frontal lobes in depression and
fewer axons in bipolar disorder
Brain cell communication (neurotransmitters):
more norepinephrine (arousing) in mania, less in
depression
reduced serotonin in depression

Preventing or Reducing
Depression:

Using Knowledge of the Biology of

Depression
1. Adjust
neurotransmitters
with medication.
2. Increase
serotonin levels
with exercise.
3. Reduce brain
inflammation with
a healthy diet
(especially olive
and fish oils).
4. Prevent excessive
alcohol use .

Understanding Mood
Disorders: The SocialCognitive
Perspective
Discounting positive

Low SelfEsteem

information and
assuming the worst
about self, situation,
and the future

Depression is
associated
with:
Ruminatio
n

Learned
Helpless
ness

Depressi
ve
Explanat
ory Style

Stuck focusing on
whats bad

Self-defeating
beliefs such as
assuming that
one (self) is
unable to
cope,
improve,
achieve, or be
happy

Depressive Explanatory
Style
How we analyze bad
news predicts mood.
Problematic
event:
Assumptions
about the
problem
The problem
is:
The problem
is:
The problem
is:
Mood/result
that goes along
with these

Depressions Vicious
Cycle
A depressed mood
may develop when a

person with a negative outlook experiences

repeated stress.
The
depressed
mood
changes a
persons
style of
thinking and
interacting in
a way that
makes
stressful
experience
more likely.

the mind is split from

reality, e.g. a split from
Schizophrenia:
ones own thoughts so
that they appear as
hallucinations.
Psychosis
refers to a
mental split
Schizophrenia
from reality
symptoms
and
include:
rationality.
disorganized
and/or
delusional
thinking.
disturbed
perceptions.
inappropriate
emotions and
actions.

Positive and Negative

Symptoms of
Positive
Negativ
Schizophrenia
+
epresence
of
problema
tic
behaviors

Hallucinations
(illusory
perceptions),
especially auditory
Delusions (illusory
beliefs), especially
persecutory
Disorganized
thought and
nonsensical speech

absence
of
healthy
behaviors

Flat affect (no

emotion showing in
the face)
Reduced social
interaction
Anhedonia (no
feeling of
enjoyment)
Avolition (less
motivation,

Schizophrenia Symptoms:

Problems in Thinking and

Disorganized speech, including
Speaking
the word salad of loosely
?!?!
associated phrases
Delusions (illusory beliefs), often
bizarre and not just mistaken;
most common are delusions of
grandeur and of persecution
Problems with selective
attention, difficulty filtering
thoughts and choosing which
thoughts to believe and to say
out loud

?!?!

Schizophrenia Symptoms:

Disturbed Perceptions
People with schizophrenia often experience
hallucinations, that is, perceptual
experiences not shared by others.
The most common form of hallucination is
hearing voices that no one else hears,
often with upsetting (e.g. shaming) content.
Hallucinations can also be visual,
olfactory/smells, tactile/touch, or
gustatory/taste.

Am I
evil?

Youre
evil!

Schizophrenia Symptoms:

Inappropriate Emotions
Odd and socially
inappropriate responses
such as looking bored or
amused while hearing of a
death
Flat affect: facial/body
expression is flat with no
visible emotional content
Impaired perception of
emotions, including not
reading others
intentions and feelings

Schizophrenia Symptoms:

Inappropriate
Odd and socially inappropriate
Actions/Behavior
behavior can be caused by

symptoms such as:

errors in social perception.
disorganized, unfiltered thinking.
delusions and hallucinations.
The schizophrenic body exhibits
symptoms such as:
repetitive behaviors such as
rocking and rubbing.
catatonia, such as sitting
motionless and unresponsive for
hours.

Onset and
Development
of
Schizophreni
a

Onset: Typically, schizophrenic

symptoms appear at the end of
adolescence and in early adulthood, later
for women than for men.
Prevalence: Nearly 1 in 100 people
develop schizophrenia, slightly more men
than women.
Development: The course of
schizophrenia can be acute/reactive or
chronic.

Course of
Schizophrenia

Acute/Reactive
Schizophrenia In
reaction to stress, some
people develop positive
symptoms such as
hallucinations.
Recovery is likely.
Chronic/Process
Schizophrenia develops
slowly, with more
negative symptoms such
as flat affect and social
withdrawal.
With treatment and
support, there may
be periods of a
normal life, but not a
cure.

Subtypes of Schizophrenia

Understanding
Schizophrenia
Whats going on
in the brain in
schizophrenia?

Abnormal brain
structure and
activity
Too many dopamine/D4
receptors help to explain
paranoia and hallucinations;
its like taking amphetamine
overdoses all the time.
Poor coordination of neural
firing in the frontal lobes
impairs judgment and selfcontrol.
The thalamus fires during
hallucinations as if real
sensations were being
received.

Understanding
Schizophrenia
Are there biological risk
factors affecting early
development?

Biological Risk Factors

Schizophrenia is somewhat more
likely to develop when one or more of
these factors is present:
low birth weight
maternal diabetes
older paternal age
famine
oxygen deprivation during
delivery
maternal virus during midpregnancy impairing brain

Schizophrenia is
more likely to
develop in babies
born:
during and after
flu epidemics.
in densely
populated areas.
a few months
after flu season.
after mothers had
the flu during the
second trimester,
or had antibodies
showing viral
infection.
Theget
lesson
is to:
flu shots
with early fall
pregnancies.

Understanding
Schizophrenia

Are there genetic risk factors? If so, we

would see more similar schizophrenia
risk shared between identical twins
than fraternal twins (graph below). Do
we?

Genetic Factors
If one twin has
schizophrenia, the
chance of the other
one also having it are
much greater if the
twins are identical.
Having adoptive
siblings (or parents)
with schizophrenia
does not increase the
likelihood of
developing
schizophrenia.

Understanding
Schizophrenia

Even if maternal
flu during the
Even in identical twins, genetics do
second trimester
not fully predict schizophrenia.
doubles the risk
This could be because of
of schizophrenia,
this means only 2
environmental differences.
percent of these
First difference: twins in separate
babies develop
placentas.
the disorder.
Genetics may
differentiate
these 2 percent.
Research shows
many genes
linked to
schizophrenia,
but it may take
environmental
Only one of two twins has the enlarged
factors to turn on
ventricles seen in schizophrenia.
these genes.

Genetic and Prenatal Causes

Understanding
Schizophrenia
Are there
psychological
causes?

SocialPsychological
Factors
Research does not support
the idea that social or
psychological factors (such as
parenting) alone can cause
schizophrenia.
However, there may be
factors such as stress that
affect the onset of
schizophrenia.
Until we find a mechanism of
causation, all we may have is
a list of factors which
correlate with increased risk.

Predicting
Schizophrenia:
Early Warning Signs
Social/psychological
factors which tend to
appear before the
onset of
schizophrenia:
early separation from
parents
short attention span
disruptive OR withdrawn
behavior
emotional unpredictability
poor peer relations and/or
solitary play

Biological factors
which tend to appear
before the onset of
schizophrenia:
having a mother with
severe chronic
schizophrenia
birth complications,
including oxygen
deprivation and low
birth weight
poor muscle
coordination

Other
Disorders

Eating
Disorders

Dissociati
ve
Disorders

Personali
ty
Disorders

 Dissociation refers to a
Dissociati
separation of conscious
awareness from thoughts,
ve
memory, bodily sensations,
Disorders
feelings, or even from identity.
Dissociation can serve as a
psychological escape from an
overwhelmingly stressful
situation.
A dissociative disorder refers to
dysfunction and distress caused
Examples:
by chronic and severe
dissociation.
Loss
of
memory
with no known physical
Dissociative

Amnesia:

cause; inability to recall selected memories

or any memories

Dissociative
Fugue

Running away state; wandering away

from ones life, memory, and identity, with
no memory of these

Dissociative
Identity
Disorder
(D.I.D.)

Development of separate personalities

Dissociative Identity
Disorder (D.I.D.) formerly
Multiple PersonalityAlternative
Disorder

In the rare actual cases of

D.I.D., the personalities:
are distinct, and not present
in consciousness at the same
time.
may or may not appear to be
aware of each other.

Explanations for
D.I.D.

Dissociative
identities might just
be an extreme form of
playing a role.
D.I.D. in North America
might be a recent
cultural construction,
similar to the idea of
being possessed by evil
spirits.
Cases of D.I.D. might
be created or worsened
by therapists
encouraging people to

D.I.D., or DID Not?

Evidence that D.I.D. is Real
Different personalities
have involved:
different brain wave
patterns.
different left-right
handedness.
different visual acuity
and eye muscle balance
patterns.
Patients with D.I.D. also
show heightened activity
in areas of the brain
associated with managing
and inhibiting traumatic
memories.

Explaining
fragmentation of
personality from
different
perspectives
Psychoanalytic
perspective:
diverting id
Cognitive
perspective:
coping with abuse
Learning perspective:
dissociation pays
Social influence:

Eating
Disorders
Anorexia nervosa
Bulimia nervosa
Binge-eating disorder

Anorexia
Nervosa
Bulimia
Nervosa

These may involve:

unrealistic body image and
extreme body ideal.
a desire to control food and
the body when ones situation
cant be controlled.
cycles of depression.
health problems.

Definition
Prevalence
Compulsion to lose weight, 0.6 percent
coupled with certainty
meet criteria
about being fat despite
at some time
being 15 percent or more
during
underweight
lifetime
Compulsion to binge,
eating large amounts fast,
then purge by losing the
1.0 percent
food through vomiting,
laxatives, and extreme
exercise

Eating Disorders: Associated

Factors
Family factors:
having a mother focused on
her weight, and on childs
appearance and weight
negative self-evaluation in the
family
for bulimia, if childhood
obesity runs in the family
for anorexia, if families are
competitive, high-achieving,
and protective
Cultural factors:
unrealistic ideals of body
appearance

Personali
ty
Disorders

Personality
disorders are
enduring patterns
of social and other
behavior that
impair social
functioning.

There are three clusters/categories of

personality disorders.
Anxious: e.g., Avoidant P.D., ruled by fear
of social rejection
Eccentric/Odd: e.g. Schizoid P.D., with
flat affect, no social attachments
Dramatic: e.g. Histrionic, attentionseeking; narcissistic, self-centered;
antisocial, amoral

Antisocial Personality Disorder

[APD]
Antisocial
personality disorder
refers to acting
impulsively or
fearlessly without
regard for others
needs and feelings.
The diagnostic
criteria include a
pattern of violating
the rights of others
since age 15,
including three of
these:

Deceitfulness
Disregard for safety of
self or others
Aggressiveness
Failure to conform to
social norms
Lack of remorse
Impulsivity and failure to
plan ahead
Irritability
Irresponsibility regarding
jobs, family, and money

Which Kids May Develop APD

as Adults? Biological APD Risk Factors
About half of children with persistent
antisocial behavior develop lifelong
APD.
Which kids are at risk? Psychological
factors:
those who in preschool were
impulsive, uninhibited, unconcerned
with social rewards, and low in anxiety.
those who endured child abuse, and/or
inconsistent, unavailable caretaking.

Antisocial or unemotional
biological relatives increases
risk.
Some associated genes
have been identified.
Risk factors include bodybased fearlessness, lower
levels of stress hormones, and
low physiological arousal in
stressful situations such as
awaiting receiving a shock.
Fear conditioning is impaired.
Reduced prefrontal cortex
tissue leads to impulsivity.
Substance dependence is

Antisocial PD
Criminality

Many career criminals do show empathy

and selflessness with family and friends.
Many people with A.P.D. do not commit
crimes.

Antisocial Crime

If antisocial personality disorder is not a full picture

of most criminal activity, what can we say about
people who commit crime, especially violent crime?

Biosocial roots of
crime: birth
complications and
poverty combine to
increase risk.

Biosocial Roots of Crime:

The Brain

People who commit

murder seem to
have less tissue
and activity in the
part of the brain
that suppresses
impulses.

Other differences include:

less amygdala response when viewing violence.
an overactive dopamine reward-seeking system.

How common are

psychological disorders?

Countries vary greatly in the percentage of people

reporting mental health issues in the past year.

Rates of
Psychologica
l Disorders
This list takes a closer look at
the past-year prevalence of
various mental health
diagnoses in the United
States.

Risks and Protective

Factors for Mental
Disorders

Who is at risk of mental

disorders?
Who is less at risk?

Outcomes for People with

Psychological Disorders
There are risks to be watchful of,
obstacles to be overcome, and
improvements to be made, often
with the help of with treatment.
Some people with psychological
disorders do not recover.
Some achieve greatness, even
with a psychological disorder.