PSYCHOLOGY

(9th Edition)

David Myers
PowerPoint Slides
Aneeq Ahmad
Henderson State University
Worth Publishers, 2010

Psychological Disorders
Chapter 14
2

Psychological Disorders
Perspectives on Psychological
Disorders
Defining Psychological Disorders
Understanding Psychological
Disorders
Classifying Psychological Disorders
Labeling Psychological Disorders
3

Anxiety Disorders
Generalized Anxiety Disorder
Panic Disorder
Phobias
Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorder
Understanding Anxiety Disorders

Somatoform Disorders

Dissociative Disorders
Dissociative Identity Disorder
Understanding Dissociative
Identity Disorder

Mood Disorders
Major Depressive Disorder
Bipolar Disorder
Understanding Mood Disorders
5

Schizophrenia
Symptoms of Schizophrenia
Onset and Development of Schizophrenia
Understanding Schizophrenia

Personality Disorders
Antisocial Personality Disorder
Understanding Antisocial Personality
Disorder

Rates of Psychological Disorders

Psychological Disorders
I felt the need to clean my room would spend four to
five hours at it At the time I loved doing it. Then I
didn't want to do it any more, but I couldnt stop The
clothes hung two fingers apart I touched my
bedroom wall before leaving the house I had constant
anxiety I thought I might be nuts.
Marc, diagnosed with
obsessive-compulsive disorder
(from Summers, 1996)

Psychological Disorders
People are fascinated by the exceptional, the
unusual, and the abnormal. This fascination
may be caused by two reasons:
1.

During various moments we feel, think, and act like

an abnormal individual.

2.

Psychological disorders may bring unexplained

physical symptoms, irrational fears, and suicidal
thoughts.
8

Psychological Disorders
To study the abnormal is the best way of
understanding the normal.
William James (1842-1910)

1.

There are 450 million people suffering from

psychological disorders (WHO, 2004).

2.

Depression and schizophrenia exist in all cultures

of the world.
9

Defining Psychological Disorders

Mental health workers view psychological
disorders as persistently harmful thoughts,
feelings, and actions.
When behavior is deviant, distressful, and
dysfunctional psychiatrists and psychologists
label it as disordered (Comer, 2004).

10

Deviant, Distressful & Dysfunctional

Carol Beckwith

1. Deviant behavior
(going naked) in one
culture may be
considered normal,
while in others it may
lead to arrest.
2. Deviant behavior must
accompany distress.
3. If a behavior is
dysfunctional it is
clearly a disorder.

In the Wodaabe tribe men

wear costumes to attract
women. In Western society
this would be considered
abnormal.

11

Understanding Psychological
Disorders
Ancient Treatments of psychological disorders
include trephination, exorcism, being caged like
animals, being beaten, burned, castrated,
mutilated, or transfused with animals blood.
John W. Verano

Trephination (boring holes in the skull to remove evil forces)

12

The Medical Model

Philippe Pinel (1745-1826) from France, insisted
that madness was not due to demonic possession,
but an ailment of the mind.
George Wesley Bellows, Dancer in a Madhouse, 1907. 1997 The Art Institute of Chicago

Dance in the madhouse.

13

Medical Model
When physicians discovered that syphilis led to
mental disorders, they started using medical models
to review the physical causes of these disorders.
1.
2.
3.
4.

Etiology: Cause and development of the

disorder.
Diagnosis: Identifying (symptoms) and
distinguishing one disease from another.
Treatment: Treating a disorder in a psychiatric
hospital.
Prognosis: Forecast about the disorder.
14

The Biopsychosocial Approach

Assumes that biological, socio-cultural, and
psychological factors combine and interact to
produce psychological disorders.

15

Classifying Psychological Disorders

The American Psychiatric Association rendered
a Diagnostic and Statistical Manual of Mental
Disorders (DSM) to describe psychological
disorders.
The most recent edition, DSM-IV-TR (Text
Revision, 2000), describes 400 psychological
disorders compared to 60 in the 1950s.

16

Multiaxial Classification
Is a Clinical Syndrome (cognitive, anxiety,
Axis I
mood disorders [16 syndromes]) present?
Axis II

Is a Personality Disorder or Mental Retardation

present?

Is a General Medical Condition (diabetes,

Axis III
hypertension or arthritis etc) also present?
Are Psychosocial or Environmental Problems
Axis IV
(school or housing issues) also present?
What is the Global Assessment of the persons
Axis V functioning?
17

Multiaxial Classification
Note 16 syndromes in Axis I

18

Multiaxial Classification
Note Global Assessment for Axis V

19

Goals of DSM
1.
2.

Describe (400) disorders.

Determine how prevalent the
disorder is.

Disorders outlined by DSM-IV are reliable.

Therefore, diagnoses by different professionals
are similar.
Others criticize DSM-IV for putting any kind
of behavior within the compass of psychiatry.
20

Labeling Psychological Disorders

1. Critics of the DSM-IV argue that labels may
stigmatize individuals.
Elizabeth Eckert, Middletown, NY. From L. Gamwell and
N. Tomes, Madness in America, 1995. Cornell University Press.

Asylum baseball team (labeling)

21

Labeling Psychological Disorders

2. Labels may be helpful for healthcare
professionals when communicating with
one another and establishing therapy.

22

Labeling Psychological Disorders

Elaine Thompson/ AP Photo

3. Insanity labels
raise moral and
ethical questions
about how society
should treat people
who have disorders
and have
committed crimes.

Theodore Kaczynski
(Unabomber)

23

Anxiety Disorders
Feelings of excessive apprehension and anxiety.
1.
2.
3.
4.
5.

Generalized anxiety disorder

Panic disorder
Phobias
Obsessive-compulsive disorder
Post-traumatic stress disorder
24

Generalized Anxiety Disorder

Symptoms
1. Persistent and uncontrollable tenseness and
apprehension.
2. Autonomic arousal.
3. Inability to identify or avoid the cause of
certain feelings.

25

Panic Disorder
Symptoms
Minutes-long episodes of intense dread which
may include feelings of terror, chest pains,
choking, or other frightening sensations.
Anxiety is a component of both disorders. It
occurs more in the panic disorder, making
people avoid situations that cause it.
26

Phobias
Marked by a persistent and irrational fear of an
object or situation that disrupts behavior.

27

Kinds of Phobias
Agoraphobia
Acrophobia
Claustrophobia
Hemophobia

Phobia of open places.

Phobia of heights.
Phobia of closed spaces.
Phobia of blood.

28

Obsessive-Compulsive Disorder
Persistence of unwanted thoughts (obsessions)
and urges to engage in senseless rituals
(compulsions) that cause distress.

29

Brain Imaging
A PET scan of the brain
of a person with
Obsessive-Compulsive
Disorder (OCD). High
metabolic activity (red)
in the frontal lobe areas
are involved with
directing attention.

Brain image of an OCD

30

Post-Traumatic Stress Disorder

Four or more weeks of the following symptoms
constitute post-traumatic stress disorder
(PTSD):
1. Haunting memories
2. Nightmares
3. Social withdrawal
Bettmann/ Corbis

4. Jumpy anxiety
5. Sleep problems
31

Resilience to PTSD
Only about 10% of women and 20% of men
react to traumatic situations and develop PTSD.
Holocaust survivors show remarkable resilience
against traumatic situations.
All major religions of the world suggest that
surviving a trauma leads to the growth of an
individual.
32

Explaining Anxiety Disorders

Freud suggested that we repress our painful
and intolerable ideas, feelings, and thoughts,
resulting in anxiety.

33

The Learning Perspective

John Coletti/ Stock, Boston

Learning theorists
suggest that fear
conditioning leads to
anxiety. This anxiety
then becomes
associated with other
objects or events
(stimulus
generalization) and is
reinforced.
34

The Learning Perspective

Investigators believe that fear responses are
inculcated through observational learning.
Young monkeys develop fear when they watch
other monkeys who are afraid of snakes.

35

The Biological Perspective

Natural Selection has led our ancestors to learn
to fear snakes, spiders, and other animals.
Therefore, fear preserves the species.

Twin studies suggest that our genes may be

partly responsible for developing fears and
anxiety. Twins are more likely to share phobias.

36

The Biological Perspective

Anterior Cingulate Cortex

of an OCD patient.
37

S. Ursu, V.A. Stenger, M.K. Shear, M.R. Jones, & C.S. Carter (2003). Overactive action
monitoring in obsessive-compulsive disorder. Psychological Science, 14, 347-353.

Generalized anxiety,
panic attacks, and even
OCD are linked with
brain circuits like the
anterior cingulate cortex.

Dissociative Disorders
Conscious awareness becomes separated
(dissociated) from 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.
38

Dissociative Identity Disorder (DID)

A disorder in which a person exhibits two or
more distinct and alternating personalities,
formerly called multiple personality disorder.

Lois Bernstein/ Gamma Liason

Chris Sizemore (DID)

39

DID Critics
Critics argue that the diagnosis of DID
increased in the late 20th century. DID has
not been found in other countries.
Critics Arguments
1. Role-playing by people open to a
therapists suggestion.
2. Learned response that reinforces
reductions in anxiety.
40

Mood Disorders
Emotional extremes of mood disorders come in
two principal forms.

1. Major depressive disorder

2. Bipolar disorder

41

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
42

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
43

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
44

Bipolar Disorder
Many great writers, poets, and composers
suffered from bipolar disorder. During their
manic phase creativity surged, but not during
their depressed phase.

Clemens

Hemingway
45

Earl Theissen/ Hulton Getty Pictures Library

The Granger Collection

Wolfe

George C. Beresford/ Hulton Getty Pictures Library

Bettmann/ Corbis

Whitman

Explaining Mood Disorders

Since depression is so prevalent worldwide,
investigators want to develop a theory of
depression that will suggest ways to treat it.
Lewinsohn et al., (1985, 1998) note that a theory
of depression should explain the following:
1. Behavioral and cognitive changes
2. Common causes of depression
46

Theory of Depression
3. Gender differences

47

Theory of Depression
4. Depressive episodes self-terminate.
5. Stressful events often precede depression.
6. Depression is increasing, especially in the
teens.

Desiree Navarro/ Getty Images

Post-partum depression

48

Suicide
The most severe form of behavioral response to
depression is suicide. Each year some 1 million
people commit suicide worldwide.
1.
2.
3.
4.
5.

Suicide Statistics
National differences
Racial differences
Gender differences
Age differences
Other differences
49

Biological Perspective
Genetic Influences: Mood disorders run in
families. The rate of depression is higher in
identical (50%) than fraternal twins (20%).

Jerry Irwin Photography

Linkage analysis and

association studies link
possible genes and
dispositions for depression.

50

The Depressed Brain

PET scans show that brain energy consumption
rises and falls with manic and depressive
episodes.

Courtesy of Lewis Baxter an Michael E.

Phelps, UCLA School of Medicine

51

Social-Cognitive Perspective
The social-cognitive perspective suggests that
depression arises partly from self-defeating
beliefs and negative explanatory styles.

52

Negative Thoughts and Moods

Explanatory style plays a major role in becoming depressed.

53

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.

54

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.

55

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)

56

Disorganized & Delusional Thinking

This morning when I was at Hillside [Hospital], I was
making a movie. I was surrounded by movie stars
Im 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).
(Im Mary
Poppins).
57

Disorganized & Delusional Thinking

Many psychologists believe disorganized
thoughts occur because of selective attention
failure (fragmented and bizarre thoughts).

58

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

Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign

August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg

59

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).

60

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.
61

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.
62

Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited
by the symptoms of the mind.

Brain Abnormalities
Dopamine Overactivity: Researchers found that
schizophrenic patients express higher levels of
dopamine D4 receptors in the brain.

63

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

64

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

65

Viral Infection
Schizophrenia has also been observed in
individuals who contracted a viral infection
(flu) during the middle of their fetal
development.

66

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

67

Genetic Factors
The following shows the prevalence of
schizophrenia in identical twins as seen in
different countries.

68

Psychological Factors
Psychological and environmental factors can
trigger schizophrenia if the individual is
genetically predisposed (Nicol & Gottesman,
1983).

Courtesy of Genain Family

Genain Sisters

The genetically identical

Genain
sisters suffer from
schizophrenia. Two more than
others, thus there are
contributing environmental
factors.
69

Personality Disorders
Personality disorders
are characterized by
inflexible and
enduring behavior
patterns that impair
social functioning.
They are usually
without anxiety,
depression, or
delusions.
70

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.

71

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.
72

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

73

Rates of Psychological Disorders

74

Rates of Psychological Disorders

The prevalence of psychological disorders during
the previous year is shown below (WHO, 2004).

75