13

Psychological
Disorders
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Understanding Psychological Disorders, Part 1

Key Theme
Understanding psychological disorders
includes considerations of their origins,
symptoms, and development, as well as
how behavior relates to cultural and social
norms.
 What Is Psychopathology?

Scientific study of the origins, symptoms, and development of

psychological disorders

• The dividing line between normal and abnormal behavior is

often determined by social or cultural context.
• Strong social stigma attached to suffering from a
psychological disorder.
• Pattern of behavioral or psychological symptoms
must represent a serious departure from the
prevailing social and cultural norms.
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• Standard descriptions of disorders from the DSM-5

must be used.
 What Is a Psychological Disorder? Part 1

Psychological disorder or mental disorder:

• Pattern of behavioral and psychological symptoms that:

• Causes significant personal distress
• Impairs the ability to function in one or more
important areas of life, or both
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 What Is a Psychological Disorder? Part 2

• DSM-5 (Diagnostic and Statistical Manual of Mental

Disorders, Fifth Edition); published by the American
Psychiatric Association:
• It describes the specific symptoms and diagnostic
guidelines for different psychological disorders.
 Describes more than 260 specific psychological
disorders
 Includes symptoms, criteria that must be met to
make a diagnosis, and typical course for each
mental disorder
 Has increased in number of disorders classified
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over the years

 What Is a Psychological Disorder? Part 3

ICD (International Classification of Diseases)

• World Health Organization’s diagnostic classification
• Diagnostic codes required for (insurance)
reimbursements
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 CRITICAL THINKING
Should Social Media Help to Diagnose Disorders?

• Differences were found in Instagram photos posted by

depressed and nondepressed people.
• Google searches (“how to kill yourself” or “painless
suicide”) are higher in suicidal people.
• Information about online behavior should be
harnessed.
• Confidentiality of information
• Ethical guidelines should be developed.
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 The Prevalence of a Psychological Disorder
A 50–50 Chance?
Research by Kessler & others, 2005,
shows:
• Psychological disorders are much
more prevalent than many people
believe.

• Approximately 26% of a
representative sample of 9,000
Americans experienced symptoms
of a psychological disorder during
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the previous year.

The Lifetime Prevalence of Psychological Disorders
 Some Additional Diagnostic Categories in DSM-5

• Neurodevelopmental disorders

• Substance-related and addictive disorders

• Somatic symptom and related disorders

• Disruptive, impulse control, and conduct disorders

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 Anxiety Disorders, Posttraumatic Stress Disorder, and
Obsessive–Compulsive Disorder

Key Theme
Intense anxiety that disrupts normal functioning is an essential
feature of the anxiety disorders, posttraumatic stress disorder,
and obsessive–compulsive disorder.
 Anxiety Disorders, Posttraumatic Stress Disorder,
and Obsessive–Compulsive Disorder

• Anxiety: unpleasant emotional state

characterized by physical arousal and
feelings of tension, apprehension, and
worry
 Physically alert; mentally alert

• Anxiety disorders: category of

psychological disorders in which extreme
anxiety is the main diagnostic feature and
causes significant disruptions in the
person’s cognitive, behavioral, or
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interpersonal functioning.
 Irrational; uncontrollable; disruptive
 Generalized Anxiety Disorder
Worrying About Anything and Everything

• Generalized Anxiety Disorder (GAD): anxiety disorder

characterized by excessive, global, and persistent
symptoms of anxiety; also called free-floating anxiety
 When one source of worry is removed, another takes
its place.

• Explaining GAD
 Environmental, psychological, genetic, and other
biological factors are probably involved in GAD.
 Problematic anxiety can be evident from a very early
age.
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 Early stressful experiences may contribute.

 Panic Attacks and Panic Disorders
Sudden Episodes of Extreme Anxiety

• Panic attack: sudden episode of extreme anxiety that

rapidly accelerates in intensity

• Panic disorder: anxiety disorder in which person

experiences frequent and unexpected panic attacks

• Agoraphobia: anxiety disorder involving extreme fear of

experiencing a panic attack or other embarrassing or
incapacitating symptoms in a public situation where escape
is impossible and help is unavailable
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 Explaining Panic Disorder

• Triple vulnerabilities model of panic (Barlow)

 Biological predisposition toward anxiety
 Low sense of control over potentially life-threatening
events
 Oversensitivity to physical sensations

• Catastrophic cognitions theory (Hinton & others)

 Oversensitive to physical sensations and also tend to
catastrophize meaning of their experience
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 The Phobias
Fear and Loathing, Part 1

• Phobia: persistent and irrational fear of a specific object,

situation, or activity

• Specific phobia: excessive, intense, and irrational fear of

a specific object, situation, or activity that is actively
avoided or endured with marked anxiety
 Encountering feared situation or object can provoke a
full-fledged panic attack.
 Approximately 13% of the general population
experiences a specific phobia.
 More than twice as many women as men suffer from
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specific phobia.
 Some Unusual Phobias

Amathophobia Fear of dust

Anemophobia Fear of wind
Aphephobia Fear of being touched by another person
Bibliophobia Fear of books
Catotrophobia Fear of breaking a mirror
Ergophobia Fear of work or responsibility
Erythrophobia Fear of red objects
Gamophobia Fear of marriage
Hypertrichophobia Fear of growing excessive amounts of body hair
Levophobia Fear of things being on the left side of your body
Phobophobia Fear of acquiring a phobia
Phonophobia Fear of the sound of your own voice
Triskaidekaphobia Fear of the number 13
 The Phobias
Fear and Loathing, Part 2

• Generally, the objects or situations that produce

specific phobias tend to fall into four categories:
 Fear of particular situations
 Fear of features of the natural environment
 Fear of injury or blood
 Fear of animals and insects
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 Social Anxiety Disorder
Fear of Being Judged in Social Situations, Part 1

• Social anxiety disorder: an anxiety disorder involving the

extreme and irrational fear of being embarrassed, judged, or
scrutinized by others in social situations.
• One of the most common psychological disorders
• More prevalent among women than men
• Core of social phobia seems to be an irrational fear of
being embarrassed, judged, or critically evaluated by
others
• Can vary by culture:
 Japanese men suffer from taijin kyofusho (fear that their
own appearance or smell, facial expression, or body
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language will offend, insult, or embarrass other people).

 Social Anxiety Disorder
Fear of Being Judged in Social Situations, Part 2
 Explaining Phobias
Learning Theories

• Basic learning principles: Some phobias can be

explained in terms of classical conditioning, operant
conditioning, and observational learning.

• Biological preparation: Certain fears, such as of spiders

or heights, have an evolutionary history and may
represent a fear of contamination.
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 Posttraumatic Stress Disorder and
Obsessive–Compulsive Disorder

Key Theme
Extreme anxiety and intrusive thoughts are symptoms of both
posttraumatic stress disorder (PTSD) and obsessive–
compulsive disorder (OCD).
 Posttraumatic Stress Disorder and Obsessive–
Compulsive Disorder

Posttraumatic stress disorder (PTSD)

• Disorder triggered by exposure to a
highly traumatic event;
• Results in recurrent, involuntary, and
intrusive memories of the event;
• Avoidance of stimuli and situations
associated with the event;
• Negative changes in thoughts, moods,
and emotions; and
• A persistent state of heightened
physical arousal.
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 Posttraumatic Stress Disorder
Reexperiencing the Trauma

• Originally, PTSD was associated with military

combat.
 Can develop in survivors of other extreme trauma
• Core symptoms have been identified.
• Likelihood of developing PTSD is linked to personal
or family history and/or magnitude of trauma
experienced.
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 Obsessive–Compulsive Disorder
Checking It Again and Again, Part 1

Obsessive–compulsive disorder (OCD): disorder

characterized by
• The presence of intrusive, repetitive, and unwanted
thoughts (obsessions) and
• Repetitive behaviors or mental acts that an individual feels
driven to perform (compulsions).
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 Obsessive–Compulsive Disorder
Checking It Again and Again, Part 2

• Obsessions
 Repeated, intrusive, and uncontrollable irrational
thoughts or mental images that cause extreme anxiety
 Common: fear of dirt, germs; pathological doubt about
having completed a task
• Compulsions
 Repetitive behaviors or mental acts that a person feels
driven to perform to prevent or reduce anxiety and
distress, or to prevent a dreaded event or situation
 May be overt or covert
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 The Most Common Obsessions and Compulsions

Obsession Description
Contamination Irrational fear of contamination by dirt, germs, or other toxic substances. Typically
accompanied by cleaning or washing compulsion.
Pathological doubt Feeling of uncertainty about having accomplished a simple task. Recurring fear that
you have inadvertently harmed someone or violated a law. Typically accompanied by
checking compulsion.
Violent or sexual Fear that you have harmed or will harm another person or have engaged or will
thoughts engage in some sort of unacceptable behavior. May take the form of intrusive mental
images or impulses.
Compulsion Description
Washing Urge to repeatedly wash yourself or clean your surroundings. Cleaning or washing
may involve an elaborate, lengthy ritual. Often linked with contamination obsession.
Checking Checking repeatedly to make sure that a simple task has been accomplished.
Typically occurs in association with pathological doubt. Checking rituals may take
hours.
Counting Need to engage in certain behaviors a specific number of times or to count to a
certain number before performing some action or task.
Symmetry and precision Need for objects or actions to be perfectly symmetrical or in an exact order or
position. Need to do or undo certain actions in an exact fashion.
 Explaining Obsessive–Compulsive Disorder

• Deficiency in serotonin, norepinephrine implicated

 Drugs that increase the availability of these
neurotransmitters decrease symptoms.

• Dysfunction in specific brain areas

 Areas involved in the fight-or-flight response
 Frontal lobes, which play a key role in our ability to think
and plan ahead
 Heightened neural activity in caudate nucleus involved
in regulating movements
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Disorders Involving Intense Anxiety

Generalized Anxiety Disorder

• Persistent, chronic, unreasonable worry and anxiety
• General symptoms of anxiety, including persistent physical arousal
Panic Disorder
• Frequent and unexpected panic attacks, with no specific or
identifiable trigger
Phobias
• Intense anxiety or panic attack triggered by a specific object or
situation
• Persistent avoidance of feared object or situation
Posttraumatic Stress Disorder (PTSD)
• Anxiety triggered by intrusive, recurrent memories of a highly
traumatic experience
Obsessive–Compulsive Disorder (OCD)
• Anxiety caused by uncontrollable, persistent, recurring thoughts
(obsessions) and/or urges to perform certain actions (compulsions)
 Depressive and Bipolar Disorders
Disordered Moods and Emotions

Key Theme
In the depressive and the bipolar disorders, disturbed
emotions cause psychological distress and impair daily
functioning.
 Understanding Depressive and Bipolar Disorders

• Emotions violate criteria of normal moods in quality,

intensity, and duration.

• Depressive disorders and bipolar disorders are given

distinct DSM-5 categories.

• Both the depressive and bipolar disorders are sometimes

called mood disorders or affective disorders.
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 Major Depressive Disorder
More Than Ordinary Sadness

Major depressive disorder:

• A mood disorder that
 Is characterized by extreme and persistent feelings of
despondency, worthlessness, and hopelessness.
 Causes impaired emotional, cognitive, behavioral, and
physical functioning.
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The Symptoms of Major Depressive Disorder
 The Prevalence and Course of Major Depressive
Disorder, Part 1

• Prevalence: 6% to 7% of Americans are affected by major

depression
• Lifetime prevalence: About 15% of Americans at some
point in their lives
• Gender: Women are about twice as likely as men to be
affected by major depression
• Women more vulnerable because
• Experience greater degree of chronic stress in daily life
• Have lesser sense of personal control
• More prone to dwell on their problems
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 The Prevalence and Course of Major Depressive
Disorder, Part 2

• In major depressive disorder, a person must display most

symptoms described in DSM-5 for two weeks or longer.
• Persistent depressive feelings may or may not be triggered
by life events.
 Bereavement
 Seasonal affective disorder (SAD)
 Persistent depressive disorder
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 The Prevalence and Course of Major Depressive
Disorder, Part 3

• More than half of all people who have been through one
episode of major depression can expect a relapse, usually
within two years.
• Symptoms tend to increase in severity, and time between
episodes decreases.
• Left untreated, symptoms of major depression can easily
last six months or longer, and depression may recur and
become progressively more severe.
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 Bipolar Disorder
An Emotional Roller Coaster

• Bipolar disorder: a mood

disorder involving periods of
incapacitating depression
alternating with periods of
extreme euphoria and
excitement; formerly called
manic depression
• Manic episode: a sudden,
rapidly escalating emotional
state characterized by
extreme euphoria, excitement,
physical energy, and rapid
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thoughts and speech.

 The Symptoms of Bipolar Disorder, Part 1

• Bipolar disorder
 Person experiences extreme mood swings.
 Episodes of incapacitating depression alternate with
shorter periods of extreme euphoria, called manic
episodes.
 Usually, manic episode immediately precedes or follows
a bout with major depression.
 Small percentage of people experience only manic
episodes.
 Involves abnormal moods at both ends of emotional
spectrum.
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 The Symptoms of Bipolar Disorder, Part 2

• Cyclothymic disorder (milder form of bipolar disorder)

 People experience moderate but frequent mood swings
for two years or longer .
 Mood swings are not severe enough to qualify as either
bipolar disorder or major depression.
 People with it are perceived as being extremely moody,
unpredictable, and inconsistent.
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 The Prevalence and Course of Bipolar Disorder

• Typically occurs in the person’s early 20s; lasts from a few

days to a couple of months
• Commonly recurs every few years; small percentage
display rapid cycling
• Less common than major depression with lifetime risk
approximately 1%
• No gender differences in prevalence
• Can often be controlled by medication (lithium)
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 Explaining Depressive Disorders and
Bipolar Disorders

• Genetic predisposition
• Activation of brain structure differences
• Brain chemistry
• Stress
• Cigarette smoking and development of major depression
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 Depressive Disorders and Bipolar Disorders

Major Depressive Disorder

• Loss of interest or pleasure in almost all activities
• Despondent mood; feelings of emptiness, worthlessness, or excessive guilt
• Preoccupation with death or suicidal thoughts
• Difficulty sleeping or excessive sleeping
• Diminished ability to think, concentrate, or make decisions
• Diminished appetite and significant weight loss
Persistent Depressive Disorder
• Chronic depressed feelings that are often less severe than those that accompany
major depressive disorder
Seasonal Affective Disorder (SAD)
• Recurring episodes of depression that follow a seasonal pattern, typically occurring
in the fall and winter months and subsiding in the spring and summer months

Bipolar Disorder
• One or more manic episodes characterized by euphoria, high energy, grandiose
ideas, flight of ideas, inappropriate self-confidence, and decreased need for sleep
• Usually one or more major depressive episodes
• In some cases, may rapidly alternate between symptoms of mania and major
depressive disorder
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Cyclothymic Disorder
• Moderate, recurring mood swings that are not severe enough to qualify as major
depressive disorder or bipolar disorder
 CRITICAL THINKING: Does Smoking Cause Major
Depressive Disorder and Other Psychological Disorders?

• Lasser found that people with mental illness are twice as

likely to smoke cigarettes as people with no mental illness.

Do you know why?

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 Eating Disorders
Anorexia, Bulimia, and Binge-Eating Disorder

Key Theme
Anorexia nervosa, bulimia nervosa, and binge-eating disorder
are psychological disorders characterized by severely
disturbed, maladaptive eating behaviors.
 Characteristics of Eating Disorders

• Eating disorders involve:

 Serious and maladaptive
disturbances in eating behavior,
 Reduced food intake,
 Severe overeating, and
 Obsessive concerns about body
shape or weight.

• 90 to 95% of the people who

experience an eating disorder are
female
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 Eating Disorders
Anorexia Nervosa
• Severe and extreme disturbance in eating habits and calorie intake
• Body weight that is significantly less than what would be considered normal for
the person’s age, height, and gender, and refusal to maintain a normal body
weight
• Intense fear of gaining weight or becoming fat
• Distorted perceptions about the severity of weight loss and a distorted self-
image, such that even an extremely emaciated person may perceive herself
as fat
Bulimia Nervosa
• Recurring episodes of binge eating, which is defined as an excessive amount
of calories within a two-hour period
• The inability to control or stop the excessive eating behavior
• Recurrent episodes of purging, which is defined as using laxatives, diuretics,
self-induced vomiting, or other methods to prevent weight gain
Binge-Eating Disorder
• Recurring episodes of binge eating
• The inability to control or stop the excessive eating behavior
• Not associated with recurrent episodes of purging or other methods to prevent
weight gain
 Anorexia Nervosa
Life-Threatening Weight Loss

• Eating disorder characterized by excessive weight loss,

an irrational fear of gaining weight, and distorted body
self-perception

Key Features
• Refuses to maintain a minimally normal body weight
• Intense fear of gaining weight or becoming fat
• Distorted perception about the size of body
• Denies the seriousness of weight loss
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 Bulimia Nervosa and Binge-Eating Disorder, Part 1

• Bulimia nervosa: eating disorder characterized by binges

of extreme overeating followed by self-induced vomiting,
misuse of laxatives, or other inappropriate methods to
purge the excessive food and prevent weight gain

• Key Features
 Fear of gaining weight
 Stay within a normal weight range
 Recognize that they have an eating disorder
 Binges typically occur twice a week
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 Bulimia Nervosa and Binge-Eating Disorder, Part 2

Binge-eating disorder:
• Engage in bingeing behaviors (DSM-5, 2013)
• Do not engage in purging or other behaviors that rid their
bodies of the excess food
• Experience the same feelings of distress, lack of control,
and shame that people with bulimia experience.
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 Causes of Eating Disorders
A Complex Picture

• Decreases in brain activity of the neurotransmitter

serotonin
 Genetic factors implicated in both
• Family interaction patterns
 Critical comments by parents
 Parental modeling of disordered eating
• Western cultural attitudes toward thinness
• Perfectionism, rigid thinking, poor peer relations, social
isolation, low self-esteem associated with anorexia
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 CULTURE AND HUMAN BEHAVIOR
Culture-Bound Syndromes

• Some culture-specific disorders are found only in a single

culture.
• Hikkomori (Japan)
 Involves a pattern of extreme social withdrawal
 Primarily affects young males
 Includes more than a million young Japanese
 May be extreme reaction to pressure to succeed in
school and conform to social expectations
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 Personality Disorders
Maladaptive Traits

Key Theme
The personality disorders are characterized by inflexible,
maladaptive patterns of thoughts, emotions, behavior, and
interpersonal functioning.
 What Are Personality Disorders?

• Personality disorders
 Inflexible, maladaptive pattern of thoughts, emotions,
behaviors, and interpersonal functioning
 Stable over time and across situations
 Deviate from expectations of individual’s culture
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 Diagnosing Personality Disorders

• Categorized into three basic clusters

• Odd, eccentric
• Dramatic, emotional, erratic
• Anxious, fearful
• Individuals also assessed on the basis of:
1. a severity scale, which assesses the degree of
impairment in personality functioning; and
2. a trait scale, which rates the person on pathological
personality traits.
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 Personality Disorders
Odd, Eccentric Cluster
Paranoid Personality Disorder
• Pervasive but unwarranted
distrust and suspiciousness;
assumes that other people intend
to deceive, exploit, or harm them.
Schizoid Personality Disorder
• Pervasive detachment from
social relationships; emotionally
cold and flat; indifferent to praise
or criticism from others;
preference for solitary activities;
lacking in close friends.
Schizotypal Personality Disorder
• Odd thoughts, speech, emotional
reactions, mannerisms, and
appearance; impaired social and
interpersonal functioning; often
superstitious.
Dramatic, Emotional, Erratic Cluster
Antisocial Personality Disorder
• Blatantly disregards or violates the rights of others;
impulsive, irresponsible, deceitful, manipulative, and
lacking in guilt or remorse.
Borderline Personality Disorder
• Intense, unstable relationships, emotions, and self-
image; impulsive; desperate efforts to avoid real or
imagined abandonment; feelings of emptiness; self-
destructive tendencies.
Histrionic Personality Disorder
• Exaggerated, overly dramatic expression of emotions
and attention-seeking behavior that often includes
sexually seductive or provocative behaviors.
Narcissistic Personality Disorder
• Grandiose sense of self-importance; exaggerates
abilities and accomplishments; excessive need for
admiration; boastful, pretentious; lacking in empathy.
Anxious, Fearful Cluster
Avoidant Personality Disorder
• Extreme social inhibition and social
avoidance due to feelings of
inadequacy, and hypersensitivity to
criticism, rejection, or disapproval.
Dependent Personality Disorder
• Excessive need to be taken care of,
leading to submissive, clinging
behaviors; fears of separation; and
the inability to assume
responsibility.
Obsessive–Compulsive Personality
Disorder
• Rigid preoccupation with
orderliness, personal control, rules,
or schedules that interferes with
completing tasks; unreasonable
perfectionism.
 Antisocial Personality Disorder

• Central feature is a pattern of blatantly disregarding

and violating the rights of others
 Deceiving and manipulating others for their own
personal gain
 Seem to lack “conscience”
 More prevalent in men than women
 High rates of alcoholism and other forms of substance
abuse
• Evidence often seen in childhood (conduct disorder)
 Cruelty to animals
 Attacking or harming adults or other children
 Theft
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 Setting fires and destroying property

 Sociopath Versus Psychopath

Anders Breivik (left), who murdered dozens of children at a

summer camp in Norway, would be considered a
sociopath, according to neuroscientist Jack Pemment
(2013). The serial killer Israel Keyes (right), who buried
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weapons and shovels used to dispose of bodies all over

the United States to facilitate his homicides, is likely a
psychopath.
 Borderline Personality Disorder, Part 1

Borderline personality disorder (BPD):

• A personality disorder characterized by instability of
interpersonal relationships, self-image, and emotions,
and marked impulsivity
• Most serious and disabling of the personality disorders
• Moods and emotions are intense, fluctuating, and
extreme, often vastly out of proportion
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 Borderline Personality Disorder, Part 2

• Relationships with others are

chaotic; desperately afraid of
abandonment
• “Cutting” or other acts of self-
mutilation, threats of suicide, and
suicide attempts are common.
• Highest prevalence among
women, people in lower-income
groups, and Native American men
• Lowest incidence among women
of Asian descent
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 What Causes Borderline Personality Disorder?

• Early views
 Disruption in attachment relationships in early childhood; neglect or
physical, sexual, or emotional abuse in childhood

• Biosocial developmental theory

 Combination of biological, psychological, and environmental factors
 Biological temperament characterized by extreme emotional
sensitivity, impulsivity, and tendency to experience negative
emotions
 Caregivers do not teach control of impulses or regulation of
emotions.
 Parents or caregivers shape and reinforce pattern of frequent,
intense emotional displays.
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 History of abuse and neglect may be present but is not a necessary

ingredient.
 The Dissociative Disorders
Fragmentation of the Self

Key Theme
In the dissociative disorders,
disruptions in awareness, memory,
and identity interfere with the
ability to function in everyday life.
 Understanding Dissociative Disorders

• Dissociative disorders: Extreme and frequent disruptions

of awareness, memory, and personal identity impair the
ability to function.

• Two basic disorders

1. Dissociative amnesia, which can occur either with or
without dissociative fugue

2. Dissociative identity disorder, which was previously

called multiple personality disorder
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 Dissociative Amnesia and Dissociative Fugue

• Dissociative amnesia
 Refers to partial or total inability to recall important
information that is not due to a medical condition
 Amnesia for personal events and information, rather
than for general knowledge or skills

• Dissociative fugue
 Suddenly and inexplicably travels away from home,
wandering to other cities or even countries
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 Dissociative Identity Disorder (DID)

• Dissociative disorder involves extensive memory

disruptions.
• The presence of two or more distinct identities, or
“personalities”
• Formerly called multiple personality disorder.
• Not all mental health professionals are convinced that
dissociative identity disorder is a genuine psychological
disorder.
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 Dissociative Disorders

Dissociative Amnesia
• Inability to remember important personal information, too extensive to be explained
by ordinary forgetfulness
Dissociative Amnesia with Dissociative Fugue
• Sudden, unexpected travel away from home
• Confusion about personal identity or assumption of new identity
Dissociative Identity Disorder
• Presence of two or more distinct identities, each with consistent patterns of
personality traits and behavior
• Behavior that is controlled by two or more distinct recurring identities
• Amnesia; frequent memory gaps
 Explaining Dissociative Identity Disorder

• Dissociative identity disorder is extreme form of

dissociative coping.
• High percentage of DID patients report having suffered
extreme physical or sexual abuse. Child “dissociates” from
it, creating alternate personalities to experience trauma.
• Dissociative coping theory is difficult to test empirically.
• Opposite effect occurs to most trauma victims.
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 Schizophrenia
A Different Reality

Key Theme
One of the most serious psychological disorders is
schizophrenia, which involves severely distorted beliefs,
perceptions, and thought processes.
 Understanding Schizophrenia

• Schizophrenia is a
psychological disorder
that involves severely
distorted beliefs,
perceptions, and thought
processes.
• Schizophrenia is
diagnosed when two or
more of these
characteristic symptoms
are actively present for a
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month, or longer.
 Symptoms of Schizophrenia

Positive Symptoms
• Symptoms that reflect excesses or distortions of normal
functioning, including delusions, hallucinations, and
disorganized thoughts and behavior
 Delusions, or false beliefs; can lead to dangerous
behaviors
 Hallucinations, or false perceptions; can be
indistinguishable from reality
 Severely disorganized thought processes, speech
 Severely disorganized behavior
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 FOCUS ON NEUROSCIENCE
THE HALLUCINATING BRAIN

• Researcher David Silbersweig and

his colleagues (1995) used PET
scans to take a “snapshot” of brain
activity during schizophrenic
hallucinations.
• The scan shown here was
recorded at the exact instant a
schizophrenic patient hallucinated
disembodied heads yelling orders
at him.
• The bright orange areas reveal
activity in the left auditory and
visual areas of his brain, but not in
the frontal lobe, which normally is
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involved in organized thought

processes.
 Negative Symptoms of Schizophrenia

Negative Symptoms
• Consist of marked deficits or decreases in behavioral or
emotional functioning
• Symptoms can occur in combination and vary across
cultures:

 Flat affect
 Alogia
 Avolition
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 Schizophrenia Symptoms and Culture

• Symptoms of schizophrenia often vary across cultures.

• Cultural differences in hallucinations
• Cultural differences in delusions
 Content of delusions changes as culture shifts.
• Recently, delusions are more likely to involve technology
and media.
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 The Prevalence and Course of Schizophrenia,
Part 1

• Prevalence
 200,000 new cases are diagnosed in United States per
year
 Approximately 1 million Americans are treated annually.
 1% of the U.S. population will experience at least one
episode during life
 Most cultures correspond very closely to the 1% rate.
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 The Prevalence and Course of Schizophrenia,
Part 2

• Course
 Onset of schizophrenia typically occurs during young
adulthood.
 One-quarter of those who experience an episode of
schizophrenia recover completely.
 One-quarter experience recurrent episodes of
schizophrenia but with minimal impairment in ability to
function.
 For one-half, schizophrenia becomes a chronic mental
illness, and the ability to function may be severely
impaired.
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 Explaining Schizophrenia, Part 1

• Genetic Factors: family, twin, and adoption studies

 Schizophrenia clusters in certain families
 More closely related a person is to someone who has
schizophrenia, the greater the risk of schizophrenia
 Chromosome locations associated with genes that
influence brain development, memory, and cognition
seem related.
 No specific pattern of genetic variation can be identified
as the genetic “cause” of schizophrenia, but presence of
certain genetic variations increases susceptibility.
 If either biological parent of an adopted individual had
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schizophrenia, there is a greater risk of developing

schizophrenia.
Explaining Schizophrenia, Part 2
 Explaining Schizophrenia, Part 3

Immune System: viral infection theory

• Women exposed to flu virus during the first trimester had a
sevenfold increased risk of a child who developed
schizophrenia.
• Mothers who were exposed to flu virus during the first or
second trimester show an increased rate of schizophrenia.
• Schizophrenia occurs more often in those born in the
winter and spring months, when upper respiratory
infections are most common.
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 Explaining Schizophrenia, Part 4

Abnormal Brain Structures

• Evidence
 50% of people with schizophrenia
show some type of brain structure
abnormality
 Most consistent finding: enlargement
of the ventricles
 Loss of gray matter tissue and lower
overall volume of the brain
• Not Conclusive
 Some people with schizophrenia do
not show brain structure
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abnormalities.
 Evidence is correlational…..
 Explaining Schizophrenia, Part 5

Abnormal Brain Chemistry

• Imbalances in neurotransmitters
• Excessive activity of dopamine in the brain
 Antipsychotic drugs reduce/block dopamine activity in
the brain.
 Drugs that enhance dopamine activity in the brain
increase symptoms in those who already have
schizophrenia.
• Imbalances in glutamate and adenosine are related to
schizophrenia.
• However, connection between neurotransmitters and
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schizophrenia symptoms remains unclear.

 FOCUS ON NEUROSCIENCE
Schizophrenia: A Wildfire in the Brain
• In a five-year prospective study,
neuroscientist Paul Thompson
and his colleagues used high-
resolution brain scans to map
brain structure changes.
• Adolescents with early-onset
schizophrenia
 Severe loss of gray matter
developed in a specific,
wavelike pattern and
correlated with clinical
symptoms.
 Pattern of loss mirrored
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progression of neurological
and cognitive deficits.
 Explaining Schizophrenia
Psychological Factors: Unhealthy Families
 A Finnish study found
adopted children with a
biological schizophrenic
mother had a higher rate
of schizophrenia when
raised in a disturbed,
adoptive home (Tienari
& others).

 This graph shows the

strong influence of the
adoptive family
environment on the
development of serious
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mental disorders.
 PSYCH FOR YOUR LIFE
Understanding and Helping to Prevent Suicide, Part 1

How many risk factors can you identify?

 PSYCH FOR YOUR LIFE
Understanding and Helping to Prevent Suicide, Part 2

• Reasons for attempting or committing suicide

 View of life becomes more pessimistic and negative.
 View of self-inflicted death become more acceptable and
positive.
 Suicide seen as escape from pain.

• Ways to help prevent suicide

 Actively listen.
 Do not deny or minimize person’s intentions.
 Identify other potential solutions.
 Ask person to delay decision.
 Encourage person to seek professional help.