Psychological disorders are: dysfunctional melee 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 one’s daily life and well being. Deviant means differing from the norm.A Pinu eeu “Deviant”? The Role of Context and Culture Desai To deviate, in general, Er ei el means to vary from r i ope what typically would happen. Bae In psychology, a < the behavior or mental leer state is considered bh Sle deviant by a culture when it is different from what woul expected in that culture. A disorder may also be a deviation froma typical developmental pathway.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 can’t 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 t! nature/cause of the psychological symptoms: " Based on older understanding of psychological disorders, treatments have included: exorcising evil spirits, beatings, caging/restraint, and —————>* Philippe Pinel (1745-1826) and others sought to reform brutal treatment by promoting a new understanding of the ature of mental disorders. * Pinel proposed that mental disorders Pacenuencinpraved were not caused by demonic possession, [lives but often Get ROE but by environmental factors such as effectively reat mental stress and inhumane conditions. * Pinel's “moral treatment” involved the mentally ill: Pinel’s humane environmental improving the environment and But replacing the asylum beatings with hyper-elevated mood that is euphoric, giddy, easily irritated, hyperactive, impulsive, overly optimistic, and even grandiose. Gene Depressed mood: stuck feeling “down,” with: exaggerated pessimism social withdrawal lack of felt pleasu inactivity and no i difficulty focusing fatigue and excessive desire to sleep ative ‘Mania: euphoric, giddy, easily irritated, with: " exaggerated optimism hypersocialty and sexuality delight in everything impulsivity and overactivity racing thoughts; the mind won't settle down little desire for sleepBipolar Disorder in Children and BCE 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.Why Does Depression Have so Many Symptoms? hebletinen, quit, enpsiness, + eae eekly dsomnecid konoten + Turning away from other people ** Insomnia, early morni or oversieeping iiiecetocaee ¢ Las ol physical and manal energy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." Every year, 1 million people commit suicide, giving Melk We eole tee) mea nach ae) STM eal emotional well-being. Bee Ma] >) Sama uN -ce) ol eR Te trapped, isolated, ineffective, and see no end to Ps Non-suicidal self-injury has other functions sueh as Fxo1aol Lal ae Mant ect) OMe Ls od Lavan |Understanding Mood Disorders Evolutionary Genetic Brain /Body Biological aspects and een riCne Negative thoughts and Cer Renee esac negative mood and explanations Explanatory style The vicious cycle=—“Depression, inits milder, ron- disordered 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. MlBiology of Depression: Genetics Evidence of genetic influence on depression: 1.DNA linkage analysis reveals depressed gene regions 2.twin/adoption heritability studies 90% The heritability of various psychological s disorders Researchers Joseph Bienvenu, Dimitry 70 Davydow, and Kenneth Kendler (2011) aggregated data from studies of identical and fratemal twins eo toestimate the heritability of bipolar disorder, 50 schizophrenia, anorexia nervosa, major depressive ad disorder, and generalized anxiety disorder. 30 Il Bipolar disorder on IH Schizophrenia I Anorexia nervosa Bi Major depressive disorder 0 J . 1 Generalized anaiety disorder Heritability estimatesBiology of Depression au 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 Depressed state Manic state Depressed state nay 37) (May 18) (May 27)Preventing or Reducing Depression: Using Knowledge of the Biology of DepressionUnderstanding Mood Disorders: The Social-Cognitive Perspective Discounting positive information ane assuming the worst about self, situation, lear and the future Self-defeating eet Beliefs such as assuming that Sm one (self) is i Persea unable to cope, improve, achieve, or be happy Depression is associated with: Prarie Explanatory airy ‘Stuck focusing on what's badDepressive Explanatory Style How we analyze bad news predicts mood. Problematic event: T Assumptions about the problem Gone eaute steerer gtr tin o ‘ital F wines pts ant eee Tete ca, Ul ATS Deeds ourbreskup was all my felt it th ~ Mood/result that Sea goes along with these views:Depression’s Vicious Cycle A depressed mood may develop when a person with a negative outlook experiences repeated stress. The depressed Sirecehit mood changes a experiences person’s style of thinking and ; ee 7 2 interacting ina cogiitie and Negative way that makes behavioral changes explanatory style stressful experience more likely. 3 Depressed moodSchizophrenia: ed Psychosis refers to a mental split from reality and feeling Ls the mind is split from reality, e.g. a split from one’s own thoughts so that they appear as LE) elec l iene Schizophrenia symptoms include: "disorganized , and/or delusional thinking. "disturbed perceptions. "inappropriate ee emotions and actions.Preaek eae iced ere Pence sn] perceptions), especially Bri PECAN PSS ames sri persecutory Dee Runt ae Presi e acd CT aC Mery Gein GOL urn showing in the face) Reet eel interaction PON OR aad yur sule Po as Pura eae focus on tasks)Schizophrenia Symptoms: Problems in Thinking and Speaking " Disorganized speech, including the “word salad” of loosely associated phrases * Delusions flusory belief), often bizarre and not just mistaken; most common are delusion 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 * Peoole with schizophrenia often & experience hallucinations, that is, perceptual experiences not e 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 algo be visual, clfactory/smels,tactile/touch, or gustatory/taste,Schizophrenia Symptoms: Schizophrenia Symptoms: Inappropriate Emotions Inappropriate Actions/Behavior * Odd and socially inappropriate Odd and socially inappropriate responses such as looking bored behavior can be caused by symptoms i while hearing of a suchas: eat "errors in social perception. " Flat affect faial/body "disorganized, unfiltered thinking, expression is “flat” with no visible emational content @ @ "delusions and hallucinations. @@ " Impaired perception of emotions, including not The schizophrenic body exhibits “reacing’ others’ intentions and symptoms such a: feelings — "repetitive behaviors such as rocking and rubbing, "catatonia, uch as siting motionless and unresponsive for hours.Onset and Development of Nol rey yesyal es 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 TeWec-laatelameensac-cHmcoluaT people develop positive symptoms such as LENA LeCOn alleen LV LCN Chronic/Process Schizophrenia develops slowly, with more ies -claNory OOS onic nile affect and social withdrawal. Beak (tam ce -teltnrcanl at ale] support, there may be periods of a normal life, folie gTel are ol om — Without treatment, this type of schizophrenia often leads to poverty and social problems.Subtypes of Schizophrenia Ee * Plagued by hallucinations, often with negative messages, and delusions, both grandiose and persecutory OE * Primary symptoms are flat affect, incoherent speech, and random behavior a * Rarely initiating or controlling movement; copies others’ speech and actions Sirhan * Many varied symptoms Es * Withdrawal continues after positive symptoms have disappearednderstanding Schizophrenia What's going on in Abnormal brain the brain in > structure and schizophrenia? activity * Too many dopamine/D4 receptors help to explain paranoia and hallucinations; it’s like taking amphetamine overdoses all the time. Poor coordination of neural firing in the frontal lobes impairs judgment and self-control. " The thalamus fires during hallucinations as if real sensations were being received. There is general shrinking of many brain areas and connections between them.ndersta g 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 mid-pregnancy impairing brain developmentderstanding Schizo Are there genetic risk factors? If so, we would see more . similar schizophrenia risk -» Genetic Factors renia shared between identical twins If one twin has than fraternal twins (graph schizophrenia, the below). Do we? chance of the other Schizophrenia risk one also having it are for twins of those much greater if the diagnosed twins are identical. with schizophrenia 70% | Mil Fraternal twins 60 | dentical wins Having adoptive 0 siblings (or parents) “0 with schizophrenia a does not increase the - likelihood of ae developing a schizophrenia. Japan Denmark Finland Germany U.K. (1998) (1996) 4998) 6998) (999),Understanding Schizophrenia Genetic and Prenatal Causes * Even in identical twins, genetics do not fully predict schizophrenia. " This could be because of environmental differences. "First difference: twins in separate placentas. ecu PM eae trimester doubles the Fite ee eae rec M es rn el Re pecans had Coogee ™ Genetics may Tamed Pires eee arn each See eae a neva’ Sura factors to turn on these genes. Neschephee ‘Seen Only one of two twins has the enlarged ventricles seen in schizophrenianderstanding Schizophrenia Are there Social-_ psychological Psychological causes? 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.Prosieting Sctmsouivonte: Early early separation from parents short attention span disruptive OR withdrawn behavior emotional unpredictability poor peer relations and/or = solitary play arning Signs factor: d before the onset ete having a mother with severe chronic schizophrenia birth complications, including oxygen deprivation and low birth weight poor muscle coordination" Dissociation refers to a separation of Other Dever ti conscious awareness from thoughts, 4 ee memory, bodily sensations, feelings, Disorders 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 by Examples: chronic and severe dissociation, reer Loss of memory with no known physical cause; inability to recall selected memories or any memories mid “Running away’ state; wandering away from one’s Disorders MAMORU NAO euN Renu aaa eee eCCSTs eros In the rare actual cases of PA Different personales hve ; D.LD. the personalities: VISTAS SI noted: ree "are distinct, and not present PULSARS UMCUISN ferent bin uave 4 inconsciousness a the same fioullda iene oats, Sl time. SOMO SCM ferent tht Ps "may or may not appear to be dade ui gol f handedness, aware of each other. Sol reuULUmamCA ferent viva auiy and Ce aay eye muscle balance pattern. Patints with DD. ago show heightened activity in areas ofthe brain associated with managing and inhibiting traumatic memories. Omics BERT UD TOM IaCd errlcoKua URNS] HC useC KONE people to think of different parts of themselves,These may involve: "unrealistic body image and extreme body ideal. "a desireto control food and the body when one’s situation can’t be controled. iy Usa Anorexia nervosa 4 Bina feo cycles of depression, : _ "health problems, Binge-eating disorder PECL) oe) ae Anorexia Compulsion tolose weight, O.6 percent coupled with certainty about meet criteria at it bag tng etn some time or more underweight dling lifetime Bulimia Compulsion to binge, eating large Nervosa 2mtounts fst, then purge by losing LOpecent the food through vomiting, lavatives, and extreme exercise Binge-Eating Compuson to bing, followed by Disorder sult and depression 28percet Eating Disorders: Associated Factors Family factors: "having a mother focused on her weight, and on child's appearance and weight fete self-evaluation in the family for bulimia, if childhood obesity runsinthe faily for anorexia if families are competitive, high-achieving, and protective Cultural factors: "unrealistic ideals of body appearancePersonality Disorders Personality kat behavior that impai 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, attention-seeking; narcissistic, self-centered; antisocial, amoralAntisocial Personality Disorder [APD] Antisocial personality cisorder refers to acting impubively 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 ofthese: About half of children with persistent antisocial behavior develop lifelong 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. Biological APD Risk Factors "Antisocial or unemotional biological relatives increases risk. * Some associated genes have been identified. *Risk factors include body-based fearlessness, lower levels of stress ASAE MAN Seo arousal in stressful situations such as awaiting receiving a shock. "Fear conditioning is impaired, "Reduced prefrontal cortex tissue leads to impulsivity, "Substance dependence is more relAntisocial PD # Criminality Criminals: people People with Who repeatedly antisocial commit crimes personality disorder 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 nota full picture of most criminal activity, what can we say about people who commit crime, especially violent crime? Pecentage 35% dtc offenders Bb Biosoil rots of crime: birth complications and" poverycombineto increase risk, 5 a Ttalerime Thievery Violence Chithood — Mosel gety cals With poet and ltl complains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. Normal Murderer Other differences include: "less amygdala response when viewing violence. ™an overactive dopamine reward-seeking system.Risks and Protective Factors for ; Mental Disorders TCU TaN aU Risk Factors Protective Factors Aaa vgn Academic failure Aerobic exercise Birth complications Community offering empowerment Caring or chronically lor patients with dementia Child abuse and neglect Heer CaN AO LOa GOAN 0) coco ENON en NO Mn Mats UA treatment Chronic insomnia Chronic pain Family disorganization or conflict Low birth weight Literacy Postve attachment and early bonding Low socioeconomic status Medical liness Positive parent-child relationships Neoctenial nblce Prem lings BT Vc0o a LUTION Parental mental ili Resilient coping with stress and adversity albeit ae mee substance abuse loss and bereavement Social and work skills Gree ie Sec agporton aniyandnets METER o occ escacTU ITU CeN SOU Reading disabilities Sensory disables Who is at risk of mental disorders? Saliack Who is less at risk?