Psychologi

cal
Disorders

PowerPoint
®
Presentation
by Jim
Foley
© 2013 Worth Publishers
What we’ll 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 Questions to Keep in Mind
psychological
disorders
How do we decide when a set of
Thinking symptoms are severe enough to
critically about be called a disorder that needs
ADHD treatment?
Understandin
g Can we define specific disorders
psychological clearly enough so that we can
disorders know that we’re all referring to
the same behavior/mental state?
Classifying
psychologic
al disorders Can we use our diagnostic labels
to guide treatment rather than to
Labeling stigmatize people?
psychological
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
one’s daily life and well being.
 Deviant means differing from the
norm.
 Defining Deviance:
“Deviant” The Role of Context
and
? Culture
Context: whether a behavior
To deviate, in varies from expectation
general, means to depends on the situation in
vary from what which the behavior occurs
typically would Yelling for hours is not
deviant when it happens at a
happen. football game.
In psychology, a Culture: these painted faces
behavior or mental might seem deviant when
state is considered viewed from a different culture
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
 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
the nature/cause of the psychological
symptoms.
Based on older understanding
of psychological disorders,
treatments have included:
exorcising evil spirits, beatings,
caging/restraint, and
Pinel’s New
From the humane
Approach
 Philippe Pinel (1745-1826) and others
sought to reform brutal treatment by
view to the scientific
view of the mentally
promoting a new understanding of ill:
the nature of mental disorders.
Pinel’s humane
 Pinel proposed that mental disorders environmental
were not caused by demonic interventions improved
possession, but by environmental lives but often did not
factors such as stress and inhumane effectively treat
 conditions. mental illness
Pinel’s “moral treatment” But
involved improving the then
environment and replacing the …
 The The discovery that the disease of
syphilis causes mental symptoms
Medical (by infecting the brain) suggested
a medical model for mental
Model
Psychological disorders
illness.
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
Examples: a disorder.

Bulimia Nervosa: binging/purging, in the United

States Running amok: violent outbursts, in Malaysia
Hikikomori: social withdrawal, in Japan
Classifying Psychological
Disorders
Why create
The Diagnostic
and Statistical
classifications of mental Manual
illness? What is the
value of talking about It’s easier to count
diagnoses instead of just cases of autism if we
talking about individuals? have a clear
1.Diagnoses create a definition.
verbal shorthand for
referring to a list of Versions: DSM-IV-TR,
associated DSM-V (May 2013)
symptoms.
The DSM is used
2.Diagnoses allow us to to justify payment
statistically study many for treatment.
similar cases, learning
to predict outcomes. It’s consistent with
3.Diagnoses can diagnoses used by
guide treatment 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
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
Anxiety
Disorders
GAD:
Generalized
 Emotional-cognitive
Anxiety 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:
“I’m
A panic Dying”
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 it’s a heart
attack.
a feeling of a need to
escape.
Panic disorder refers to
 Specific
A specific phobia is more than
Phobia
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
What trendsPhobias
are
evident here?
Which varies
more,
fear or phobias?
What does
this imply?

Some Other Phobias

Agoraphobia is Social phobia refers to an
avoidance
the of situations fear of being watched and judged
intense
which
in one will fear having by others. It is visible as a fear of
a panic attack, especially a public appearances in which
situation in which it is embarrassment or humiliation is
difficult to get help, and possible, such as public speaking,
from which it difficult to eating, or performing.
escape.
Obsessive-Compulsive Disorder
Obsessions are intense,
[OCD]
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 doesn’t 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
 Common OCD Behaviors
Percentage of children and adolescents with OCD
reporting these obsessions or compulsions:

Common pattern: RECHECKING

Although you know that
you’ve already made sure the
door is locked, you feel you
must check again. And again.
 Post-Traumatic
Stress
Disorder
About 10[PTSD]
to 35 percent of
people who experience
trauma not only have
burned-in memories, but
also four weeks to a lifetime
of:
repeated intrusive recall
of those memories.
nightmares and other
re- experiencing.
social withdrawal or
phobic avoidance.
jumpy anxiety
or
 Resilience and
Which People get Post- Traumatic
Growth
Those with less control in
PTSD?
the situation
Resilience/recovery
after trauma
Those traumatized more may include:
frequently some lingering,
Those with brain differences but not
Those who have less overwhelming,
stress.
resiliency
finding strengths
Those who get re- in yourself.
traumatized
finding connection
with others.
finding hope.
seeing the trauma
as a challenge that
can be overcome.
 Understanding Anxiety
Disorders:
Explanations from Different Perspectives
Classical Operant
Psychodynam conditioning:
ic/ Freudian: overgeneralizin conditionin
repressed g a conditioned g: rewarding
impulses response avoidance

Observation Cognitive Evolutionary:

al learning: appraisals: surviving by
worrying like uncertainty avoiding
mom is danger 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
 In theand Anxiety
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.
The result is a phobia
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
 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
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

don’t 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
“they’re talking about me”
 Biology and Anxiety:
An Evolutionary
1. Human phobic objects: 2. Similar but non-phobic objects:
Perspective
Snak Fish
es Heights Low places
Closed Open
spaces spaces
3. Dangerous yetDarkness
non-phobicBright light
subjects:
We are likely to become cautious about, but not phobic
about:
Guns
Electric
wiring
Evolutionary psychologists Cars
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 fear of list
#3 (the gun list) to spread in the population.
Biology and Anxiety:
Genes
Studies show that Genes and
identical twins, even Neurotransmitte
raised separately, rs
develop similar Genes regulate
phobias (more levels of
similar than two neurotransmitters.
unrelated people).
Some people seem to People with anxiety have
have an inborn high- problems with a gene
strung temperament, associated with levels of
while others are serotonin, a neurotransmitter
more easygoing. involved in regulating sleep and
Temperament may mood.
be encoded in our People with anxiety also
genes. have a gene that triggers high
levels of glutamate, an
 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 The OCD brain shows extra
habitual behaviors. activity in the ACC, which
monitors our actions and
checks for errors.
ACC = anterior cingulate gyrus
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.”
 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. Don’t add
criticism by implying the
depression is an exaggerated
response.
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
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
Depression: The “Common
Cold” of Disorders?
Although both are “common”
(occurring frequently and
pervasively), comparing depression
to a cold doesn’t 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.
And…depressive pain is beyond
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 winter’s short, dark, cold days.
Survey: “Have you cried today”? Result:
More people answer “yes” in winter.

Percentage who cried

Men Wome
August 4 n 7
Decemb 8 21
er
 Bipolar
Disorder
Bipolar disorder was
once called “manic-
depressive disorder.”
Bipolar disorder’s two
polar opposite moods
are depression and
mania.
Contrasting Symptoms
Depressed mood: stuck
feeling “down,” with:
 exaggerated pessimism
 social withdrawal
 lack of felt pleasure
 inactivity and no initiative
 difficulty focusing
 fatigue and excessive desire to
sleep
Mania refers to a period
of hyper-elevated mood
that is euphoric, giddy,
easily irritated,
hyperactive, impulsive,
overly optimistic, and
even grandiose.
Mania: euphoric, giddy,
easily irritated, with:
 exaggerated optimism
 hypersociality and sexuality
 delight in everything
 impulsivity and overactivity
 racing thoughts; the mind
won’t 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
Suicide and Self-
Injury
Every year, 1 million people commit suicide, giving
up on the process of trying to cope and improve
their emotional well-being.
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
Evolutionar
Biological aspects
and y Genetic
explanations Brain /Body

Negative thoughts
Social-cognitive aspects and negative mood
and explanations Explanatory style
The vicious
cycle
An Evolutionary Perspective on
the Biology of Depression
Depression, in its milder,
non- 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.
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
Using Knowledge
Depression: 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
The Social-Cognitive
Disorders:
Perspective
Discounting positive
Low and the
information and assuming Self-defeating
Self- the worst about self,
future beliefs such as
Esteem situation, assuming that
Learned one (self) is
Helplessne unable to cope,
ss improve,
achieve, or be
Depression is happy
associated
with:
Depressive
Explanato
ry Style
Ruminatio
n
Stuck focusing
on what’s bad
 Depressive Explanatory
How we analyze bad news predicts
Style
mood.
Problematic event:

Assumptions
about the
problem

The problem is:

The problem is:

The problem is:

Mood/result that
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
mood changes
a person’s 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 one’s own
Schizophrenia thoughts so that they appear as
hallucinations.
:
Psychosis refers
to a mental
split from Schizophrenia
reality and symptoms
rationality. include:
disorganized
and/or
delusional
thinking.
disturbed
perception
s.
inappropria
Positive and Negative Symptoms
of Schizophrenia
Positive + Negative -
presence of absence
of
problemati healthy
c behaviors
behaviors

 Hallucinations (illusory  Flat affect (no

perceptions), especially emotion showing in
auditory  the face)
 Delusions (illusory Reduced social
beliefs),  interaction
especially Anhedonia (no feeling
 persecutory  of enjoyment)
Disorganized thought Avolition (less
 and nonsensical speech motivation, initiative,
Bizarre behaviors  focus on tasks)
Schizophrenia Symptoms:
Problems in Thinking and
 Disorganized speech,
Speaking
including 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 You’re
 People with schizophrenia often Am I evil!
experience hallucinations, that evil?
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.
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
Actions/Behavior
Odd and socially inappropriate
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 Course of
Development Schizophren
Acute/Reactive
ia Schizophrenia
of In reaction to stress, some
people develop positive
Schizophrenia
 Onset: Typically, symptoms such
schizophrenic as hallucinations.
symptoms appear at – Recovery is
the end of adolescence likely.
and in early adulthood, Chronic/Process
later for women than Schizophrenia
for men. develops slowly,
 Prevalence: Nearly 1 in with more
100 people develop negative symptoms such as
schizophrenia, slightly flat affect and social
more men than women. withdrawal.
 Development: The – With treatment and
course of schizophrenia support, there may be
can be acute/reactive or periods of a normal
chronic. life, but not a cure.
Subtypes of
Schizophrenia
Understanding
Schizophrenia
What’s going on Abnormal brain
in 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
Understanding
Schizophrenia Schizophrenia is
more likely to
Are there biological risk develop in babies
factors affecting early born:
development?
during and after
flu epidemics.
Biological Risk Factors in densely
Schizophrenia is somewhat more populated areas.
likely to develop when one or more of a few months after
these factors is present: flu season.
 low birth weight
 maternal diabetes after mothers had
 older paternal age the flu during the
 famine second trimester, or
 oxygen deprivation during delivery had antibodies
showing viral
 maternal virus during mid- infection.
pregnancy impairing brain The lesson is to:
development
 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
Genetic and Prenatal Causes
 Even in identical twins, genetics do  Even if maternal flu
during the second
not fully predict schizophrenia. trimester doubles
 This could be because of the risk of
environmental differences. schizophrenia, this
 First difference: twins in separate means only 2
percent of these
placentas. babies develop 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.
Understanding
Schizophrenia
Are there Social-
psychologic Psychological
al 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.
 Predicting
Schizophrenia: Early
Warning
Social/psychological
Signs
factors which tend to Biological factors
appear before the which tend to appear
onset of before the onset of
schizophrenia: schizophrenia:

 early separation from  having a mother with

parents severe chronic
 short attention span schizophrenia
 birth complications,
 disruptive OR withdrawn including oxygen
behavior deprivation and low
 emotional unpredictability birth weight
 poor peer relations  poor muscle
and/or solitary play
coordination
 Other
Disorde
rs Dissociativ
e
Disorders

Eating Personalit
Disorder y
s Disorders
  Dissociation refers to a separation
Dissociativ of
conscious awareness from thoughts,
e memory, bodily sensations,
Disorders  Dissociation can serve
feelings, or even from as a
identity.
psychological escape from an
overwhelmingly stressful
situation.
 A dissociative disorder refers to
Examples: dysfunction and distress caused
by chronic and severe
Dissociative Loss of memory with no known physical cause;
dissociation.
Amnesia: inability to recall selected memories or any
memories
Dissociative “Running away” state; wandering away from one’s
Fugue life, memory, and identity, with no memory of
these
Dissociative
Identity
Disorder Development of separate
(D.I.D.) personalities
 Dissociative Identity Disorder
formerly “Multiple Personality
(D.I.D.)
Disorder” Alternative Explanations
In the rare actual cases of for D.I.D.
D.I.D., the personalities: Dissociative “identities”
are distinct, and not present might just be an
in consciousness at the same extreme form of playing
time. a role.
may or may not appear to be D.I.D. in North America
aware of each other. 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 think of
different parts of
 D.I.D., or DID
Not? that D.I.D. is
Evidence
Real
Different personalities
have involved: Explaining
fragmentation of
different brain wave personality from
patterns. different perspectives
different left-right Psychoanalytic
handedness. perspective:
diverting
different visual acuity and
eye muscle balance patterns. id Cognitive perspective:
c
Patients with D.I.D. also
show heightened activity in oping with abuse
areas of the brain Learning
associated with managing perspective:
and inhibiting traumatic dissociation
memories.
pays Social influence:
 These may involve:
Eating unrealistic body image and
Disorder extreme body ideal.
s a desire to control food and the
body when one’s situation can’t
Anorexia nervosa be controlled.
Bulimia nervosa cycles of depression.
Binge-eating disorder health problems.
D
Anorexi e to lose weight,
Compulsion 0.6 percent
a coupled with
f certainty about meet criteria
Nervosa being fat despite being 15 at
percent or i more underweight some time
Bulimia Compulsionnto binge, eating large during
amountsi fast, then purge by lifetime
losing the food through vomiting, 1.0
Nervos t
laxatives, and percent
a i extreme exercise
Binge- Compulsiono to binge, followed 2.8
Eating by guilt and depression
n
Eating Disorders: Associated
Factors
Family factors:
having a mother focused on her
weight, and on child’s
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:
 Personalit Personality disorders
are enduring patterns
y of social and other
Disorders 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, attention-
seeking; narcissistic, self-centered;
antisocial, amoral
Antisocial Personality Disorder
[APD]
Antisocial personality
disorder refers to Deceitfulness
acting impulsively or Disregard for safety of self
fearlessly without or others
regard for others’
needs and feelings. Aggressiveness
Failure to conform to
The diagnostic criteria social
norms
include a pattern of
violating the rights of Lack of remorse
others since age 15, Impulsivity and failure to
including three of plan
these: ahead
Irritability
Irresponsibility regarding
 Which Kids May Develop APD as
Adults?
About half of children Biological APD Risk Factors
with persistent antisocial Antisocial or unemotional
behavior develop
lifelong APD. biological relatives increases risk.
Which kids are at  Some associated genes
risk? Psychological have been identified.
factors:
those who in Risk factors include body-based
preschool were fearlessness, lower levels of stress
impulsive, uninhibited, hormones, and low physiological
unconcerned with arousal in stressful situations such
social rewards, and low as awaiting receiving a shock.
in anxiety.
Fear conditioning is impaired.
those who endured
child abuse, and/or Reduced prefrontal cortex
inconsistent, tissue leads to impulsivity.
 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
suppress
es
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
Psychologi
cal
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.