Transcript Mood Disorders

Psychological Disorders
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“I felt the need to clean my room at home in Indianapolis every
Sunday and would spend four to five hours at it. I would take
every book out of the bookcase, dust and put it back. At the time
I loved doing it. Then I didn’t want to do it anymore, but I
couldn’t stop. The clothes in my closet hung exactly two fingers
apart.… I made a ritual of touching the wall in my bedroom
before I went out because something bad would happen if I
didn’t do it the right way. I had a constant anxiety about it as a
kid, and it made me think for the first time that I might be nuts.”
Marc, diagnosed with obsessive-compulsive
disorder (from Summers, 1996)
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Possible causes of Depression:
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Disease
Death of a loved once
Divorce
Loss of job
A break-up
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Nearly 450 million people suffer from mental
or behavioral disorders
Disorders account for 15.4% of years lost due
to death or disability
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Psychological Disorders: Deviant, distressful,
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Remember the 3D’s
and dysfunctional behavior patterns.
Schizophrenia
Depression
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ADHD : a psychological disorder marked by
the appearance by age7 of one or more of
three key symptoms; extreme inattention,
hyperactivity, and impulsivity.
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Mostly males are diagnosed with ADHD
In the past 20 years the number of diagnoses
have tripled
Some doubt the legitimacy of the disorder
due to this
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ADHD is potentially heritable
Ritalin and Adderall are stimulants used to
treat ADHD symptoms
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Children with ADHD appear to have delayed
pruning but when it occurs, however, kids
can mature later into normal adults.
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Over the last two centuries, the mentally ill
were caged, beaten, castrated, got holes
drilled in their skull, had teeth removed, and
more.
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Insisted mental disorders were sickness of
the mind caused by stress and inhumane
conditions, not demons
Made great strides to help serve justice to the
mentally ill
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Medical Model : the concept that diseases, in
this case psychological, can be diagnosed,
treated, and in most cases, cured, often
through treatment in a hospital.
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Biopsychosocial approach contends that all
behaviors are an interaction of genetics and
experiences
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Susto: a condition marked by severe anxiety,
restlessness, and a gear of black magic. It is
prevalent in Latin America.
Taijin Kyofusho: Social anxiety about one’s
appearance combined with a readiness to
blush and a fear of eye contact Commonly
Found in Japan.
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DSM-IV-TR: The American Psychiatric
Association’s diagnostic and statistical mauel
of mental disorders, fourth edition, with an
updated “text revision”; a widely used system
for classifying psychological disorders.
Goal: to describe and classify disorders, it
does not explain why they occur or how they
can be treated.
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Criticisms of the DSM:
◦ Casts too wide of a net for possible diagnosis
◦ The number of disorder categories has swelled
considerably
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Six clusters of 24 strengths: wisdom and
knowledge, courage, love, justice,
temperance, and transcendence.
◦ Seligman came up with this
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Labels create preconceptions that guide our
perceptions and our interpretations.
David Rosenhan experiment: Rosenhan and 7
other perfectly healthy men went to a hospital
claiming they heard voices in their heads.
They answered follow up questions truthfully
and normally, yet all were misdiagnosed with
a disorder.
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Pros of labeling disorders: health
professionals can use labels to communicate
about their cases and to discern treatment.
Cons: can create bias and self-fulfilling
prophecy
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The majority of individuals with psychological
disorders are not violent.
16% of US jai land prison inmates have sever
mental disorders
Jail or hospital? Two weeks after being
taken off antipsychotic medication by
her psychiatrist, Andrea Yates drowned
her five children, ages 7, 5, 3, 2, and 6
months, in her bathtub, apparently
believing she was sparing them “the
fires of hell.” Although she was
psychotic, one jury rejected the
insanity defense, believing Yates still
could have discerned right from
wrong. On retrial, a second jury found
her not guilty by reason of insanity.
AP Photo
 Anxiety disorders: psychological
disorders characterized by distressing,
persistent anxiety, or maladaptive
behaviors that reduce anxiety.
 5 anxiety disorders:
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Generalized anxiety disorder
Panic disorder
Phobias
Obsessive compulsive disorder
Post traumatic stress disorder
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Generalized anxiety disorder: a person is
continually tense, apprehensive, and in a
state of autonomic nervous system arousal.
◦ 2/3 of those with this disorder are women
◦ May lead to high blood pressure or ulcers
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Panic attack: a minutes-long episode of
intense fear that something horrible is
going to happen.
◦ Tremble
◦ Dizziness
◦ Choking sensation
◦ May be perceived as
A heart attack
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Phobia: an intense, irrational fear of
something.
Agoraphobia: a fear or avoidance of situations in which
escape might be difficult or help unavailable.
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Common and uncommon fears
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PET Scan of brain of
person with
Obsessive/
Compulsive disorder
High metabolic
activity (red) in
frontal lobe areas
involved with
directing attention
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Post-Traumatic Stress Disorder: PTSD, is an anxiety disorder
that can develop after exposure to a terrifying event or ordeal
in which grave physical harm occurred or was threatened that
comes with…..depression, anxiety, paranoia, mood swings
Possible causes: rape, war, torture, kidnapping, attacks etc.
After 9/11 8.5% of Manhattan residents has PTSD
Heavy combat Vietnam survivors had 32% PTSD
A sensitive limbic system makes one more susceptible to
PTSD
On the other hand: holocaust survivior became more
empathetic, responsible, and developed larger capacities for
caring after their traumatic experiences “Post Traumatic
Growth”
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Using classical conditioning, researchers created
anxious, ulcer-prone rats by giving them
unpredictable electric shocks
Stimulus generalization: attacked by one dog but
fear all different breeds of dogs
Naturally selected fears: spiders, snakes, closed
spaces, darkness storms, heights.
Genes affect fears due to temperament; identical
twins usually have the same anomocity of fear
and feared subjects.
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Somatoform disorder: a psychological
disorder in which the symptoms take a
somatic form with out apparent physical
cause.
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Vomiting
Dizziness
Blurred vision
Prolonged pain
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Conversion disorder: a person experiences
very specific genuine physical symptoms for
which no physiological basis can be found
◦ Real physical symptoms
◦ Blindness
◦ Inability to swallow
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Hypochondriasis: a person interprets normal
physical sensations as symptoms of a
disease.
I have a
headache
..is it
cancer?
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Dissociative disorders: disorders in which
conscious awareness becomes separated
dissociated from previous memories,
thoughts, and feelings
◦ Forget previous experiences
◦ Often in response to stress
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Dissociation is not rare
Comparable to an “out of body” experience
Freud might call this phenomenon repression
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D.I.D: A rare dissociative disorder in which a
person exhibits two or more distinct and
alternating personalities. Formerly called
multiple personality disorder
◦ Each personality may
have its own distinct qualities
◦ Individuals are not aware
or this personality switch
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Kenneth Bianchi the “Hillside Strangler” was
accused of the rape and murder of 10 women
in California in 1984
Faked a Dissociative Identity
Disorder in court to attempt
to escape a jail sentence
The faults in his act were
seen; he was figured out
and was convicted
Asked college students to pretend they were
accused murderers being examined by
psychiatrist.
 Most spontaneously expressed a second
personality
 “Are dissociative identities
simply a more extreme version
of our capacity to vary the
‘selves’ we present? “
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In the 1980’s the number of DID diagnosis
skyrocketed to nearly 20,000
Number of personalities mushroomed: 3% to
12% per patient
Outside North America this disorder is almost
non existent
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These therapists have detected that shifting
visual activity and eye muscles balance as
people switched personalities
Heightened brain activity in brain areas for
control and inhibition of traumatic memories
Some therapists “fish” for multiple
personalities
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Psychoanalysts see DID as defenses against
the anxiety caused by the eruption of
unacceptable impulses
Learning theorists think it is a type of
reinforcement
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Mood disorders are marked by emotional
extremes
◦ People are most
Susceptible to
Depression in the
winter
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Major Depressive Disorder
 a mood disorder in which a person,
for no apparent reason, experiences
two or more weeks of depressed
moods, feelings of worthlessness,
and diminished interest or pleasure
in most activities
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Symptoms:
◦ Discouraged about the future
◦ Dissatisfied with life
◦ Socially isolated
 44% college kids report
Being depressed
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Depression is the leading cause of disability
world wide
Depression is usually a response to past and
current loss
1 in 4 people who are depressed are ismply
struggling with normal emotional impact of a
significant loss
Major Depressive Disorder
 a mood disorder in which a person,
for no apparent reason, experiences
two or more weeks of depressed
moods, feelings of worthlessness,
and diminished interest or pleasure
in most activities
 Canadian depression rates
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Manic Episode
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Bipolar Disorder
 a mood disorder marked by a
hyperactive, wildly optimistic state
 a mood disorder in which the person
alternates between the hopelessness
and lethargy of depression and the
overexcited state of mania
 formerly called
manic-depressive disorder
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PET scans show that brain energy
consumption rises and falls with emotional
switches
Depressed state
Manic state
Depressed state
40% fold increase in diagnosis's for
individuals under 19 from 1994-2003
 Mostly males are diagnosed; 2/3 of those
diagnosed
 Composers, artists, poets,
Novelists, and entertainers
Are more prone to bipolar
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A mood disorder in which a person
experiences, in the absence of drugs or a
medical condition, two or more weeks of
significantly depressed moods, feelings of
worthlessness, and diminished interest or
pleasure in most activities.
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Negative outcomes: inactive, unmotivated,
more often recall negative memories
Women internalize depression while men
externalize it
“women get sadder, men get madder”
Most people with major depression eventually
return to normal without professional health
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Most people with major depressive disorder
usually return to normal on their own
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Generally depression results more often from
a pile up of stresses than from a single loss
of failure
Events that typically precede depression:
family members death, job loss, marital
crisis, or physical assault
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Freud's hypothesis: depression often occurs
when significant losses evoke feelings
associated with losses experienced in
childhood
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Mood disorders tend to run in families
If one identical twin is depressed, there is a
50% chance the other twin will develop
depression too
Kendler estimates that heritability of major
depression is 35-40%
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Geneticists examine DNA from affected and
unaffected family members looking for
differences
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Nearly 1million people commit suicide a year
European suicide rates are higher than
American suicide rates
In the united states whites are 2 times more
likelyto commit suicide than blacks
Women attempt suicide more often, but men
succeed more often
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Study: 13 elite Canadian swimmers watched
Olympic videos where they failed to make the
team . Their fmri’s appeared to be similar to a
patient in a depressed mood
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The left frontal lobe which is active during
positive emotions, is likely to be inactive
during depressed states
In people with severe depression, fMRI’s show
frontal loves are 7% smaller than normal
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Prozac, zolof, and paxil are drugs that relieve
depression by blocking reuptake of nor
epinephrine and serotonin, or their chemical
breakdown
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Repetitive physical exercise reduces
depression as it increases serotonin
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More common in women than in men
Research shows self-defeating beliefs and
negative explanatory style feeds depression
and its vicious cycle
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The majority of college students have claimed
to have felt depressed at come point
Students who have optimism as they begin
college develop more social support and have
lower risks of depression
Figure 14.8 The vicious cycle of
depressed thinking Cognitive
therapists attempt to break this cycle,
as we will see in Chapter 15, by
changing the way depressed people
process events. Psychiatrists attempt
to alter with medication the biological
roots of persistently depressed moods.
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Schizophrenia: a group of severe disorders
characterized by disorganized and delusional
thinking, disturbed perceptions, and
inappropriate emotions and actions.
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Includes delusions: false beliefs, often of
persecution or grandeur, that may
accompany psychotic disorders
“word salad” jumbled ideas
Unable to utilize selective attention
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Sensory experiences without sensory
stimulations
◦ Most common form: auditory
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Hallucinations
Disorganized speech
Inappropriate emotions
Over-the-top actions
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The flat effect: an emotionless state
Catatonia: motionless for hours and then
become agitated after
Toneless voice
Mute
Rigid bodies
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Men are more likely to get it more than
women
It is one of the most researched disorders
The development of schizophrenia over a
long period of time is easier to treat rather
than if it is contracted very rapidly
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Schizophrenics have excess dopamine
receptors, drugs that increase dopamine
amplify symptoms
Schizophrenics have low brain activity in the
frontal lobes but access activity in the
amygdala
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More likely to contract schizophrenia if…
◦ Ones country experienced a flu epidemic while
pregnant
◦ Live in densely populated area
◦ Born during winter and spring
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If a parent or sibling has it, there is a 1 in 10
chance of them too
If and identical twin has it, it becomes 1 in 2
Twins who shared placenta have a heightened
chance of both contracting schizophrenia
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Followed 163 teens and people in their early
20’s who had relatives with
schizophrenia(2005)
◦ 20% developed schizophrenia
◦ These subjects became socially withdrawn
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May develop in the early 20’s if…
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Mother with severe schizophrenia
Birth complications involving low oxygen
Separation from parents
Short attention span
Disruptive or withdrawn behavior
Emotionally unpredictable
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Personality disorders: psychological disorders
characterized by inflexible and enduring
behavior patterns that impair social
functioning
Avoidant personality
disorder: an unusually
fearful sensitivity
to rejection
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Narcissistic personality disorder:
to be overly focused and self inflating
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Schizoid personality disorder:
emotionless disengagement
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Antisocial personality disorder: a person,
usually a man, exhibits a lack of conscience
for wrong doing, even towards friends and
family.
◦ Former names: sociopath,psychopath
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Lying, stealing, fighting, displaying
unrestrained sexual behavior
About ½ of children who show these
characteristics become antisocial adults
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Early signs have been observed in 3-6 year
olds
◦ They are impulsive, uninhibited, unconcerned with
social rewards, and low in anxiety
Figure 14.10 Cold-blooded
arousability and risk of crime Levels of
the stress hormone adrenaline were
measured in two groups of 13-year-old
Swedish boys. In both stressful and
non-stressful situations, those later
convicted of a crime (as 18- to 26year-olds) showed relatively low
arousal. (From Magnusson, 1990.)
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PET scans of 41 murderers showed reduced
activity in their frontal loves and repeat
offenders had 11% less frontal lobe tissue
than normal
“Perhaps a biologically based fearlessness, as well
as early environment, helps explain the reunion
of long-separated sisters Joyce Lott, 27, and
Mary Jones, 29—in a South Carolina prison where
both were sent on drug charges. After a
newspaper story about their reunion, their longlost half-brother Frank Strickland called. He
explained it would be a while before he could
come see them—because he, too, was in jail, on
drug, burglary, and larceny charges (Shepherd et
al., 1990). According to a 2004 U.S. Justice
Department report, 48 percent of 2 million state
prison inmates say they have had incarcerated
relatives (Johnson, 2008).”
Figure 14.12 Biopsychosoci
al roots of crime Danish
male babies whose
backgrounds were marked
both by obstetrical
complications and social
stresses associated with
poverty were twice as likely
to be criminal offenders by
ages 20 to 22 as those in
either the biological or social
risk groups. (From Raine et
al., 1996.)
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Compared to 1960, you are 2x more likely to
be murdered, 4x more likely to be robbed,
and 5x more likely to be assaulted
14.12 Does a full moon trigger
“madness” in some people? James
Rotton and I. W. Kelly (1985) examined
data from 37 studies that related lunar
phase to crime, homicides, crisis calls,
and mental hospital admissions. Their
conclusion: There is virtually no
evidence of “moon madness.” Nor does
lunar phase correlate with suicides,
assaults, emergency room visits, or
traffic disasters (Martin et al., 1992;
Raison et al., 1999).•
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About 26% of adult Americans suffer
diagnosable mental disorders in a given year
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Mood disorders are most common, phobias
too
Incidence of serious psychological disorders
is doubly high among those below the
poverty line